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<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Immunol.</journal-id>
<journal-title-group>
<journal-title>Frontiers in Immunology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Immunol.</abbrev-journal-title>
</journal-title-group>
<issn pub-type="epub">1664-3224</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
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<article-meta>
<article-id pub-id-type="doi">10.3389/fimmu.2025.1754107</article-id>
<article-version article-version-type="Version of Record" vocab="NISO-RP-8-2008"/>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Review</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Targeting the plasticity of intestinal neutrophils: bidirectional regulation strategies by natural products</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" equal-contrib="yes">
<name><surname>Kang</surname><given-names>Ruotong</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="author-notes" rid="fn003"><sup>&#x2020;</sup></xref>
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<contrib contrib-type="author" equal-contrib="yes">
<name><surname>Sun</surname><given-names>Anqi</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="author-notes" rid="fn003"><sup>&#x2020;</sup></xref>
<role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Writing &#x2013; original draft" vocab-term-identifier="https://credit.niso.org/contributor-roles/writing-original-draft/">Writing &#x2013; original draft</role>
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<contrib contrib-type="author" equal-contrib="yes">
<name><surname>Yang</surname><given-names>Jiayin</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="author-notes" rid="fn003"><sup>&#x2020;</sup></xref>
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<contrib contrib-type="author">
<name><surname>Chang</surname><given-names>Linyuan</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
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</contrib>
<contrib contrib-type="author">
<name><surname>Sun</surname><given-names>Wenguang</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
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</contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>Kou</surname><given-names>Fushun</given-names></name>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<xref ref-type="corresp" rid="c001"><sup>*</sup></xref>
<uri xlink:href="https://loop.frontiersin.org/people/1414626/overview"/>
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<contrib contrib-type="author" corresp="yes">
<name><surname>Cheng</surname><given-names>Yuan</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="corresp" rid="c001"><sup>*</sup></xref>
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<aff id="aff1"><label>1</label><institution>School of Integrative Medicine, Nanjing University of Chinese Medicine</institution>, <city>Nanjing</city>,&#xa0;<country country="cn">China</country></aff>
<aff id="aff2"><label>2</label><institution>Jiangsu Collaborative Innovation Center of Traditional Chinese Medicine Prevention and Treatment of Tumor, the First Clinical Medical College, Nanjing University of Chinese Medicine</institution>, <city>Nanjing</city>,&#xa0;<country country="cn">China</country></aff>
<author-notes>
<corresp id="c001"><label>*</label>Correspondence: Yuan Cheng, <email xlink:href="mailto:290535@njucm.edu.cn">290535@njucm.edu.cn</email>; Fushun Kou, <email xlink:href="mailto:koufushun@126.com">koufushun@126.com</email></corresp>
<fn fn-type="equal" id="fn003">
<label>&#x2020;</label>
<p>These authors have contributed equally to this work</p></fn>
</author-notes>
<pub-date publication-format="electronic" date-type="pub" iso-8601-date="2026-01-12">
<day>12</day>
<month>01</month>
<year>2026</year>
</pub-date>
<pub-date publication-format="electronic" date-type="collection">
<year>2025</year>
</pub-date>
<volume>16</volume>
<elocation-id>1754107</elocation-id>
<history>
<date date-type="received">
<day>25</day>
<month>11</month>
<year>2025</year>
</date>
<date date-type="accepted">
<day>19</day>
<month>12</month>
<year>2025</year>
</date>
<date date-type="rev-recd">
<day>16</day>
<month>12</month>
<year>2025</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2026 Kang, Sun, Yang, Chang, Sun, Kou and Cheng.</copyright-statement>
<copyright-year>2026</copyright-year>
<copyright-holder>Kang, Sun, Yang, Chang, Sun, Kou and Cheng</copyright-holder>
<license>
<ali:license_ref start_date="2026-01-12">https://creativecommons.org/licenses/by/4.0/</ali:license_ref>
<license-p>This is an open-access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License (CC BY)</ext-link>. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</license-p>
</license>
</permissions>
<abstract>
<p>Historically, neutrophils have been regarded primarily as pro-inflammatory cells, yet recent advancements have revealed their phenotypic heterogeneity and functional plasticity with versatile immunophenotypes. Distinct subpopulations of neutrophils exhibit a functional duality, not only initiating and amplifying inflammation, but also actively promoting tissue restoration in diseases, such as inflammatory bowel disease (IBD), colorectal cancer (CRC) and intestinal infections. They contribute to the formation of a dynamic immune microenvironment in concert with the intestinal microbiota, epithelial cells, and other immune cell types. Current first-line therapies for enteric diseases often lack precision in modulating neutrophil functions. In contrast, natural products including alkaloids, polysaccharides, polyphenols, quinones, and glycosides, as well as microbiota-derived metabolites, exhibit distinct advantages for ability to achieve multi-targeted and bidirectional immunomodulation. These compounds target neutrophil activation, migration, neutrophil extracellular trap formation, cytokine release, oxidative stress, and energy metabolism etc. In this review, we systematically examine the heterogeneity and functional diversity of intestinal neutrophils, highlighting their interaction mechanisms with the surrounding microenvironment. Potential of natural products to modulate neutrophil functions via multi-target strategies has not been fully explored. Moreover, the review discusses novel precision therapeutic approaches based on neutrophil nanotechnology and engineered cell drug delivery. These cutting-edge technologies aim to enhance natural products delivery to inflammatory sites, provide controllable regulation of neutrophil function, and facilitate the degradation of pathological structures. Collectively, the study presents new research directions and theoretical frameworks for intervention of natural products in neutrophils of intestinal immune-related disorders, notably IBD and even CRC.</p>
