A comprehensive review on the polysaccharides derived from Codonopsis pilosula: Extraction, isolation and purification, structural characteristics, biological activities, structure-activity relationships, toxicity, and development and utilization.

ETHNOPHARMACOLOGICAL RELEVANCE: Codonopsis pilosula, a perennial medicinal plant of the family Campanulaceae, possesses considerable pharmaceutical and nutritional value. Its polysaccharides serve as the material basis for its diverse biological activities. AIM OF THE REVIEW: This article systematically reviews the research progress on Codonopsis pilosula polysaccharides (CPPs) in terms of extraction, isolation and purification, structural characterization, biological activities, structure-activity relationships, toxicity, and development and utilization, to provide a theoretical basis for the further development and utilization of CPPs. MATERIALS AND METHODS: Relevant literature published between 2000 and 2026 was systematically retrieved from PubMed (https://pubmed.ncbi.nlm.nih.gov/), Web of Science (https://www.webofscience.com/), and CNKI (https://www.cnki.net/) using the keywords "Codonopsis pilosula" and "polysaccharide." Plants names are provided in accordance with "The Plant List" (https://wfoplantlist.org/). Geographic distribution data are obtained from https://www.gbif.org. RESULT: This review systematically presents recent progress in the preparation, structure, bioactivities, and safety of CPPs. With diverse extraction methods and complex structures, CPPs exhibit immunomodulatory, antioxidant, and antitumor activities influenced by molecular weight, monosaccharide composition, and chemical modifications. Preliminary safety evaluations are favorable, supporting their promising applications in food, pharmaceutical, and animal husbandry industries. CONCLUSION: This review systematically summarizes recent advances in the extraction and purification of CPPs, and provides an in-depth analysis of their structural characteristics, structure-activity relationships, biological activities, and toxicity, along with a comprehensive overview of their development and utilization. On this basis, the article identifies major challenges in current research and proposes key directions for future development, aiming to provide a theoretical foundation for further investigation and translational applications of these polysaccharides.