Natural compounds targeting inflammation and oxidative stress in intestinal ischemia-reperfusion injury: a comprehensive review

Abstract

Background

Intestinal ischemia-reperfusion (I/R) injury is a severe condition characterized by significant morbidity and mortality, caused by the temporary disruption of blood supply to the intestines followed by reperfusion. This pathological process induces oxidative stress, inflammation, and cellular damage, which collectively impair intestinal function. Recent studies have explored natural therapeutic approaches, including the use of plants, herbal formulations, and phytochemicals, to mitigate the detrimental effects of intestinal I/R injury. Numerous plant-derived compounds, such as flavonoids, alkaloids, and terpenoids, exhibit antioxidant, anti-inflammatory, and cytoprotective properties, offering potential to modulate the underlying pathophysiological mechanisms.

Purpose

This review aims to consolidate current knowledge regarding the therapeutic potential of plants and their bioactive constituents in managing intestinal I/R injury. It also seeks to identify promising phytochemicals and plant-derived formulations that can alleviate oxidative damage, support gut barrier integrity, and promote tissue repair. The objective is to provide a comprehensive analysis of the mechanistic pathways targeted by these natural compounds and to highlight areas requiring further research for optimizing clinical applications.

Method

The review systematically compiled data from clinical trials, systematic reviews, meta-analyses, and recent peer-reviewed studies published over the past decade. The search was conducted using four major databases: PubMed, Scopus, Web of Science, and Google Scholar, with key terms including "phytochemicals," "intestinal I/R injury," "herbal formulations," and "bioactive compounds." Studies were selected based on their focus on the therapeutic effects of phytochemicals on intestinal I/R injury, particularly those addressing oxidative stress, inflammation, and intestinal barrier disruption. The data were categorized according to phytochemical classes, mechanisms of action, and therapeutic outcomes.

Results

Phytochemicals such as flavonoids, polyphenols, and alkaloids exhibit potent antioxidant and anti-inflammatory effects. These compounds reduce reactive oxygen species (ROS) levels, inhibit NF-κB activation, and regulate cytokine release, thereby mitigating inflammatory responses. Herbal decoctions, particularly those rich in bioactive compounds and polysaccharides, have demonstrated efficacy in maintaining intestinal integrity, protecting tight junction proteins, minimizing bacterial translocation, and preventing endotoxemia. Additionally, these natural formulations have shown potential in minimizing tissue damage, promoting gut repair, and reducing the risk of systemic complications, including sepsis and multiple organ dysfunction syndrome (MODS).

Conclusion

Phytochemicals, herbal extracts and herbal decoctions offer promising complementary therapeutic options for managing intestinal I/R injury. Through their multi-targeted effects on oxidative stress, inflammation, and intestinal barrier integrity, these natural compounds can significantly reduce tissue damage and support recovery. Further research is essential to elucidate their precise mechanisms of action and to establish their efficacy in clinical settings, paving the way for integrating herbal-based interventions into I/R injury management strategies.