Medicinal Plant Research 2025, Vol.15, No.5, 224-232 http://hortherbpublisher.com/index.php/mpr 225 inform evidence-based practice, facilitate standardized use, and guide future clinical and pharmacological research in respiratory medicine. 2 Pharmacological Basis and Mechanisms of Astragalus 2.1 Anti-inflammatory and immunomodulatory effects Astragalus membranaceus and its major bioactive compounds, such as astragaloside IV and polysaccharides, exert potent anti-inflammatory and immunomodulatory effects in respiratory disorders. They suppress inflammatory cell infiltration and inhibit the production of pro-inflammatory cytokines such as TNF-α, IL-6, and IL-1β. Astragaloside IV can suppress NF-κB pathway activation, decrease Th2 cytokines, and affect transcription factors such as STAT6 and RORγt to alleviate airway remodeling and inflammation in asthma. The Astragalus polysaccharides also decrease lung fibrosis and damage by suppressing the TLR4/NF-κB pathway and affecting the balance of Treg/Th17 cells involved in immune homeostasis in asthma and other respiratory disorders (D'Avino et al., 2023) (Figure 1). Besides, Astragalus may control the gut-lung axis by enhancing the composition of gut microbiota, which in turn is responsible for its immunoregulatory impacts on pulmonary pathology (Shen et al., 2019; Wang et al., 2019; Yang and Wang, 2019; Wei et al., 2023). Figure 1Astragalus extracts in the inhibition of allergic and non-allergic inflammation (Adopted from D’Avino et al., 2023) 2.2 Antioxidant and anti-apoptotic activities Astragalus and its components possess potent antioxidant activity, which is essential for protective effects of lung tissue against oxidative stress-induced damage. Astragaloside IV reduces the indicators of oxidative stress, replenishes glutathione levels, and decreases iron levels in lung tissue and hence inhibits ferroptosis, a form of cell death involved in respiratory injury. All these activities are mediated through Nrf2/SLC7A11/GPX4 pathway activation, augmenting cellular antioxidant function. Moreover, Astragalus polysaccharides can inhibit lung tissue apoptosis by regulating key signaling pathways and increasing the redox capacity of cells, inhibiting further pulmonary fibrosis tissue damage in pulmonary fibrosis models and particulate matter-induced lung injury models (Wu et al., 2020; Wang et al., 2022). 2.3 Anti-fibrotic and anti-tumor mechanisms Astragalus has potent anti-fibrotic effects against several genes and pathways involved in pulmonary fibrosis, such as VCAM1, RELA, and JUN. Its bioactive ingredients inhibit collagen synthesis, extracellular matrix deposition, and epithelial-mesenchymal transition that are responsible for fibrosis development. Astragaloside IV also promotes autophagy by the Ras/Raf/MEK/ERK pathway to inhibit aberrant collagen synthesis and promote lung function. In addition, astragalosides and analogs exhibited anti-cancer activities in lung cancer models by suppressing the PI3K/Akt and HIF-1 signaling pathways and hitting targets such as STAT3 and AKT1, showing a potential therapeutic use to the prevention and adjunctive therapy of lung cancers (Bing et al., 2022; Yu et al., 2022; Ding et al., 2025).
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