Astragaloside, particularly Astragaloside IV, is a bioactive saponin compound extracted from the root of Astragalus membranaceus, a traditional Chinese medicinal herb. While Astragalus has a long history of use in traditional medicine, the rationale for utilizing astragaloside specifically in fibrosis primarily rests on emerging scientific studies rather than historical precedent.

Preclinical research over the past decade has demonstrated that astragaloside IV exhibits anti-fibrotic effects in various organ systems, including the liver, lungs, kidneys, and heart. In animal models of pulmonary, hepatic, and renal fibrosis, astragaloside IV has been shown to reduce collagen deposition and inhibit the activation of fibroblasts and myofibroblasts, key processes in fibrotic tissue remodeling. Mechanistically, it appears to downregulate the TGF-β/Smad signaling pathway, which is central to the development of fibrosis, and modulate inflammatory and oxidative responses.

Despite these promising findings from in vitro and animal studies, clinical evidence in humans remains very limited. There are few, if any, high-quality randomized controlled trials evaluating the efficacy and safety of astragaloside for the treatment of fibrosis in humans. Therefore, while there is a plausible scientific rationale and supportive preclinical data, the overall evidence base is still preliminary.