</abstract>
<kwd-group>
<kwd>cell interactions</kwd>
<kwd>intestinal immune diseases</kwd>
<kwd>intestinal neutrophils</kwd>
<kwd>natural products</kwd>
<kwd>novel therapeutic techniques</kwd>
</kwd-group>
<funding-group>
<funding-statement>The author(s) declared that financial support was received for this work and/or its publication. The authors and their work were supported by National Natural Science Foundation of China for Young Scientists (No. 82305143, No. 82505431), National Natural Science Foundation of China-Youth Science Foundation Funding Matching Project (No: XPT82305143), the first batch of the &#x201c;Double Hundred Plan&#x201d;(Academic Experience Inheritance Project for Renowned Traditional Chinese Medicine Experts) of Nanjing University of Chinese Medicine (013062024003-22).</funding-statement>
</funding-group>
<counts>
<fig-count count="4"/>
<table-count count="2"/>
<equation-count count="0"/>
<ref-count count="193"/>
<page-count count="25"/>
<word-count count="9968"/>
</counts>
<custom-meta-group>
<custom-meta>
<meta-name>section-at-acceptance</meta-name>
<meta-value>Mucosal Immunity</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
<body>
<sec id="s1" sec-type="intro">
<label>1</label>
<title>Introduction</title>
<p>The intestinal immune system is critical in maintaining systemic homeostasis and protecting against pathogenic invasion. Its dysfunction could lead to the development of various complex immune-mediated intestinal disorders. Multiple immune cell types, including lymphocytes, macrophages, dendritic cells, and neutrophils, coordinate interplay to sustain intestinal immune homeostasis (<xref ref-type="bibr" rid="B1">1</xref>). Neutrophils, as the primary effector cells of innate immunity, are a key effector response to tissue infection and inflammation. Recent studies have highlighted their remarkable plasticity and functional heterogeneity within the gut, expanding our understanding of their role beyond innate defense (<xref ref-type="bibr" rid="B2">2</xref>). Intestinal neutrophils refer to neutrophils that are recruited from the circulation into the intestinal mucosa in response to homeostatic or inflammatory signals. Shaped by the local microenvironment, particularly the microbiota, they adopt specific functional states. Upon intestinal homeostasis disruption, chemokines and cytokines guide neutrophils into intestinal tissue (<xref ref-type="bibr" rid="B3">3</xref>), where they undergo transcriptomic and phenotypic reprogramming into distinct functional subsets (<xref ref-type="bibr" rid="B4">4</xref>, <xref ref-type="bibr" rid="B5">5</xref>). Although whether there exist tissue-resident neutrophil populations like macrophages remains controversial, evidence indicates that circulating neutrophils can adapt and persist locally. For instance, subsets such as CXCR4<sup>+</sup> neutrophils exhibit transcriptional profiles skewed toward non-immune regulatory roles (<xref ref-type="bibr" rid="B6">6</xref>, <xref ref-type="bibr" rid="B7">7</xref>). Further support comes from the phenomenon of &#x201c;reverse transendothelial migration, &#x201c; wherein tissue-reprogrammed neutrophils re-enter circulation (<xref ref-type="bibr" rid="B8">8</xref>).</p>
<p>Research has identified distinct functional subsets of intestinal neutrophils. These neutrophil subsets engage in complex interactions with the gut microbiota, epithelial cells, and other immune cells through processes such as migration, phagocytosis, neutrophil extracellular trap formation (NETs) formation, and cytokine production (<xref ref-type="bibr" rid="B9">9</xref>, <xref ref-type="bibr" rid="B10">10</xref>). The dynamic equilibrium of neutrophil subset quantity, function, and spatial distribution is a critical determinant of intestinal immune homeostasis. Disruption of this balance can contribute to the pathogenesis and exacerbation of several intestinal immune disorders, particularly inflammatory bowel disease (IBD) and colorectal cancer (CRC) (<xref ref-type="bibr" rid="B9">9</xref>).</p>
<p>Current therapeutic approaches for these conditions primarily involve anti-inflammatory agents (such as aminosalicylates), corticosteroids, and biologics (e.g., anti-TNF-&#x3b1; monoclonal antibodies and interleukin inhibitors) (<xref ref-type="bibr" rid="B11">11</xref>). The medicinal value of aspirin, a conventional anti-inflammatory medication, in these scenarios has recently been investigated. Current statistical evidence implies that low-dose aspirin (160mg/d) as a supplementary treatment could diminish the likelihood of CRC returning through the PI3K pathway, although its exact modes of action are not yet fully elucidated (<xref ref-type="bibr" rid="B12">12</xref>). These treatments aim to control inflammation, alleviate symptoms, and protect the intestinal mucosa by broadly or selectively inhibiting immune activation (<xref ref-type="bibr" rid="B13">13</xref>). Still, most of these therapies have notable limitations and side-effects. Specifically, long-term corticosteroid use is associated with severe metabolic and infective complications, whereas biologics are hampered by high cost, variable efficacy, and potential safety risks (<xref ref-type="bibr" rid="B14">14</xref>, <xref ref-type="bibr" rid="B15">15</xref>). Furthermore, these therapies tend to modulate neutrophil function in a non-selective manner, which makes it challenging to effectively suppress excessive NETs formation and oxidative burst of pathogenic neutrophils while preserving or enhancing their pathogen-clearance and tissue-repair abilities (<xref ref-type="bibr" rid="B16">16</xref>). As a critical element of the immune defense mechanism, NETs have