Chinese Journal of Tissue Engineering Research ›› 2025, Vol. 29 ›› Issue (17): 3675-3683.doi: 10.12307/2025.630

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Role of ferroptosis in ischemic brain injury and the regulatory mechanism of traditional Chinese medicine

Zhou Panpan1, Yang Tong2, Wang Shurui2, Cui Yinglin2     

  1. 1The Second Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou 450002, Henan Province, China; 2Henan Provincial Hospital of Traditional Chinese Medicine, Zhengzhou 450002, Henan Province, China
  • Received:2024-05-22 Accepted:2024-07-20 Online:2025-06-18 Published:2024-11-06
  • Contact: Cui Yinglin, MS, Chief physician, Doctoral supervisor, Henan Provincial Hospital of Traditional Chinese Medicine, Zhengzhou 450002, Henan Province, China
  • About author:Zhou Panpan, MD candidate, The Second Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou 450002, Henan Province, China
  • Supported by:
    Henan Province Chinese Medicine Scientific Research Special Project, No. 2023ZY1007 (to CYL); Research on the Development Status and Countermeasures of Chinese Medicine Health Tourism in Henan Province under the Perspective of Embodiment, No. TCM2022018 (to YT); The Second National Famous Chinese Medicine Doctor Inheritance Workshop Construction Project of the State Administration of Traditional Chinese Medicin in 2022, No. [2022]245 (to CYL)

Abstract: BACKGROUND: Ferroptosis is a programmed cell death mode regulated by iron dependent lipid peroxidation, closely related to the occurrence, development, and outcome of ischemic brain injury. With the continuous deepening of research on ferroptosis in recent years, it has been found that Chinese herbal compounds and monomers can regulate ferroptosis by reducing iron overload, reducing the production of reactive oxygen species, and regulating lipid synthesis, to alleviate cerebral ischemic injury and promote neurological function recovery. 
OBJECTIVE: To explore the relationship between ferroptosis and ischemic brain injury, and the mechanism by which traditional Chinese medicine regulates ferroptosis in the treatment of ischemic brain injury. 
METHODS: Literature on ferroptosis and ischemic brain injury and the regulatory mechanism of traditional Chinese medicine published from January 2018 to May 2024 was searched in CNKI and PubMed databases. The search terms were “iron death, ischemic stroke, brain injury, reactive oxygen species, lipid metabolism, traditional Chinese medicine formulas, terpenes, flavonoids, phenols, alkaloids, phthalides” in Chinese and English, respectively. Irrelevant, duplicated or outdated literature was excluded. A total of 1 526 relevant literature were retrieved, and 87 articles were ultimately included. 
RESULTS AND CONCLUSION: Numerous experimental studies have confirmed that ferroptosis plays an important role in ischemic brain injury. Chinese medicine prescriptions can regulate ferroptosis through various approaches, for examples: total saponins of Panax notoginseng can regulate iron metabolism and inhibit lipid peroxidation; carvacrol inhibits neuronal ferroptosis by increasing glutathione peroxidase 4 expression; Chinese herbal compounds and monomeric active ingredients can regulate ferroptosis-related pathways , such as glutathione/glutathione peroxidase 4 (GPX4), nuclear factor E2-related factor 2 (Nrf2)/hemoglobin oxygenase 1 (HO-1), ferric death inhibitory protein 1 (FSP1)/CoQ10 and guanosine triphosphate cyclohydrolase 1 (GCH1)/tetrahydrobiopterin (BH4), to reduce neuronal damage and death, and exert neuroprotective effects.

中国组织工程研究杂志出版内容重点:组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程

Key words: ferroptosis, ischemic brain injury, signaling pathway, traditional Chinese medicine, mechanism of action

CLC Number: