Research Progress on the Pharmacological Mechanism of Traditional Chinese Medicine Danshen in the Treatment of Cerebral Ischemic Stroke
DOI:
https://doi.org/10.53469/jcmp.2024.06(10).39Keywords:
Danshen, Cerebral ischemic stroke, Pharmacological mechanisms, Research progressAbstract
Cerebral ischemic stroke (CIS) is an acute cerebrovascular disease characterized by focal neurological deficits. Many modern scholars believe that the pathogenesis of CIS is related to factors such as endothelial injury, oxidative stress imbalance, neuroinflammation, cell apoptosis and autophagy, calcium overload, and excessive accumulation of oxygen free radicals. Traditional Chinese medicine believes that the pathogenesis of CIS is obstructed meridians, phlegm and blood stasis, and obstruction of the brain and orifices. Danshen, as a commonly used traditional Chinese medicine in clinical practice, has the effects of promoting blood circulation and removing blood stasis, unblocking meridians and relieving pain, clearing the heart and eliminating restlessness, cooling blood and eliminating carbuncle. In addition, modern pharmacological research has found that the specific pharmacological components of Salvia miltiorrhiza include tanshinone, salvianolic acid, shikimic acid, danshensu, protocatechualdehyde, etc. It has antioxidant stress, regulation of cell autophagy, anti-inflammatory factors, antiplatelet aggregation, and protection of vascular endothelium. This article aims to analyze and summarize the pharmacological mechanism of salvia miltiorrhiza in treating CIS, providing scientific basis for clinical application of salvia miltiorrhiza in treating CIS.
References
Kole M J, Wessell A P, Ugiliweneza B, et al. Low - Dose In⁃ travenous Heparin Infusion After Aneurysmal Subarachnoid Hemorrhage is Associated With Decreased Risk of Delayed Neurological Deficit and Cerebral Infarction[J]. Neurosur⁃ gery, 2021, 88(3):523 -530.
Almalki W H, Alghamdi S, Alzahrani A, et al. Emerging paradigms in treating cerebral infarction with nanotheranos⁃ tics: opportunities and clinical challenges [J]. Drug Discov Today, 2021, 26(3):826 -835.
Guo Minmin, Cai Le, Wang Yong, et al. Research progress on the pathogenesis of cerebral ischemia-reperfusion injury [J] World's Latest Medical Information Digest, 2019, 19 (30): 80-81
Wang Lu, Zhang Shibin, Hua Zhipeng, et al. Research progress on the pathogenesis of cerebral ischemia - reperfusion injury [J] Journal of Stroke and Neurological Disorders, 2023, 40 (02): 168-170.
Wang Yongjun, Li Zixiao, Gu Hongqiu, et al. Chinese Stroke Report 2020 (Chinese Version) (3) [J] Chinese Journal of Stroke, 2022,17 (07): 675-682
Herpich F, Rincon F. Management of acute ischemic stroke[J]. Crit Care Med, 2020, 48(11):1654⁃1663.
Yu Chuanhua, Luo Lisha, Li Mei,, et al. The severity of the burden of stroke disease in China from a global perspective Public Health and Preventive Medicine, 2016, 27 (1): 1-5.
Malin, Chao Baohua, Cao Lei, et al. Analysis of the Epidemic Trends and Characteristics of Stroke in China from 2007 to 2017 Chinese Journal of Cerebrovascular Disease (Electronic Edition), 2020, 14 (5): 253-258.
Cao Yali, Luo Ying, et al. Clinical study on the treatment of acute ischemic stroke (blood stasis phlegm heat syndrome) with Zhao Jifu's modified Hua Yu Qing San Tang combined with "awakening the brain and opening the orifices" acupuncture method [J] Smart Health, 2022,8 (25): 165-168.
Tang Bo, Wang Xia, Wu Fujian, et al. Clinical Observation of Body Pain Zhuyu Decoction Combined with Rehabilitation Exercise in Treating Hemiplegia after Stroke of Blood Stasis Obstruction Type [J] Guangming Traditional Chinese Medicine, 2022, 37 (14): 2492-2494.
