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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Neurol.</journal-id>
<journal-title>Frontiers in Neurology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Neurol.</abbrev-journal-title>
<issn pub-type="epub">1664-2295</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fneur.2024.1490640</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Neurology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Cynaroside: a potential therapeutic agent targeting arachidonate 15-lipoxygenase to mitigate cerebral ischemia/reperfusion injury</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" equal-contrib="yes">
<name><surname>Cao</surname> <given-names>Wenpeng</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
<xref ref-type="author-notes" rid="fn0001"><sup>&#x2020;</sup></xref>
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</contrib>
<contrib contrib-type="author" equal-contrib="yes">
<name><surname>Hu</surname> <given-names>Yufeng</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<xref ref-type="author-notes" rid="fn0001"><sup>&#x2020;</sup></xref>
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</contrib>
<contrib contrib-type="author" equal-contrib="yes">
<name><surname>Yu</surname> <given-names>Xingyu</given-names></name>
<xref ref-type="aff" rid="aff4"><sup>4</sup></xref>
<xref ref-type="author-notes" rid="fn0001"><sup>&#x2020;</sup></xref>
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<contrib contrib-type="author">
<name><surname>Long</surname> <given-names>Tingting</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
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<contrib contrib-type="author">
<name><surname>Sun</surname> <given-names>Baofei</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
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<contrib contrib-type="author">
<name><surname>Lei</surname> <given-names>Shan</given-names></name>
<xref ref-type="aff" rid="aff5"><sup>5</sup></xref>
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<contrib contrib-type="author">
<name><surname>Xie</surname> <given-names>Peng</given-names></name>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
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<contrib contrib-type="author" corresp="yes">
<name><surname>Yu</surname> <given-names>Wenfeng</given-names></name>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
<xref ref-type="corresp" rid="c001"><sup>&#x002A;</sup></xref>
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<aff id="aff1"><sup>1</sup><institution>Department of Anatomy, School of Basic Medicine, Guizhou Medical University</institution>, <addr-line>Guiyang</addr-line>, <country>China</country></aff>
<aff id="aff2"><sup>2</sup><institution>Key Laboratory of Human Brain Bank for Functions and Diseases of Department of Education of Guizhou Province, Guizhou Medical University</institution>, <addr-line>Guiyang</addr-line>, <country>China</country></aff>
<aff id="aff3"><sup>3</sup><institution>Key Laboratory of Molecular Biology, School of Basic Medical, Guizhou Medical University</institution>, <addr-line>Guiyang</addr-line>, <country>China</country></aff>
<aff id="aff4"><sup>4</sup><institution>Class 5, Nursing, Grade 2023, Guizhou Medical University</institution>, <addr-line>Guiyang</addr-line>, <country>China</country></aff>
<aff id="aff5"><sup>5</sup><institution>Department of Physiology, School of Basic Medicine, Guizhou Medical University</institution>, <addr-line>Guiyang</addr-line>, <country>China</country></aff>
<author-notes>
<fn fn-type="edited-by" id="fn0002">
<p>Edited by: Mohd Kaisan Mahadi, National University of Malaysia, Malaysia</p>
</fn>
<fn fn-type="edited-by" id="fn0003">
<p>Reviewed by: Jannathul Firdous, University of Kuala Lumpur, Malaysia</p>
<p>Ros Siran, Faculty of Medicine UiTM, Malaysia</p>
</fn>
<corresp id="c001">&#x002A;Correspondence: Wenfeng Yu, <email>wenfengyu@gmc.edu.cn</email></corresp>
<fn fn-type="equal" id="fn0001"><p><sup>&#x2020;</sup>These authors have contributed equally to this work</p></fn>
</author-notes>
<pub-date pub-type="epub">
<day>14</day>
<month>02</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="collection">
<year>2024</year>
</pub-date>
<volume>15</volume>
<elocation-id>1490640</elocation-id>
<history>
<date date-type="received">
<day>16</day>
<month>09</month>
<year>2024</year>
</date>
<date date-type="accepted">
<day>11</day>
<month>11</month>
<year>2024</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2025 Cao, Hu, Yu, Long, Sun, Lei, Xie and Yu.</copyright-statement>
<copyright-year>2025</copyright-year>
<copyright-holder>Cao, Hu, Yu, Long, Sun, Lei, Xie and Yu</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>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) and the copyright owner(s) 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.</p>
</license>
</permissions>
<abstract>
<sec>
<title>Introduction</title>
<p>Due to the anti-inflammatory and antioxidant properties of cynaroside (Cyn), it may be useful in the treatment of cerebral ischemia/reperfusion injury (I/R). This study aims to evaluate the effect of Cyn on cerebral ischemia/reperfusion injury.</p>
</sec>
<sec>
<title>Methods</title>
<p>Transient middle cerebral artery occlusion model (tMCAO) and oxygen and glucose deprivation/reperfusion (OGD/R) microglia models were used to evaluate the effect of Cyn. The direct interaction between Cyn and Alox15 was investigated through bioinformatics, molecular docking and biolayer interferometry.</p>
