Shengping Luo,1,2 Jiayu Zhu,3 Le Yang,1,2 Jing Liu,1,2 Yihui Deng4 1School of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, People’s Republic of China; 2Hunan Province Key Laboratory of Cerebrovascular Disease Prevention and Treatment of Integrated Traditional Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, People’s Republic of China; 3The First Clinical College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, People’s Republic of China; 4School of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, People’s Republic of ChinaCorrespondence: Yihui Deng, School of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, People’s Republic of China, Email dengyihui@hnucm.edu.cnAbstract: Ischemic stroke remains one of the leading causes of death and long-term disability worldwide. The current standard-of-care therapies—intravenous thrombolysis and mechanical thrombectomy—restore cerebral blood flow but may paradoxically evoke cerebral ischemia–reperfusion injury. Recent studies have revealed that ferroptosis, a form of regulated cell death dependent on iron, plays a pivotal role in cerebral ischaemia-reperfusion injury. Traditional Chinese herbal formulas and their bioactive components can modulate ferroptosis, thereby mitigating brain damage induced by ischemia-reperfusion. This article reviews the molecular mechanisms of ferroptosis and its pathophysiological roles in cerebral ischaemia-reperfusion. It focuses particularly on the key mechanisms underlying the therapeutic effects of Chinese herbal medicines in targeting ferroptosis. The aim is to provide a theoretical basis for developing novel therapeutics.Keywords: ferroptosis, Chinese herbal medicine, cerebral ischemia-reperfusion injury, protective effect
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