Protective Role and Mechanism of Action of Garlic in OrganIschemia-reperfusion Injury: Where do we Stand?

Introduction: Ischemia-reperfusion injury (IRI) is a major cause of morbidity and mortality in surgeries and conditions like stroke and organ transplantation. Despite restoring blood flow, IRI-induced damage remains a critical unmet therapeutic challenge. This review aims to summarize the protective effects of garlic against organ IRI, focusing on its underlying cellular and molecular mechanisms. Methods: We conducted a comprehensive narrative review of the current literature to gather and synthesize data from preclinical and clinical studies investigating the effects of garlic and its bioactive compounds (e.g., allicin) on various models of organ IRI. Results: The compiled evidence demonstrates that garlic and its constituents exert significant protective effects against IRI in multiple organs, including the heart, brain, liver, and kidney. Key mechanisms include potent reductions in oxidative stress markers (e.g., MDA), inflammation (e.g., TNF-α, IL-6), and apoptosis, alongside enhancements in antioxidant defenses (e.g., SOD, GSH). Discussion: The findings position garlic as a promising multi-target therapeutic agent against IRI, primarily by modulating pivotal pathways involved in inflammation and oxidative damage. Its efficacy across diverse organ systems underscores its translational potential. Limitations of the current evidence include variability in study designs, garlic formulations, and doses used. Conclusion: Garlic demonstrates substantial potential for mitigating IRI-related complications. Further standardized clinical research is warranted to validate these protective effects and establish optimal treatment protocols for human application.