Rhizoma Paridis saponins in respiratory diseases: a narrative review of multi-target mechanisms and therapeutic potential.

Rhizoma Paridis saponins (RPS) are bioactive constituents of Rhizoma Paridis with reported anti-inflammatory and antitumor activities. However, their roles in respiratory diseases remain incompletely understood. This study is a narrative review rather than a systematic review. A narrative literature review was conducted using PubMed and CNKI databases to retrieve studies published between 2014 and 2025. Keywords included "Rhizoma Paridis," "polyphyllin," and "respiratory diseases." Studies were selected based on relevance to respiratory disease mechanisms and pharmacological evidence. RPS and its derivatives exhibit multi-target regulatory activities across respiratory disease models, including chronic obstructive pulmonary disease (COPD), pulmonary hypertension (PH), pulmonary fibrosis (PF), and lung cancer. These effects are primarily mediated through modulation of inflammation, oxidative stress, apoptosis, and key signaling pathways such as NF-κB, PI3K/AKT, MAPK, and Nrf2. Current evidence is exclusively derived from preclinical studies, including in vitro and in vivo experimental models, with no clinical data available in humans. Although RPS demonstrates promising multi-target pharmacological effects in respiratory disease models, these findings should be interpreted with caution. Further pharmacokinetic, toxicological, and clinical studies are required to evaluate its translational potential.