A Review of Medicinal Herbs with Antioxidant Properties in the Treatment ‎of Cerebral Ischemia and Reperfusion

Stroke is the second most common cause of death and a major cause of disability in individuals aged over 65 years, worldwide. Considering the complex pathological process of ischemia, use of one single agent does not seem ideal for treatment. Therefore, studies in search of effective compounds and methods are under way. In recent years, increased attention has been paid to medicinal plants as potential sources for the treatment of ischemia and reperfusion. This study aimed to introduce the pathogenesis of cerebral ischemia and review the effects of medicinal plants and their mechanisms of action in cerebral ischemia. In this study, articles indexed in scientific databases including ISI, SID, PubMed, PubMed Central, Scopus, and Web of Science were evaluated, using the following keywords in Farsi and English: "Ischemia and reperfusion", "medicinal herbs", and "antioxidant properties". The review of conducted studies showed that medicinal plants and their compounds are capable of reducing infarct volume, cerebral edema, neuronal damages, sensory problems, and motor disorders through reducing oxidative and nitrative stress. Moreover, these plants are able to decrease the expression of inflammatory mediators, inhibit DNA fragmentation and oxidative DNA damage, reduce microglial and astrocyte activities, increase the expression of mitochondrial genes, inhibit apoptotic protein expression, reduce eicosanoids, and boost anti-apoptotic protein expression. Medicinal herbs and their compounds are able to diminish the damages caused by cerebral ischemia through several pathways; therefore, they can be used as new sources against cerebral ischemia.