become a major focus for developing direct pharmacological interventions. Notably, PAD4 inhibitors, including GSK484 and Cl-amidine, can block NETs formation by inhibiting histone citrullination (<xref ref-type="bibr" rid="B17">17</xref>, <xref ref-type="bibr" rid="B18">18</xref>). Similarly, DNase I degraded the DNA scaffold of existing NETs, and alleviated NETs-mediated immunothrombosis and tissue injury (<xref ref-type="bibr" rid="B19">19</xref>). Furthermore, studies indicated that PAD4 inhibitors and DNase I synergistically reduce hepatic metastasis and peritoneal dissemination in CRC models (<xref ref-type="bibr" rid="B20">20</xref>). Although the neutrophil elastase inhibitor sivelestat is primarily used for acute lung injury (<xref ref-type="bibr" rid="B21">21</xref>), it may theoretically influence NETs formation and require experimental validation in intestinal diseases. Nevertheless, such drugs are often limited by single targets, short half-lives, potential interference with normal anti-infective immunity, and unverified long-term safety (<xref ref-type="bibr" rid="B22">22</xref>, <xref ref-type="bibr" rid="B23">23</xref>), precluding their adoption as standard therapies.</p>
<p>Natural products and their derived compounds, encompassing alkaloids, quinones, polysaccharides, polyphenols, glycosides, terpenoids, microbiota-derived metabolites, which offer a promising alternative therapeutic strategy for the bidirectional regulation of neutrophils due to their multi-target mechanisms, low toxicity, and favorable safety profiles (<xref ref-type="bibr" rid="B24">24</xref>). These compounds have garnered attention for their potential in bidirectional immune modulation. Numerous studies have demonstrated that natural products can precisely intervene in neutrophil-mediated inflammatory processes and tissue damage (<xref ref-type="bibr" rid="B25">25</xref>). Notably, the effects of natural products are not confined to single targets. They also indirectly modulate neutrophil function by influencing epithelial barrier, T-cell differentiation, and the gut microbiota, thereby demonstrating a multi-layered, network-based immunomodulatory potential (<xref ref-type="bibr" rid="B26">26</xref>). In addition, emerging strategies point to targeting neutrophils to enhance the therapeutic precision and efficacy of natural products in intestinal immune diseases (<xref ref-type="bibr" rid="B27">27</xref>).</p>
<p>Taken together, the review aims to systematically elucidate the heterogeneity and functional diversity of intestinal neutrophils, along with their complex interactions within the intestinal microenvironment. It particularly focuses on how natural products precisely and multi-targetedly modulate neutrophil functions. The objective is to provide a robust theoretical framework and forward-looking insights to guide the development of novel therapeutic strategies that leverage natural products for the precise and bidirectional regulation of neutrophils.</p>
</sec>
<sec id="s2">
<label>2</label>
<title>Heterogeneity and functional diversity of intestinal neutrophils</title>
<sec id="s2_1">
<label>2.1</label>
<title>Classification, phenotypic characteristics, and function of intestinal neutrophil subpopulations</title>
<p>Different neutrophil subtypes possess specific surface markers, which serve as key indicators for distinguishing between subtypes. The classification of intestinal neutrophil subpopulations (N1, N2, N3), which is based on their function and activation state, should not be conflated with that of tumor-associated neutrophils (TANs, also termed N1 and N2). In fact, their functional roles are often opposing (<xref ref-type="table" rid="T1"><bold>Table&#xa0;1</bold></xref>).</p>
<table-wrap id="T1" position="float">
<label>Table&#xa0;1</label>
<caption>
<p>Classification, phenotypic characteristics and functions of different subtypes of neutrophils in the intestinal tract.</p>
</caption>
<table frame="hsides">
<thead>
<tr>
<th valign="middle" align="center">Basis of classification</th>
<th valign="middle" align="center">Subtype</th>
<th valign="middle" align="center">Phenotypic characteristics</th>
<th valign="middle" align="center">Function</th>
<th valign="middle" align="center">Implications in disease</th>
<th valign="middle" align="center">References</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="middle" rowspan="3" align="center">Function &amp; Activation State</td>
<td valign="middle" align="center">N1</td>
<td valign="middle" align="center">High expression of CD66b, CD11b, CD16; highly activated, pro-inflammatory</td>
<td valign="middle" align="center">Phagocytosis, ROS production, NETosis, bactericidal, tissue damage</td>
<td valign="middle" align="center">Acute infection, active IBD</td>
<td valign="middle" rowspan="2" align="center">(<xref ref-type="bibr" rid="B28">28</xref>)</td>
</tr>
<tr>
<td valign="middle" align="center">N2</td>
<td valign="middle" align="center">High expression of CXCR4, CD63; anti-inflammatory and pro-repair</td>
<td valign="middle" align="center">Anti-inflammatory, immunomodulatory and pro-reparative effects</td>
<td valign="middle" align="center">IBD remission, tissue repair</td>
</tr>
<tr>
<td valign="middle" align="center">N3</td>
<td valign="middle" align="center">Similar to bone marrow mature neutrophils; immunomodulatory</td>
<td valign="middle" align="center">Potential role in immune homeostasis (function under investigation)</td>
<td valign="middle" align="center">Present in IBD</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B9">9</xref>)</td>
</tr>
<tr>
<td valign="middle" rowspan="3" align="center">Density-based subgroups</td>
<td valign="middle" align="center">LDNs</td>
<td valign="middle" align="center">Low density; high expression of CD11b, CD16 or immature phenotypes</td>
<td valign="middle" align="center">Immunosuppressive or pro-inflammatory</td>
<td valign="middle" align="center">Autoimmunity, sepsis, cancer, and other chronic inflammatory conditions</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B29">29</xref>, <xref ref-type="bibr" rid="B30">30</xref>)</td>
</tr>
<tr>
<td valign="middle" align="center">NDNs</td>
<td valign="middle" align="center">Conventional neutrophils; altered in disease</td>
