Andrographolide Sulfonates and Xiyanping: A Review of Chemical Composition, Pharmacological Activities, Clinical Applications, and Adverse Reactions

Abstract

Andrographis paniculata is a plant of the Acanthaceae family and its primary bioactive constituent, andrographolide, exhibits a broad spectrum of pharmacological activities and notable clinical efficacy. However, its poor solubility and limited bioavailability pose significant challenges for therapeutic applications. To overcome these limitations, researchers have synthesized andrographolide sulfonates by reacting andrographolide with ethanol and sulfuric acid. This sulfonated derivative significantly enhances water solubility and bioavailability while retaining key pharmacological properties such as anti-inflammatory and antiviral activities. As a representative formulation, Xiyanping injection has been widely employed in the treatment of respiratory infections, pneumonia, and related conditions, playing a critical role during the COVID-19 pandemic. Despite its widespread application, there has yet to be a comprehensive review of its chemical composition and pharmacological mechanisms. Additionally, the safety of Xiyanping injection remains a topic of some debate. This review systematically examines the chemical composition, pharmacological activities, clinical applications, and adverse reactions of andrographolide sulfonates and their formulation in Xiyanping injection to provide a scientific basis for further research and applications, while also offering valuable insights for the development of similar sulfonated drugs.

Keywords: adverse reaction; andrographolide sulfonate; anti-inflammatory; antiviral activities; chemical composition; clinical application; pharmacological activity.

Figure 1

Andrographis paniculata, andrographolide, andrographolide sulfonate and Xiyanping injection (喜炎平).

Figure 2

Chemical structure of andrographolide sulfonate.

Figure 3

The chemical reaction process of the formation of andrographolide sulfate from andrographolide.

Figure 4

The pharmacological activities of andrographolide sulphonate and Xiyanping.

Figure 5

Anti-inflammatory mechanisms of andrographolide sulfonates. 1: Andrographolide sulfonates alleviate inflammation by inhibiting p38 phosphorylation. 2: Andrographolide sulfonates alleviate inflammation by inhibiting MAPK phosphorylation. 3: Andrographolide sulfonates reduce inflammation by inhibiting NF-κB phosphorylation. 4: Andrographolide sulfonates alleviate inflammation through negative regulation of STAT3 activation.

Figure 6

Clinical application of XYP; (A) Distribution of patient gender (4023 cases) [64]; (B) Distribution of patient age (4023 cases) [64]; (C) Distribution of patient medication purposes (848 cases) [65].