Mechanistic insights into the neuroprotective effects of Radix Astragali (Huang Qi): Bridging Traditional Chinese Medicine and modern pharmacology

Radix Astragali , a major herb in Traditional Chinese Medicine, has traditionally been used to strengthen vital energy and promote blood circulation. Recent research has revealed its neuroprotective potential in disorders such as ischemic stroke, Alzheimer’s disease, and traumatic brain injury. This review evaluates recent preclinical and clinical studies on the neuroprotective effects of Radix Astragali and its active components, including astragaloside four, flavonoids, polysaccharides, terpenoids, alkaloids, and amino acids. Peer-reviewed scientific literature was analyzed and interpreted within the context of Traditional Chinese Medicine principles. Radix Astragali exhibits multiple neuroprotective actions, including antioxidant, anti-inflammatory, anti-apoptotic, and immune-regulating effects. Astragaloside IV regulates critical signaling pathways, including phosphoinositide 3-kinase/protein kinase B, mitogen-activated protein kinase, and nuclear factor-κB, thereby supporting neuronal survival and reducing oxidative damage. Flavonoids and polysaccharides enhance synaptic plasticity, nerve regeneration, and cerebral blood flow. These findings are consistent with Traditional Chinese Medicine concepts of replenishing vital energy and stimulating blood flow in neurological disorders. Radix Astragali exemplifies the integration of Traditional Chinese Medicine and modern neuropharmacology. However, clinical translation remains limited due to challenges in standardization, potential herb drug interactions, and insufficient large-scale clinical validation. Future studies should emphasize pharmacokinetics, synergistic formulations, and biomarker-based personalized neurotherapy to ensure safe and effective clinical application. Neuroprotective mechanisms of Radix Astragali via multiple bioactive pathways.