{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:24:57Z","timestamp":1787765097749,"version":"build-2784847793"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract:<\/jats:title>\n                  <jats:p>Ischemic stroke is a major global health crisis, characterized by high morbidity and mortality rates. Although there have been significant advancements in treating the acute phase of this condition, there remains a pressing need for effective treatments that can facilitate the recovery of neurological functions. Danggui-Shaoyao-San (DSS), also known as the Decoction of Chinese Angelica and Peony, is a traditional Chinese herbal formula. It has demonstrated promising results in the regulation of microglial polarization and modulation of neurosteroid receptor expression, which may make it a potent strategy for promoting the recovery of neurological functions. Microglia, which plays a crucial role in neuroplasticity and functional reconstruction poststroke, is regulated by neurosteroids. This review posits that DSS could facilitate the recovery of neuronal function poststroke by influencing microglial polarization through the neurosteroid receptor pathway. We will further discuss the potential mechanisms by which DSS could enhance neural function in stroke, including the regulation of microglial activation, neurosteroid regulation, and other potential mechanisms.<\/jats:p>","DOI":"10.4103\/bc.bc_45_23","type":"journal-article","created":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T15:00:09Z","timestamp":1703257209000},"page":"5-10","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["A narrative review of potential neural repair poststroke: Decoction of Chinese angelica and peony in regulating microglia polarization through the neurosteroid pathway"],"prefix":"10.4103","volume":"10","author":[{"given":"Linhui","family":"Qin","sequence":"first","affiliation":[{"name":"Beijing Key Laboratory of Hypoxia Translational Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Kamash","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Herbal Formula Science, Chinese Medicine College, Beijing University of Chinese Medicine, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuchuan","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changhong","family":"Ren","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Hypoxia Translational Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,12,21]]},"reference":[{"key":"R1-20240830","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1016\/S1474-4422(21)00252-0","article-title":"Global, regional, and national burden of stroke and its risk factors, 1990-2019:A systematic analysis for the global burden of disease study 2019","volume":"20","year":"2021","journal-title":"Lancet Neurol"},{"key":"R2-20240830","doi-asserted-by":"crossref","first-page":"178","DOI":"10.4103\/bc.bc_35_21","article-title":"Timing is everything:Exercise therapy and remote ischemic conditioning for acute ischemic stroke patients","volume":"7","author":"Lee","year":"2021","journal-title":"Brain Circ"},{"key":"R3-20240830","doi-asserted-by":"crossref","first-page":"69","DOI":"10.4103\/bc.bc_27_22","article-title":"Perspectives on benefit of early and prereperfusion hypothermia by pharmacological approach in stroke","volume":"8","author":"Li","year":"2022","journal-title":"Brain Circ"},{"key":"R4-20240830","doi-asserted-by":"crossref","first-page":"1585","DOI":"10.1016\/S0140-6736(22)01882-7","article-title":"Intensive blood pressure control after endovascular thrombectomy for acute ischaemic stroke (ENCHANTED2\/MT):A multicentre, open-label, blinded-endpoint, randomised controlled trial","volume":"400","author":"Yang","year":"2022","journal-title":"Lancet"},{"key":"R5-20240830","doi-asserted-by":"crossref","first-page":"e4","DOI":"10.1002\/brx2.4","article-title":"Systolic pressure target after endovascular thrombectomy in acute large-vessel occlusion ischemic stroke patients:Comment on ENCHANTED2\/MT","volume":"1","author":"Yuan","year":"2023","journal-title":"Brain