Traditional Chinese medicine (TCM) exerts unique therapeutic effects, while some unfavorable physicochemical properties limit its therapeutic potential. Exosomes are involved in cellular communication and may enhance the efficacy of TCM. The relationship between TCM and exosomes is supported by the connection between exosomes and the theory of “Qi, Xue and Ye” (one of the basic theories of TCM). Also, the functional resemblance between exosomes and Qi, which is less researched. We fill this gap by systematically summarizing exosomes from different sources with therapeutic effects and exploring the mechanisms and implications of exosomes in TCM treatment. TCM and exosomes undergo two-way communication, with TCM affecting exosomes and exosomes loading TCM monomers. The dual roles of exosomes as destructive agents in disease development are also emphasized; current obstacles and future scope of TCM–exosome therapeutic strategies are fully discussed. The objective of this review is to stimulate further investigation and create a new application of TCM.

Indobufen is a new generation of antiplatelet agents and has been shown to have antithrombotic effects in animal models. However, its therapeutic potential and mechanisms against cerebral ischemia/reperfusion (I/R) injury remain unclear. In this study, we evaluated the in vivo neuroprotective effects of indobufen through both pretreatment and posttreatment regimens in a rat model of middle cerebral artery occlusion/reperfusion (MCAO/R). In vitro, human umbilical vein endothelial cells (HUVECs) subjected to oxygen-glucose deprivation/reoxygenation (OGD/R) were employed to investigate the relationship between indobufen and the pyroptosis-associated NF-κB/Caspase-1/GSDMD pathway. The pharmacodynamic tests revealed that indobufen ameliorated I/R injury by decreasing the level of thromboxane B₂ (TXB₂), infarct size, brain edema and neurological impairment in rats and rescuing cell pyroptosis in HUVECs. The underlying mechanisms were probably related to pyroptosis suppression by regulating the NF-κB/Caspase-1/GSDMD pathway. Overall, these studies indicate that indobufen exerts protective and therapeutic effects against I/R injury by pyroptosis suppression via downregulating NF-κB/Caspase-1/GSDMD pathway.