<td valign="middle" align="center">Chemotaxis, phagocytosis, antibacterial</td>
<td valign="middle" align="center">Health and disease</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B31">31</xref>)</td>
</tr>
<tr>
<td valign="middle" align="center">HDNs</td>
<td valign="middle" align="center">Mature; similar to NDNs, but resting state</td>
<td valign="middle" align="center">Classical neutrophil functions (chemotaxis, phagocytosis, bactericidal activity)</td>
<td valign="middle" align="center">Minimal in health, resting state</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B32">32</xref>)</td>
</tr>
<tr>
<td valign="middle" rowspan="2" align="center">Tumor-Associated Neutrophils (TANs)</td>
<td valign="middle" align="center">N1 (Anti-tumor)</td>
<td valign="middle" align="center">IFN-&#x3b2;-driven; high expression of Fas, TRAIL, ICAM-1, low Arg1 activity</td>
<td valign="middle" align="center">Phagocytosis, cytotoxicity, T cell recruitment, production of TNF-&#x3b1;/ROS,<break/>antibody-dependent cellular cytotoxicity (ADCC), immune activation</td>
<td valign="middle" align="center">Anti-tumor in inflammation and cancer</td>
<td valign="middle" rowspan="2" align="center">(<xref ref-type="bibr" rid="B33">33</xref>, <xref ref-type="bibr" rid="B34">34</xref>)</td>
</tr>
<tr>
<td valign="middle" align="center">N2 (Pro-tumor)</td>
<td valign="middle" align="center">TGF-&#x3b2;-driven; high expression of CXCR4, VEGF, MMP9, high Arg1 activity</td>
<td valign="middle" align="center">T cell suppression, promotion of angiogenesis and metastasis, NETosis</td>
<td valign="middle" align="center">Tumor progression, immunosuppression</td>
</tr>
<tr>
<td valign="middle" rowspan="2" align="center">Surface Marker-Based</td>
<td valign="middle" align="center">CD177+</td>
<td valign="middle" align="center">Releases ROS/AMPs/NETs; produces IL-22/TGF-&#x3b2;</td>
<td valign="middle" align="center">Antibacterial, immunomodulation, microbiota interaction</td>
<td valign="middle" align="center">Dysregulation exacerbates inflammation</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B35">35</xref>, <xref ref-type="bibr" rid="B36">36</xref>)</td>
</tr>
<tr>
<td valign="middle" align="center">OLFM4+</td>
<td valign="middle" align="center">OLFM4 protein expression</td>
<td valign="middle" align="center">Modulates NETs, antibacterial (controversial)</td>
<td valign="middle" align="center">Biomarker in UC, epithelial injury</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B37">37</xref>)</td>
</tr>
<tr>
<td valign="middle" rowspan="3" align="center">Maturity</td>
<td valign="middle" align="center">Segmented Neutrophils (PMNs)</td>
<td valign="middle" align="center">Fully differentiated, segmented nucleus (2&#x2013;5 lobes)</td>
<td valign="middle" align="center">Chemotaxis, phagocytosis, antibacterial</td>
<td valign="middle" align="center">Increased in infection/inflammation</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B28">28</xref>)</td>
</tr>
<tr>
<td valign="middle" align="center">Band Neutrophils</td>
<td valign="middle" align="center">Immature, basic function</td>
<td valign="middle" align="center">Functional but less efficient chemotaxis and phagocytosis compared to segmented neutrophils</td>
<td valign="middle" align="center">Left shift in acute infection/IBD</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B38">38</xref>)</td>
</tr>
<tr>
<td valign="middle" align="center">Metamyelocytes</td>
<td valign="middle" align="center">Immature, not fully functional</td>
<td valign="middle" align="center">Maturation in bone marrow</td>
<td valign="middle" align="center">Severe left shift in infection/leukemia</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B39">39</xref>)</td>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
<sec id="s2_2">
<label>2.2</label>
<title>Dual mechanisms of different neutrophil subtypes in various diseases</title>
<p>Neutrophils play a complex dual role in intestinal diseases and are regulated by specific subtypes. In IBD, neutrophils are recruited to the mucosa in response to inflammatory signals, where they release reactive oxygen species (ROS), proteolytic enzymes, pro-inflammatory cytokines, and NETs. These actions contribute to epithelial barrier breakdown, crypt abscess formation, and amplifying inflammation (<xref ref-type="bibr" rid="B3">3</xref>, <xref ref-type="bibr" rid="B40">40</xref>, <xref ref-type="bibr" rid="B41">41</xref>). However, excessive NETs deposition is associated with an increased risk of thrombosis in active IBD, particularly UC, although it may also provide some protective hemostatic functions (<xref ref-type="bibr" rid="B42">42</xref>). Furthermore, neutrophils promote the progression of UC colitis and even transform into colitis-associated carcinomas (CAC) through the activation of the JAK/STAT pathway (<xref ref-type="bibr" rid="B43">43</xref>, <xref ref-type="bibr" rid="B44">44</xref>). Conversely, specific subsets such as CD177<sup>+</sup> neutrophils enhance bactericidal activity and produce tissue-healing factors, thereby supporting mucosal repair (<xref ref-type="bibr" rid="B35">35</xref>, <xref ref-type="bibr" rid="B36">36</xref>, <xref ref-type="bibr" rid="B45">45</xref>). Similarly, CXCR4<sup>high</sup> neutrophils contribute to tissue remodeling via MMP9 secretion (<xref ref-type="bibr" rid="B46">46</xref>, <xref ref-type="bibr" rid="B47">47</xref>). In addition, neutrophils produce pro-resolving lipid mediators, vascular endothelial growth factor (VEGF), and MCPIP1, which collectively represent another mechanism to limit excessive inflammation and maintain tissue homeostasis (<xref ref-type="bibr" rid="B48">48</xref>).</p>
