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World J Clin Cases. Oct 6, 2022; 10(28): 10004-10016
Published online Oct 6, 2022. doi: 10.12998/wjcc.v10.i28.10004
Review of the pharmacological effects of astragaloside IV and its autophagic mechanism in association with inflammation
Ying Yang, Meng Hong, Wen-Wen Lian, Zhi Chen
Ying Yang, Meng Hong, Wen-Wen Lian, Zhi Chen, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Author contributions: Yang Y wrote this review; Chen Z conceived this review; Hong M and Lian WW revised this review; all authors have read and approve the final manuscript.
Supported by Project of Zhejiang Traditional Chinese Medicine Technology, No. 2018ZA063; Chinese National Natural and Science Foundation, No. 81700552; and Natural Science Fund Committee of Zhejiang Province, No. LQ20C200010.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi Chen, Doctor, Academic Fellow, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. zjuchenzhi@zju.edu.cn
Received: April 17, 2022
Peer-review started: April 17, 2022
First decision: May 11, 2022
Revised: May 23, 2022
Accepted: August 25, 2022
Article in press: August 25, 2022
Published online: October 6, 2022
Abstract

Astragalus membranaceus Bunge, known as Huangqi, has been used to treat various diseases for a long time. Astragaloside IV (AS-IV) is one of the primary active ingredients of the aqueous Huangqi extract. Many experimental models have shown that AS-IV exerts broad beneficial effects on cardiovascular disease, nervous system diseases, lung disease, diabetes, organ injury, kidney disease, and gynaecological diseases. This review demonstrates and summarizes the structure, solubility, pharmacokinetics, toxicity, pharmacological effects, and autophagic mechanism of AS-IV. The autophagic effects are associated with multiple signalling pathways in experimental models, including the PI3KI/Akt/mTOR, PI3K III/Beclin-1/Bcl-2, PI3K/Akt, AMPK/mTOR, PI3K/Akt/mTOR, SIRT1–NF-κB, PI3K/AKT/AS160, and TGF-β/Smad signalling pathways. Based on this evidence, AS-IV could be used as a replacement therapy for treating the multiple diseases referenced above.

Keywords: Astragaloside IV, Pharmacological effect, Autophagy, Inflammation

Core Tip: Astragaloside IV (AS-IV) is one of the main active ingredients of the aqueous extract Huangqi. Many experimental models have shown that AS-IV has broad beneficial effects on various diseases. This review demonstrates and summarizes the pharmacological effects and autophagic mechanism of AS-IV. The autophagic effects are associated with inflammation or not and multiple signalling pathways in experimental models. Based on this evidence, AS-IV will be used as replacement therapy for treating the above various diseases.