Rutin as a Potential Therapeutic Agent for Multi-Organ Ischemia–Reperfusion Injury: From Multidimensional Mechanisms to Clinical Translation

Ischemia–reperfusion injury (IRI) is a prevalent pathological process in clinical settings characterized by complex pathogenesis involving the interplay of oxidative stress, inflammation, mitochondrial dysfunction, and diverse cell death pathways. Fundamentally, IRI manifests as a complication arising from reperfusion therapies aimed at restoring blood flow following ischemia. Despite the existence of various therapeutic strategies, the development of effective interventions for IRI remains a significant challenge. Rutin, a low-molecular-weight flavonoid glycoside ubiquitously present in vegetables, fruits, and herbal medicines, exhibits promising therapeutic potential due to its pleiotropic biological activities, including antioxidant, anti-inflammatory, and cytoprotective effects against cell death. This review systematically elucidates the molecular mechanisms underlying the protective effects of rutin against IRI and synthesizes evidence from preclinical studies regarding its diverse modes of action. However, the clinical application of rutin is currently hampered by its relatively low bioavailability. Future research should prioritize the development of innovative pharmaceutical formulations to enhance its bioavailability, thereby fully unlocking its clinical translational value.