Guo Xingfu, Feng Jiangjiang, Zhang Yunxue, et al. The effect of modified Tongqiao Huoxue Tang on neurological function and quality of life in patients with blood stasis obstruction syndrome during the recovery period of hemorrhagic stroke [J] Guangming Traditional Chinese Medicine, 2020,35 (07): 1020-1022.
Wang Jianan. Research on Traditional Chinese Medicine Medication Rules for Stroke Based on Data Mining [D] Beijing Jiaotong University, 2021.
Huang Xindi, Ding Changsong, Su Qihou, et al. Research on the regularity of traditional Chinese medicine prescription and medication for ischemic stroke based on data mining [J] Yunnan Journal of Traditional Chinese Medicine, 2022, 43 (01): 23-28.
Chang Xuehui, Zhang Liangzhi, Ji Wenyao, et al. Research on the medication pattern of Li carp in the treatment of ischemic stroke based on data mining [J] National Medical Forum, 2022, 37 (04): 29-33.
National Pharmacopoeia Committee Pharmacopoeia of the People's Republic of China [M] Beijing: China Medical Science and Technology Press, 2020:42.
EO Nwafor, P Lu, JW Li, et al. Traditional Chinese medicine of Salvia miltiorrhiza Bunge:a review of phytochemistry, pharmacology and pharmacokinetics[J]. Traditional Medicine Research, 2021, 6(4):25.
Shan Xiaoxiao, Hong Bangzhen, Liu Jie, et al. Research progress on chemical composition, pharmacological effects, clinical applications, and predictive analysis of quality markers of Danshen [J] Chinese Journal of Traditional Chinese Medicine, 2021, 46 (21): 5496-5511.
REN J X, LI C, YAN X L, et al. Crosstalk between oxidative stress and ferroptosis/oxytosis in ischemic stroke: possible targets and molecular mechanisms[J]. Oxid Med Cell Longev,2021,2021:6643382.
LiuYW, WangLJ, LiXK, etal. Tanshinone IIA improves impaired nerve functions in experimental diabetic rats [J]. Biochem Biophys Res Commun, 2010, 399(1): 49-54.
Liu Shixu, Li Yunman, Fang Weirong, et al. The protective effect of salvianolic acid B sodium salt on focal cerebral ischemia-reperfusion injury in rats [J] Journal of China Pharmaceutical University, 2012, (04): 338-342.
Cai M, Guo Y, Wang S, et al. Tanshinone IIA elicits neuroprotective effect through activating the nuclear factor erythroid 2-related factor-dependent antioxi- dant response [J]. Rejuvenation Res, 2017, 20(4): 286-297.
Lv Juan, Zhao Hongmei, Sun Guifang, et al. The protective effects of salvianolic acid B induced angiogenesis and alleviation of oxidative stress on brain tissue injury in focal cerebral ischemia-reperfusion rats [J] Chinese Journal of Immunology, 2019, 35 (10): 1174-1178.
TUO Q Z, ZHANG S T, LEI P. Mechanisms of neuronal cell death in ischemic stroke and their therapeutic implications[J]. Med Res Rev,2022,42(1):259.
Malpartida AB, Williamson M, Narendra DP, et al. Mitochondrial Dysfunction and Mitophagy in Parkinson's Disease: From Mechanism to Therapy. [J].Trends Biochem Sci. 2021 Apr;46(4):329-343.
Wang Zheyi. Mechanism of Danshentong IIA Sodium Sulfonate Regulating HIF1 α/mTOR Mediated Cellular Autophagy Intervention in Ischemic Stroke [D] Beijing University of Traditional Chinese Medicine, 2021.
Xu Xuan. Study on the mechanism of action of tanshinone IIA on the PTEN PI3K/AKT/mTOR signaling pathway after cerebral ischemia in rats [D] Anhui Medical University, 2020.
Zhu Bo, Yang Yan, Su Renyi, et al. The effect of salvianolic acid II A injection on autophagy and Akt mTOR pathway of cortical neurons in neonatal rats with ischemic hypoxic brain injury [J] Chinese Traditional Chinese Medicine Emergency, 2019, 28 (02): 204-208.
Xin Meiying. Exploring the role of autophagy in ischemic brain injury and the neuroprotective mechanism of salvianolic acid B based on the AMPK/mTOR/ULK1 pathway [D] Jilin University, 2020.
