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Bletilla striata polysaccharide (BSP) is a naturally derived, high-molecular-weight glucomannan extracted from the tubers of the orchid species *Bletilla striata*, which has a long history of use in traditional Chinese medicine. Chemically, BSP is a water-soluble heteropolysaccharide primarily composed of D-mannose and D-glucose residues linked by β-1,4-glycosidic bonds. It exhibits a wide range of pharmacological activities, including anti-inflammatory, antioxidant, immunomodulatory, hemostatic, and tissue-protective properties. In preclinical models, BSP has been shown to attenuate ischemia-reperfusion injury (IRI) following lung transplantation and protect against acute respiratory distress syndrome (ARDS) and metabolic dysfunction-associated steatotic liver disease (MASLD). Its therapeutic mechanism is largely mediated by the inhibition of the NLRP3/Caspase-1/GSDMD pyroptotic pathway, as well as the modulation of HMGB1/TLR4 signaling, which suppresses the release of pro-inflammatory cytokines such as IL-1β and IL-18.
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