X"},{"key":"R6-20240830","doi-asserted-by":"crossref","first-page":"11","DOI":"10.4103\/bc.bc_58_19","article-title":"Multiphase adjuvant neuroprotection:A novel paradigm for improving acute ischemic stroke outcomes","volume":"6","author":"Zhao","year":"2020","journal-title":"Brain Circ"},{"key":"R7-20240830","doi-asserted-by":"crossref","first-page":"230","DOI":"10.4103\/bc.bc_33_21","article-title":"Progress and challenges in preclinical stroke recovery research","volume":"7","author":"Wolf","year":"2021","journal-title":"Brain Circ"},{"key":"R8-20240830","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1016\/j.immuni.2021.04.022","article-title":"Treg cell-derived osteopontin promotes microglia-mediated white matter repair after ischemic stroke","volume":"54","author":"Shi","year":"2021","journal-title":"Immunity"},{"key":"R9-20240830","first-page":"38","article-title":"Protective effects of Danggui Shaoyao powder on the brain of mice with cerebral ischemic stroke","volume":"27","author":"Li","year":"2022","journal-title":"Chinese J Inf TCM"},{"key":"R10-20240830","first-page":"3747285","article-title":"Systematic understanding of mechanism of Danggui Shaoyao San against ischemic stroke using a network pharmacology approach","volume":"2022","author":"Li","year":"2022","journal-title":"Evid Based Complement Alternat Med"},{"key":"R11-20240830","doi-asserted-by":"crossref","first-page":"727899","DOI":"10.3389\/fncel.2021.727899","article-title":"New insights into the roles of microglial regulation in brain plasticity-dependent stroke recovery","volume":"15","author":"Yu","year":"2021","journal-title":"Front Cell Neurosci"},{"key":"R12-20240830","doi-asserted-by":"crossref","first-page":"100788","DOI":"10.1016\/j.yfrne.2019.100788","article-title":"Neurosteroids as regulators of neuroinflammation","volume":"55","author":"Yilmaz","year":"2019","journal-title":"Front Neuroendocrinol"},{"key":"R13-20240830","doi-asserted-by":"crossref","first-page":"245","DOI":"10.14336\/AD.2014.1126","article-title":"Herbal formula Danggui-Shaoyao-San promotes neurogenesis and angiogenesis in rat following middle cerebral artery occlusion","volume":"6","author":"Ren","year":"2015","journal-title":"Aging Dis"},{"key":"R14-20240830","doi-asserted-by":"crossref","first-page":"502","DOI":"10.14336\/AD.2015.1220","article-title":"Danggui-Shaoyao-San:New hope for Alzheimer's disease","volume":"7","author":"Fu","year":"2016","journal-title":"Aging Dis"},{"key":"R15-20240830","first-page":"2285","article-title":"Connotation exploration of Danggui Shaoyao powder syndrome","volume":"36","author":"Cui","year":"2021","journal-title":"Acta Chin Med"},{"key":"R16-20240830","first-page":"749","article-title":"Danggui Shaoyao powder combined with western medicine treating 60 cases of cerebral infarction","volume":"24","author":"Wang","year":"2009","journal-title":"Guangming J Chin Med"},{"key":"R17-20240830","first-page":"110","article-title":"Effect of Danggui Shaoyao powder on bulbar conjunctiva microcirculation and hemorheological factor in patients with asymptomatic cerebral infarction","volume":"27","author":"Yi","year":"2005","journal-title":"Foreign Med Sci"},{"key":"R18-20240830","first-page":"261","article-title":"Efficacy and hemorheology of argatroban combined with Danggui Shaoyao powder in the treatment of acute cerebral infarction","volume":"21","author":"Zhu","year":"2021","journal-title":"World Latest Med Inf"},{"key":"R19-20240830","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.pneurobio.2016.01.005","article-title":"The biphasic function of microglia in ischemic stroke","volume":"157","author":"Ma","year":"2017","journal-title":"Prog Neurobiol"},{"key":"R20-20240830","doi-asserted-by":"crossref","first-page":"37","DOI":"10.4103\/bc.bc_16_21","article-title":"Major histocompatibility complex class II-based therapy for stroke","volume":"7","author":"Gonzales-Portillo","year":"2021","journal-title":"Brain Circ"},{"key":"R21-20240830","doi-asserted-by":"crossref","first-page":"74","DOI":"10.7150\/thno.35841","article-title":"Microglia exacerbate white matter injury via