Single Traditional Chinese Medicine For Treating Cerebral Ischemia-reperfusion Injury

In the history of the treatment of ischemic stroke, traditional Chinese medicines such as promoting blood circulation, clearing heat, tonifying, dispelling dampness, and calming the liver can promote blood circulation, remove blood stasis, and dredge collaterals, clear heat, and purifying fire and detoxify, nourish kidney and Qi, and dispel wind and dampness. , Resolving phlegm, dredging the internal organs, and harmonizing the camp and health play a better therapeutic role. Modern studies have found that the main active parts or active ingredients in these single herbs also have good therapeutic effects on CIRI, such as ginsenosides in ginseng, gastrodin in Gastrodia elata, and angelica polysaccharides in angelica.

Gastrodia elata

Gastrodiae Rhizoma is the dry tuber of the orchid plant Gastrodia elata Bl. It has the effects of relieving wind and spasm, calming liver yang, dispelling wind, and dredging collaterals, and can reduce oxidative stress damage, inhibit cell apoptosis and reduce neurotoxicity, etc. pathway exerts an anti-CIRI effect. Gastrodia elata mainly contains gastrodin and phenolic components.

Click to cistanche tubulosa powder for cerebral ischemia-reperfusion injury

Studies have found that gastrodin can significantly inhibit the overexpression of central nervous system-specific proteins after CIRI and play an anti-CIRI role; the fat-soluble phenolic components of gastrodia can exert neuroprotective effects by regulating the expression level of calmodulin-dependent protein kinase 2; p-Hydroxybenzaldehyde in Gastrodia elata can achieve the anti-CIRI effect by inhibiting apoptosis [13-15].

In addition, Chen Tingting et al [16] also explored the differences in the anti-CIRI effects of Gastrodia elata powder with different particle sizes around the two aspects of oxidative stress and neurotoxicity and found that different specifications of Gastrodia elata powder can improve the CIRI rats. Nervous function, the 500-mesh Gastrodia elata superfine powder has a more obvious neuroprotective effect than other specifications of Gastrodia elata powder.

Angelica

Angelicae Sinensis Radix is the dried root of Angelica sinensis (Oliv.) Diels, an umbrella plant. Autophagy level and other ways play a neuroprotective role.

Polysaccharides and volatile oils are their main chemical components. Cheng et al[17] found that 0.5, 1 mg of water extract of Angelica sinensis can significantly improve the survival rate of neurons in the hippocampus CA1 area of the rat model of ischemia-reperfusion injury, which suggests that water extract of Angelica sinensis affects the brain tissue of CIRI rats. The protective effect is mainly related to the activation of phosphorylated serine-threonine kinase/phosphorylated Bad protein (serine-threonine kinase, p90RSK/p-Bad) and phosphorylated serine-threonine kinase/cyclic adenosine monophosphate response element binding protein/brain Neurotrophic factor (p90RSK/cAMP-response element binding protein, CREB/brain-derived neurotrophic factor, BDNF) signaling pathway, thereby protecting the integrity of mitochondria and inhibiting apoptosis.

In addition, studies have shown that the volatile oil components in Angelica sinensis can activate the phosphorylated protein kinase B/target of rapamycin (phosphorylated protein kinase B, p-Akt/mammaliantargetofrapamycin, mTOR) signal transduction pathway, and then regulate the autophagy protein to play a role. Anti-CIRI effect [18]. Angelica polysaccharides also exhibit significant neuroprotective effects, which may be closely related to anti-inflammation, anti-oxidation, inhibition of nerve cell apoptosis, and promotion of angiogenesis [19-20].

Rhubarb

Rhei Radix et Rhizoma is the dry root and rhizome of Rheum palmatum L., R. tanguticum Maxim. ex Balf. or R. officinale Baill., which has the functions of purging and clearing heat. It has the functions of purging fire, cooling blood and detoxifying, clearing blood stasis and dredging menstrual flow, promoting dampness and reducing jaundice, etc. It can protect ischemic brain tissue by inhibiting oxidative stress, inflammatory response, and cell apoptosis. Rhubarb mainly contains anthraquinones. Studies have found that anthraquinones are the main material basis of rhubarb's anti-CIRI, and its anti-CIRI mechanism is related to anti-oxidation and anti-inflammation [21].

Chrysophanol, emodin, and other components have also been found to regulate adenosine monophosphate-activated protein kinase by inhibiting the cyclic adenosine monophosphate/protein kinase A (cyclic adenosine monophosphate, cAMP/PKA) signal transduction pathway and regulating the acetylation level of mitochondrial proteins, respectively. / Glycogen synthase kinase 3β (adenosine monophosphate-activated protein kinase, AMPK/glycogen synthase kinase 33β, GSK3β) and phosphatase and tensin homolog genes deleted on chromosome 10 / Phosphatidylinositol 3 kinase / Serine threonine The protein kinase (phosphatase and tensin homolog deleted on chromosome ten, PTEN/phosphatidylinositol 3 kinases, PI3K/Akt) signaling pathway and other methods achieve neuroprotection on the brain tissue of CIRI model rats [22-25].

Tripterygium wisteria

Tripterygii Tripterygii Radix is the dry root of Tripterygium wilfordii Hook. f., a plant of the Euonymus family. It has the effects of expelling wind and dampness, promoting blood circulation and dredging collaterals, reducing swelling and pain, killing insects, and detoxifying, mainly by an inhibiting inflammatory response and cell apoptosis, Regulates the immune system to play an anti-CIRI role. Tripterygium wilfordii mainly contains terpenoids, and triptolide is its main active ingredient. Bai et al[26] found that triptolide could significantly improve the neurological function of rats in the CIRI model group after the intervention, and speculated that triptolide could inhibit the nuclear factor-κB (nuclear factor-kappaB, NF-κB) signaling pathway Activated to play a protective role against CIRI. In addition, studies have shown that the anti-CIRI effect of triptolide is also related to the regulation of the expression of cysteine protease-3 (Caspase-3), inducible nitric oxide synthase, and TNF-α, and the normal expression of NF-κB/p53. It is closely related to the signaling pathway of the p53 up-regulate modulator of apoptosis (PUMA)[27-29].3

Cistanche

Cistanche contains a variety of active ingredients such as echinacoside and acteoside, which have been shown to possess strong antioxidant and anti-inflammatory properties. When cerebral ischemia (lack of blood flow to the brain) occurs, it can lead to the accumulation of harmful free radicals and inflammation, resulting in cell damage and death.  When blood flow is restored during reperfusion, it can cause additional damage to brain tissue through an inflammatory response known as reperfusion injury.  Cistanche's active ingredients can help to mitigate these deleterious effects by neutralizing free radicals and reducing inflammation, thus protecting the brain tissue from damage and improving recovery outcomes.