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Ischemic neuronal injury results from a complex series of pathophysiological events, including oxidative, excitotoxicity, inflammation and nitrative stress. Consequently, many of these events can induce cell death, including necrosis
(unregulated cell death) and apoptosis (a type of regulated cell death). These are long-established paradigms to which newly
discovered regulated cell death processes have been added, such as necroptosis (a regulated form of necrosis) and autophagy-dependent cell death. Moreover, many researchers have targeted products associated with Chinese herbal medicine at
regulated pathways for the treatment of ischemic neuronal injury. In East Asia, these drugs have been known for centuries to
protect and improve the nervous system. Herbal extracts, especially those used in Chinese herbal medicine, have emerged as
new pharmaceuticals for the treatment of ischemic neuronal injury. Here, we review the evidence from preclinical studies
investigating the neuroprotective properties and therapeutic application of Chinese herbal medicines (Chinese herbal monomer, extract, and medicinal compounds) and highlight the potential mechanisms underlying their therapeutic effects via
targeting different regulated cell death pathways. Notably, many herbs have been shown to target multiple mechanisms of
regulated cell death and, in combination, may exert synergistic effects on signaling pathways, thereby attenuating multiple
aspects of ischemic pathology. In this review, we summarize a general regulated pathway of cell death as a target for novel
natural herbal regimens against ischemic neuronal injury.
Homocysteine and glutamate receptors in the neuronal dysfunction and cell death in levodopa therapy: Are B-complex vitamins and herbal medicine the panacea?