</sec>
<sec>
<title>Results</title>
<p>tMCAO mice treated with Cyn show improved neurological deficits, reduced infarct volume and edema, and inhibition of microglial activation. In addition, Cyn inhibited tMCAO-induced Alox15 expression. Cyn significantly reduced the overproduction of the M1 microglia-regulated pro-inflammatory cytokines NLRP3, ASC, and cleaved caspase-1, as well as the overproduction of IL-1&#x03B2; and IL-18, induced by tMCAO or OGD/R. Cyn also inhibits the expression of Tfrc, COX2, and Acsl4 in tMCAO and OGD/R-treated mice and BV-2 cells.</p>
</sec>
<sec>
<title>Discussion</title>
<p>These results suggest that Cyn may attenuate cerebral ischemia/reperfusion injury by inhibiting Alox15 to reduce inflammation and reduce ferroptosis. This study reveals the underlying molecular mechanism of Cyn in the treatment of ischemic stroke.</p>
</sec>
</abstract>
<kwd-group>
<kwd>Cynaroside</kwd>
<kwd>cerebral ischemia/reperfusion injury</kwd>
<kwd>ferroptosis</kwd>
<kwd>inflammation</kwd>
<kwd>Alox15</kwd>
</kwd-group>
<counts>
<fig-count count="6"/>
<table-count count="0"/>
<equation-count count="0"/>
<ref-count count="42"/>
<page-count count="10"/>
<word-count count="5991"/>
</counts>
<custom-meta-wrap>
<custom-meta>
<meta-name>section-at-acceptance</meta-name>
<meta-value>Stroke</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
<body>
<sec sec-type="intro" id="sec1">
<label>1</label>
<title>Introduction</title>
<p>Cerebral ischemia/reperfusion (I/R) injury is a significant cause of morbidity and mortality worldwide (<xref ref-type="bibr" rid="ref1">1</xref>). Current mainstream treatments, such as intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT), have shown efficacy in restoring blood flow and improving clinical outcomes. However these treatments have limitations, including a narrow therapeutic window and potential for hemorrhagic complications (<xref ref-type="bibr" rid="ref2">2</xref>). Additionally, the inflammatory response and oxidative stress associated with reperfusion can exacerbate neuronal damage (<xref ref-type="bibr" rid="ref3">3</xref>). Therefore identifying a novel therapeutic approach has become a critical aspect of all research into cerebral ischemia/reperfusion injury.</p>
<p>When cerebral blood flow decreases, whether temporarily or permanently, it can cause cerebral ischemia, which can result in necrosis and cell death (<xref ref-type="bibr" rid="ref3">3</xref>). The subsequent restoration of blood supply, known as reperfusion, may exacerbate the harm to ischemic brain tissue (<xref ref-type="bibr" rid="ref4">4</xref>). Specifically, cerebral ischemia/reperfusion (I/R) injury is a progressive form of brain damage that is strongly associated with neurologic impairments, cognitive dysfunction, and significant injury to the brain (<xref ref-type="bibr" rid="ref5">5</xref>). Additionally, reactive oxygen species (ROS) and oxidative stress are increased, as is neuroinflammation and neuronal apoptosis (<xref ref-type="bibr" rid="ref6">6</xref>).</p>
<p>Astrocytes, another critical player in the central nervous system, have been shown to contribute significantly to the pathophysiology of cerebral I/R injury. These glial cells are &#x201C;double-edged sword&#x201D; in the pathological process of CIRI with both neurotoxic and neuroprotective effects on the central nervous system. These cells have been shown to contribute sighnificantly to mitigating oxidative stress (<xref ref-type="bibr" rid="ref7">7</xref>). Compared to healthy brains, the presence of activated astrocytes is increased in ischemic brains, highlighting the potential involvement of activated astrocytes in the pathogenesis of cerebral ischemia/reperfusion injury (<xref ref-type="bibr" rid="ref8">8</xref>).</p>
<p>Cynaroside is a flavonoid compound abundant in various plant species including honeysuckle, chrysanthemum, and celery, which exhibits a range of beneficial properties such as antioxidant and anti-inflammatory effects (<xref ref-type="bibr" rid="ref9">9</xref>). Research has indicated that Cyn possesses antioxidative, anti-inflammatory, antibacterial, antiviral, anticancer, and other bioactive functions (<xref ref-type="bibr" rid="ref10">10</xref>). Notably, recent studies have demonstrated the cardioprotective potential of Cyn <italic>in vitro</italic>, therefore Cyn also improved neurodegeneration diseases such as Alzheimer&#x2019;s and polyglutamine disease by suppressing insulin/IGF-1 signaling pathway, yet there is a scarcity of literature regarding its neuroprotective effects (<xref ref-type="bibr" rid="ref11">11</xref>, <xref ref-type="bibr" rid="ref12">12</xref>).</p>
<p>Cerebral ischemia&#x2013;reperfusion (I/R) injury following thrombolysis in stroke results in the rapid demise of neurons in the ischemic penumbra (<xref ref-type="bibr" rid="ref13">13</xref>). The pathophysiology of neuronal injury subsequent to cerebral ischemia is intricate, with a growing body of research indicating the significant involvement of the inflammatory response in this process (<xref ref-type="bibr" rid="ref14">14</xref>). Elevated levels of inflammatory cytokines and pro-inflammatory mediators exacerbate neurological damage and facilitate ferroptosis in neural cells post-ischemia (<xref ref-type="bibr" rid="ref15">15</xref>). Therefore, we infer that Cyn may serve as an intervention for ischemic stroke by preventing inflammation and ferroptosis.</p>
