Abstract

Several clinical therapies such as tissue repair by replacing injured tissues with functional ones have been reported; however, there is great potential for exploring traditional herbal-induced regeneration with good safety. Tongqiao Huoxue Decoction (TQHXD), a well-known classical traditional Chinese medicinal formula, has been widely used for clinical treatment of stroke. However, biological activity and mechanisms of action of its constituents toward conferring protection against cerebral ischemia-reperfusion (I/R) injury remain unclear. In this present study, we evaluated TQHXD quality using HPLC; then, it was screened for its potential active ingredients using a series of indices, such as their drug-likeness and oral bioavailability. Subsequently, we analyzed the potential mechanisms of TQHXD anti-I/R using gene ontology functional enrichment analyses. The network pharmacological approach enabled us to screen 265 common targets associated with I/R, indicating that TQHXD had remarkable protective effects on infarction volume, neurological function scores, and blood-brain barrier (BBB) injury. In addition, TQHXD significantly promoted the recovery of regional cerebral blood flow (rCBF) 7 days after reperfusion compared to rats in the vehicle group. Immunofluorescence results revealed a significantly higher CD34 expression in TQHXD-treated rats 7 days after reperfusion. TQHXD is not merely effective but eventually develops a secretory profile composed of VEGF and cerebral blood flow, a typical signature termed the angiogenesis-associated phenotype. Mechanistically, our data revealed that TQHXD (6 g/kg) treatment resulted in a marked increase in expression of p-focal adhesion kinase (FAK) and p-Paxillin proteins. However, Ki8751-mediated inhibition of VEGFR2 activity repealed its angiogenesis and protective effects and decreased both p-FAK and p-Paxillin protein levels. Taken together, these findings affirmed the potential of TQHXD as a drug for the management of stroke, which might be exerted by increasing the angiogenesis via the VEGF pathway. Therefore, these results provide proof-of-concept evidence that angiogenesis is a major contributor to TQHXD-treated I/R and that TQHXD is a promising traditional ethnic medicine for the management of this condition.

Highlights

  • Stroke is the second leading cause of death in the world owing to its high morbidity, mortality, and disability rates (Benjamin et al, 2018)

  • A total of 929 significant genes were obtained from the GeneCards, OMIM, and DrugBank databases after screening out some targets with low credibility (Supplementary Table S1)

  • We show that TQHXD is a key mediator of angiogenesis

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Summary

Introduction

Stroke is the second leading cause of death in the world owing to its high morbidity, mortality, and disability rates (Benjamin et al, 2018). Four-fifths of all patients with stroke suffer from ischemia stroke, and most of them live with disabilities for a long time (Mozaffarian et al, 2015). One of the principles of clinical treatment of ischemic stroke is to restore blood flow in time. This approach is an effective protection measure, long-term accumulation of reperfusion can lead to cerebral ischemia-reperfusion (I/R) injury. Treatment of I/R injuryinduced ischemic stroke is challenging. The development of novel drugs is necessary to aid in the management of patients with stroke

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