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

Shengping Luo,1,2 Jiayu Zhu,3 Le Yang,1,2 Jing Liu,1,2 Yihui Deng4 1School of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, People’s Republic of China; 2Hunan Province Key Laboratory of Cerebrovascular Disease Prevention and Treatment of Integrated Traditional Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, People’s Republic of China; 3The First Clinical College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, People’s Republic of China; 4School of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, People’s Republic of ChinaCorrespondence: Yihui Deng, School of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, People’s Republic of China, Email dengyihui@hnucm.edu.cnAbstract: 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.Keywords: ferroptosis, Chinese herbal medicine, cerebral ischemia-reperfusion injury, protective effect