<p>Cynaroside has demonstrated strong antioxidant and anti-inflammatory effects, crucial in mitigating neuroinflammation and oxidative stress associated with CIRI. Its ability to regulate gene translation related to neuroprotection, reduce ROS, and inhibit pro-inflammatory cytokines underscores its potential as a therapeutic target for cerebral ischemia/reperfusion injury.</p>
<p>The Alox15 pathway, responsible for the metabolism of arachidonic acid, has been identified as a significant factor in cerebral ischemia injury (<xref ref-type="bibr" rid="ref16">16</xref>). Studies have shown an upregulation of Alox15 expression in brain tissue following 24&#x202F;h of ischemia, with knockdown of Alox15 resulting in reduced brain injury (<xref ref-type="bibr" rid="ref17">17</xref>). These findings highlight the importance of investigating the molecular mechanisms underlying the role of Alox15 in cerebral ischemia injury. Further research is needed to elucidate the potential molecular mechanisms involved in iron dysregulation and inflammatory responses triggered by cerebral ischemia&#x2013;reperfusion injury.</p>
<p>Using middle cerebral artery occlusion/reperfusion (MCAO/R) mouse models, and oxygen&#x2013;glucose deprivation/reoxygenation (OGD/R)-induced BV-2 cells <italic>in vitro</italic>, this study aims to examine the effects and mechanisms of Cyn. In this study, the neuroprotective effects of Cyn against ischemic stroke, its modulation of ferroptosis and inflammation, as well as the regulatory pathways involved, will be investigated.</p>
</sec>
<sec sec-type="results" id="sec2">
<label>2</label>
<title>Results</title>
<sec id="sec3">
<label>2.1</label>
<title>Cyn protects against tMCAO-induced brain injury</title>
<p><xref ref-type="fig" rid="fig1">Figure 1A</xref> illustrates the effects of Cyn on a mouse model of transient middle cerebral artery occlusion (tMCAO), which replicates cerebral I/R injury. The mice were assessed for their neurologic behavior based on their deficit scores after MCAO induction. A significantly higher deficit score was observed in MCAO mice compared to sham-operated control mice. Neurological deficit scores decreased significantly after treatment with Cyn (<xref ref-type="fig" rid="fig1">Figure 1B</xref>). Additionally, brain water content, which was elevated in MCAO mice, decreased significantly after Cyn treatment (<xref ref-type="fig" rid="fig1">Figure 1C</xref>). TTC staining was used to visualize the infarcted area, and the percentage of infarcted area in each brain section was calculated. Infarction on the ipsilateral side of the brain was not detected following the sham operation, whereas it was significantly increased following the MCAO. Treatment with Cyn inhibited tMCAO-induced infarction (<xref ref-type="fig" rid="fig1">Figure 1D</xref>). On the ipsilateral side of tMCAO, HE staining revealed neuronal loss in the cerebral cortex region. Cyn treatment mitigated this neuronal loss (<xref ref-type="fig" rid="fig1">Figure 1E</xref>).</p>
<fig position="float" id="fig1">
<label>Figure 1</label>
<caption>
<p>Cyn protects against tMCAO-induced brain injury and decreases microglia activation <italic>in vivo</italic>. <bold>(A)</bold> Diagram of animal model establishment and Cyn administration. A mouse model of tMCAO was established to mimic cerebral I/R injury <italic>in vivo</italic>. Mice were subjected to MCAO for 1&#x202F;h followed by reperfusion (R) for 24&#x202F;h. Cyn treatment at the dose of 10 (L) and 20&#x202F;mg/kg (H) was performed 30&#x202F;min before MCAO and 12&#x202F;h after MCAO, respectively. After 24&#x202F;h reperfusion, mice or brains were collected for further detection. <bold>(B)</bold> Assessment of neurological deficit scores. <bold>(C)</bold> Detection of brain water content. <bold>(D)</bold> Evaluation of infarct area with TTC staining. <bold>(E)</bold> Determination of neuron deficit with HE staining in the cerebral cortex region in the ipsilateral side of tMCAO. &#x002A; represents <italic>p</italic>&#x202F;&#x003C;&#x202F;0.05; &#x002A;&#x002A; represents <italic>p</italic>&#x202F;&#x003C;&#x202F;0.01; &#x002A;&#x002A;&#x002A; represents <italic>p</italic>&#x202F;&#x003C;&#x202F;0.001. <italic>n</italic>&#x202F;=&#x202F;3. The control group was used for comparison. Data are shown as mean&#x202F;&#x00B1;&#x202F;SD.</p>
</caption>
<graphic xlink:href="fneur-15-1490640-g001.tif"/>
</fig>
</sec>
<sec id="sec4">
<label>2.2</label>
<title>Alox15 was identified as a key target of Cyn</title>
<p>Using SwissTargetPrediction, we identified Alox15 as having the highest betweenness centrality (<xref ref-type="fig" rid="fig2">Figure 2A</xref>). Subsequently, we conducted an analysis of the binding model between Cyn and the Alox15 protein using molecular docking technology. The result of 3D-molecular docking illustrated that Cyn can effectively bind to the residues Gly211 and His212 of the Alox15 protein, demonstrating a stabilizing binding conformation (<xref ref-type="fig" rid="fig2">Figure 2B</xref>). Bio-layer interferometry (BLI) results demonstrated a kinetic association constant (Kd) of 21.63&#x202F;&#x03BC;M for Cyn binding to Alox15 (<xref ref-type="fig" rid="fig2">Figure 2C</xref>). Western blotting and immunofluorescence analyses indicated an upregulation of Alox15 expression following tMCAO, which was subsequently downregulated in the presence of Cyn, with a more pronounced downregulation observed at higher doses of Cyn compared to lower doses (<xref ref-type="fig" rid="fig2">Figures 2D</xref>&#x2013;<xref ref-type="fig" rid="fig2">F</xref>).</p>
