Clinical efficacy and mechanisms of Astragalus membranaceus, active components, and herbal formulas for chronic atrophic gastritis

Table 3 Experimental studies and mechanisms of action of Astragalus and its active components in the chronic atrophic gastritis treatment

Research contents	Action targets	Outcomes	Ref.
Astragalus membranaceus	H. pylori vacuolating cytotoxin A	Inhibition of H. pylori activity	Wang et al[58]
	Inflammatory factors	Suppression of pro-inflammatory cytokines and immunomodulation	Liu et al[60]
	Th1/Th2 and Treg/Th17 immune axes	Enhancing immune tolerance	Chang et al[63]
	PI3K/Akt, Wnt/β-catenin, and Janus kinase-signal transducer and activator of transcription 3 pathways	Protecting the gastric mucosa	Liu et al[66]; Yan and Zhang[67]
	Acetobacter and Escherichia coli	Alleviating gut microbial metabolic disorders	Liu[71]; Liu et al[72]
Astragaloside IV	H. pylori urease and related genes (ureA, ureB)	Attenuating the colonization ability of H. pylori	Wang et al[59]
	CXCL5-CXCR2 axis and the NF-κB pathway	Anti-inflammatory effects and inhibition of inflammation-to-cancer transformation	Pei et al[64]; Tian et al[65]
	Thrombin/PAR-1, p53, and MAPK signaling pathways	Increasing gastric acid secretion and protecting the gastric mucosa	Shen et al[68]; Duan et al[69]
	Bifidobacterium and the Wnt3a/β-catenin signaling pathway	Regulation of serum metabolite levels and anti-tumor effects	Wen et al[73]
	Reactive oxygen species, serum nitric oxide, and inducible nitric oxide synthase	Antioxidant and anticancer effects and improvement of clinical efficacy in CAG	Xia et al[75]; Li et al[76]
Astragalus polysaccharides	NF-κB p65/MAPK signaling pathway	Enhancement of immunomodulatory effects	Feng et al[62]
	Epidermal growth factor receptor downstream effector proteins cyclooxygenase-2 and metalloproteinases-2	Protection of the gastric mucosa	Zhu et al[70]
Total astragalosides	Immune factors	Enhancement of immunomodulatory capacity	Zhang et al[61]

CAG: Chronic atrophic gastritis; H. pylori: Helicobacter pylori; PI3K: Phosphoinositide 3-kinases; Akt: Protein kinase B; NF-κB: Nuclear factor-κB; MAPK: Mitogen-activated protein kinases.