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Hydroxyasiaticoside (also known as madecassoside) is a natural pentacyclic triterpenoid saponin isolated from the medicinal plant *Centella asiatica* (Gotu Kola). It possesses potent anti-inflammatory, antioxidant, wound-healing, and skin-barrier-repairing properties. Mechanistically, hydroxyasiaticoside stimulates collagen type I and type III synthesis via the TGF-β/Smad signaling pathway, suppresses pro-inflammatory cytokine production (such as TNF-α, IL-6, and IL-1β) by inhibiting NF-κB and MAPK signaling, and directly binds to targets such as protein kinase C beta (PKCB), serine racemase, and melanocortin 1 receptor (MC1R). It is being clinically evaluated by West China Hospital of Sichuan University as a topical repair cream (often in combination with panthenol) for the treatment of acne-related post-inflammatory erythema, and as oral tablets for sclerotic chronic graft-versus-host disease (cGVHD).
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