Skip to main content Skip to main navigation menu Skip to site footer

The potential of MLC901 as adjuvant therapy for traumatic spinal cord injury by multi-pathway biomechanism: a systematic review


Background: Traumatic spinal cord injury (tSCI) is a severe neurological condition that causes long-term nerve function impairment and can even cause death. Further efforts are needed to find better therapy for this condition to improve patients' quality and life expectancy. Moleac 901 (MLC901) is a phytopharmacological refinement that incorporates important molecules to facilitate progenitor nerve cell amplification and differentiation and has significant neuroprotective effects in tSCI cases. This systematic review aims to discover the potential of MLC901 as adjuvant therapy for traumatic spinal cord injury by multi-pathway biomechanism.

Methods: Researchers searched for data sources using three databases (PubMed, Science Direct, and Google Scholar) using the keywords “MLC901” and “Spinal Cord Injury.” Articles are included if related to the potential and biomechanism of MLC901 and/or its constituent components in tSCI therapy, using RCT designs, observational, animal studies, and/or original research, including national and international articles from 2013-2023. Article selection followed PRISMA's guidelines for measuring the quality of systematic reviews.

Results: Total of 123 articles were obtained from the database search, and then 13 articles were identified that met the review requirements. Of the 13 articles reviewed, two were related to MLC901 therapy in tSCI: one animal study article and one cohort study in humans. In contrast, the other 11 articles are animal and pharmacological analysis studies discussing the benefits of MLC901 components for tSCI therapy. The MLC901's active ingredients, such as paeoniflorin, safflower yellow, salvianolic acid B, and astragali radix-angelicae sinensis radix, have demonstrated their potential in targeting multiple pathways involved to prevent inflammation, improve microcirculation, protect damaged nerve cells, and promote nerve repair and regeneration.

Conclusion: MLC901 acts primarily as an adjuvant treatment for spinal cord injury by promoting a neuroprotective effect, inhibiting apoptosis, stimulating neurite growth, and reducing pro-inflammatory cytokines.