complement C3\/C3aR pathway after hypoperfusion","volume":"10","author":"Zhang","year":"2020","journal-title":"Theranostics"},{"key":"R22-20240830","doi-asserted-by":"crossref","first-page":"466","DOI":"10.14336\/AD.2020.0701","article-title":"Microglial polarization:Novel therapeutic strategy against ischemic stroke","volume":"12","author":"Xue","year":"2021","journal-title":"Aging Dis"},{"key":"R23-20240830","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.biopha.2018.05.108","article-title":"Dangguishaoyao-San attenuates LPS-induced neuroinflammation via the TLRs\/NF-\u03baB signaling pathway","volume":"105","author":"Ding","year":"2018","journal-title":"Biomed Pharmacother"},{"key":"R24-20240830","doi-asserted-by":"crossref","first-page":"976270","DOI":"10.1155\/2013\/976270","article-title":"Dangguijakyak-San protects against 1-methyl-4-phenyl-1,2,3,6,-tetrahydropyridine-induced neuronal damage via anti-inflammatory action","volume":"2013","author":"Hwang","year":"2013","journal-title":"Evid Based Complement Alternat Med"},{"key":"R25-20240830","doi-asserted-by":"crossref","first-page":"3630","DOI":"10.3760\/cma.j.issn.0366-6999.20141589","article-title":"Danggui-Shaoyao-San, a traditional Chinese medicine prescription, alleviates the orthodontic pain and inhibits neuronal and microglia activation","volume":"127","author":"Li","year":"2014","journal-title":"Chin Med J (Engl)"},{"key":"R26-20240830","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.neuint.2005.10.008","article-title":"Neuroprotection by tetramethylpyrazine against ischemic brain injury in rats","volume":"48","author":"Kao","year":"2006","journal-title":"Neurochem Int"},{"key":"R27-20240830","doi-asserted-by":"crossref","first-page":"e08269","DOI":"10.1016\/j.heliyon.2021.e08269","article-title":"Atractylenolide-III suppresses lipopolysaccharide-induced inflammation via downregulation of toll-like receptor 4 in mouse microglia","volume":"7","author":"Novianti","year":"2021","journal-title":"Heliyon"},{"key":"R28-20240830","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1006\/hbeh.1998.1473","article-title":"Estradiol enhances learning and memory in a spatial memory task and effects levels of monoaminergic neurotransmitters","volume":"34","author":"Luine","year":"1998","journal-title":"Horm Behav"},{"key":"R29-20240830","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1002\/hipo.20357","article-title":"Estradiol enhances long term potentiation in hippocampal slices from aged apoE4-TR mice","volume":"17","author":"Yun","year":"2007","journal-title":"Hippocampus"},{"key":"R30-20240830","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1111\/jne.12162","article-title":"Oestradiol-induced synapse formation in the female hippocampus:Roles of oestrogen receptor subtypes","volume":"26","author":"Zhou","year":"2014","journal-title":"J Neuroendocrinol"},{"key":"R31-20240830","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1186\/s12906-017-2015-6","article-title":"Dangguijakyak-San ameliorates memory deficits in ovariectomized mice by upregulating hippocampal estrogen synthesis","volume":"17","author":"Hwang","year":"2017","journal-title":"BMC Complement Altern Med"},{"key":"R32-20240830","doi-asserted-by":"crossref","first-page":"327294","DOI":"10.1155\/2014\/327294","article-title":"Danggui-Shaoyao-San improves learning and memory in female SAMP8 via modulation of estradiol","volume":"2014","author":"Huang","year":"2014","journal-title":"Evid Based Complement Alternat Med"},{"key":"R33-20240830","doi-asserted-by":"crossref","first-page":"1948","DOI":"10.4103\/0366-6999.160562","article-title":"Effects of Danggui-Shaoyao-San on the influence of spatial learning and memory induced by experimental tooth movement","volume":"128","author":"Li","year":"2015","journal-title":"Chin Med J (Engl)"},{"key":"R34-20240830","doi-asserted-by":"crossref","first-page":"677","DOI":"10.3892\/etm.2021.10109","article-title":"Antidepressant-like effects of Z-ligustilide on chronic unpredictable mild stress-induced depression in