Macrophage polarization in disease therapy: insights from astragaloside IV and cycloastragenol

Dysregulated activation and polarization of macrophages drive the pathogenesis of diverse diseases, including inflammatory, autoimmune, ischemic, metabolic disorders, and cancers. Despite therapeutic advances, precise regulation of macrophage polarization remains challenging. Natural products have r...

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Main Authors: Bei-Bei Xiong, Yu-Mei Zhuo, Huan Wang, Qiao-Ling Zheng, Feng Tang, Qun Huang, Man Yao
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Pharmacology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2025.1598022/full
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author Bei-Bei Xiong
Yu-Mei Zhuo
Huan Wang
Qiao-Ling Zheng
Feng Tang
Qun Huang
Man Yao
author_facet Bei-Bei Xiong
Yu-Mei Zhuo
Huan Wang
Qiao-Ling Zheng
Feng Tang
Qun Huang
Man Yao
author_sort Bei-Bei Xiong
collection DOAJ
description Dysregulated activation and polarization of macrophages drive the pathogenesis of diverse diseases, including inflammatory, autoimmune, ischemic, metabolic disorders, and cancers. Despite therapeutic advances, precise regulation of macrophage polarization remains challenging. Natural products have recently emerged as promising therapeutic regulators. Astragaloside IV (AS-IV) and its hydrolysate cycloastragenol (CAG), which are bioactive compounds derived from Astragalus membranaceus, have garnered significant interest due to their notable pharmacological properties encompassing anti-inflammatory, immunomodulatory, and antitumor effects. Nevertheless, the intricate multi-pathway mechanisms through which AS-IV and CAG regulate macrophage polarization are still not fully understood. A systematic review of literature from PubMed, Google Scholar, and SciFinder (2013–2025) shows that AS-IV and CAG modulate macrophage polarization. These compounds target critical signaling pathways, including TLR4/NF-κB, PI3K-AKT, AMPK, and PPARγ. These compounds exhibit therapeutic potential by suppressing pro-inflammatory M1 phenotypes and promoting anti-inflammatory/reparative M2 phenotypes. Their activities include anti-inflammatory, tissue-regenerative, and antitumor effects, with applications in inflammatory diseases, autoimmune disorders, ischemic vascular pathologies, metabolic syndromes, and cancer therapy. Furthermore, the integration of nanotechnology has emerged as a transformative approach to significantly enhance the bioavailability and targeted delivery of AS-IV and CAG, thereby expanding their clinical applicability. Despite the significant therapeutic potential of AS-IV and CAG in various disease models, their clinical translation remains constrained by low bioavailability. Future advancements that incorporate gene-editing technologies, computer-aided drug design, and nanotechnology are anticipated to optimize their pharmacokinetics and clinical efficacy. These innovations may position AS-IV and CAG as transformative agents in future therapies.
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spelling doaj-art-ab6e88a71c0442a4bbef931e7a0acd0c2025-08-20T03:53:50ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-05-011610.3389/fphar.2025.15980221598022Macrophage polarization in disease therapy: insights from astragaloside IV and cycloastragenolBei-Bei Xiong0Yu-Mei Zhuo1Huan Wang2Qiao-Ling Zheng3Feng Tang4Qun Huang5Man Yao6Department of Oncology, The First People’s Hospital of Shuangliu District, Chengdu, ChinaSchool of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaSchool of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaDepartment of Respiratory and Critical Care Medicine, The First People’s Hospital of Shuangliu District, Chengdu, ChinaSichuan Academy of Medical Sciences, Sichuan Provincial People’s Hospital, Chengdu, Sichuan, ChinaDepartment of Ophthalmology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaDepartment of Ophthalmology, Chengdu First People’s Hospital, Chengdu, ChinaDysregulated activation and polarization of macrophages drive the pathogenesis of diverse diseases, including inflammatory, autoimmune, ischemic, metabolic disorders, and cancers. Despite therapeutic advances, precise regulation of macrophage polarization remains challenging. Natural products have recently emerged as promising therapeutic regulators. Astragaloside IV (AS-IV) and its hydrolysate cycloastragenol (CAG), which are bioactive compounds derived from Astragalus membranaceus, have garnered significant interest due to their notable pharmacological properties encompassing anti-inflammatory, immunomodulatory, and antitumor effects. Nevertheless, the intricate multi-pathway mechanisms through which AS-IV and CAG regulate macrophage polarization are still not fully understood. A systematic review of literature from PubMed, Google Scholar, and SciFinder (2013–2025) shows that AS-IV and CAG modulate macrophage polarization. These compounds target critical signaling pathways, including TLR4/NF-κB, PI3K-AKT, AMPK, and PPARγ. These compounds exhibit therapeutic potential by suppressing pro-inflammatory M1 phenotypes and promoting anti-inflammatory/reparative M2 phenotypes. Their activities include anti-inflammatory, tissue-regenerative, and antitumor effects, with applications in inflammatory diseases, autoimmune disorders, ischemic vascular pathologies, metabolic syndromes, and cancer therapy. Furthermore, the integration of nanotechnology has emerged as a transformative approach to significantly enhance the bioavailability and targeted delivery of AS-IV and CAG, thereby expanding their clinical applicability. Despite the significant therapeutic potential of AS-IV and CAG in various disease models, their clinical translation remains constrained by low bioavailability. Future advancements that incorporate gene-editing technologies, computer-aided drug design, and nanotechnology are anticipated to optimize their pharmacokinetics and clinical efficacy. These innovations may position AS-IV and CAG as transformative agents in future therapies.https://www.frontiersin.org/articles/10.3389/fphar.2025.1598022/fullastragaloside IVcycloastragenolmacrophage polarizationnano drug deliverynatural products
spellingShingle Bei-Bei Xiong
Yu-Mei Zhuo
Huan Wang
Qiao-Ling Zheng
Feng Tang
Qun Huang
Man Yao
Macrophage polarization in disease therapy: insights from astragaloside IV and cycloastragenol
Frontiers in Pharmacology
astragaloside IV
cycloastragenol
macrophage polarization
nano drug delivery
natural products
title Macrophage polarization in disease therapy: insights from astragaloside IV and cycloastragenol
title_full Macrophage polarization in disease therapy: insights from astragaloside IV and cycloastragenol
title_fullStr Macrophage polarization in disease therapy: insights from astragaloside IV and cycloastragenol
title_full_unstemmed Macrophage polarization in disease therapy: insights from astragaloside IV and cycloastragenol
title_short Macrophage polarization in disease therapy: insights from astragaloside IV and cycloastragenol
title_sort macrophage polarization in disease therapy insights from astragaloside iv and cycloastragenol
topic astragaloside IV
cycloastragenol
macrophage polarization
nano drug delivery
natural products
url https://www.frontiersin.org/articles/10.3389/fphar.2025.1598022/full
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