Pharmacodynamic
and biodistribution effects are two important factors
in drug research. As a clinical drug, the neuroprotective effects
and mechanisms of hydroxysafflor yellow A (HSYA) have been widely
reported but have still not been described in enough detail. In this
study, we first aimed to improve the pharmacology of HSYA in nerve
injury treatments. The down-regulative expression of cytokines, including
NLRP3, ASC, Caspase-1, GSDMD, IL-1β, IL-18, LDH, NF-κB,
and p-p56, suggested that HSYA could both suppress pyroptosis and
apoptosis pathway activation during the nerve injury. Additionally,
HSYA improved the cellular viability in an oxidative stress damage
cell model. Second, to further improve the therapeutic effect of the
HSYA, we tried to enhance the concentration of HSYA in a lesion. The
FDA-approved adenosine receptor agonist Lexiscan (Lex) could inhibit
the expression of P-glycoprotein on the endothelial cell surface to
transiently increase the permeability of the blood–brain barrier
(BBB) without any sustained damage, which was used to assist HSYA
in passing through the BBB to increase the accumulation in the brain.
Furthermore, living image and distribution detection
in vivo
showed that the accumulation of HSYA in the brain could be significantly
increased with the addition of Lex. Lastly, HSYA together with Lex
(Lex-HSYA) could significantly reduce the volume of cerebral infarction,
improve the histopathological morphology, and recruit brain-derived
neurotrophic factors to alleviate the cerebral ischemia reperfusion
injury. In conclusion, the pyroptosis pathway could act as a novel
therapeutic target of HSYA in nerve injury treatment, and Lex-HSYA
could be a promising candidate for nerve injury treatments.