rats","volume":"22","author":"Ma","year":"2021","journal-title":"Exp Ther Med"},{"key":"R35-20240830","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/S1043-2760(01)00503-3","article-title":"Neurosteroids:Biochemistry and clinical significance","volume":"13","author":"Mellon","year":"2002","journal-title":"Trends Endocrinol Metab"},{"key":"R36-20240830","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/j.jsbmb.2014.03.008","article-title":"Dehydroepiandrosterone:A neuroactive steroid","volume":"145","author":"St\u00e1rka","year":"2015","journal-title":"J Steroid Biochem Mol Biol"},{"key":"R37-20240830","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1016\/j.cell.2011.03.050","article-title":"An ADIOL-ER\u03b2-CtBP transrepression pathway negatively regulates microglia-mediated inflammation","volume":"145","author":"Saijo","year":"2011","journal-title":"Cell"},{"key":"R38-20240830","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.brainres.2015.05.017","article-title":"Changes in the gene expression of estrogen receptors involved in the protective effect of estrogen in rat's trumatic brain injury","volume":"1618","author":"Khaksari","year":"2015","journal-title":"Brain Res"},{"key":"R39-20240830","doi-asserted-by":"crossref","first-page":"e103969","DOI":"10.1371\/journal.pone.0103969","article-title":"Anti-inflammatory effects of progesterone in lipopolysaccharide-stimulated BV-2 microglia","volume":"9","author":"Lei","year":"2014","journal-title":"PLoS One"},{"key":"R40-20240830","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1007\/s12031-013-0137-y","article-title":"Regulation of hypoxia-induced inflammatory responses and M1-M2 phenotype switch of primary rat microglia by sex steroids","volume":"52","author":"Habib","year":"2014","journal-title":"J Mol Neurosci"},{"key":"R41-20240830","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.pneurobio.2015.05.003","article-title":"Alternatively activated microglia and macrophages in the central nervous system","volume":"131","author":"Franco","year":"2015","journal-title":"Prog Neurobiol"},{"key":"R42-20240830","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1016\/j.cellbi.2007.10.004","article-title":"Aqueous extract of the Chinese medicine, Danggui-Shaoyao-San, inhibits apoptosis in hydrogen peroxide-induced PC12 cells by preventing cytochrome c release and inactivating of caspase cascade","volume":"32","author":"Qian","year":"2008","journal-title":"Cell Biol Int"},{"key":"R43-20240830","doi-asserted-by":"crossref","first-page":"653795","DOI":"10.3389\/fphar.2021.653795","article-title":"Danggui-Shaoyao-San (DSS) ameliorates cerebral ischemia-reperfusion injury via activating SIRT1 signaling and inhibiting NADPH oxidases","volume":"12","author":"Luo","year":"2021","journal-title":"Front Pharmacol"},{"key":"R44-20240830","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.jep.2016.04.060","article-title":"Neuroprotective effects of Danggui-Jakyak-San on rat stroke model through antioxidant\/antiapoptotic pathway","volume":"188","author":"Kim","year":"2016","journal-title":"J Ethnopharmacol"},{"key":"R45-20240830","first-page":"56","article-title":"Danggui Shaoyao San regulates angiogenesis in ischemic stroke mice through blood activating and or body fluidtransportation and transformation actions","volume":"44","author":"Zhang","year":"2020","journal-title":"Drug Eval Res"}],"container-title":["Brain Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/bc.bc_45_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:56:43Z","timestamp":1787763403000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/bc.bc_45_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,21]]},"references-count":45,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/bc.bc_45_23","relation":{},"ISSN":["2394-8108","2455-4626"],"issn-type":[{"value":"2394-8108","type":"print"},{"value":"2455-4626","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,21]]},"assertion":[{"value":"2023-05-26","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-13","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}