<p>Within the intestinal tumor microenvironment, the function of neutrophils is influenced by local cytokines and displays context-dependence. In response to stimulation of different cytokines, such as TGF-&#x3b2;, IFN-&#x3b3;, and IFN-&#x3b2;, neutrophils have the potential to polarize toward an antitumorigenic phenotype (N1) or toward a protumorigenic phenotype (N2) (<xref ref-type="bibr" rid="B34">34</xref>, <xref ref-type="bibr" rid="B49">49</xref>&#x2013;<xref ref-type="bibr" rid="B51">51</xref>). N1 neutrophils exert anti-tumor effects through phagocytosis, ROS-mediated cytotoxicity, and recruitment of T cells. N2 neutrophils promote tumor progression by suppressing T cell activity, facilitating angiogenesis via VEGF signaling, and promoting metastasis through MMP9 and NETosis (<xref ref-type="bibr" rid="B52">52</xref>, <xref ref-type="bibr" rid="B53">53</xref>). This pro-tumorigenic NETosis can be potently induced by specific members of the dysbiotic intestinal microbiota. A key example is <italic>Fusobacterium nucleatum</italic>, a pathobiont frequently enriched in CRC. It has been demonstrated to trigger NETs formation, which subsequently enhances tumor cell proliferation and invasiveness, thereby facilitating CRC progression (<xref ref-type="bibr" rid="B54">54</xref>). This exemplifies a direct mechanistic link between a dysbiotic bacterium, neutrophil activation, and tumor progression.</p>
<p>Moreover, the functional duality of neutrophils extends to other intestinal disorders. In infectious enteritis, neutrophils provide essential defense against pathogens like Salmonella through phagocytosis, ROS production, and NETs formation (<xref ref-type="bibr" rid="B55">55</xref>&#x2013;<xref ref-type="bibr" rid="B57">57</xref>). However, excessive activation can exacerbate tissue damage, as seen in Clostridium difficile infection (<xref ref-type="bibr" rid="B58">58</xref>). In irritable bowel syndrome, neutrophils contribute to barrier disruption and chronicity, whereas in intestinal obstruction and necrotizing enterocolitis, their early bactericidal activity may be offset by ROS and protease-mediated injury (<xref ref-type="bibr" rid="B59">59</xref>). In diverticulitis, rapid neutrophil recruitment localizes infection and prevents peritonitis, albeit at the cost of local tissue destruction (<xref ref-type="bibr" rid="B60">60</xref>&#x2013;<xref ref-type="bibr" rid="B62">62</xref>).</p>
</sec>
</sec>
<sec id="s3">
<label>3</label>
<title>Mechanisms of interaction between neutrophils and the microbiome and other cells</title>
<p>Neutrophils are of crucial significance for maintaining intestinal homeostasis and could influence the intestine through three primary interaction mechanisms, including neutrophil-gut microbiota interactions, neutrophil-epithelial cell interactions, and neutrophil-immune cell interactions.</p>
<sec id="s3_1">
<label>3.1</label>
<title>Neutrophils-gut microbiota</title>
<p>Neutrophils directly or indirectly impact the local gut microbiota via multiple pathways (<xref ref-type="fig" rid="f1"><bold>Figure&#xa0;1</bold></xref>). Their phagocytic activity eliminates pathogens and dysbiotic commensals (<xref ref-type="bibr" rid="B63">63</xref>). Activated neutrophils release antimicrobial peptides and ROS via receptors such as GPR120 to eliminate bacteria (<xref ref-type="bibr" rid="B38">38</xref>, <xref ref-type="bibr" rid="B57">57</xref>, <xref ref-type="bibr" rid="B64">64</xref>). In addition, NETs can directly capture and kill microorganisms during NETosis (<xref ref-type="bibr" rid="B65">65</xref>, <xref ref-type="bibr" rid="B66">66</xref>). Furthermore, NETosis itself can be mediated by the inflammasome, leading to the release of chemokines and cytokines that indirectly affect the microbiota (<xref ref-type="bibr" rid="B58">58</xref>, <xref ref-type="bibr" rid="B67">67</xref>). Neutrophils can also activate the NF-&#x3ba;B signaling pathway through TLR receptors and help counteract dysbiosis through the upregulation of AHR-mediated &#x3b1;-defensin 1 (<xref ref-type="bibr" rid="B68">68</xref>, <xref ref-type="bibr" rid="B69">69</xref>). Oxidative stress from neutrophils may suppress anaerobes and promote aerotolerant pathogens, worsening dysbiosis (<xref ref-type="bibr" rid="B66">66</xref>, <xref ref-type="bibr" rid="B70">70</xref>). This dysbiosis-driven process can exert influence on tumor microenvironments beyond the gut. For instance, a recent single-cell analysis of CRC peritoneal metastasis revealed that intestinal microbiota dysbiosis promotes the recruitment of inflammatory, pro-tumorigenic neutrophils, which in turn drive mesenchymal transition of malignant and mesothelial cells, thereby facilitating metastatic spread (<xref ref-type="bibr" rid="B71">71</xref>). This exemplifies a direct link between dysbiosis, neutrophil recruitment, and tumor progression. Conversely, the intestine microbiota precisely regulates neutrophil function through metabolic products and molecular signaling. Specific microbial metabolites influence neutrophil metabolism (<xref ref-type="bibr" rid="B72">72</xref>). (Refer to Section 3.8 for details.) The microbiota also employs multiple indirect pathways to fine-tune neutrophil recruitment, activation, and function. These, including the C3 complement pathway (<xref ref-type="bibr" rid="B73">73</xref>), AMPK signaling (<xref ref-type="bibr" rid="B74">74</xref>), the CXCL3-PD-L1 axis (<xref ref-type="bibr" rid="B75">75</xref>), inflammasome activity (<xref ref-type="bibr" rid="B76">76</xref>), and Treg cell differentiation (<xref ref-type="bibr" rid="B77">77</xref>), form a complex network of immune microenvironment interactions.</p>
<fig id="f1" position="float">
<label>Figure&#xa0;1</label>
<caption>
<p>The interaction mechanism between neutrophils and gut microbiota, epithelial cells. <bold>(A)</bold> Neutrophils act on the microbiota through phagocytosis, the release of ROS, antimicrobial peptides (AMPs), and NETs, or through signaling pathways, inflammatory pathways, and immune regulation. Beneficial metabolites in the intestinal microbiota regulate the chemotaxis, apoptosis and NETosis of neutrophils, while pathogen-related molecules strongly activate neutrophils or indirectly regulate them through signaling pathways. <bold>(B)</bold> Neutrophils and epithelial cells interact through inflammatory pathways, signaling pathways, immune regulation and apoptosis in the four stages of recruitment and adhesion, transepithelial migration, epithelial-site interaction, and repair and regression.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-16-1754107-g001.tif">
