Medicinal Plant Research 2025, Vol.15, No.5, 224-232 http://hortherbpublisher.com/index.php/mpr 227 polysaccharides can promote alveolar macrophage phagocytic activity, suppress pro-inflammatory cytokine IL-6, IL-8, and TNF-α levels, and reverse lung injury. Astragaloside II can relieve lung injury and histopathological damage by being involved in the process of the mTORC1/GSK-3β pathway suppressing NF-κB-induced inflammation. These findings suggest that Astragalus and its active constituents are powerful adjuncts for the management of COPD via inhibiting inflammation and enhancing lung function, though more clinical trials are required to prove such benefits among human patients (Chu et al., 2016; Tan et al., 2023; Chen et al., 2024). 4.2 Bronchial asthma Astragalus membranaceus is most well known for its anti-asthmatic effect, which is explained by its immune response modulating and down-regulating action on airway inflammation. Experimental and clinical data indicate that Astragalus extracts standardized on the content of polysaccharides are able to inhibit the release of pro-inflammatory mediators, decrease airway hyperresponsiveness, and suppress airway remodeling and fibrosis. Astragaloside IV, the principal saponin, was found to modulate Th2 immune responses, decrease IgE levels, and inhibit sensitization in asthmatic allergy models. Astragalus, in combination with standard treatment, improved lung function and modulated the Treg/Th17 cell ratio in children with remitted asthma, reaffirming its application as an adjunctive treatment in asthma (Wang et al., 2019; D'Avino et al., 2023; Yuan et al., 2023). 4.3 Interstitial lung diseases Astragalus membranaceus's anti-inflammatory and anti-fibrotic effects make it a potential candidate drug for interstitial lung disease. Its bioactive compounds can modulate immune cell function, suppress the secretion of pro-inflammatory cytokines, and inhibit the formation of tissue fibrosis. Research studies in network pharmacology have identified some targets and pathways on which Astragalus polysaccharides exerts its effects, such as regulating genes VCAM1, RELA, and JUN. These polytarget therapies have the ability to slow the progression of interstitial lung disease and improve clinical outcomes, though additional focused clinical trials will be required (Bing et al., 2022; Zhu et al., 2022). 4.4 Pulmonary fibrosis Astragalus membranaceus showed significant anti-fibrotic effects in preclinical and clinical studies of pulmonary fibrosis. Astragalus polysaccharides act on various pathways and mechanisms, regulating the expression of genes involved in fibrosis development, and inhibiting collagen deposition and extracellular matrix formation (Sun et al., 2024) (Figure 2). Systematic reviews and meta-analyses indicate that Astragalus, when used alone or in combination with other herbal medicines, has the potential to improve pulmonary function, exercise tolerance, and quality of life in idiopathic pulmonary fibrosis patients, with an acceptable safety profile. These findings offer evidence to substantiate the use of Astragalus in pulmonary fibrosis as an effective and safe adjunctive therapy, for which large-scale, high-quality randomized controlled trials are still needed to continue building the evidence base (Zhang et al., 2020; Bing et al., 2022; Gong et al., 2022). 5 Studies onAstragalus Formulations and Combination Therapies 5.1 Use in classic traditional Chinese medicine formulas Astragalus membranaceus is one of the fundamental herbs in most classical prescriptions in traditional Chinese medicine (TCM) for preventing and treating respiratory and fibrotic diseases, such as Yupingfeng San and Bu Zhong Yi Qi Tang. Astragalus is often combined with other herbs, i.e., Angelica sinensis and Salvia miltiorrhiza, for enhanced therapeutic activity, particularly in chronic respiratory and fibrotic diseases. Astragalus combined with Angelica sinensis has, for example, been found to have greater therapeutic effect in experimental idiopathic pulmonary fibrosis models than either individually, through mechanisms including autophagy induction and suppression of the mTOR signaling pathway. These synergistic effect-based polyherbal preparations, targeting a range of pathological processes including inflammation, oxidative stress, and tissue remodeling, form a mainstay of TCM clinical practice in respiratory medicine (Zhu et al., 2022; Sun et al., 2024).
RkJQdWJsaXNoZXIy MjQ4ODYzNA==