Calycosin and kidney health: a molecular perspective on its protective mechanisms.

Kidney diseases encompass a diverse group of pathological conditions characterized by the progressive loss of renal function, leading to systemic complications and increased morbidity. Their global prevalence increasing, posing a substantial public health challenge. The underlying pathophysiology involves complex molecular interactions that drive inflammation, fibrosis, and tissue injury. Notably, the AGE/RAGE axis activates NF-κB, a pivotal transcription factor responsible for pro-inflammatory cytokine production. This response is further intensified by NLRP3-inflammasome activation, which detects cellular stress and promotes IL-1β release. Additionally, TGF-β signaling through SMADs and MAPK pathways induces ECM accumulation, contributing to tissue fibrosis. Besides this, oxidative stress-induced ferroptosis and apoptosis also play critical roles in disease progression. Given the multifactorial nature of kidney diseases, agents with multi-targeted actions are promising for effective renoprotection. Significant research interest has emerged in exploring calycosin's protective effects against kidney-related pathologies, owing to its diverse pharmacological properties, including anti-inflammatory, antioxidant, anti-apoptotic, and anti-fibrotic effects. Calycosin is a naturally occurring isoflavone primarily found in Astragalus membranaceus, a well-known medicinal herb in traditional Chinese medicine. Several studies have demonstrated that calycosin exerts its renoprotective effects by modulating key molecular mediators, including RAGE, NF-κB, TGF-β, MAPKs, NLRP3-inflammasome, Nrf-2, PPARγ, and Sirtuin-3, among others, thereby providing a multitargeted defense against kidney diseases. Considering the potential of calycosin in modulating these mediators, the present study was conceptualized to study the mechanistic interplay underlying its renoprotective effects. By investigating these interconnected pathways, this study will provide foundational insights that will enable future researchers to address existing gaps and further elucidate calycosin's potential in renal disorders.