Zhao Aimei, Liu Nan, Yao Mingjiang, Zhang Yehao, Yao Zengyu, Feng Yujing, Liu Jianxun, Zhou Guoping
Department of Acupuncture and Moxibustion, Neuroscience Centre, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China.
Beijing Increasepharm Safety and Efficacy Co., Ltd., Beijing, China.
Front Pharmacol. 2022 Jul 7;13:946752. doi: 10.3389/fphar.2022.946752. eCollection 2022.
Ischemic stroke has been considered one of the leading causes of mortality and disability worldwide, associated with a series of complex pathophysiological processes. However, effective therapeutic methods for ischemic stroke are still limited. Panax ginseng, a valuable traditional Chinese medicine, has been long used in eastern countries for various diseases. Ginsenosides, the main active ingredient of Panax ginseng, has demonstrated neuroprotective effects on ischemic stroke injury during the last decade. In this article, we summarized the pathophysiology of ischemic stroke and reviewed the literature on ginsenosides studies in preclinical and clinical ischemic stroke. Available findings showed that both major ginsenosides and minor ginsenosides (such as Rg3, Rg5, and Rh2) has a potential neuroprotective effect, mainly through attenuating the excitotoxicity, Ca overload, mitochondria dysfunction, blood-brain barrier (BBB) permeability, anti-inflammation, anti-oxidative, anti-apoptosis, anti-pyroptosis, anti-autophagy, improving angiogenesis, and neurogenesis. Therefore, this review brings a current understanding of the mechanisms of ginsenosides in the treatment of ischemic stroke. Further studies, especially in clinical trials, will be important to confirm the clinical value of ginseng and ginsenosides.
缺血性中风被认为是全球死亡率和致残率的主要原因之一，与一系列复杂的病理生理过程相关。然而，缺血性中风的有效治疗方法仍然有限。人参是一种珍贵的传统中药，在东方国家长期用于治疗各种疾病。人参皂苷是人参的主要活性成分，在过去十年中已显示出对缺血性中风损伤的神经保护作用。在本文中，我们总结了缺血性中风的病理生理学，并回顾了关于人参皂苷在临床前和临床缺血性中风研究的文献。现有研究结果表明，主要人参皂苷和次要人参皂苷（如Rg3、Rg5和Rh2）均具有潜在的神经保护作用，主要通过减轻兴奋性毒性、钙超载、线粒体功能障碍、血脑屏障（BBB）通透性、抗炎、抗氧化、抗凋亡、抗焦亡、抗自噬、改善血管生成和神经发生来实现。因此，本综述带来了对人参皂苷治疗缺血性中风机制的当前理解。进一步的研究，特别是临床试验，对于确认人参和人参皂苷的临床价值将具有重要意义。
