Pharmacological basis and antifibrotic potential of Zhuang medicine huanggen in hepatic and pulmonary fibrosis

Fibrosis is a dynamic yet a stage that poses therapeutic challenges in chronic liver diseases and other systemic disorders. Huanggen (HG), the dried root of Prismatomeris connata or Prismatomeris tetrandra , has long been used in Zhuang traditional medicine to treat hepatitis, silicosis, rheumatism, and other chronic conditions. Modern studies reveal a diverse chemical profile, including anthraquinones, triterpenes, polysaccharides, and trace organometallics, which contribute to its pharmacological activities. HG exerts antitumor, anti-inflammatory, and antioxidant effects; suppresses hepatic stellate cell activation; inhibits epithelial-mesenchymal transition; and regulates macrophage polarization through modulation of TGF-β/Smad, PI3K/Akt, Nrf2/HO-1 pathways, as well as oxidative stress and immune responses. This review integrates phytochemistry, pharmacology, and mechanistic insights into HG, with a particular focus on its role in hepatic and pulmonary fibrosis, aiming to provide a foundation for the development of novel antifibrotic therapeutics.