Abstract
In recent years, the incidence and mortality of cardio-cerebrovascular diseases have been increasing year by year, which has become global burden and challenge. Based on the holistic thinking of “brain disease affects the heart” and “heart disease affects the brain,” as well as the characteristics of multi-target and multi-path effects of Chinese medicine, Chinese medicine is more advantageous in the treatment of cardio-cerebrovascular diseases. As a botanical medicine, storax is known for its resuscitation, filth avoidance and pain-relieving effects in the treatment of cardio-cerebrovascular diseases. By reviewing and collating the relevant domestic and international literature in the past 10 years, we have sorted out an overview of the medicinal parts, traditional uses and chemical composition of storax. For the first time, based on the idea of “cerebral and cardiac simultaneous treatment,” the pharmacological activities and mechanisms of heart and brain protection of storax for treating cardio-cerebrovascular diseases were summarized and analyzed, showing that storax has the pharmacological effects of anti-cerebral ischemia, regulation of blood-brain barrier, bidirectional regulation of the central nervous system, anti-myocardial ischemia, anti-arrhythmia, anti-thrombosis and anti-platelet aggregation. It mainly exerts its protective effects on the brain and heart through mechanisms such as inhibition of inflammatory immune factors, anti-oxidative stress, anti-apoptosis, pro-neovascularization and regulation of NO release. On the basis of the current findings and limitations, the future research strategies and perspectives of storax are proposed, with a view to providing a reference for further application and development of this medicine, as well as contributing new thoughts and visions for the clinical application of “treating brain-heart synchronously”.
Highlights
Storax (ST), which is named Styrax or Su-Hexiang, is a kind of processed and refined aromatic resin exuded from the trunk of the Liquidambar orientalis Mill in the family Hamamelidaceae (State Pharmacopoeia Committee, 2020)
cardio-cerebrovascular diseases (CCVDs) are ischaemic or hemorrhagic diseases of the heart and brain caused by thickened blood, atherosclerosis, hypertension and hyperlipidemia, including cardiovascular and cerebrovascular lesions, which pose a serious threat to human health
Damage to the brain and the volume of cerebral infarction in middle cerebral artery occlusion (MCAO) rats. These results have indicated that ST has a noticeable improvement on ischemic brain tissue, and its primary mechanisms of action are shown in Figure 5, including inhibition of Ca2+ overload, improvement of blood rheology, anti-apoptosis of brain cells, anti-oxidative stress, inhibition of inflammatory mediators, promotion of angiogenesis, regulation of NO production and the blood-brain barrier (BBB)
Summary
Storax (ST), which is named Styrax or Su-Hexiang, is a kind of processed and refined aromatic resin exuded from the trunk of the Liquidambar orientalis Mill in the family Hamamelidaceae (State Pharmacopoeia Committee, 2020) It has been widely used as a folk medicine in East Asia, India, Africa and Turkey for many years (U.S Pharmacopeial Convention, 2017; Duru et al, 2010), and being a popular spice for food and wine (Zhang et al, 2020). It is reasonable and inevitable to adopt the methodology of “regulating the brain and heart simultaneously,” and the flexible application of this principle can help improve the curative effect of CCVDs. At present, 84 chemical components have been isolated from ST, mainly including terpenoids, aromatic organic acids, and their derivatives, which have various pharmacological activities (e.g., anticoagulant, anti-inflammatory and antibacterial). The limitations of current works are debated, coupled with prospects on the future research directions of ST, which are paramount for deeper exploration, development and utilization of ST, and will offer a new outlook for the clinical diagnosis and treatment of CCVDs, besides supplying the basis for the application of the theory of “simultaneous regulation of the brain and heart.”
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