Advances In Angiogenesis And Related Treatment Of Chinese Herbal Medicine After Ischemic Stroke

Stroke is an acute disease caused by cerebral vascular hemorrhage or occlusion.Of all strokes,ischemic stroke accounts for 87%,is a major concern of the world medical science field and a serious threat to human life and health with its sustained increase in incidence,morbidity,mortality and recurrence.The underlying pathophysiology of ischemic stroke is highly complicated,consisting of impairments of multiple signaling pathways,and numerous pathological process such as glutamate-inducd excitotoxicity,calcium overload,inflammatory response and reactive oxygen species(ROS)generation.According to the pathophysiological characteristics,current clinical treatment for ischemic stroke mainly focused on thrombolysis in the ultra-early phase,neurological protection during acute stage,and reconstruction of neuronal structure and function in convalescent period.Nevertheless,due to narrow therapeutic window and strictly selected patients,the application of thrombolysis to clinical is limited and few patients benefit from it.Although some of the cerebral protection drugs have been confirmed effective in the basic research,the clinical application does not show the desired effect,which may be due to the difference between experimental animals and human in body metabolism and internal environment,and the underlining mechanism is still inadequate,still need further clinical trials to demonstrate its effectiveness and safty.Reconstruction of neurovascular structure and function in convalescent period gradually getting more and more attention,recent studies have shown that new vessel formation after stroke not only enhances oxygen and nutrient supply to the affected tissue but also facilitates highly coupled neurorestorative processes including neurogenesis and synaptogenesis which in turn lead to improved functional recovery.Mounting evidence indicates that angiopoietin(VEGF,Ang-1,etc.),mi RNAs and lnc RNA play animportant role in the regulation of angiogenesis after stroke,as a new target for the treatment of angiogenesis after ischemic stroke become the focus of the current study.In this regard,Chinese herbal medicine(CHM)has a long history in treating stroke and the associated diseases.A number of studies have demonstrated the pro-angiogenic effects of various Chinese herbs and herbal formulations in both in vitro and in vivo settings.In this article,we present a comprehensive review of the current knowledge on angiogenesis in the context of ischemic stroke and discuss the potential use of CHM in stroke management through modulation of angiogenesis.