Abstract
Radix Astragali (RA) is widely used in traditional Chinese medicine (TCM), and astragaloside IV (AS-IV) is the most critical component of RA. Previous studies have demonstrated that AS-IV exerts effects on the myocardium, nervous system and endocrine system, among others. In the present review article, data from studies conducted over the past 20 years were collated, which have evaluated the effects of AS-IV on tumors. The mechanisms of action of AS-IV on malignant cells both in vivo and in vitro were summarized and it was demonstrated that AS-IV plays a vital role, particularly in inhibiting tumor growth and metastasis, promoting the apoptosis of tumor cells, enhancing immune function and preventing drug resistance. Moreover, AS-IV controls several epithelial-mesenchymal transformation (EMT)-related and autophagy-related pathways, such as the phosphoinositide-3-kinase (PI3K)/protein kinase B (AKT), Wnt/β-catenin, mitogen-activated protein kinase (MAPK)/extracellular regulated protein kinase (ERK) and transforming growth factor-β (TGF-β)/SMAD signaling pathways, which are commonly affected in the majority of tumors. The present review provides new perspectives on the functions of AS-IV and its role as an adjuvant treatment in cancer chemotherapy.
Highlights
Radix Astragali (RA) is widely used in traditional Chinese medicine (TCM), and astragaloside IV (AS‐IV) is the most critical component of RA
The inclusion criteria were as follows: Studies exploring the molecular mechanisms of AS‐IV in cancer; studies with comparable experimental and control groups, and those that successfully established animal models of cancer; studies in which animal experiments were approved by an ethics committee; and studies that investigated related pathways involving upstream and downstream molecular mechanisms and published experimental findings, which could be retrieved
AS‐IV noticeably reduces the cardiomyopathy induced by DOX, decreases the oxidative stress caused by NOX2 and NOX4, attenuates the complica‐ tions of doxorubicin, and, appears suitable as an adjuvant to chemotherapy [111]
Summary
Studies in English and Chinese, as well as trials published before June 1, 2020, were searched on online databases. In the present review, ‘astragaloside IV’, ‘Cancer’ and ‘mechanism’ were used as the key search concepts. The inclusion criteria were as follows: Studies exploring the molecular mechanisms of AS‐IV in cancer; studies with comparable experimental and control groups, and those that successfully established animal models of cancer; studies in which animal experiments were approved by an ethics committee; and studies that investigated related pathways involving upstream and downstream molecular mechanisms and published experimental findings, which could be retrieved. The exclusion criteria were as follows: Studies that included only AS‐IV or astragalus polysaccharide (APS) as the experimental group; studies that had an obvious risk of bias, including selection bias, performance bias, detection bias, reporting bias and attrition bias; case studies, cross‐over studies and studies without a separate control group; studies combining AS‐IV with other TCM interventions, in which data specific to the effect of AS‐IV interventions on cancer could not be extracted separately
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
