Pathogenic mechanisms of cerebral ischemia and potential gut-brain axis-oriented therapeutic strategies

Sep 19, 2025Phytomedicine : international journal of phytotherapy and phytopharmacology

Damage Processes in Brain Stroke and Possible Treatments Targeting Gut-Brain Communication

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Abstract

Cerebral ischemia's pathogenesis may be influenced by the gut-brain axis.

There is a bidirectional regulation mechanism between the brain and gut microbiota.
The gut-brain axis may play a critical role in the development and progression of cerebral ischemia.
Chinese herbal medicines and other formulations could provide therapeutic effects by regulating intestinal flora.
These interventions may help reduce neuroinflammation and oxidative stress associated with cerebral ischemia.
Current understanding of the gut-brain axis's role in cerebral ischemia remains limited and requires further investigation.

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BACKGROUND: Cerebral ischemia is a serious cerebrovascular disease, and its pathogenesis is complex and involves a variety of pathological processes. In recent years, the theory of gut-brain axis has provided a new research perspective to reveal the synergistic pathological changes between brain and gut during cerebral ischemia. According to this theory, there is a bidirectional regulation mechanism between the central nervous system and gut microbiota, and the gut-brain axis plays a pivotal role in the occurrence and progression of cerebral ischemia. Therefore, drug intervention strategies based on gut-brain axis have gradually attracted attention. Existing studies have shown that, Chinese herbal medicines, compound prescriptions and Chinese patent medicines, can play potential therapeutic effects on cerebral ischemia by regulating intestinal flora, reducing neuroinflammation and oxidative stress. Despite the continuous progress of related research in recent years, the understanding of the role of gut-brain axis in cerebral ischemia is still patchy and lack of systematic summary.

PURPOSE: This article reviews the pathogenesis of cerebral ischemia regulated by the gut-brain axis and frontier drug intervention research based on this theory, in order to provide reference for follow-up research and clinical practice.

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Pathogenic mechanisms of cerebral ischemia and potential gut-brain axis-oriented therapeutic strategies

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