Benefits and mechanisms of polysaccharides derived from traditional Chinese medicine for ulcerative colitis treatment (Review).

Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by abdominal pain, diarrhea and bloody mucopurulent stools. The UC global incidence is rising and conventional therapies remain limited. Therefore, there is an urgent need for novel treatments. Polysaccharides derived from traditional Chinese medicine (TCM) have emerged as promising candidates due to their multifaceted bioactivities. Preclinical studies have demonstrated that these polysaccharides can regulate immune system pathways, thereby reducing intestinal inflammation and oxidative stress. This protects the intestinal mucosal barrier, enhances tight junction protein expression and modulates the gut microbiota. However, their precise molecular targets and structure-activity associations remain to be fully elucidated. Translational advancement is currently constrained by challenges such as undefined mechanisms, poor oral bioavailability and a lack of clinical validation. Therefore, the present review focused on a number of polysaccharides derived from TCM herbs. The aim of the present review was to systematically analyze their functions and mechanisms for UC prevention and treatment, thus underscoring the necessity for integration of mechanistic discovery with innovative delivery strategies to facilitate the clinical translation of TCM polysaccharides in UC management.