<alt-text content-type="machine-generated">Diagram illustrating the interaction between neutrophils, gut microbiota, and epithelial cells. Section A depicts mutual influences: neutrophils release antimicrobial peptides and form NETs impacting microbiota, while microbiota metabolites like SCFA affect neutrophil function. Section B shows neutrophil behavior concerning epithelial cells: recruitment and adhesion through LFA-1/ICAM-1, transepithelial migration involving MMP-9, interactions producing ROS and apoptosis, and repair processes involving LXs. The diagram highlights complex immune and microbial interactions in the gut.</alt-text>
</graphic></fig>
</sec>
<sec id="s3_2">
<label>3.2</label>
<title>Neutrophil-epithelial cell</title>
<p>The interaction between neutrophils and intestinal epithelial cells (IECs) can be divided into four key processes. Recruitment and adhesion: Under inflammatory stimuli, IECs release chemokines (<xref ref-type="bibr" rid="B78">78</xref>, <xref ref-type="bibr" rid="B79">79</xref>), promoting neutrophil adhesion to and retention within the epithelium via adhesion molecules such as LFA-1/ICAM-1 (<xref ref-type="bibr" rid="B80">80</xref>, <xref ref-type="bibr" rid="B81">81</xref>). Transmigration: Neutrophils migrate from the lamina propria to the epithelium guided by IL-8, IL-6, IL-33 (<xref ref-type="bibr" rid="B82">82</xref>&#x2013;<xref ref-type="bibr" rid="B84">84</xref>), and other factors, utilizing proteases such as CD11b/CD18 and MMP-9 to cleave tight junction proteins and form migration channels (<xref ref-type="bibr" rid="B78">78</xref>, <xref ref-type="bibr" rid="B85">85</xref>). Interaction: Neutrophils interact with IECs at injury sites through NETs release, ROS, degranulation, and pro-inflammatory factors (<xref ref-type="bibr" rid="B86">86</xref>, <xref ref-type="bibr" rid="B87">87</xref>). At the same time, IECs modulate neutrophil antimicrobial responses and infiltration levels via the chemerin-CMKLR1/LPO axis (<xref ref-type="bibr" rid="B88">88</xref>). Resolution of Inflammation: During resolution, neutrophils undergo apoptosis or release pro-resolving mediators, and thus facilitate tissue repair (<xref ref-type="bibr" rid="B89">89</xref>&#x2013;<xref ref-type="bibr" rid="B91">91</xref>). It is noteworthy that excessive neutrophil activity or dysregulated defensins can exacerbate mucosal damage (<xref ref-type="bibr" rid="B92">92</xref>).</p>
</sec>
<sec id="s3_3">
<label>3.3</label>
<title>Neutrophils-immune cells</title>
<sec id="s3_3_1">
<label>3.3.1</label>
<title>Neutrophils-myeloid immune cells</title>
<p>The recruitment of neutrophils is regulated by myeloid immune cells such as monocytes, macrophages, and dendritic cells (DCs). In the pre-inflammatory stage, macrophages and DCs produce factors such as CXCL8 and TNF-&#x3b1; that stimulate neutrophil recruitment (<xref ref-type="bibr" rid="B93">93</xref>) (<xref ref-type="fig" rid="f2"><bold>Figure&#xa0;2</bold></xref>). Neutrophils amplify recruitment signals to attract macrophages and DCs, forming a feedback loop. Macrophages also influence neutrophil trafficking in the inflamed mucosa by modulating the endothelial cell (EC) TNFR2 axis (<xref ref-type="bibr" rid="B81">81</xref>). When neutrophils and macrophages reach the site of inflammation, they cooperate in phagocytosis and antigen presentation. During the resolution phase of inflammation, macrophages not only drive necroptosis of neutrophils by inhibiting the TLR4/NF-&#x3ba;B pathway (<xref ref-type="bibr" rid="B94">94</xref>), but also efficiently clear apoptotic neutrophils through phagocytosis (<xref ref-type="bibr" rid="B95">95</xref>). Failed clearance of apoptotic neutrophils leads to secondary necrosis and persistent inflammation. In addition, the metabolic reprogramming cooperation between neutrophils and macrophages can also regulate inflammatory responses (<xref ref-type="bibr" rid="B96">96</xref>).</p>
<fig id="f2" position="float">
<label>Figure&#xa0;2</label>
<caption>
<p>The interaction relationships between neutrophils and myeloid, lymphoid immune cells.Neutrophils act on macrophages, DCs, T cells and B cells through immune regulation, pyroptosis, apoptosis and inflammatory pathways. Myeloid immune cells activate neutrophils in the early stage and phagocytize apoptotic neutrophils in the later stage of inflammation.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-16-1754107-g002.tif">
<alt-text content-type="machine-generated">Diagram illustrating the role of neutrophils as immune cells. It shows bacterial migration to the inflammation site, activating neutrophils. Arrows depict interactions between macrophages, dendritic cells (DCs), T cells, and B cells, with processes like transportation, apoptosis, proliferation, and antigen presentation. Key molecules such as EC-TNF-2, TNF-alpha, IL-1beta, IL-6, GSDMD, TCRγδ/CD8αα Lymphocyte, and CXCL8 are labeled, highlighting specific pathways and responses, including Th17 and Treg cell functions.</alt-text>
</graphic></fig>
</sec>
<sec id="s3_3_2">
<label>3.3.2</label>
<title>Neutrophil-lymphoid immune cells</title>
<p>Neutrophils suppress intestinal inflammation by regulating TCR&#x3b3;&#x3b4;CD8&#x3b1;&#x3b1;-expressing intestinal lymphocyte activation through GSDMD-mediated pyroptosis (<xref ref-type="bibr" rid="B35">35</xref>). IL-6 drives Th17 differentiation, and Th17-derived chemokines recruit neutrophils in adaptive immunity (<xref ref-type="bibr" rid="B97">97</xref>, <xref ref-type="bibr" rid="B98">98</xref>). In the gut, neutrophils play a crucial role in maintaining the balance between Th17 cells and Treg cells. Meanwhile, lymphocytes also exert feedback regulation on neutrophils (<xref ref-type="bibr" rid="B77">77</xref>). Additionally, neutrophils can directly present antigens to T cells under certain conditions (<xref ref-type="bibr" rid="B99">99</xref>, <xref ref-type="bibr" rid="B100">100</xref>). In CRC, the interaction between CD15<sup>+</sup> neutrophils and CD8<sup>+</sup> T cells is linked to tumor progression (<xref ref-type="bibr" rid="B101">101</xref>). Neutrophils further support B cell survival, proliferation, and plasma cell differentiation, enhancing IgA production in the mucosa (<xref ref-type="bibr" rid="B102">102</xref>).</p>
</sec>
</sec>
</sec>
<sec id="s4">
<label>4</label>
<title>Regulatory effects of natural products targeting intestinal neutrophils</title>
<sec id="s4_1">
<label>4.1</label>
<title>Alkaloids</title>
