Research progress on targeting traditional Chinese medicine in the treatment of ischemic stroke based on the NLRP3 signaling pathway

Corresponding author: Gao Lili, gaolilidexingfu@163.com

DOI: 10.12201/bmr.202509.00056

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  Abstract: Ischemic stroke (IS) is an acute cerebrovascular disease based on necrosis and neurological impairment caused by interruption of blood flow in brain tissue, and the clinical manifestations cover a variety of functional disorders such as motor, speech, sensory, and cognitive. The pathological mechanism of the disease is complex, involving the inflammatory cascade, the toxic effect of excitatory amino acids, mitochondrial dysfunction and other aspects, and has the significant characteristics of high morbidity, high mortality rate, high disability rate and high recurrence rate, and is the primary cause of death in China. In the theoretical system of traditional Chinese medicine, IS belongs to the category of stroke, and its core pathogenesis lies in the damage to the body caused by pathological factors such as wind, fire, phlegm, and stasis, resulting in the imbalance of yin and yang, the reversal of qi and blood, and the onset of the disease by disturbing the clear body. With its advantages of overall regulation, multi-target intervention and relatively few adverse reactions, TCM treatment has shown good results in improving the prognosis of IS patients and reducing the risk of recurrence, and has the value of in-depth research and promotion. Recent studies have revealed that TCM can exert neuroprotective effects on IS by regulating the network acting on the NLRP3 inflammasome-mediated pyroptosis process and influencing downstream mediator secretion to optimize the microenvironment. This opens up a new perspective for in-depth exploration of the pathological mechanism of IS, and lays a theoretical foundation for exploring the treasure trove of traditional Chinese medicine. The purpose of this article is to systematically review the relevant literature at home and abroad in recent years, and summarize the mechanism of action of TCM monomers and compound preparations in the treatment of NLRP3 inflammasomes in the treatment of IS, in order to enrich the theoretical basis of TCM in the prevention and treatment of IS and provide a reference for clinical practice.

  Key words: ischemic stroke; NLRP3 inflammasome; Inflammation; Medicinal herb; Chinese medicine compounds; Mechanism of action, research progress

  Submit time: 26 September 2025

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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