Imbalance and Management of Iron Homeostasis and the Intervention of Chinese Medicine in Intracerebral Hemorrhage: A Review

Intracerebral hemorrhage (ICH) is a devastating form of stroke associated with high morbidity and mortality. Numerous researches confirmed that the imbalance of iron homeostasis in perihematoma caused by haemoglobin-derived iron plays a major role in secondary brain damage, which is a key variable influencing the long-term prognosis following ICH. However, brain damage caused by iron is varied and complex, and its diagnosis and treatment have not yet formed a clear specification. This review summarizes and analyses the existing evidence on the imbalance of iron homeostasis and its mechanism of neurotoxicity, the expression of iron regulatory and transport proteins, current status of diagnosis and treatment, especially the intervention of Chinese Medicine. It comes to the conclusion that neurotoxicity of iron overload in ICH has become a subject of consensus. Iron regulatory and transport proteins play a key role in iron homeostasis, but some of the mechanisms are unclear, and there are no effective intervention measures. Chinese Medicine (CM) therapies including herbal medicine, acupuncture, and other non-medication therapies were confirmed effectively ameliorate iron homeostasis following ICH. However, the mechanism of its efficacy has not been fully elucidated. Therefore, further investigation including large sample and multicenter clinical trial and basic research are required.