Angiogenesis in Ischemic Stroke and Angiogenic Effects of Chinese Herbal Medicine.
Stroke is one of the major causes of death and adult disability worldwide. The underlying pathophysiology of stroke is highly complicated, consisting of impairments of multiple signalling pathways, and numerous pathological processes such as acidosis, glutamate excitotoxicity, calcium overload, cerebral inflammation and reactive oxygen species (ROS) generation. The current treatment for ischemic stroke is limited to thromolytics such as recombinant tissue plasminogen activator (tPA). tPA has a very narrow therapeutic window, making it suitable to only a minority of stroke patients. Hence, there is great urgency to develop new therapies that can protect brain tissue from ischemic damage. Recent studies have shown that new vessel formation after stroke not only replenishes blood flow to the ischemic area of the brain, but also promotes neurogenesis and improves neurological functions in both animal models and patients. Therefore, drugs that can promote angiogenesis after ischemic stroke can provide therapeutic benefits in stroke management. 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.
National Institute of Complementary Medicine, Western Sydney University, Locked Bag 1797, Penrith 2751, NSW, Australia. s.seto@westernsydney.edu.au.
Sai-Wang
SW
Seto
National Institute of Complementary Medicine, Western Sydney University, Locked Bag 1797, Penrith 2751, NSW, Australia. d.chang@westernsydney.edu.au.
Dennis
D
Chang
National Institute of Complementary Medicine, Western Sydney University, Locked Bag 1797, Penrith 2751, NSW, Australia. 16292521@student.uws.edu.au.
Anita
A
Jenkins
National Institute of Complementary Medicine, Western Sydney University, Locked Bag 1797, Penrith 2751, NSW, Australia. a.bensoussan@westernsydney.edu.au.
Alan
A
Bensoussan
Faculty of Medicine, University of New South Wales, Sydney 2052, NSW, Australia. hosen.kiat@chi.org.au.|School of Medicine, Western Sydney University, Locked Bag 1797, Penrith 2751, NSW, Australia. hosen.kiat@chi.org.au.|Faculty of Medicine and Health Sciences, Macquarie University, Sydney 2109, NSW, Australia. hosen.kiat@chi.org.au.
Hosen
H
Kiat
Chinese Herbal Medicine; angiogenesis; cerebral ischemia; stroke