Adventitious root (AR) cultures of Cynanchum wilfordii are rich in bioactive compounds, including C21 steroidal glycosides. However, research on C. wilfordii ARs has focused on their culture, with limited attention on other aspects, affecting their further application. To provide a basis for the efficient utilization of this precious resource, in this study, flash extraction, a novel green extraction approach, was employed to extract C. wilfordii ARs, and the extraction process was optimized by applying response surface methodology (RSM) to maximize the yield of C21 steroidal glycosides. The obtained C. wilfordii AR extract (CWARE) was used to evaluate cancer cell inhibition by assessing cell viability, migration, senescence, and apoptosis. Through the optimization extraction process, flash extraction conditions of 69% ethanol concentration, 66 s of extraction time, and a 33 mL/g of liquid-to-material ratio were identified as optimal, resulting in a C21 steroidal glycoside yield of 9.22%. In evaluating cancer cell inhibition, we found that CWARE significantly (p < 0.01) inhibited the viability of all tested human cancer cell lines, with the human non-small-cell lung cancer cell line A549 exhibiting the highest sensitivity, showing a half-maximal inhibitory concentration of 195.4 μg/mL. Furthermore, CWARE inhibited A549 cell migration, promoted cell senescence, and induced apoptosis via both intrinsic and extrinsic pathways. These findings suggest that the optimized flash extraction process is efficient for extracting C. wilfordii ARs and the extract has a promising ability to inhibit cancer cells. This study provides a strong foundation for the further development and utilization of C. wilfordii ARs.
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