Paeoniflorin as a potential therapeutic agent for cerebrovascular diseases: A comprehensive review

Cerebrovascular diseases (such as ischemic stroke, cerebral hemorrhage, and vascular dementia) are characterized by high incidence and disability rates, posing significant challenges in clinical treatment. Paeoniflorin, a primary active compound derived from the traditional Chinese herb Paeonia lactiflora, exhibits a multi-targeting nature by acting through multiple molecular pathways in the treatment of cerebrovascular diseases. However, its mechanisms of action and efficacy have not yet been systematically reviewed. Therefore, we aimed to summarize the current research progress on paeoniflorin in the field of cerebrovascular diseases and elucidate its pharmacological actions and therapeutic mechanisms. Extensive studies have shown that paeoniflorin exerts neuroprotective effects by suppressing inflammatory responses, alleviating oxidative stress, improving microcirculation, and promoting neural repair and angiogenesis. Its remarkable clinical efficacy and unique mechanisms of action provide novel strategies for cerebrovascular disease treatment and establish a crucial theoretical foundation for developing new neuroprotective drugs, indicating its broad prospects for clinical application and research value. This review aims to summarize the evidence regarding the efficacy of paeoniflorin in treating cerebrovascular diseases, elucidate its multipath pharmacological activities, provide insights for clinical application and novel drug development, and identify potential challenges for future drug development.