<fig position="float" id="fig2">
<label>Figure 2</label>
<caption>
<p>Alox15 was identified as a key target of Cyn. <bold>(A)</bold> The top 10 Cyn targets were visualized. <bold>(B)</bold> 3D-molecular docking of Cyn with OTUD7B. <bold>(C)</bold> Interaction of the Cyn with Alox15 by biolayer interferometry. <bold>(D)</bold> The protein expressions of Alox15 in cortex of cerebral ischemia reperfusion model with Cyn treatment. <bold>(E)</bold> Statistical analysis of the protein expression intensity of Alox15. <bold>(F)</bold> Immunofluorescence for Alox15 and counterstaining with DAPI in the cortex regions in the ipsilateral side of tMCAO. &#x002A;&#x002A; represents <italic>p</italic>&#x202F;&#x003C;&#x202F;0.01. <italic>n</italic>&#x202F;=&#x202F;3. The control group was used for comparison. Data are shown as mean&#x202F;&#x00B1;&#x202F;SD.</p>
</caption>
<graphic xlink:href="fneur-15-1490640-g002.tif"/>
</fig>
</sec>
<sec id="sec5">
<label>2.3</label>
<title>Cyn inhibited inflammation after tMCAO <italic>in vivo</italic></title>
<p>Iba1 immunofluorescence staining showed that increased Iba1-positive microglia within the infarct region on the ipsilateral side of tMCAO, which decreased when treated with Cyn (<xref ref-type="fig" rid="fig3">Figure 3A</xref>). Cyn treatment in tMCAO mice decreased NLRP3-mediated inflammatory cytokine IL-1&#x03B2; and IL-18 release, as evidenced by ELISA tests, in the mice (<xref ref-type="fig" rid="fig3">Figures 3B</xref>,<xref ref-type="fig" rid="fig3">C</xref>). The levels of NLRP3, ASC, and cleaved caspase-1 were elevated following tMCAO, but decreased following Cyn treatment, However, full-length caspase-1 expression was not differentiated among the experimental groups (<xref ref-type="fig" rid="fig3">Figures 3D</xref>,<xref ref-type="fig" rid="fig3">E</xref>). These findings underscore the potential of Cyn in attenuating NLRP3 inflammasome-mediated inflammation subsequent to tMCAO.</p>
<fig position="float" id="fig3">
<label>Figure 3</label>
<caption>
<p>Cyn decreases tMCAO-induced NLRP3-inflammasome level <italic>in vivo</italic>. <bold>(A)</bold> Immunofluorescence for Iba1 and counterstaining with DAPI in the cortex regions in the ipsilateral side of tMCAO. <bold>(B)</bold> ELISA blot detected the secretion of IL-1&#x03B2;. <bold>(C)</bold> ELISA blot detected the secretion of IL-18. <bold>(D,E)</bold> Western blot detected the expression of NLRP3, ASC and caspasaae-1 and cleaved caspase-1. &#x002A; represents <italic>p</italic>&#x202F;&#x003C;&#x202F;0.05; &#x002A;&#x002A; represents <italic>p</italic>&#x202F;&#x003C;&#x202F;0.01; &#x002A;&#x002A;&#x002A; represents <italic>p</italic>&#x202F;&#x003C;&#x202F;0.001. <italic>n</italic>&#x202F;=&#x202F;3. The control group was used for comparison. Data are shown as mean&#x202F;&#x00B1;&#x202F;SD.</p>
</caption>
<graphic xlink:href="fneur-15-1490640-g003.tif"/>
</fig>
</sec>
<sec id="sec6">
<label>2.4</label>
<title>Cyn suppressed tMCAO-induced ferroptosis <italic>in vivo</italic></title>
<p>She et al. reported that factors involved in ferroptosis regulation include lipid peroxidation, Fe<sup>2+</sup> levels and GPX4 activity (<xref ref-type="bibr" rid="ref18">18</xref>). Rats subjected to MCAO/R for an hour, reactive oxygen species, malondialdehyde, glutamate, and iron levels significantly increased, while glutathione levels decreased. After treatment with Cyn, these changes were reversed (<xref ref-type="fig" rid="fig4">Figures 4A</xref>&#x2013;<xref ref-type="fig" rid="fig4">E</xref>). Moreover, The Western Blot analysis revealed a significant upregulation in the expression levels of COX2, Tfrc, and Acsl4 following tMCAO, with a subsequent decrease in protein expression levels after treatment with Cyn (<xref ref-type="fig" rid="fig4">Figures 4F</xref>,<xref ref-type="fig" rid="fig4">G</xref>).</p>
<fig position="float" id="fig4">
<label>Figure 4</label>
<caption>
<p>Cyn inhibited ferroptosis in MCAO/R mice. <bold>(A)</bold> Measurement and statistical analysis of ROS level. <bold>(B)</bold> Measurement and statistical analysis of MDA level. <bold>(C)</bold> Measurement and statistical analysis of glutamate level. <bold>(D)</bold> Measurement and statistical analysis of Fe<sup>2+</sup> in brain tissue. <bold>(E)</bold> Measurement and statistical analysis of GSH level. <bold>(F)</bold> Western blot and quantification of Tfrc, Acsl4 and COX2 of mice. <bold>(G)</bold> Statistical analysis of the expression intensity of Tfrc, Acsl4 and COX2. &#x002A; represents <italic>p</italic>&#x202F;&#x003C;&#x202F;0.05; &#x002A;&#x002A; represents <italic>p</italic>&#x202F;&#x003C;&#x202F;0.01; &#x002A;&#x002A;&#x002A; represents <italic>p</italic>&#x202F;&#x003C;&#x202F;0.001. <italic>n</italic>&#x202F;=&#x202F;3. The control group was used for comparison. Data are shown as mean&#x202F;&#x00B1;&#x202F;SD.</p>
</caption>
<graphic xlink:href="fneur-15-1490640-g004.tif"/>
</fig>
</sec>
<sec id="sec7">
<label>2.5</label>
<title>Cyn inhibited inflammation in OGD/R induced BV-2 cells</title>
<p>We further investigated Cyn&#x2019;s effects <italic>in vitro</italic> using BV-2 microglia cells with oxygen and glucose deprivation/reoxygenation (OGD/R) and varying concentrations of Cyn (25, 50&#x202F;&#x03BC;M). ELISA analysis indicated an increase in the release of IL-1&#x03B2; and IL-18 mediated by NLRP3 inflammasome after OGD/R, which was attenuated by Cyn treatment (<xref ref-type="fig" rid="fig5">Figures 5A</xref>,<xref ref-type="fig" rid="fig5">B</xref>). Western blot analysis revealed that the expression levels of NLRP3, ASC, and caspase-1, key NLRP3 inflammasome proteins, were higher in OGD/R-treated cells but decreased in Cyn-treated cells. Full-length caspase-1 expression showed no significant difference (<xref ref-type="fig" rid="fig5">Figures 5C</xref>,<xref ref-type="fig" rid="fig5">D</xref>).</p>