  1. Alizadeh A, Dyck SM, Karimi-Abdolrezaee S. Traumatic spinal cord injury: An overview of pathophysiology, models and acute injury mechanisms. Front Neurol. 2019;10(March):1–25.
  2. Anjum A, Yazid MD, Daud MF, Idris J, Hwei Ng AM, Naicker AS, et al. Spinal cord injury: Pathophysiology, multimolecular interactions, and underlying recovery mechanisms. Int J Mol Sci. 2020;21(20):1–35.
  3. Kang Y, Ding H, Zhou H, Wei Z, Liu L, Pan D, et al. Epidemiology of worldwide spinal cord injury: a literature review. J Neurorestoratology. 2017;Volume 6(1):1–9.
  4. National Spinal Cord Injury Statisctical Center. Spinal Cord Injury (SCI) 2016 Facts and Figures at a Glance. J Spinal Cord Med. 2016;39(4):493–4.
  5. Lapuente-Chala C, Céspedes-Rubio A. Biochemical events related to glial response in spinal cord injury. Rev Fac Med. 2018;66(2):269–77.
  6. Liu X, Zhang Y, Wang Y, Qian T. Inflammatory Response to Spinal Cord Injury and Its Treatment. World Neurosurg. 2021;155:19–31.
  7. Ahuja CS, Wilson JR, Nori S, Kotter MRN, Druschel C, Curt A, et al. Traumatic spinal cord injury. Nat Rev Dis Prim. 2017;3.
  8. Abbaszadeh F, Fakhri S, Khan H. Targeting apoptosis and autophagy following spinal cord injury: Therapeutic approaches to polyphenols and candidate phytochemicals. Pharmacol Res. 2020;160(July):105069.
  9. Zhao N, Huang W, Cãtãlin B, Scheller A, Kirchhoff F. L-Type Ca2+ Channels of NG2 Glia Determine Proliferation and NMDA Receptor-Dependent Plasticity. Front Cell Dev Biol. 2021;9(October).
  10. Parolisi R, Boda E. NG2 Glia: Novel Roles beyond Re-/Myelination. Neuroglia. 2018;1(1):151–75.
  11. Bradbury EJ, Burnside ER. Moving beyond the glial scar for spinal cord repair. Nat Commun. 2019;10(1):1–15.
  12. Hellenbrand DJ, Quinn CM, Piper ZJ, Morehouse CN, Fixel JA, Hanna AS. Inflammation after spinal cord injury: a review of the critical timeline of signaling cues and cellular infiltration. J Neuroinflammation. 2021;18(1):1–16.
  13. Zhang Y, Mamun A Al, Yuan Y, Li Q, Xiong J, Yang S, et al. Acute spinal cord injury: Pathophysiology and pharmacological intervention (Review). Mol Med Rep. 2021;23(6):1–18.
  14. Cao S, Hou G, Meng Y, Chen Y, Xie L, Shi B. Network Pharmacology and Molecular Docking-Based Investigation of Potential Targets of Astragalus membranaceus and Angelica sinensis Compound Acting on Spinal Cord Injury. Dis Markers. 2022;1–10.
  15. Fan ZK, Lv G, Wang YF, Li G, Yu DS, Wang YS, et al. The protective effect of salvianolic acid B on blood-spinal cord barrier after compression spinal cord injury in rats. J Mol Neurosci. 2013;51(3):986–93.
  16. Fu J, Fan H Bin, Guo Z, Wang Z, Li XD, Li J, et al. Salvianolic acid B attenuates spinal cord ischemia-reperfusion-induced neuronal injury and oxidative stress by activating the extracellular signal-regulated kinase pathway in rats. J Surg Res. 2014;188(1):222–30. Available from: doi: 10.1016/j.jss.2013.11.1118
  17. Kuboyama T, Kominato S, Nagumo M, Tohda C. Recovery from spinal cord injury via M2 microglial polarization induced by Polygalae Radix. Phytomedicine. 2021;82(153452).
  18. Tao B, Wang Q, Cao J, Yasen Y, Ma L, Sun C, et al. The mechanisms of Chuanxiong Rhizoma in treating spinal cord injury based on network pharmacology and experimental verification. Ann Transl Med. 2021;9(14):1145–1145.
  19. Wahyudi, Islam AA, Hatta M, Adhimarta W, Faris M, Mustamir N, et al. The role of MLC901 in reducing VEGF as a vascular permeability marker in rats with spinal cord injury. Ann Med Surg. 2022;75(103344):1–5.
  20. Wang B, Dai W, Shi L, Teng H, Li X, Wang J, et al. Neuroprotection by Paeoniflorin against Nuclear Factor Kappa B-Induced Neuroinflammation on Spinal Cord Injury. Biomed Res Int. 2018;
  21. Xu J, Xiao-Qiang E, Liu HY, Tian J, Yan JL. Angelica sinensis attenuates inflammatory reaction in experimental rat models having spinal cord injury. Int J Clin Exp Pathol. 2015;8(6):6779–85.
  22. Zhou D, Liu B, Xiao X, Dai P, Ma S, Huang W. The effect of safflower yellow on spinal cord ischemia reperfusion injury in rabbits. Oxid Med Cell Longev. 2013;
  23. Zhou LY, Song Z, Zhou LW, Qiu Y, Hu N, Hu Y, et al. Protective role of astragalus injection in spinal cord ischemiareperfusion injury in rats. Neurosciences. 2018;23(2):116–21.
  24. Kumar R, Htwe O, Baharudin A, Rhani SA, Ibrahim K, Nanra JS, et al. Spinal cord injury–assessing tolerability and use of combined rehabilitation and NeuroAiD (SATURN) study–primary results of an exploratory study. J Spinal Cord Med. 2022;1–5.
  25. Fu J, Fan H Bin, Guo Z, Wang Z, Li XD, Li J, et al. Salvianolic acid B attenuates spinal cord ischemia-reperfusion-induced neuronal injury and oxidative stress by activating the extracellular signal-regulated kinase pathway in rats. J Surg Res. 2014;188(1):222–30.
