Astragali Radix-Carthami Flos alleviate brain-heart injury after cerebral ischemia/reperfusion via regulating TSPO signaling.

Ischemic stroke is often accompanied by secondary cardiac dysfunction, yet its underlying pathogenesis remains under investigation. Astragali Radix-Carthami Flos (ARCF) is a drug pair with medicine food homology, commonly used for cerebrovascular and cardiovascular diseases. This study found that in the middle cerebral artery occlusion/reperfusion rat model, ARCF management mitigated CI/R-induced brain-heart injury, as evidenced by improved neurological function, reduced cerebral and cardiac damage, restored serum biomarker levels, and enhanced overall cardiac function. Transcriptomic analysis, combined with network pharmacology and molecular docking, identified oxidative phosphorylation process and reactive oxygen species (ROS) production as key pathogenic mechanisms, with TSPO as a central target. Mechanistic studies revealed that the ARCF maintained mitochondrial homeostasis by inhibiting the TSPO/VDAC1/MCU pathway in the brain and the TSPO-VDAC1 axis in the heart. These findings highlight the potential of ARCF as a functional food-derived intervention for mitigating stroke-induced brain-heart injury, offering new insight into the food-based management of neurocardiac complications.