MAIDA C D, NORRITO R L, DAIDONE M, et al. Neuroinflammatory mechanisms in ischemic stroke: focus on cardioembolic stroke, background, and therapeutic approaches [J]. Int J Mol Sci, 2020, 21(18): 6454.
Jurcau A, Simion A. Neuroinflammation in Cerebral Ischemia and Ischemia/Reperfusion Injuries: From Pathophysiology to Therapeutic Strategies. [J] Int J Mol Sci. 2021 Dec 21;23(1):14.
Yang K, Zeng L, Ge A, et al. A systematic review of the research progress of non-coding RNA in neuroinflammation and immune regulation in cerebral infarction/ischemia-reperfusion injury. [J] Front Immunol. 2022 Oct 7;13:930171.
Song Z, Feng J, Zhang Q, et al. Tanshinone IIA pro- tects against cerebral ischemia reperfusion injury by regulating microglial activation and polarization via NF - κB pathway[J]. Front Pharmacol, 2021, 12: 641848.
Wang J, Tong H, Wang X, et al. Tanshinone IIA allevi- ates the damage of neurocytes by targeting GLUT1 in ischaemia reperfusion model (in vivo and in vitro ex- periments) [J]. Folia Neuropathol, 2020, 58(2): 176- 193.
Huang Bei, Zhang Wen, Song Junke, et al. Danshensu acid A inhibits the NF - κ B signaling pathway and alleviates lipopolysaccharide induced inflammation in BV2 microglia [J] Chinese Journal of Pharmacology and Toxicology, 2023, 37 (04): 241-248.
Guo Lin. Exploring the mechanism of Danshensu Sodium in inhibiting microglial activation and alleviating cerebral ischemia-reperfusion injury based on miR-130b-5p/TLR4 signaling [D] Tianjin University of Traditional Chinese Medicine, 2023.
Yang M, Huo X, Miao Z, et al. Platelet Glycoprotein IIb/IIIa Receptor Inhibitor Tirofiban in Acute Ischemic Stroke. [J] Drugs. 2019 Apr;79(5):515-529.
Nikolic D, Jankovic M, Petrovic B, et al. Genetic Aspects of Inflammation and Immune Response in Stroke. [J] Int J Mol Sci. 2020 Oct 8;21(19):7409.
Zhang Zewen, Wang Duanxu, Lin Wenjie, et al. Study on the G protein signaling pathway of Danshen ketone Ⅱ A inhibiting platelet activation [J] International Journal of Laboratory Medicine, 2017, 38 (11): 1449-1451.
Cui Guozhen, Chen Yan, Guo Lin, et al. Research on the Target of Danshensu's Antiplatelet Aggregation Effect [J] New Chinese Medicine Drugs and Clinical Pharmacology, 2017, 28 (04): 450-453.
Zetterberg F, Svensson P. State of affairs: Design and structure- activity relationships of reversible P2Y12 receptor antagonists[J]. Bioorg Med Chem Let, 2017, 10(2): 9-15.
Panovanoeva M, Marchetti M, Russo L, et al. ADP-induced platelet aggregation and thrombin generation are increased in Essential Thrombocythemia and Polycythemia Vera[J]. Thromb Res, 2018, 12(2): 88-93.
ZHAO X, EYO U B, MURGUAN M, et al. Microglial interaction with the neurovascular system in physiology and pathology[J]. Dev Neurobiol, 2018, 78(6): 604.
You Yiping. The clinical efficacy of sodium tanshinone IIA sulfonate in the treatment of ischemic cerebrovascular disease and its effects on insulin resistance, adiponectin, and endothelial cell function [J] Practical Journal of Cardiovascular and Cerebrovascular Diseases, 2016, 24 (12): 121-123.
Zhang Sen, Liu Chengdi, Kong Dewen, et al. The protective effect and mechanism of salvianolic acid A on the angiogenesis ability of human brain microvascular endothelial cells induced by oxygen glucose deprivation injury [J] Chinese Journal of Pharmacology and Toxicology, 2022, 36 (03): 161-169.
Deng Suihui. Danshensu sodium improves angiotensin II induced endothelial dysfunction by activating AMPK [D] Guangzhou Medical University, 2021.
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