Danshen (Salvia miltiorrhiza) extract in spinal cord injury (SCI): a systematic review and meta-analysis

This study aims to systematically assess the effectiveness of Danshen (Salvia miltiorrhiza) extract in animal models of spinal cord injury (SCI) and provide high-quality evidence to support the translation from preclinical research to clinical practice.

A systematic review and meta-analysis of 35 randomized controlled trials involving animal models of SCI were conducted. Data were extracted regarding the effects of Danshen extract on motor function (measured by the BBB score), inflammation, oxidative stress, apoptosis, and edema. Subgroup analyses based on model type, drug dosage, and compound type were also performed.

Danshen extract significantly improved motor function at multiple time points (3, 7, 14, and 21 days post-injury). The BBB scores were higher in the treatment group across all time points (SMD = 4.53 at 3 days, p < 0.001). Additionally, Danshen reduced inflammatory markers (TNF-α, IL-1β), oxidative stress (MDA), and apoptotic markers (Caspase-3), while increasing antioxidant activity (SOD). It also significantly reduced spinal cord edema, as indicated by decreased water content in the injury areas (SMD = -3.88, p < 0.00001). Subgroup analysis showed the most significant improvements in contusion and ischemic models, with higher doses (>20 mg/kg) and water-soluble phenolic acids providing the best outcomes.

Danshen extract exhibits significant potential in treating SCI through its diverse mechanisms, such as reducing inflammation, combating oxidative stress, preventing cell death, and alleviating edema. However, further research is needed to refine treatment protocols and establish its clinical relevance.

https://www.crd.york.ac.uk/PROSPERO/recorddashboard.