Astragali Radix metabolites show anti-inflammatory and immunomodulatory activities for allergic respiratory conditions

The global incidence of allergic respiratory diseases (ARDs) is rising, imposing severe socioeconomic and public health burdens worldwide. Astragali Radix (AR), a well-recognized traditional Chinese medicinal botanical drug with proven efficacy in ARDs management, exerts its therapeutic effects primarily through three major classes of bioactive metabolites: polysaccharides (e.g., APS), saponins (e.g., AS-II/IV/VII), and flavonoids (e.g., quercetin, calycosin). Of these, AS-IV and APS are the most extensively investigated, exhibiting prominent anti-inflammatory, immunomodulatory, anti-airway remodeling, and anti-fibrotic activities. Based on a comprehensive literature search across multiple authoritative databases, this narrative review innovatively focuses on ARDs (allergic asthma, ARh, AC, HP) from the perspective of a unified disease spectrum, summarizing the pharmacodynamic mechanisms of these AR metabolites in ARDs--pecifically, targeting core pathogenic signaling pathways (e.g., NF-κB, MAPK, TGF-β1/Smad) and regulating immune homeostasis (e.g., inhibiting ILC2 activation, rebalancing Th1/Th2 polarization, and suppressing Th17/IL-17-mediated inflammation). By integrating AR’s pharmacodynamic effects with its molecular targets and correlating preclinical evidence with clinical data (including RCTs), this review establishes a comprehensive foundation for the clinical application of AR and the development of novel targeted therapeutics for ARDs.