Recently, the importance of the neurovascular unit, which is comprised of neurons, endothelial cells and astrocytes, has received great attention in the field of stroke, because stroke affects not only neurons, but also astrocytes and microvessels. Within the neurovascular unit, endothelial cells are critical for maintaining normal hemodynamic and metabolic homeostasis. Vascular damage during ischemia often leads to the disruption of the blood-brain barrier and dysregulation of vascular tonus, eventually causing substantial cell death. The Chinese herbs Rhodiolase, Notoginseng, Folium Ginkgo and Rhizoma Chuanxiong have been used for stroke ancillary treatment in China for years. Braintone contains four major active ingredients: Radix Rhodiolase Essence (a major constituent of Rhodiola rosea L.), Radix Notoginseng Essence, Folium Ginkgo Essence and Rhizoma Chuanxiong.
A recent study published in the Neural Regeneration Research (Vol. 8, No. 19, 2013) combined novel in vivo and in vitro experiments to show that Braintone dose-dependently increased the expression of hypoxia inducible factor 1α, heme oxygenase-1 and vascular endothelial growth factor in the ischemic cortex of rats with middle cerebral artery occlusion. Braintone-containing serum increased levels of hypoxia-inducible factor 1α mRNA and protein, and elevated vascular endothelial growth factor mRNA and heme oxygenase-1 protein expression in a dose-dependent manner in human umbilical vein endothelial cells after glucose-oxygen deprivation. Collectively, these experimental findings suggest that Braintone has neuroprotective effects on ischemia-induced brain damage via the up-regulation of hypoxia-inducible factor 1α, heme oxygenase-1 and vascular endothelial growth factor expression in vascular endothelial cells.