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Neuroprotective potential for mitigating ischemiareperfusion-induced
damage
Zi Ye, Runqing Liu, Hangxing Wang, Aizhen Zuo, Cen Jin, Nan Wang, Huiqi Sun, Luqian Feng, Hua Yang
2025, 20 (8):
2199-2217.
doi: 10.4103/NRR.NRR-D-23-01985
Reperfusion following cerebral ischemia causes both structural and functional damage
to brain tissue and could aggravate a patient’s condition; this phenomenon is known as
cerebral ischemia-reperfusion injury. Current studies have elucidated the neuroprotective
role of the sirtuin protein family (Sirtuins) in modulating cerebral ischemia-reperfusion
injury. However, the potential of utilizing it as a novel intervention target to influence
the prognosis of cerebral ischemia-reperfusion injury requires additional exploration. In
this review, the origin and research progress of Sirtuins are summarized, suggesting the
involvement of Sirtuins in diverse mechanisms that affect cerebral ischemia-reperfusion
injury, including inflammation, oxidative stress, blood–brain barrier damage, apoptosis,
pyroptosis, and autophagy. The therapeutic avenues related to Sirtuins that may improve
the prognosis of cerebral ischemia-reperfusion injury were also investigated by modulating
Sirtuins expression and affecting representative pathways, such as nuclear factor-kappa
B signaling, oxidative stress mediated by adenosine monophosphate-activated protein
kinase, and the forkhead box O. This review also summarizes the potential of endogenous
substances, such as RNA and hormones, drugs, dietary supplements, and emerging
therapies that regulate Sirtuins expression. This review also reveals that regulating Sirtuins
mitigates cerebral ischemia-reperfusion injury when combined with other risk factors.
While Sirtuins show promise as a potential target for the treatment of cerebral ischemiareperfusion
injury, most recent studies are based on rodent models with circadian rhythms
that are distinct from those of humans, potentially influencing the efficacy of Sirtuinstargeting
drug therapies. Overall, this review provides new insights into the role of Sirtuins
in the pathology and treatment of cerebral ischemia-reperfusion injury.
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