Insights of Chinese herbal medicine for mitochondrial dysfunction in chronic cerebral hypoperfusion induced cognitive impairment: Existed evidences and potential directions

Abstract

Chronic cerebral hypoperfusion (CCH) is one of the main pathophysiological markers of cognitive impairment in central nervous system diseases. Mitochondria are cores of energy generation and information process. Mitochondrial dysfunction is the key upstream factors of CCH induced neurovascular pathology. Increasing studies explored the molecular mechanisms of mitochondrial dysfunction and self-repair for effective targets to improve CCH-related cognitive impairment. The clinical efficacy of Chinese herbal medicine in the treatment of CCH induced cognitive impairment is definite. Existed evidences from pharmacological studies have further proved that, Chinese herbal medicine could improve mitochondrial dysfunction and neurovascular pathology after CCH by preventing calcium overload, reducing oxidative stress damage, enhancing antioxidant capacity, inhibiting mitochondria-related apoptosis pathway, promoting mitochondrial biogenesis and preventing excessive activation of mitophagy. Besides, CCH mediated mitochondrial dysfunction is one of the fundamental causes for neurodegeneration pathology aggravation. Chinese herbal medicine also has great potential therapeutic value in combating neurodegenerative diseases by targeting mitochondrial dysfunction.

Research progress of mitophagy in chronic cerebral ischemia

“…Traditional Chinese medicine has been reported to improve the activity of the ETC complex, decrease calcium overload following excitability toxicity, and restore the self-regulation function of mitochondria by focusing on mitochondrial dysfunction. This preserves the integrity of mitochondrial structure and function, promotes the reconstruction of energy metabolism, and ultimately improves brain injury and cognitive impairment ( Wang et al, 2023 ). For example, the Zuogui pill and Naoxin capsule improve mitochondrial structure and function and reduce ROS accumulation by improving mitochondrial respiratory chain enzyme complexes ( Yu et al, 2014 ; Feng et al, 2022 ).…”