Evidence map›Paper›PMID 41999222›Full record

ArticleMediators of inflammation2026

Rougan Tongluo Decoction Initiates Neuroprotection Against Cerebral Ischemia by Activating the Endogenous SLC6A8-Creatine-EARS2 Mitochondrial Pathway.

Changze Ou, Zheng-Ping Bai, Guo-Heng Hu, Binbin Chen, Da-Hua Wu, Hua-Jun Long

Abstract read
In one paragraph

Article in Mediators of inflammation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Changze OuGraduate School, Hunan University of Chinese Medicine, Changsha, 410208, Hunan, China, hnctcm.edu.cn.
Zheng-Ping BaiHunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine (The Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine), Changsha, 410006, Hunan, China.
Guo-Heng HuThe First Hospital of Hunan University of Chinese Medicine, Changsha, 410007, Hunan, China, hnctcm.edu.cn.
Binbin ChenGraduate School, Hunan University of Chinese Medicine, Changsha, 410208, Hunan, China, hnctcm.edu.cn.
Da-Hua WuHunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine (The Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine), Changsha, 410006, Hunan, China.ORCID https://orcid.org/0000-0002-0943-0037
Hua-Jun LongHunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine (The Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine), Changsha, 410006, Hunan, China.ORCID https://orcid.org/0000-0002-7489-3943

Funding

2022 National Famous Elderly Chinese Medicine Experts Inheritance Workshop Construction Project [2022] 75Hunan Provincial Health and Wellness Commission Scientific Research Program Project C202303078160Natural Science Foundation of Changsha City kq2208145Natural Science Foundation of Hunan Province 2026JJ81855
6 · The paper itself

Abstract

objectiveThe traditional Chinese medicine formula Rougan Tongluo Decoction (RGTL) was widely used to treat neurological injury after cerebral ischemia, though its specific underlying mechanisms remain unknown. This study investigates the mechanisms via which RGTL helps alleviate cerebral ischemic injury to provide theoretical support for its application in cerebral ischemia treatment.

methodsA middle cerebral artery occlusion reperfusion (MCAO/R) rat model was established and treated with RGTL, N-acetylcysteine (NAC), creatine, or sh-EARS2. Network pharmacology and metabolomics were conducted to analyze the key efficacy-related metabolites in the hippocampal tissue. An OGD/R cell model was constructed using PC12 cells and treated with creatine, RGTL-containing serum, sh-SLC6A8, and sh-EARS2. Neuronal damage in the hippocampal tissues was assessed using HE and Nissl staining. Neuronal cell viability, mitochondrial membrane potential, and ROS levels were measured using CCK8, JC-1, and DCFH-DA assays. Mitochondrial damage was determined using transmission electron microscopy. The expression of SLC6A8/EARS2 axis and mitochondrial-related proteins (cytochrome c [Cyt c]) was examined using RT-qPCR and Western blot.

resultsRGTL treatment reduced TNF-α, IL-6, and ROS levels while increasing ATP and JC-1 in brain tissues of MCAO/R rats, thereby alleviating mitochondrial damage. The neuroprotective effects of RGTL were more pronounced than those of NAC. Succinic acid and creatine were identified as active drug ingredients and differential metabolites that may mediate RGTL's therapeutic effects via MMP3, GAMT, SLC6A8, and CASP3. Silencing SLC6A8 abolished the protective effects of creatine against OGD/R-induced neuronal cell apoptosis and mitochondrial damage. Creatine could bind to the EARS2 protein. Cell and animal experiments demonstrated that silencing EARS2 blocked the therapeutic effects of creatine in OGD/R and MCAO/R models, reversing its inhibition of neuronal apoptosis and mitochondrial damage.

conclusionCreatine mediates the neuroprotective effects of RGTL by binding to EARS2, thus inhibiting mitochondrial damage and neuronal apoptosis to improve ischemic brain injury.

Indexed as

Brain IschemiaCreatineDrugs, Chinese HerbalMitochondriaNeuroprotective AgentsAnimalsApoptosisCell SurvivalHippocampusMaleMembrane Potential, MitochondrialPC12 CellsRatsRats, Sprague-DawleyReactive Oxygen SpeciesCreatineDrugs, Chinese HerbalNeuroprotective AgentsReactive Oxygen Speciesapoptosiscerebral ischemic injurycreatineEARS2mitochondriaRGTL

Identifiers

PMID41999222
PMCPMC13091013

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.