Recent Advances in Chinese Herbal Medicine for Cerebral Ischemic Reperfusion Injury

Abstract

Cerebral ischemic reperfusion injury (CI/RI) is a critical factor that leads to a poor prognosis in patients with ischemic stroke. It is an extremely complicated pathological process that is clinically characterized by high rates of disability and mortality. Current available treatments for CI/RI, including mechanical and drug therapies, are often accompanied by significant side effects. Therefore, it is necessary to discovery new strategies for treating CI/RI. Many studies confirm that Chinese herbal medicine (CHM) was used as a potential drug for treatment of CI/RI with the advantages of abundant resources, good efficacy, and few side effects. In this paper, we investigate the latest drug discoveries and advancements on CI/RI, make an overview of relevant CHM, and systematically summarize the pathophysiology of CI/RI. In addition, the protective effect and mechanism of related CHM, which includes extraction of single CHM and CHM formulation and preparation, are discussed. Moreover, an outline of the limitations of CHM and the challenges we faced are also presented. This review will be helpful for researchers further propelling the advancement of drugs and supplying more knowledge to support the application of previous discoveries in clinical drug applications against CI/RI.

The Differences of Metabolites in Different Parts of the Brain Induced by Shuxuetong Injection against Cerebral Ischemia-Reperfusion and Its Corresponding Mechanism

“…The brain pathological mechanism of the CIR injury process is complex, usually involving energy metabolism disorder, inflammatory response, oxidative stress injury, cell necrosis and apoptosis, excitatory toxicity, and other processes [ 3 ]. The coexistence of brain injury and recovery during reperfusion makes the treatment of IS more difficult [ 4 ]. Therefore, it is important to study the mechanism of anti-CIR injury for the treatment of IS to improve the quality of life of patients with cerebral ishemia and reduce the mortality of the disease.…”

The role of JAK/STAT signaling pathway in cerebral ischemia-reperfusion injury and the therapeutic effect of traditional Chinese medicine: A narrative review

“…[2] It is the main reason that directly causes cerebral infarction and reduces the prognosis of patients with cerebral ischemia. [3] Therefore, it is a subject in the field of cerebrovascular disease to find treatments to restore blood supply and reduce CIRI, and effectively protect cerebrovascular and brain tissue.…”

The Signaling Pathways and Targets of Natural Compounds from Traditional Chinese Medicine in Treating Ischemic Stroke

“…IS is a complex pathological cascade reaction involving various pathological factors, including oxidative stress, inflammation, apoptosis, autophagy, and BBB damage. Oxidative stress, inflammation, and apoptosis are the critical factors in cerebral ischemic injury [ 8 , 9 ]. An imbalance in the amount of reactive oxygen species (ROS) is the cause of oxidative stress [ 10 ].…”

“…An imbalance in the amount of reactive oxygen species (ROS) is the cause of oxidative stress [ 10 ]. Under normal physiological conditions, the body maintains a dynamic ROS balance, during cerebral ischemia, a large accumulation of ROS leads to intracellular damage as well as mitochondrial damage, and cell transduction pathways are disrupted, inducing an apoptotic cascade reaction which in turn promotes the inflammatory response and the occurrence of apoptosis, further aggravating the oxidative damage of the organism [ 11 ], and finally leads to neuronal cell necrosis, senescence and apoptosis [ 9 , 12 ]. In the pathological process of IS, oxidative stress, inflammation, and apoptosis interact with each other and form a complex signaling network that plays a key role in the cerebral ischemic cascade [ 13 ].…”