Therapeutic potential of
Li Qinghua, Chen Wangqi, Xie Yuxia, Zhu Hong
Abstract
CONTEXT: Endoscopic submucosal dissection (ESD) is the standard treatment for early gastrointestinal cancers but is often complicated by delayed healing and stenosis. Current therapies like proton pump inhibitors primarily suppress acid without actively promoting mucosal regeneration. Asiaticoside (AS), a triterpenoid from Centella asiatica, shows promise in tissue repair. OBJECTIVE: This review evaluates the therapeutic potential of AS for ESD-induced wound healing, focusing on its pharmacological mechanisms and emerging delivery strategies. METHODS: A comprehensive literature search was conducted using databases such as PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI). Relevant in vitro, preclinical, and clinical studies regarding AS, wound healing, fibrosis, and drug delivery systems were selected and synthesized to analyze efficacy and safety. RESULTS: AS accelerates healing through multifaceted mechanisms: it exerts anti-inflammatory effects via NF-κB and MAPK pathways, reduces oxidative stress through Nrf2/HO-1 signaling, and inhibits fibrosis by modulating TGF-β/Smad axes. Additionally, AS promotes angiogenesis and collagen synthesis. While clinical data supports its use in skin wounds, its gastrointestinal application is hindered by poor bioavailability. Novel delivery systems, including hydrogels and microneedles, are identified as solutions for localized, sustained release. CONCLUSION: AS offers a promising therapeutic evolution, moving from reliance on passive acid suppression toward a synergistic model that integrates acid control with active mucosal regeneration for ESD management. Future research should focus on optimizing endoscope-compatible delivery platforms to facilitate clinical translation and reduce postoperative complications.
Key Findings
- Asiaticoside (AS) accelerates wound healing via anti-inflammatory effects through NF-κB and MAPK pathways.
- AS reduces oxidative stress by activating Nrf2/HO-1 signaling and inhibits fibrosis by modulating TGF-β/Smad pathways.
- Novel delivery systems such as hydrogels and microneedles improve AS bioavailability for localized, sustained release in gastrointestinal applications.
Clinical Significance
Asiaticoside presents a promising therapeutic approach to enhance mucosal regeneration and reduce complications after endoscopic submucosal dissection, with advanced delivery methods facilitating its clinical translation.
Citation
Li Qinghua, Chen Wangqi, Xie Yuxiaet al.. Therapeutic potential of Pharmaceutical biology. 2026-Dec.