Traditional Chinese Medicine for Cerebral Ischemia-Reperfusion Injury Prevention: Molecular Mechanisms and Future Perspectives

As reperfusion therapy becomes more common, cerebral ischemia–reperfusion (I/R) injury has emerged as a notable factor affecting the outcome of ischemic stroke. The intricate pathological mechanisms involved include oxidative stress, neuroinflammation, and various forms of cell death, characterized by interactions between multiple signaling pathways. Natural products, such as traditional Chinese medicines (TCMs), offer multi-targeted intervention effects through their diverse natural active compounds and integrate pharmacological and nutritional functions into 1 entity (Food and Medicine Homology), supporting their long-term use to prevent cerebral I/R injury. It was found that TCMs, such as Gastrodia elata Blume and Lycium barbarum L., potentially exert synergistic effects on redox imbalance, inflammation, apoptosis, and autophagy by concurrently modulating various pathways, including Nrf2/ARE, NF-κB, PI3K/Akt/mTOR, Bcl-2/Bax, and PARP-1. The prophylactic administration of TCMs may represent a novel approach for mitigating cerebral I/R injury. To advance the application of TCMs from the laboratory to clinical practice, it is essential to conduct clinical research to confirm their effectiveness and safety in preventing cerebral I/R injury.