Notoginseng leaf triterpenes (NLTs), a compound derived from Panax notoginseng, protected against cerebral ischemia and oxygen-glucose deprivation/reoxygenation-induced neuronal injury by activating the nicotinamide phosphoribosyltransferase–sirtuin (SIRT)1/2/3–Forkhead box O3 (Foxo3a)–MnSOD signaling pathway, demonstrating MnSOD’s role as a key effector in NAD+-dependent antioxidant defenses [209,210]. This evidence concerns the gene FOXO3 and Cerebral ischemia.