Abstract
Background: Rhodiola rosea L. has long been used as traditional medicines in Europe and Asia to treat a variety of common conditions and diseases including Alzheimer’s disease, cardiovascular disease, cognitive dysfunctions, cancer, and stroke. Previous studies reported that Rhodiola rosea L. and its components (RRC) improve ischemia stroke in animal models. Here, we conducted a systematic review and meta-analysis for preclinical studies to evaluate the effects of RRC and the probable neuroprotective mechanisms in ischemic stroke. Methods: Studies of RRC on ischemic stroke animal models were searched in seven databases from inception to Oct 2021. The primary measured outcomes included the neural functional deficit score (NFS), infarct volume (IV), brain water content, cell viability, apoptotic cells, terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-biotin nick end labeling (TUNEL)-positive cells, B-cell lymphoma-2 (Bcl-2) level and tumor necrosis factor-α (TNF-α) level. The secondary outcome measures were possible mechanisms of RRC for ischemic stroke. All the data were analyzed via RevMan version 5.3. Results: 15 studies involving 345 animals were identified. Methodological quality for each included studies was accessed according to the CAMARADES 10-item checklist. The quality score of studies range from 1 to 7, and the median was 5.53. Pooled preclinical data showed that compared with the controls, RRC could improve NFS (Zea Longa (p < 0.01), modified neurological severity score (mNSS) (p < 0.01), rotarod tests (p < 0.01), IV (p < 0.01), as well as brain edema (p < 0.01). It also can increase cell viability (p < 0.01), Bcl-2 level (p < 0.01) and reduce TNF-α level (p < 0.01), TUNEL-positive cells (p < 0.01), apoptotic cells (p < 0.01). Conclusion: The findings suggested that RRC can improve ischemia stroke. The possible mechanisms of RRC are largely through antioxidant, anti-apoptosis activities, anti-inflammatory, repressing lipid peroxidation, antigliosis, and alleviating the pathological blood brain barrier damage.
Highlights
Ischemic stroke, a common neurological disease, has been the major cause for the central nervous system dysfunction with a relative high mortality and morbidity in clinical practice (Benjamin et al, 2017; Benjamin et al, 2018)
The present study showed RRC could exert potential neuroprotective effects in experimental for ischemic stroke indicating that RRC are candidates for ischemic stroke treatment and can be used for further clinical trials
This study showed that RRC exerted potential neuroprotective effects in ischemic stroke largely through anti-oxidative, antiinflammatory, antigliosis, anti-apoptotic, neuroprotective, and alleviating the pathological BBB damage mechanisms
Summary
A common neurological disease, has been the major cause for the central nervous system dysfunction with a relative high mortality and morbidity in clinical practice (Benjamin et al, 2017; Benjamin et al, 2018). Cerebral ischemia causes several pathological processes, such as inflammation, oxidative stress, cell apoptosis, ion imbalance, and calcium overload (Jayaraj et al, 2019) leading to neurologic deficits in ischemic stroke. In spite of the substantial research and development efforts, the available therapeutic options remains insufficient for acute ischemic stroke. Rhodiola rosea L. has long been used as traditional medicines in Europe and Asia to treat a variety of common conditions and diseases including Alzheimer’s disease, cardiovascular disease, cognitive dysfunctions, cancer, and stroke. Previous studies reported that Rhodiola rosea L. and its components (RRC) improve ischemia stroke in animal models. We conducted a systematic review and meta-analysis for preclinical studies to evaluate the effects of RRC and the probable neuroprotective mechanisms in ischemic stroke
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