Research Progress on the Mechanism and Application of Rhodiolae Crenulatae Radix et Rhizoma in the Prevention and Treatment of High Altitude Disease

• • Salidroside mitigates hypoxia-induced cardiomyocyte apoptosis and oxidative stress while suppressing inflammatory cascades, with protective effects against chronic hypoxia-induced pulmonary arterial hypertension mediated via AMPKα1-dependent pathways (Am J Transl Res, 2016;8(1):12-27); this positions salidroside as a multi-target candidate for HAPE prophylaxis where conventional vasodilators exhibit systemic hypotension. • • Salidroside attenuates insulin resistance through activation of the mitochondria-associated AMPK/PI3K/Akt/GSK3β signaling axis (Br J Pharmacol, 2015;172(13):3284-3301), and dose-dependent upregulation of PI3K and GLUT-4 in skeletal muscle of type 2 diabetic rats (Anatomy Journal, 2017;40(6):682-684) addresses the glucose metabolic dysregulation observed at altitude, where glycolysis is downregulated and lactic acid/amino acid-pyruvate-TCA pathways are upregulated (Sci Total Environ, 2023;894:164998). • • Salidroside ameliorates neuronal ferroptosis via the HIF-1α/HO-1 pathway in NHIE rats (Huazhong University of Science and Technology, 2024) and inhibits H2O2-induced ferroptosis in HT22 neurons (Henan University of Science and Technology, 2024), directly countering hypoxia-driven hippocampal ferroptosis pathways (Acta Physiologica Sinica, 2024;76(4):507-516) that underpin cognitive deficits in HAD. • • Salidroside regulates pyroptosis through NLRP3 inflammasome modulation, protecting against PM2.5-induced lung injury (Chengdu University of TCM, 2023) and preventing myocardial fibrosis via TLR4-mediated pyroptosis pathways (China Pharmacy, 2023;34(9):1053-1059); given that high-altitude hypoxia induces renal cell pyroptosis via NOD-like receptor signaling (Acta Universitatis Medicinalis Anhui, 2025;60(11):2052-2058), this mechanism is clinically relevant for multi-organ protection.