Research progress on traditional Chinese medicine remodeling the immune microenvironment in ischemic stroke by regulating HIF-1α-mediated glycolytic reprogramming
- VernacularTitle:中药调控HIF-1α介导的糖酵解重编程重塑缺血性卒中免疫微环境的研究进展
- Author:
Jiayu DU
1
;
Senyu WANG
1
;
Chen BAI
2
;
Yingxu HAO
1
;
Xiangzhe LIU
2
Author Information
1. Encephalopathy Center of The First Affiliated Hospital of Henan University of Chinese Medicine，Zhengzhou 450099，China;The First Clinical Medical College of Henan University of Chinese Medicine，Zhengzhou 450046，China
2. Encephalopathy Center of The First Affiliated Hospital of Henan University of Chinese Medicine，Zhengzhou 450099，China
- Publication Type:Journal Article
- Keywords:
glycolysis;
lactylation modification;
metabolic reprogramming;
immune microenvironment;
ischemic stroke;
traditional Chinese medicine
- From:
China Pharmacy
2026;37(17):2332-2337
- CountryChina
- Language:Chinese
-
Abstract:
Ischemic stroke （IS） is a serious cerebrovascular disease with high clinical incidence. Cerebral ischemia and hypoxia can induce metabolic reprogramming of cellular glycolysis. Hypoxia-inducible factor-1α （HIF-1α） serves as the core transcription factor in the hypoxic response. This article systematically reviews the molecular mechanisms of HIF-1α-mediated glycolytic reprogramming， elaborates on the effects of this metabolic alteration on the functional status of different immune cells， and summarizes the research progress of traditional Chinese medicine （TCM） interventions in this pathological process. HIF-1α reshapes glucose metabolic flux and shifts cellular metabolism toward glycolysis by regulating the transcription of key genes， including glucose transporters， glycolytic rate-limiting enzymes， and mitochondrial oxidative inhibitors. This metabolic disturbance can regulate the activation status， phenotypic differentiation， and functional remodeling of microglia， astrocytes， and peripherally infiltrated immune cells， thereby participating in the mediation of neuroinflammatory responses after IS. Moreover， multiple signaling pathways and the metabolite of glycolysis lactate can exert feedback regulation on this metabolic-immune process. Various active components of TCM and herbal formulas， such as astragaloside Ⅳ， salvianolic acid C， Ginkgo biloba extract， and Mailuo shutong pills， can inhibit abnormal glycolysis， reduce lactate accumulation， and restore the homeostasis of glucose oxidative metabolism by regulating signaling pathways including AMP-activated protein kinase/mammalian target of rapamycin/HIF-1α， HIF-1α/pyruvate kinase M2， and HIF-1α/lactate dehydrogenase A. Consequently， they effectively alleviate neuroimmune inflammation and attenuate ischemic brain injury.
