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Evidence-Based Complementary and Alternative Medicine
Volume 2016, Article ID 5739434, 16 pages
Review Article

Anti-Inflammatory Effects of Traditional Chinese Medicines against Ischemic Injury in In Vivo Models of Cerebral Ischemia

1School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
2Department of Chinese Medicine, Hui-Sheng Hospital, Taichung 42056, Taiwan
3Department of Chinese Medicine, China Medical University Hospital, Taichung 40447, Taiwan
4Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung 40402, Taiwan
5Graduate Institute of Acupuncture Science, China Medical University, Taichung 40402, Taiwan

Received 22 May 2016; Accepted 25 July 2016

Academic Editor: Xiang Liu

Copyright © 2016 Chin-Yi Cheng and Yu-Chen Lee. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Inflammation plays a crucial role in the pathophysiology of acute ischemic stroke. In the ischemic cascade, resident microglia are rapidly activated in the brain parenchyma and subsequently trigger inflammatory mediator release, which facilitates leukocyte-endothelial cell interactions in inflammation. Activated leukocytes invade the endothelial cell junctions and destroy the blood-brain barrier integrity, leading to brain edema. Toll-like receptors (TLRs) stimulation in microglia/macrophages through the activation of intercellular signaling pathways secretes various proinflammatory cytokines and enzymes and then aggravates cerebral ischemic injury. The secreted cytokines activate the proinflammatory transcription factors, which subsequently regulate cytokine expression, leading to the amplification of the inflammatory response and exacerbation of the secondary brain injury. Traditional Chinese medicines (TCMs), including TCM-derived active compounds, Chinese herbs, and TCM formulations, exert neuroprotective effects against inflammatory responses by downregulating the following: ischemia-induced microglial activation, microglia/macrophage-mediated cytokine production, proinflammatory enzyme production, intercellular adhesion molecule-1, matrix metalloproteinases, TLR expression, and deleterious transcription factor activation. TCMs also aid in upregulating anti-inflammatory cytokine expression and neuroprotective transcription factor activation in the ischemic lesion in the inflammatory cascade during the acute phase of cerebral ischemia. Thus, TCMs exert potent anti-inflammatory properties in ischemic stroke and warrant further investigation.