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Mongolian Medicine ZhenBao Pills (ZBP), also known as Eerdun Wurile or Erden-Urile, is a traditional multi-herbal formulation used in Mongolian medicine. It consists of 29 different medicinal ingredients and is primarily indicated for neurological disorders such as stroke and spinal cord injury. The main active components identified include quercetin, kaempferol, ethyl isobutyric acid, α-tigerol acetate, and ethyl linoleate. Mechanistically, the pills exert their effects through multiple pathways including PI3K-Akt signaling pathway (involved in cell survival and inflammation), IL-17 signaling pathway (inflammation), HIF-1 signaling pathway (hypoxia response), MAPK signaling pathway (cell proliferation/apoptosis), as well as modulation of TUG1/miR-214/HSP27 axis and miR-146a/GPR17 axis. These actions result in anti-apoptotic effects on neurons, inhibition of oxidative stress and inflammatory responses, reduction of regulatory T cell proportion after spinal cord injury via immune modulation pathways (TUG1/miR-214/HSP27), promotion of nerve repair/regeneration after injury by modulating neuronal apoptosis-related genes/proteins such as GPR17 via miR-146a regulation. Clinical studies suggest that adding ZBP to standard therapy improves neurological function recovery post-stroke or spinal cord injury without significant adverse effects[1][2][3][4][5].
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