<fig position="float" id="fig5">
<label>Figure 5</label>
<caption>
<p>Cyn decreases OGD/R -induced NLRP3-inflammasome level <italic>in vivo</italic>. <bold>(A)</bold> ELISA detected the secretion of IL-1&#x03B2; after the treatment of Cyn. <bold>(B)</bold> ELISA detected the secretion of IL-18 after the treatment of Cyn. <bold>(C)</bold> Western blot detected the expression of NLRP3, ASC and caspase-1 and cleaved caspase-1 after the treatment of Cyn. <bold>(D)</bold> Statistical analysis of the expression intensity of NLRP3, ASC and caspase-1 and cleaved caspase-1. &#x002A; represents <italic>p</italic>&#x202F;&#x003C;&#x202F;0.05;&#x002A;&#x002A; represents <italic>p</italic>&#x202F;&#x003C;&#x202F;0.01. <italic>n</italic>&#x202F;=&#x202F;5. The control group was used for comparison. Data are shown as mean&#x202F;&#x00B1;&#x202F;SD.</p>
</caption>
<graphic xlink:href="fneur-15-1490640-g005.tif"/>
</fig>
</sec>
<sec id="sec8">
<label>2.6</label>
<title>Cyn suppressed OGD/R-induced ferroptosis in BV-2 cells</title>
<p>We observed that Cyn modulates ferroptosis post-OGD/R treatment by increasing ROS, MDA, glutamate, and iron levels, while reducing GSH levels, as evidenced by increased levels of ROS, MDA, glutamate, and iron. Remarkably, Cyn intervention reversed these alterations (<xref ref-type="fig" rid="fig6">Figures 6A</xref>&#x2013;<xref ref-type="fig" rid="fig6">E</xref>). Correspondingly, Cyn downregulated COX2, Tfrc, and Acsl4 levels in OGD/R-exposed cells, consistent with our observations in mice (<xref ref-type="fig" rid="fig6">Figures 6F</xref>,<xref ref-type="fig" rid="fig6">G</xref>).</p>
<fig position="float" id="fig6">
<label>Figure 6</label>
<caption>
<p>Cyn inhibited ferroptosis in OGD/R-treated BV-2 cells. <bold>(A)</bold> Measurement and statistical analysis of ROS level. <bold>(B)</bold> Measurement and statistical analysis of MDA level. <bold>(C)</bold> Measurement and statistical analysis of glutamate level. <bold>(D)</bold> Measurement and statistical analysis of Fe<sup>2+</sup> in brain tissue. <bold>(E)</bold> Measurement and statistical analysis of GSH level. <bold>(F)</bold> Western blot detected the expression of Tfrc, Acsl4 and COX2 after the treatment of Cyn. <bold>(G)</bold> Statistical analysis of the expression intensity of Tfrc, Acsl4 and COX2. &#x002A; represents <italic>p</italic>&#x202F;&#x003C;&#x202F;0.05; &#x002A;&#x002A; represents <italic>p</italic>&#x202F;&#x003C;&#x202F;0.01. <italic>n</italic>&#x202F;=&#x202F;3. The control group was used for comparison. Data are shown as mean&#x202F;&#x00B1;&#x202F;SD.</p>
</caption>
<graphic xlink:href="fneur-15-1490640-g006.tif"/>
</fig>
</sec>
</sec>
<sec sec-type="discussion" id="sec9">
<label>3</label>
<title>Discussion</title>
<p>Cerebral ischemia continues to be the primary contributor to morbidity and mortality on a global scale, with no pharmaceutical interventions demonstrating efficacy in clinical trials for ischemic stroke (<xref ref-type="bibr" rid="ref19">19</xref>, <xref ref-type="bibr" rid="ref20">20</xref>). Consequently, the quest for viable and safe neuroprotective agents is of paramount importance and urgency. In recent times, natural herbal extracts have garnered significant interest due to their remarkable biological properties in various ailments (<xref ref-type="bibr" rid="ref21">21</xref>). Cyn, a flavonoid compound prevalent in plants like honeysuckle, chrysanthemum, and celery, exhibits antioxidant, anti-inflammatory, and other beneficial effects (<xref ref-type="bibr" rid="ref22">22</xref>, <xref ref-type="bibr" rid="ref23">23</xref>). Recent research has indicated that Cyn demonstrates cardioprotective effects <italic>in vitro</italic>, yet there is limited investigation into its neuroprotective properties (<xref ref-type="bibr" rid="ref24">24</xref>, <xref ref-type="bibr" rid="ref25">25</xref>). These results align with previous studies, which also reported the anti-inflammatory properties of Cyn (<xref ref-type="bibr" rid="ref23">23</xref>, <xref ref-type="bibr" rid="ref26">26</xref>). However, our findings differ from other studies, which did not observe significant improvements in neurobehavioral outcomes with Cyn treatment. This study presents novel findings demonstrating the neuroprotective effects of Cyn in rats with cerebral ischemia/reperfusion (I/R) injury. Experimental results illustrate that Cyn administration enhances neurological function and reduces brain edema following cerebral I/R injury. Additionally, histological analyses using TTC and HE staining further support the therapeutic efficacy of Cyn in rats subjected to middle cerebral artery occlusion (MCAO).</p>
<p>Mechanistically, Cyn enhances neurobehavior by modulating various signaling pathways. Specifically, Cyn has been shown to reduce neuroinflammation and oxidative stress (<xref ref-type="bibr" rid="ref23">23</xref>, <xref ref-type="bibr" rid="ref27">27</xref>), which are critical factors in neurobehavioral deficits. Cyn plays a significant role in clinical impacts and gene translation regulation, contributing to its overall neuroprotective effects (<xref ref-type="bibr" rid="ref28">28</xref>). Additionally, Cyn has been demonstrated to regulate gene translation by influencing the expression of genes involved in neuroprotection and inflammation.Our study provided additional insights into these mechanisms, revealing that Cyn&#x2019;s neuroprotective effects are mediated through the inhibition of pro-inflammatory cytokine production and remitting total reactive oxygen species.</p>
