TNF and Myocardial fibrosis: (3) Metabolites that inhibit fibrosis by regulating the PI3K/AKT signaling pathway, as well as other signaling pathways: Schisandra chinensis can effectively improve the heart coefficient, reduce the area of myocardial fibrosis, reduce the serum levels of IL-1β and TNF-α, reduce myocardial cell apoptosis, increase the expression of Bcl-2, and reduce the expression of p-PI3K/PI3K, p-AKT/AKT, P65 and Bax in heart tissue of rats with heart failure.[66] Ginsenoside Re (Gin-Re) treatment promoted AMPKα phosphorylation, decreased TGF-β1 expression, and attenuated SMAD2/3 activation.