Angelica sinensis, a traditional Chinese herbal medicine and food, which has a long history of clinical application, is used to improve health conditions and treat various diseases. Angelica sinensis polysaccharides (ASP), the main active component of this traditional Chinese medicine, have multicomponent, multitarget characteristics and very broad pharmacological activities. They play important roles in the treatment of several diseases. In addition, the effect is significant, which may provide a more comprehensive database and theoretical support for applying ASP in the treatment of disease and could be considered a promising candidate for preventing disease. This review summarizes the research progress on the extraction, chemical structure, pharmacological effects, and mechanisms of ASP and its derivatives by reviewing relevant national and international literature and provides comprehensive information and a reliable basis for the exploration of new treatment strategies involving botanical drugs for disease therapy. Literature information was obtained from scientific ethnobotany and ethnomedicine databases (up to September 2024), mainly from the PubMed, Web of Science, and CNKI databases. The literature has explored the extraction, purification, structure, and pharmacological effects of Angelica sinensis polysaccharides. The search keywords for such work included “Angelica sinensis” or “Angelica sinensis polysaccharides,” and “pharmacological effects,” “extraction” and “structure.” Multiple studies have shown that ASP has important pharmacological effects, such as antitumor, anemia-improving, anti-inflammatory, antioxidative, immunomodulatory, hepatoprotective, antifibrotic, hypoglycemic, antiradiation, and antiviral effects, the mechanisms of which appear to involve the regulation of inflammation, oxidative stress, and profibrotic signaling pathways. As a natural polysaccharide, ASP has potential applications as a drug. However, further research should be undertaken to clarify the unconfirmed regulatory mechanisms, conduct standard clinical trials, and evaluate the possible side effects. This review establishes a theoretical foundation for future studies on the structure, mechanism, and clinical use of ASP.

Fibrosis-related diseases (FRD) include conditions like myocardial fibrosis, pulmonary fibrosis, hepatic fibrosis, renal fibrosis, and others. The impact of fibrosis can be severe, causing organ dysfunction, reduced functionality, and even organ failure, leading to significant health issues. Currently, there is a lack of effective modern anti-fibrosis drugs in clinical practice. However, Chinese medicine has a certain beneficial effect on the treatment of such diseases. Angelica sinensis, with its considerable medicinal value, has garnered attention for its anti-fibrosis properties in recent investigations. In the past few years, there has been a growing number of experimental inquiries into the impact of angelica polysaccharide (ASP), angelica water extract, angelica injection, and angelica compound preparation on fibrosis-associated ailments, piquing the interest of researchers. This paper aims to consolidate recent advances in the study of Angelica sinensis for the treatment of fibrosis-related disorders, offering insights for prospective investigations. Literature retrieval included core electronic databases, including Baidu Literature, CNKI, Google-Scholar, PubMed, and Web of Science. The applied search utilized specified keywords to extract relevant information on the pharmacological and phytochemical attributes of plants. The investigation revealed that Angelica sinensis has the potential to impede the advancement of fibrotic diseases by modulating inflammation, oxidative stress, immune responses, and metabolism. ASP, Angelica sinensis extract, Angelica sinensis injection, and Angelica sinensis compound preparation were extensively examined and discussed. These constituents demonstrated significant anti-fibrosis activity. In essence, this review seeks to gain a profound understanding of the role of Angelica sinensis in treating fiber-related diseases. Organ fibrosis manifests in nearly all tissues and organs, posing a critical challenge to global public health due to its widespread occurrence, challenging early diagnosis, and unfavorable prognosis. Despite its prevalence, therapeutic options are limited, and their efficacy is constrained. Over the past few years, numerous studies have explored the protective effects of traditional Chinese medicine on organ fibrosis, with Angelica sinensis standing out as a multifunctional natural remedy. This paper provides a review of organ fibrosis pathogenesis and summarizes the recent two decades' progress in treating fibrosis in various organs such as the liver, lung, kidney, and heart. The review highlights the modulation of relevant signaling pathways through multiple targets and channels by the effective components of Angelica sinensis, whether used as a single medicine or in compound prescriptions.

Radiation therapy (RT) for the treatment of thoracic tumors causes radiation-induced heart disease (RIHD). Radiation-induced myocardial fibrosis (RIMF) is both an acute and chronic stage of RIHD, depending on the specific pathology, and is thought to be a major risk factor for adverse myocardial remodeling and vascular changes. With the use of more three-dimensional conformal radiation regimens and early screenings and diagnoses for RIMF, the incidence of RIHD is declining, but it still must be carefully investigated to minimize the mortality and morbidity of patients with thoracic malignancies after RT treatment. Effective methods for preventing RIMF involve a decrease in the direct radiation dose in the heart, and early screening and diagnosis. Medications remain as a useful adjunct for preventing or treating RIMF. This review mainly discusses the cellular and molecular mechanisms underlying RIMF, and new therapeutic drugs that can potentially be developed from this knowledge.