<p>In recent years, the burgeoning discipline of network pharmacology has made a notable impact on the practice of traditional Chinese medicine (<xref ref-type="bibr" rid="ref29">29</xref>, <xref ref-type="bibr" rid="ref30">30</xref>). A key aspect of network pharmacology involves the prediction of drug molecular mechanisms through intricate biological network models that elucidate interactions between targets and diseases (<xref ref-type="bibr" rid="ref31">31</xref>). In this study, we utilized SwissTargetPrediction to forecast potential targets of Cyn, followed by the application of molecular docking technology to assess the binding affinity between Cyn and Alox15 targets. The study revealed that Cyn exhibited the highest binding affinity to Alox15, a finding corroborated by BLI experiments.</p>
<p>Arachidonate 15-lipoxygenase (Alox15) is an enzyme responsible for oxygenating polyunsaturated fatty acids and biomembranes, leading to the generation of multiple lipid metabolites in the Alox15 pathway (<xref ref-type="bibr" rid="ref32">32</xref>). These small molecules act as potent signaling mediators implicated in various inflammatory diseases and cancers (<xref ref-type="bibr" rid="ref33">33</xref>). Using animal and cell models, Lei demonstrated that Alox15 is involved in ferroptosis and inflammation after cerebral ischemia&#x2013;reperfusion injury (<xref ref-type="bibr" rid="ref17">17</xref>). Alox15 inhibitor therapy may protect neurons from SSAT1-induced iron death and loss of viability caused by TBH (tert-Butyl hydroperoxide) treatment, suggesting a role for Alox15 in brain injury pathogenesis (<xref ref-type="bibr" rid="ref16">16</xref>). During cerebral ischemia&#x2013;reperfusion injury, Alox15 may play a crucial role in regulating ferroptosis and inflammation. The present study also observed an increase in Iba1-positive microglia in the cortical regions of the ipsilateral brain hemisphere following tMCAO. In our study, tMCAO and oxygen&#x2013;glucose deprivation/reoxygenation (OGD/R) increased NLRP3 inflammasome activation, resulting in elevated levels of pro-inflammatory cytokines, particularly IL-1&#x03B2; and IL-18 in M1 microglia. NLRP3 inflammasome components, such as NLRP3, ASC, and cleaved caspase-1, were reduced by Cyn treatment and inflammation-induced neuronal wound healing was decreased.</p>
<p>The present study also observed an increase in BV-2 microglia activity tMCAO and OGD/R, which linked to NLRP3 inflammasome activation. NLRP3 inflammasome components, such as NLRP3, ASC, and cleaved caspase-1, were reduced by Cyn treatment, leading to decreased levels of pro-inflammatory cytokines IL-1&#x03B2; and IL-18 in M1 microglia. This indicates that Cyn can modulate microglial activation and inflammation-induced neuronal damage.</p>
<p>Ischemia&#x2013;reperfusion injury is associated with ferroptosis, a newly discovered cellular mechanism that contributes to neuronal death (<xref ref-type="bibr" rid="ref34">34</xref>, <xref ref-type="bibr" rid="ref35">35</xref>). Apart from iron overload and lipid peroxidation, cerebral ischemia&#x2013;reperfusion models have been shown to cause mitochondrial damage, including changes in mitochondrial membrane potential, cytochrome c release, and reactive oxygen species (ROS) generation (<xref ref-type="bibr" rid="ref36">36</xref>, <xref ref-type="bibr" rid="ref37">37</xref>). Mitochondria play a crucial role in ATP synthesis through oxidative phosphorylation, leading to the generation of ROS, which is integral to the process of ferroptosis (<xref ref-type="bibr" rid="ref38">38</xref>, <xref ref-type="bibr" rid="ref39">39</xref>). In the current investigation, it was observed that treatment with Cyn resulted in the inhibition of ALOX15 expression and a decrease in oxidative stress, accompanied by a reduction in reactive oxygen species (ROS) production, enhanced glutathione (GSH) activity, and decreased levels of malondialdehyde (MDA), iron, and glutamate in mice with transient middle cerebral artery occlusion (tMCAO) as well as BV-2 cells subjected to oxygen&#x2013;glucose deprivation/reperfusion (OGD/R).</p>
<p>In conclusion, our results indicate that Cyn possesses neuroprotective properties against ischemic stroke by targeting Alox15, suppressing microglial activation and polarization, downregulating NLRP3-inflammasome components, and mitigating ferroptosis. Therefore, it is suggested that Cyn may represent a promising therapeutic strategy for cerebral I/R injury.</p>
</sec>
<sec sec-type="materials|methods" id="sec10">
<label>4</label>
<title>Materials and methods</title>
<sec id="sec11">
<label>4.1</label>
<title>Animal model of tMCAO</title>
