Medicinal Plant Research 2025, Vol.15, No.5, 214-223 http://hortherbpublisher.com/index.php/mpr 216 Due to the synergistic effect of its multiple components, A. sinensis can not only improve blood circulation and prevent thrombosis, but regulate lipid metabolism and protect vascular endothelium (Han et al., 2021; Chen et al., 2024). These mechanisms of action are the theoretical basis for its application in traditional medicine, and as well as the important basis for its recognition, in the prevention and treatment of modern cardiovascular and cerebrovascular diseases (Ren et al., 2025). 3 Multi-Target Effects on Cardiovascular Protection of A. sinensis 3.1 Antioxidant and anti-apoptotic mechanisms A. sinensis polysaccharides (ASP), can enhance the antioxidant defense capacity of cardiovascular tissues. Studies have shown that, ASP can enhance the activities of key antioxidant enzymes, like superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), while reducing the levels of malondialdehyde (MDA), hydrogen peroxide (H2O2), and reactive oxygen species (ROS). Thereby effectively alleviating oxidative stress in models of hypertension and myocardial ischemia (Niu et al., 2018; Song et al., 2021). ASP and its combination with other active ingredients of A. sinensis, can inhibit the apoptosis of cardiomyocytes by regulating proteins related to apoptosis. ASP treatment can down-regulate the expression of pro-apoptotic markers (e.g., Bax, cleavage caspase-3 and cleavage caspase-9), and up-regulate the anti-apoptotic protein Bcl-2, thereby reducing cell death in myocardial tissue (Song et al., 2021; Wang et al., 2024). Furthermore, the synergistic effect of ligustilide and active ingredients, like chlorogenic acid, can reduce the ratios of BAX/Bcl-2 and cleaved caspase-3/caspase-3, and provide stronger anti-apoptotic protection after myocardial infarction (Wang et al., 2024). 3.2 Anti-inflammatory and vascular protective roles A. sinensis and its active components, can inhibit the inflammatory response by suppressing the NF-κB signaling pathway, and reducing the levels of inflammatory factors (IL-1β, IL-6, TNF-α etc.) (Chen et al., 2024; Wang et al., 2024). This anti-inflammatory mechanism is of great significance for reducing myocardial and vascular damage. Animal model studies have confirmed that, it can lower the levels of inflammatory cytokines and improve cardiac function. A. sinensis extract can also protect vascular endothelial cells from oxidative and inflammatory damage, maintaining the integrity and function of vascular endothelium. This effect is mainly achieved by enhancing the activity of antioxidant enzymes, and regulating signaling pathways, like ERK and eNOS, thereby contributing to maintaining vascular health, and preventing atherosclerosis (Chen et al., 2024). 3.3 Protection against myocardial ischemia-reperfusion injury ASP can activate pathways, such as AMPK-PGC1α and ATF6, improve mitochondrial function, regulate calcium ion homeostasis, and enhance the folding ability of endoplasmic reticulum proteins. These mechanisms are crucial, for reducing ischemia-reperfusion injury, and maintaining myocardial cell viability (Niu et al., 2018). The synergistic combination of ASP and their active components, can reduce the infarct area, alleviate myocardial fibrosis, and improve cardiac function after ischemic injury. These effects are coordinated through multiple mechanisms, such as antioxidation, anti-apoptosis and anti-inflammation, thereby showing significant protective effects in myocardial tissue injury (Niu et al., 2018; Song et al., 2021; Wang et al., 2024). 4 Multi-Target Effects on Cerebrovascular Protection of A. sinensis 4.1 Mitigation of cerebral ischemia/reperfusion injury A. sinensis and its active components, especially polysaccharides and Z-ligustilide, have demonstrated excellent antioxidant effects in models of cerebral ischemia/reperfusion injury. These components can enhance the activities of antioxidant enzymes, like superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPX), while reducing oxidative stress markers and neuronal apoptosis levels (Xu et al., 2021; Chen et al., 2024; Shen et al., 2024). Mechanically, it is mainly achieved by inhibiting inflammation, reducing oxidative stress, suppressing
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