Combatting pulmonary fibrosis with Astragalus membranaceus: A review of active components and multifaceted mechanisms

Abstract

Pulmonary fibrosis (PF) is a chronic progressive lung disease characterized by excessive deposition of extracellular matrix (ECM) and loss of lung function. Treatment options are limited and can only delay disease progression, making the development of novel therapeutic strategies crucial. Astragalus membranaceus (AM), a traditional Chinese medicinal herb renowned for its lung-tonifying and immunomodulatory properties, contains bioactive constituents such as flavonoids, saponins, and polysaccharides. These components exhibit anti-inflammatory, antioxidant, anti-fibrotic, and immunoregulatory activities, demonstrating therapeutic potential in PF. This review systematically elucidates the complex pathogenesis of PF, comprehensively summarizes the principal chemical constituents of AM, and highlights its multi-targeted anti-fibrotic mechanisms of action. Research demonstrates that AM and its bioactive constituents exert anti-fibrotic effects through multiple pharmacological actions: inhibiting fibroblast activation, reversing epithelial-mesenchymal transition (EMT), modulating immune-inflammatory responses, protecting alveolar epithelial cells (AECs), and ameliorating mitochondrial function. Through the synergistic interaction of its multiple components and multi-targeted effects, AM demonstrates significant advantages in combating PF. This review provides a comprehensive theoretical basis for deepening the understanding of AM anti-fibrotic mechanisms and offers practical guidance for developing novel anti-fibrotic agents based on traditional Chinese medicine and its bioactive constituents.