Protective Effect of Chinese Herbal Medicine on Cerebral Ischemia-Reperfusion Injury by Regulating Ferroptosis

Ischemic stroke remains one of the leading causes of death and long-term disability worldwide. The current standard-of-care therapies-intravenous thrombolysis and mechanical thrombectomy-restore cerebral blood flow but may paradoxically evoke cerebral ischemia-reperfusion injury. Recent studies have revealed that ferroptosis, a form of regulated cell death dependent on iron, plays a pivotal role in cerebral ischaemia-reperfusion injury. Traditional Chinese herbal formulas and their bioactive components can modulate ferroptosis, thereby mitigating brain damage induced by ischemia-reperfusion. This article reviews the molecular mechanisms of ferroptosis and its pathophysiological roles in cerebral ischaemia-reperfusion. It focuses particularly on the key mechanisms underlying the therapeutic effects of Chinese herbal medicines in targeting ferroptosis. The aim is to provide a theoretical basis for developing novel therapeutics.