<p>In this study, a total of 50 mice aged 10&#x2013;12&#x202F;weeks and weighing 30-35&#x202F;g were obtained from Guizhou Medical University and housed under controlled conditions at 22&#x00B0;C and 45&#x2013;55% humidity with a 12&#x202F;h light/dark cycle and access to water and food <italic>ad libitum</italic>. Following a one-week acclimatization period, the mice were randomly assigned to one of four groups: (1) Sham, (2) MCAO, (3) MCAO + Cyn (L), (4) MCAO + Cyn (H). Consistent with prior studies (<xref ref-type="bibr" rid="ref40">40</xref>, <xref ref-type="bibr" rid="ref41">41</xref>), embolization was performed on the right hemisphere of the brain using a 10&#x202F;&#x00D7;&#x202F;microscope in a sterile environment. Induction and maintenance anesthesia were administered using 5% isoflurane and 2.5% halothane, respectively, prior to surgery (RWD Life Science Co, Shenzhen, China). The carotid sheath, common carotid artery, and internal carotid artery were exposed. Using a 0.26&#x202F;mm nylon thread, a plug is inserted into the internal carotid artery through the common carotid artery and advanced into the intracranial space. After ligating and securing the plug, skin sutures are placed. Following a 150-min middle cerebral artery embolization procedure, the plug was retracted approximately 1&#x202F;cm to restore blood flow. Mice in the sham group underwent identical surgical interventions without middle cerebral artery occlusion. Cyn (MCE, Wuhan, China) was administered intraperitoneally at doses of 10&#x202F;mg/kg (low dose) or 20&#x202F;mg/kg (high dose) 30&#x202F;min before middle cerebral artery occlusion. For the MCAO group, saline was administered to mice. Animals displaying a 30% reduction in cerebral blood flow during MCAO, as well as those that expired during reperfusion, were excluded from subsequent experiments. An evaluation of neurological deficit scores was performed in mice after they had received 24&#x202F;h of reperfusion. Afterward, mice were euthanized with 200&#x202F;mg/kg pentobarbital, and brain tissues were collected.</p>
</sec>
<sec id="sec12">
<label>4.2</label>
<title>Bio-layer interferometry</title>
<p>In the Octet RED96 System (ForteBio), the bio-layer interferometry (BLI) assay was used to determine Cyn&#x2019;s binding affinity to Alox15. Biotinylation was performed according to the manufacturer&#x2019;s instructions on ReadTM Streptavidin Biosensors to immobilize Alox15 proteins. The association of immobilized protein with flowing corosolic acid was detected with various concentrations of Cyn in the mobile phase. A running buffer is the PBS puffer with 0.1% DMSO and 0.02% Tween-20 was used for all experiments. Data were analyzed using ForteBio Data Analysis 9.0.</p>
</sec>
<sec id="sec13">
<label>4.3</label>
<title>Evaluation of infarct volume with TTC staining</title>
<p>Following anesthesia, the brains were extracted and cryopreserved at &#x2212;20&#x00B0;C for 15&#x202F;min. Subsequently, the cerebellum and olfactory bulb were excised, and the brain tissue was sectioned into five equal parts in the coronal plane, each approximately 2&#x202F;mm thick. The sections were then immersed in 0.4% TTC (Sangon Biotech Co., Ltd., Shanghai, China) solution at 37&#x00B0;C in a light-protected water bath, with regular flipping every 5&#x202F;min to ensure uniform staining. Non-infarcted regions appeared red, while infarcted areas exhibited a gray-white hue. Following staining, the TTC solution was decanted, and the brain tissue was fixed in 4% paraformaldehyde. After a period of 6&#x202F;h, the caudal side of each brain slice was examined using the Image-Pro Plus 6.0 system. The infarct size and total area of each slice were quantified, and the percentage of infarct area relative to the entire brain area was computed.</p>
</sec>
<sec id="sec14">
<label>4.4</label>
<title>Detection of brain water content</title>
<p>After 24&#x202F;h of reperfusion, the whole brain was harvested and weighed (wet weight). A second weight was obtained after drying the brain at 100&#x00B0;C. In order to determine the percentage of water in the brain, the formula is 100&#x202F;&#x00D7;&#x202F;(wet weight - dry weight)/wet weight.</p>
</sec>
<sec id="sec15">
<label>4.5</label>
<title>Protein evaluation</title>
<p>Protein expression levels were assessed using western blot analysis with antibodies against NLRP3 (Proteintech, No. 68102-1-Ig), ASC (Proteintech, No. 10500-1-AP), and COX2 (Proteintech, No. 66351-1-Ig), anti-caspase-1 (Proteintech, No. 22915-1-AP), anti- Alox15 (CST, No. 82129), Cleaved Caspase-1 (Bioss, No. bs-10743R), anti-Tfrc (Proteintech, No. 65236-1-Ig), anti-Acsl4 (Proteintech, No. 22401-1-AP) and anti-<italic>&#x03B2;</italic>-actin (Proteintech, No. 81115-1-RR).</p>
</sec>
<sec id="sec16">
<label>4.6</label>
<title>Molecular docking</title>
<p>ChemDraw was used to generate Cyn&#x2019;s structure, while Protein Data Bank (PDB) was used to retrieve proteins&#x2019; crystal structures. Subsequently, both the obtained protein structures and the Cyn structure were inputted into Autodock. Prior to docking, the protein structures underwent preparation steps involving the removal of water molecules and addition of hydrogen atoms. The docking process was executed using an algorithm, and the highest scoring binding model was selected for visualization of the interactions between Alox15 and Cyn.</p>
</sec>
<sec id="sec17">
<label>4.7</label>
<title>Cells and cell treatment</title>
<p>After the BV-2 microglia cells were suspended in a sugar-free and serum-free medium, they were incubated in an hypoxic environment containing 0.2% O<sub>2</sub> and 5% CO<sub>2</sub> for 3&#x202F;h before being switched to a sugar-containing medium containing 10% fetal bovine serum, and further incubated at 37&#x00B0;C with 5% CO<sub>2</sub> for 24&#x202F;h. Using standard culture conditions, control cells and cell models of cerebral ischemia&#x2013;reperfusion injury were treated with various treatments according to experimental protocols.</p>
</sec>
<sec id="sec18">
<label>4.8</label>