<p>Alkaloids are a class of nitrogen-containing organic compounds that occur widely in nature, primarily in plants. These compounds exhibit a range of significant biological activities, including antibacterial, antioxidant, anti-inflammatory, and anti-tumor effects (<xref ref-type="fig" rid="f3"><bold>Figure&#xa0;3</bold></xref>, <xref ref-type="table" rid="T2"><bold>Table&#xa0;2</bold></xref>).</p>
<fig id="f3" position="float">
<label>Figure&#xa0;3</label>
<caption>
<p>A schematic overview of natural products regulating intestinal neutrophils is described in detail. These natural products are categorised into nine classes: alkaloids, quinones, polysaccharides, polyphenols, glycosides, terpenoids, microbiota-derived metabolites, natural medicinal materials, and traditional Chinese medicine compounds.The section outside the circle illustrates five common pathways through which natural products intervene in intestinal neutrophils: oxidative stress, pyroptosis, microbiota effects, downstream inflammatory factors influenced by the NF-&#x3ba;B pathway and NETs.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-16-1754107-g003.tif">
<alt-text content-type="machine-generated">Diagram illustrating the interaction between various gut microbiota, immune responses, and different chemical compounds. It features segmented sections on polysaccharides, alkaloids, quinones, glycosides, and more. Arrows and pathways show influences on signaling molecules like NF-kB, AMPK, and ROS, reflecting complex biochemical interactions in health or disease contexts.</alt-text>
</graphic></fig>
<table-wrap id="T2" position="float">
<label>Table&#xa0;2</label>
<caption>
<p>Overview of natural products acting in the gut neutrophil.</p>
</caption>
<table frame="hsides">
<thead>
<tr>
<th valign="middle" colspan="3" align="center">Natural products</th>
<th valign="middle" align="center">Disease/research model</th>
<th valign="middle" align="center">Regulation of neutrophil functions</th>
<th valign="middle" align="center">Other regulatory functions</th>
<th valign="middle" align="center">Regulation of disease phenotype</th>
<th valign="middle" align="center">References</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="middle" rowspan="6" align="center">Alkaloids</td>
<td valign="middle" colspan="2" align="center">Berberine</td>
<td valign="middle" align="center">CPT11&#x2010;induced mice model of intestinal mucositis; Dextran sulphate sodium (DSS)-induced mice model of IBD</td>
<td valign="middle" align="center">The interaction of LINC00668 with NE&#x2193;, the nuclear translocation of NE&#x2193;; neutrophil activation and infiltration&#x2193;</td>
<td valign="middle" align="center">TJs (ZO-1, Claudin-7, Occludin)&#x2191;; COX-2&#x2193;, iNOS&#x2193;, IL-8&#x2193;; GUS activity&#x2193;, SN38&#x2193;</td>
<td valign="middle" align="center">Repair the intestinal barrier function;<break/>Anti-inflammatory effects;<break/>Regulate the &#x201c;epithelial - neutrophil&#x201d; interaction</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B86">86</xref>, <xref ref-type="bibr" rid="B103">103</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Berbamine</td>
<td valign="middle" align="center">DSS-induced mice model of UC</td>
<td valign="middle" align="center">PAD4&#x2193;, Cit-H3&#x2193;, MPO&#x2193;, NE&#x2193;, NETs&#x2193;; neutrophil activation and infiltration&#x2193;</td>
<td valign="middle" align="center">IL-1&#x3b2;, TNF-&#x3b1;&#x2193;</td>
<td valign="middle" align="center">Anti-inflammatory effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B104">104</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Lycopodium</td>
<td valign="middle" align="center">Acetic acid (AA)-induced model of IBD in rats</td>
<td valign="middle" align="center">MPO&#x2193;, calprotectin&#x2193;, neutrophil activation, recruitment and infiltration&#x2193;</td>
<td valign="middle" align="center">IL-1&#x3b2;&#x2193;, IL-23&#x2193;, NF-&#x3ba;B&#x2193;; GSH&#x2191;, SOD&#x2191;, Catalase (CAT)&#x2191;, MDA&#x2193;</td>
<td valign="middle" align="center">Anti-inflammatory effects;<break/>Reduce oxidative stress</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B105">105</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Tetramethylpyrazine</td>
<td valign="middle" align="center">Sodium taurocholate-induced ANP model in rats</td>
<td valign="middle" align="center">MPO&#x2193;,<break/>neutrophil infiltration&#x2193;</td>
<td valign="middle" align="center">Ca<sup>2+</sup>&#x2193;, ROS&#x2193;</td>
<td valign="middle" align="center">Reduce oxidative stress</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B106">106</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Lemairamin (Wgx-50)</td>
<td valign="middle" align="center">DSS immersion to establish a zebrafish colitis model</td>
<td valign="middle" align="center">Neutrophil recruitment&#x2193;</td>
<td valign="middle" align="center">Akt&#x2193;, pro-inflammatory cytokines (IL-1&#x3b2;, IL-6, CXCL8a, TNF-&#x3b1;)&#x2193;</td>
<td valign="middle" align="center">Anti-inflammatory effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B107">107</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Cavidine</td>
<td valign="middle" align="center">AA-induced model of UC in rats</td>
<td valign="middle" align="center">Neutrophil activation and migration&#x2193;</td>
<td valign="middle" align="center">GSH&#x2191;, SOD&#x2191;, MDA&#x2193;, ROS&#x2193;; NF-&#x3ba;B&#x2193;, TNF-&#x3b1;&#x2193;, IL-6&#x2193;</td>
<td valign="middle" align="center">Reduce oxidative stress;<break/>Anti-inflammatory effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B108">108</xref>)</td>
</tr>
<tr>
<td valign="middle" rowspan="2" align="center">Quinones</td>
<td valign="middle" colspan="2" align="center">TanshinoneIIA</td>
<td valign="middle" align="center">Azoxymethane (AOM)/DSS-induced murine CRC model</td>
<td valign="middle" align="center">MPO&#x2193;, neutrophil activation&#x2193;; migration and infiltration&#x2193;</td>
<td valign="middle" align="center">Ly6G&#x2193;, ROS&#x2193;; intestinal permeability&#x2193;; NF-&#x3ba;B&#x2193;, p-p65 and p-I&#x3ba;B&#x3b1;&#x2193;, pro-inflammatory cytokines (IL-1&#x3b2;, IL-6, IL-10, IL-17A, IFN-&#x3b3; and TNF-&#x3b1;)&#x2193;</td>
