SYSTEMATIC REVIEW article
Front. Pharmacol.
Sec. Ethnopharmacology
Protective Effects of Salvianolic Acid A on Ischemic Stroke: A Meta-Analysis of Preclinical Studies
Provisionally accepted
An Liu1,2
Wenjing Li2Hangyao Zhang1Pin Li3Kexin Sun2Yuqian Xiao2
Jun Wan1
Yanjie Li4Yan Wang1
Sihan Hu5
Yanjie Bai1*- 1Rehabilitation Centre of the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
- 2Rehabilitation Medicine College, Henan University of Chinese Medicine, Zhengzhou, China
- 3The First College of Clinical Medicine, Henan University of Chinese Medicine, Zhengzhou, China
- 4Department of Rehabilitation, Henan Provincial Hospital of Traditional Chinese Medicine, Zhengzhou, China
- 5Department of Integrated Traditional Chinese and Western Medicine, Peking University First Hospital; Institute of Integrated Traditional Chinese and Western Medicine, Peking University, Beijing, China
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Objective: To investigate the protective effects of SalA on cerebral ischemic injury following IS and its possible mechanisms, providing a scientific basis for future clinical research on IS. Methods: A comprehensive search was conducted across four databases: PubMed, Embase, Web of Science, and the Cochrane Library. The search included all literature from the establishment of each library up to February 2025; Data analysis was performed using STATA 15.0 software. Results: A total of 15 studies involving 564 animals were included. The analysis showed that, compared to the control group, SalA significantly reduced the infarct volume [SMD=-4.67, 95% CI (-5.98, -3.36), p<0.001] and brain edema area [SMD=-5.291, 95% CI (-7.607, -2.975), p<0.001], and improved neurological deficits [SMD=-6.39, 95% CI (-9.091, -3.688), p<0.001]. SalA also significantly inhibited IL-6, TNF-α, IL-1βand other indicators, Bax, and Caspase3 index, while showing a positive effect on Bcl-2, Bcl-2/Bax and other indicators. Conclusion: This meta-analysis demonstrates the therapeutic effects of SalA on IS. The results indicated that SalA significantly reduced infarct area, improved neurological function scores, and alleviated brain edema. These effects were achieved through multiple mechanisms, including anti-inflammatory, antioxidative, anti-apoptotic actions, and blood-brain barrier repair. SalA exhibited dose-dependent effects at different doses (especially 20 mg/kg) and administration methods. Further high-quality preclinical and clinical studies are needed for analysis.
Keywords: Salvianolic acid A, ischemic stroke, Ischemia injury, Preclinical evidence, Meta
Received: 16 May 2025; Accepted: 27 Oct 2025.
Copyright: © 2025 Liu, Li, Zhang, Li, Sun, Xiao, Wan, Li, Wang, Hu and Bai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yanjie Bai, baiyj66@126.com
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