Research Progress and Prospects of Flavonoids in the Treatment of Diseases by Regulating Autophagy: A Narrative Review

Autophagy is an essential mechanism through which cells break down and reuse intracellular proteins and organelles to preserve cellular homeostasis. Under physiological conditions, autophagy primarily exerts a cytoprotective effect; however, aberrant activation or deficiency of autophagy pathways can disturb cellular balance and even trigger apoptosis, thereby contributing to the occurrence and progression of multiple diseases. Flavonoids are natural bioactive components widely distributed in plants, characterized by distinct benefits of synergistic regulation via multiple targets and pathways. This review summarizes the primary mechanisms of flavonoids, focusing on their potential underlying mechanisms against various diseases-including atherosclerosis, cardiovascular diseases, liver diseases, lung diseases, Parkinson's disease, leukemia, and malignant tumors-via regulating autophagy (including selective autophagy), and sorts out the latest advances in related experimental research over the past five years. In conclusion, flavonoids can effectively ameliorate the pathological processes of multiple diseases by modulating autophagy pathways with favorable biosafety. Nevertheless, low bioavailability remains the core bottleneck restricting their clinical translation. Further optimization of pharmaceutical formulations is warranted to enhance their uptake efficacy in vivo, and rigorous clinical trials are needed to assess their prolonged effectiveness and potential drug interactions, so as to offer new feasible approaches and research directions for the prophylaxis and therapy of various diseases.