Hepatoprotective Potential of Radix Astragali, a Qi-tonifying Traditional Herb: Modulation of Hepatocyte Energy Metabolism and Oxidative Homeostasis.

ETHNOPHARMACOLOGICAL RELEVANCE: Radix Astragali (RA) is a widely utilized medicinal herb in traditional Chinese medicine (TCM), known for its distinctive Qi-tonifying properties, with significant therapeutic efficacy in the treatment of diverse liver ailments. The pharmacological basis of TCM's Qi-tonifying effect primarily involves enhancing cellular vitality through the stimulation of energy metabolism and mitigation of oxidative stress, thereby facilitating the restoration of tissue and organ function. AIM OF THIS REVIEW: This article presents a comprehensive review of the hepatoprotective effects of RA and its active constituents, focusing on their modulation of hepatic glucose and lipid metabolism, as well as oxidative homeostasis. MATERIALS AND METHODS: A thorough literature search was conducted using various online platforms and databases, including PubMed, Web of Science, Chinese National Knowledge Infrastructure (CNKI), and Scopus, up to July 2026. Keyword searches encompassed terms such as Radix Astragali, Huangqi Decoction, Astragalus polysaccharides, astragalosides, astragaloside IV, cycloastragenol, metabolic reprogramming, glucose metabolism, lipid metabolism, lipid deposition, blood glucose, oxidative stress, reactive oxygen species, liver diseases, and liver regeneration. RESULTS: Recent advances in pharmacological research, particularly over the past decade-with a notable concentration of findings in the last three years-have further elucidated the hepatoprotective effects of Radix Astragali and its bioactive constituents in promoting hepatic glucose and lipid metabolism and maintaining oxidative homeostasis. Given the pivotal role of the hepatocellular aquaglyceroporin/peroxiporin aquaporin-9 (AQP9) in regulating hepatic glucose and lipid metabolism and oxidative homeostasis, and the ability of Radix Astragali and its active components to enhance AQP9 expression in hepatocytes and thereby promote liver regeneration, targeting AQP9-mediated glycerol and H2O2 transport may represent a potential therapeutic avenue for liver injury; however, the available evidence remains largely preclinical. CONCLUSION: The augmentation of hepatocyte AQP9 expression underscores a significant scientific facet of RA's Qi-tonifying effect. AQP9 may represent a potential therapeutic target for liver injury, but its clinical relevance remains to be established. Future investigations should focus on identifying the specific active compounds and associated mechanisms responsible for upregulating AQP9 expression in RA.