<title>Measurement of cellular ferroptosis levels</title>
<p>Brain tissues were removed, mechanically homogenized under an ice water bath, centrifuged at 2500&#x202F;r/min for 10&#x202F;min, and the supernatant was taken for determination. The Malondialdehyde (MDA), Reactive oxygen species (ROS), Glutathione peroxidase 4 (GPXs), Glutathione (GSH) and Fe<sup>2+</sup> assay kit (Solarbio, Beijing, China) instructions were followed.</p>
</sec>
<sec id="sec19">
<label>4.9</label>
<title>Enzyme-linked immunosorbent assay</title>
<p>Blood was collected from mice&#x2019;s eye sockets overnight at 4&#x00B0;C then centrifuged at 3000&#x202F;r/min for 5&#x202F;min to separate the upper serum and lower serum. The ELISA kits were purchased from Absin (Shanghai) biotechnology company. The procedure that was followed was based on the instructions on the kit.</p>
</sec>
<sec id="sec20">
<label>4.10</label>
<title>Western blot analysis</title>
<p>Rat brain tissue from the ischemia&#x2013;reperfusion area or microglia proteins were obtained with the RIPA lysis buffer supplemented with protease and phosphatase inhibitors. The homogenates were then centrifuged at 12,000&#x202F;rpm for 15&#x202F;min at 4&#x00B0;C to remove debris. And then protein concentrations were determined using the BCA protein assay kit. Each sample of protein were isolated equally to 30&#x202F;&#x03BC;g by electrophoresis and then transferred to PVDF membranes. The membranes were placed into primary antibodies against Alox15, NLRP3, ASC, Cleaved Caspase-1, Caspase-1, COX2, Trfc, Acsl4 and <italic>&#x03B2;</italic>-acting overnight at 4&#x00B0;C after being blocked with 5% non-fat dry milk in TBS-T at 36&#x00B0;C. Subsequently, the membranes were then washed with TBS-T and incubated with HRP-conjugated secondary antibodies for an hour at 36&#x00B0;C. Protein bands were visualized using an enhanced chemiluminescence (ECL) detection kit and quantified by densitometry using ImageJ software.</p>
</sec>
<sec id="sec21">
<label>4.11</label>
<title>Neurological deficit assessment using longa score</title>
<p>Neurological function was assessed 24&#x202F;h after reperfusion by an investigator blinded to the treatment groups. The scoring was based on a five-point scale, as described by longa et al. (<xref ref-type="bibr" rid="ref42">42</xref>): 0, no neurological deficit (normal behavior); 1, failure to fully extend the contralateral forelimb; 2, circling to the contralateral side when held by the tail; 3, falling to the contralateral side; 4, no spontaneous walking with a depressed level of consciousness.</p>
</sec>
<sec id="sec211">
<label>4.12</label>
<title>Statistical analysis</title>
<p>The data, with the exception of neurological deficit scores, are presented as mean&#x202F;&#x00B1;&#x202F;standard deviation. Multivariate analysis was applied to assess the relationships between different variables, using techniques such as principal component analysis (PCA) to reduce dimensionality and identify the key patterns in the data ANOVAs and Tukey&#x2019;s multiple comparison tests were used to assess the statistical significance of the differences between groups. GraphPad Prism 7.0 software was used to conduct all statistical analyses, and a significance level of 0.05 was set for all statistical analyses. Statistical analysis was conducted using Kruskal-Wallis and Dunn&#x2019;s multiple comparison tests.</p>
</sec>
</sec>
</body>
<back>
<sec sec-type="data-availability" id="sec22">
<title>Data availability statement</title>
<p>The data used to support the findings of this study are available from the corresponding author upon reasonable request.</p>
</sec>
<sec sec-type="ethics-statement" id="sec23">
<title>Ethics statement</title>
<p>The animal study was approved by the Ethics Committee of Guizhou Medical University. The study was conducted in accordance with the local legislation and institutional requirements.</p>
</sec>
<sec sec-type="author-contributions" id="sec24">
<title>Author contributions</title>
<p>WC: Conceptualization, Investigation, Methodology, Validation, Writing &#x2013; original draft, Writing &#x2013; review &#x0026; editing. YH: Formal analysis, Writing &#x2013; original draft, Writing &#x2013; review &#x0026; editing. XY: Methodology, Software, Writing &#x2013; review &#x0026; editing. TL: Software, Writing &#x2013; review &#x0026; editing. BS: Resources, Writing &#x2013; review &#x0026; editing. SL: Conceptualization, Investigation, Validation, Writing &#x2013; review &#x0026; editing. PX: Resources, Writing &#x2013; review &#x0026; editing. WY: Writing &#x2013; review &#x0026; editing.</p>
</sec>
<sec sec-type="funding-information" id="sec25">
<title>Funding</title>
<p>The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study was funded by the Department of Education of Guizhou Province (Guizhou Teaching and Technology [2023]015).</p>
</sec>
<sec sec-type="COI-statement" id="sec26">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec sec-type="disclaimer" id="sec27">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
<fn-group>
<title>Abbreviations</title>
<fn fn-type="abbr">
<p>Cyn, Cynaroside; I/R, ischemia/reperfusion; ROS, Reactive oxygen species; MDA, Malondialdehyde; GSH, Glutathione; tMCAO, transient middle cerebral artery occlusion; OGD/R, oxygen&#x2013;glucose deprivation/reperfusion; Alox15, Arachidonate 15-Lipoxygenase; BLI, Bio-layer interferometry; ELISA, Enzyme-linked immunosorbent assay.</p>
</fn>
</fn-group>
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