Current Status and Prospects of Lily Polysaccharides in Preventing and Treating Radiation Pneumonia via the gut‑lung axis

Radiation-induced pneumonitis is a common acute complication following radiotherapy for thoracic tumors, with an incidence rate of 15%–30%. Severe cases may lead to irreversible pulmonary fibrosis. Currently, antioxidant drugs and hormone therapy exhibit limitations in terms of hormone dependency and immunosuppression. Lily polysaccharides, as the primary active component of Lilium L. species, possess antioxidant and anti-inflammatory properties, demonstrating promising application prospects. Traditional research has primarily focused on direct pulmonary protection. However, recent studies have revealed that the "gut-lung axis" can suppress pulmonary inflammation and mitigate lung injury by regulating immunity and activating antioxidant systems, with gut microbiota and their beneficial metabolites playing crucial roles. Research in this field remains nascent, with insufficient validation of key mechanisms and inadequate studies on human pharmacokinetics and safety. This review aims to systematically summarize the current research status and potential mechanisms of lily polysaccharides in preventing and treating radiation pneumonitis via the gut-lung axis, with the goal of providing new candidate solutions and theoretical references for the prevention and treatment of radiation-induce pneumonitis.