  26. Guo Z, Peng R, Song J, Integrated H, Chinese T, Hospital WM, et al. Potential mechanism of Astragali radix-Angelicae sinensis radix in the treatment of spinal cord injury based on network pharmacology and molecular docking. TMR Pharmacol Res. 2021;1(2):1–10.
  27. Xie Y, Zhang H, Zhang Y, Wang C, Duan D, Wang Z. Chinese Angelica Polysaccharide (CAP) Alleviates LPS-Induced Inflammation and Apoptosis by Down-Regulating COX-1 in PC12 Cells. Cell Physiol Biochem. 2018;49(4):1380–8.
  28. Anwar MA, Al Shehabi TS, Eid AH. Inflammogenesis of secondary spinal cord injury. Front Cell Neurosci. 2016;10(98):1–24.
  29. Thompson CD, Zurko JC, Hanna BF, Hellenbrand DJ, Hanna A. The therapeutic role of interleukin-10 after spinal cord injury. J Neurotrauma. 2013;30(15):1311–24.
  30. Ranuh IGMAR, Sari GM, Utomo B, Suroto NS, Fauzi A Al. Systematic Review and Meta-Analysis of the Efficacy of MLC901 (NeuroAiD IITM) for Acute Ischemic Brain Injury in Animal Models. J Evidence-Based Integr Med. 2021;26:1–7.
  31. Zhang Q, Yang H, An J, Zhang R, Chen B, Hao DJ. Therapeutic Effects of Traditional Chinese Medicine on Spinal Cord Injury: A Promising Supplementary Treatment in Future. Evidence-based Complement Altern Med. 2016;1–18.
  32. Wang Y, Ren Q, Zhang X, Lu H, Chen J. Neuroprotective mechanisms of calycosin against focal cerebral ischemia and reperfusion injury in rats. Cell Physiol Biochem. 2018;45(2):537–46.
  33. Huang X, Wang Z, Shen Z, Lei F, Liu YM, Chen Z, et al. Projection of global burden and risk factors for aortic aneurysm–timely warning for greater emphasis on managing blood pressure. Ann Med. 2022;54(1):553–64.
  34. Zhong J, Zhou J, Sun H, Wu Y, Wu Y, Li M. Effects of salvia miltiorrhiza injection on apoptosis of schwann cells induced by hydrogen peroxide. Ann Palliat Med. 2021;10(1):625–32.
  35. Kim JH, Song JW, Joo H, Park JW, Lee BJ, Cho JH, et al. A Review on the Pharmacological Activities of Salvia Miltiorrhizae Radix Using International Classification of Disease, 10th Revision (ICD-10) Codes. Processes. 2022;10(1860):1–30.
  36. Huang Z, Wang J, Li C, Zheng W, He J, Wu Z, et al. Application of natural antioxidants from traditional Chinese medicine in the treatment of spinal cord injury. Front Pharmacol. 2022;13(October):1–16.
  37. Wang L, Botchway BOA, Liu X. The Repression of the HMGB1-TLR4-NF-κB Signaling Pathway by Safflower Yellow May Improve Spinal Cord Injury. Front Neurosci. 2021;15(803885):1–9.
  38. Seo KH, Choi SY, Jin Y, Son H, Kang YS, Jung SH, et al. Anti-inflammatory role of Prunus persica L. Batsch methanol extract on lipopolysaccharide-stimulated glial cells. Mol Med Rep. 2020;21(5):2030–40.
  39. Elshamy AI, Abdallah HMI, El Gendy AENG, El-Kashak W, Muscatello B, De Leo M, et al. Evaluation of Anti-inflammatory, Antinociceptive, and Antipyretic Activities of Prunus persica var nucipersica (Nectarine) Kernel 1. Planta Med. 2019;85(11–12):1016–23.
  40. Kant R, Shukla RK, Shukla A. A Review on Peach (Prunus persica): An Asset of Medicinal Phytochemicals. Int J Res Appl Sci Eng Technol. 2018;6(1):2186–200.
  41. Song Z, Yin F, Xiang B, Lan B, Cheng S. Systems Pharmacological Approach to Investigate the Mechanism of Acori Tatarinowii Rhizoma for Alzheimer’s Disease. Evidence-Based Complement Altern Med. 2018;1–20.
  42. Zhang Y, Wu Y, Fu Y, Lin L, Lin Y, Zhang Y, et al. Anti-Alzheimer’s Disease Molecular Mechanism of Acori Tatarinowii Rhizoma Based on Network Pharmacology. Med Sci Monit Basic Res. 2020;26:e924203.
  43. Yan L, Liu Z, Xu L, Qian Y, Song P, Wei M. Identification of volatile active components in Acori Tatarinowii Rhizome essential oil from different regions in China by C6 glioma cells. BMC Complement Med Ther. 2020;20(255):1–13.
  44. Freyermuth-Trujillo X, Segura-Uribe JJ, Salgado-Ceballos H, Orozco-Barrios CE, Coyoy-Salgado A. Inflammation: A Target for Treatment in Spinal Cord Injury. Cells. 2022;11(17):1–34.

How to Cite

Wardhana, D. P. W. ., Satyarsa, A. B. S., Rosyid, R. M. ., Harmansyah, H. ., Mahadewa, T. G. B. ., Islam, A. A. ., Jawi, I. M. ., & Maliawan, S. . (2023). The potential of MLC901 as adjuvant therapy for traumatic spinal cord injury by multi-pathway biomechanism: a systematic review. Bali Medical Journal, 12(2), 2130–2141.




Search Panel

Dewa Putu Wisnu Wardhana
Google Scholar
BMJ Journal

Agung Bagus Sista Satyarsa
Google Scholar
BMJ Journal

Rohadi Muhammad Rosyid
Google Scholar
BMJ Journal

Husni Harmansyah
Google Scholar
BMJ Journal

Tjokorda Gde Bagus Mahadewa
Google Scholar
BMJ Journal

Andi Asadul Islam
Google Scholar
BMJ Journal

I Made Jawi
Google Scholar
BMJ Journal

Sri Maliawan
Google Scholar
BMJ Journal