Application of Traditional Chinese Medicine in the different pathological stages of ischemic stroke: Target immune cells

Immune cells play a pivotal role in the complex pathophysiology of ischemic stroke (IS), with their functions dynamically shifting throughout the disease's progression. Throughout the different pathological stages of IS, various immune cells, such as microglia, T cells, neutrophils, NK cells, and mononuclear/macrophages, contribute uniquely to the disease's trajectory. Although thrombolytic therapy remains the standard treatment for IS, its efficacy is limited by a narrow therapeutic window, underscoring the need for alternative or adjunctive therapeutic strategies. Increasingly, the therapeutic potential of Traditional Chinese Medicine (TCM) has gained recognition for its beneficial effects across multiple phases of IS. Notably, TCM interventions have been shown to attenuate early inflammatory responses and neural injury by targeting immune cells, particularly microglia. Furthermore, during the recovery phase, TCM may promote white matter repair and functional recovery through the regulation of neuroimmune interactions. This review offers a comprehensive analysis of the dynamic roles and signaling pathways of immune cells in IS, and further investigates the mechanistic basis of TCM's immunomodulatory effects. While considerable progress has been made, significant challenges remain in fully elucidating the underlying mechanisms of TCM and in optimizing its integration into current IS treatment frameworks.