Research Progress on Traditional Chinese Medicine in Treating Airway Remodeling Based on the NF-κB Signaling Pathway

Airway remodeling is a key pathological change in chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD). It is characterized by airway epithelial injury, smooth muscle proliferation, and abnormal extracellular matrix deposition, ultimately leading to irreversible pulmonary function decline. The nuclear factor-kappa B (NF-κB) signaling pathway, as a critical hub regulating inflammation, fibrosis, and oxidative stress, plays a central role in airway remodeling by activating pro-inflammatory factors (e.g., TNF-α, IL-6) and driving fibroblast activation. This review systematically summarizes the molecular mechanisms and research progress of traditional Chinese medicine (TCM) in improving airway remodeling through NF-κB pathway modulation. Studies have shown that TCM monomers and active compounds (such as baicalin and curcumin) can significantly alleviate airway fibrosis and smooth muscle proliferation by inhibiting NF-κB nuclear translocation, downregulating pro-inflammatory factor expression, and reducing oxidative stress. Classic herbal formulas (such as Xiao Qinglong Decoction and Bufei Decoction) exert multi-target synergistic regulation of NF-κB and its downstream pathways (TGF-β1/MAPK), thereby improving airway hyperresponsiveness and collagen deposition. Clinical studies have confirmed that TCM combined with conventional therapy can effectively improve pulmonary function indicators (e.g., FEV1); however, further exploration of its mechanisms and clinical evidence is needed. Future research should integrate multi-omics technologies, nano-targeted delivery, and integrative medicine strategies to elucidate the synergistic regulatory network of TCM and promote its translational application in airway remodeling therapy. This review provides a theoretical basis for TCM targeting the NF-κB pathway and identifies new directions for precision intervention in chronic airway diseases.