Neuroprotective effects of ginkgolide B against ischemic stroke: a review of current literature

Extensive evidences has shown the promising effects of Ginkgo biloba consumption on several diseases such as Alzheimer's and Parkinson’s diseases, and ischemic stroke, etc. Several studies also have reported its beneficial role on motor activity and cognitive functions. This species contain a unique class of diterpenes, namely Ginkgolide B, which possess several pharmacological activities such as protective effect against cardiovascular disease; the most important causes of death worldwide. The promising effects of Ginkgolide B on stroke, both ischemic and hemorrhagic, are suggested by an overwhelming body of scientific evidences. Many studies have shown that the increase of sirt1 expression, the suppression of nuclear factor kappa-B (NF-kB), the inhibition of the PI3K/Akt pathway and toll-like receptor 4 (TLR4)/NF-kB, the up-regulation of heme oxygenase 1, erythropoietin secretion and anti-apoptotic protein expression, the inhibition of pro-apoptotic proteins expression, and the improvement of endothelial NO synthesis are the main molecular mechanisms involved in the protective effect of Ginkgolide B on ischemic stroke. In this review, all the available data on the chemistry, mechanisms of neuroprotection and clinical impacts of Ginkgolide B are critically discussed.