<td valign="middle" align="center">Reduce oxidative stress;<break/>Repair the intestinal barrier function;<break/>Anti-inflammatory effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B109">109</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Rhein</td>
<td valign="middle" align="center">Tail-cutting-induced zebrafish inflammatory models</td>
<td valign="middle" align="center">Neutrophil migration, activation and infiltration&#x2193;</td>
<td valign="middle" align="center">NF-&#x3ba;B&#x2193;, p-p65&#x2193;, proinflammatory cytokines (IL-6, IL-1&#x3b2;, TNF-&#x3b1;)&#x2193;, iNOS&#x2193;, COX-2&#x2193;, NO&#x2193;; NLRP3&#x2193;, cleaved IL-1&#x3b2;&#x2193;</td>
<td valign="middle" align="center">Anti-inflammatory effects;<break/>Anti-pyroptotic effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B110">110</xref>)</td>
</tr>
<tr>
<td valign="middle" rowspan="3" align="center">Polysaccharides</td>
<td valign="middle" colspan="2" align="center">A. macrocephalae polysaccharides (AMP)</td>
<td valign="middle" align="center">DSS-induced mice model of acute colitis</td>
<td valign="middle" align="center">Neutrophil infiltration, migration and aggregation&#x2193;</td>
<td valign="middle" align="center">TJs (ZO-1, Claudin-7, Occludin)&#x2191;, MUC-2&#x2191;; TNF-&#x3b1;&#x2193;, IL-1&#x3b2;&#x2193;, IL-6&#x2193;; beneficial bacteria (Bifidobacterium, Faecalibaculum)&#x2191;, harmful bacteria (EscherichiaShigella, Clostridiumsensustricto1)&#x2193;</td>
<td valign="middle" align="center">Repair the intestinal barrier function;<break/>Anti-inflammatory effects;<break/>Regulate the &#x201c;microbiota-neutrophil&#x201d; interaction</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B111">111</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Agaricus blazei Murill</td>
<td valign="middle" align="center">Temporary superior mesenteric artery occlusion-induced mouse intestinal I/R model</td>
<td valign="middle" align="center">Neutrophil recruitment&#x2193;</td>
<td valign="middle" align="center">TJs (ZO-1, Occludin)&#x2191;; NLRP3&#x2193;, TNF-&#x3b1;&#x2193;, IL-1&#x3b2;&#x2193;; SCFA producing bacteria (Ligilactobacillus, Blautia)&#x2191;, butyrate&#x2191;; ROS&#x2193;</td>
<td valign="middle" align="center">Repair the intestinal barrier function;<break/>Anti-pyroptotic effects;<break/>Regulate the &#x201c;microbiota-neutrophil&#x201d; interaction;<break/>Reduce oxidative stress</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B112">112</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Grifola frondosa polysaccharides</td>
<td valign="middle" align="center">An oxazolone-induced mice model of UC</td>
<td valign="middle" align="center">Neutrophil infiltration and migration&#x2193;</td>
<td valign="middle" align="center">Anti-inflammatory cytokine (IL-10)&#x2191;, pro-inflammatory cytokines (IL-6 and TNF-&#x3b1;)&#x2193;</td>
<td valign="middle" align="center">Anti-inflammatory effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B113">113</xref>)</td>
</tr>
<tr>
<td valign="middle" rowspan="12" align="center">Polyphenols</td>
<td valign="middle" colspan="2" align="center">Forsythiaside A</td>
<td valign="middle" align="center">DSS-induced mice model of UC</td>
<td valign="middle" align="center">PAD4&#x2193;, Cit-H3&#x2193;, MPO&#x2193;, NETs&#x2193;; neutrophil infiltration&#x2193;</td>
<td valign="middle" align="center">IL-1&#x3b2;&#x2193;, TNF-&#x3b1;&#x2193;; SCFAs&#x2191;</td>
<td valign="middle" align="center">Anti-inflammatory effects;<break/>Regulate gut microbiota</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B114">114</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Isochlorogenic acid A</td>
<td valign="middle" align="center">DSS-induced mice model of UC</td>
<td valign="middle" align="center">Neutrophil recruitment, activation and infiltration&#x2193;</td>
<td valign="middle" align="center">TJs (ZO-1, ZO-2, Occludin)&#x2191;, MUC-2&#x2191;; STAT3/NF-&#x3ba;B&#x2193;, p-STAT3&#x2193;, p-p65 and p-I&#x3ba;B&#x3b1;&#x2193;, pro-inflammatory cytokines (TNF-&#x3b1;, IL-6, IL-1&#x3b2;)&#x2193;</td>
<td valign="middle" align="center">Repair the intestinal barrier function;<break/>Anti-inflammatory effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B115">115</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Chlorogenic acid</td>
<td valign="middle" align="center">DSS-induced mice model of UC; Apc<sup>min/+</sup> tumorigenesis mouse models and orthotopic implanted CRC mouse models</td>
<td valign="middle" align="center">4-HPA&#x2193;, AK2/STAT3&#x2193;, CXCL3&#x2193;, PMN-MDSC&#x2193;, neutrophil infiltration&#x2193;</td>
<td valign="middle" align="center">NF-&#x3ba;B&#x2193;, p-P65&#x2193;, IL-1&#x3b2;&#x2193;, TNF&#x3b1;&#x2193;, IL-6&#x2193;, IL-12&#x2191;; the proportions of Firmicutes and Bacteroidetes&#x2193;, the relative abundance of Akkermansia&#x2191;, mucus layer thickness&#x2191;</td>
<td valign="middle" align="center">Anti-inflammatory effects;<break/>Repair the intestinal barrier function;<break/>Anti-cancer effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B116">116</xref>, <xref ref-type="bibr" rid="B117">117</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Curcumin</td>
<td valign="middle" align="center">The colonic mucosa in an experimental model of DC; DSS-induced mice model of colitis; TNF-&#x3b1;-induced mice model of colitis</td>
<td valign="middle" align="center">MPO&#x2193;, neutrophil recruitment and infiltration&#x2193;</td>
<td valign="middle" align="center">NF-&#x3ba;B&#x2193;, pro-inflammatory cytokines (TNF-&#x3b1;, IL-6, IL-8)&#x2193;, cytokines&#x2193;, antioxidant gene&#x2191;; iNOS&#x2193;, NO&#x2193;, ROS&#x2193;; Bcl-6-Syk-BLNK&#x2193;, the transformation of primordial B cells into memory B cells&#x2191;, induced memory B cells/pro-inflammatory factors&#x2193;, tolerant memory B cells/anti-inflammatory factors&#x2191;, CXCR3&#x2193;</td>
<td valign="middle" align="center">Anti-inflammatory effects;<break/>Reduce oxidative stress;<break/>Modulate immune response</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B118">118</xref>&#x2013;<xref ref-type="bibr" rid="B120">120</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Astragalin</td>
<td valign="middle" align="center">DSS-induced mice model of UC</td>
<td valign="middle" align="center">Neutrophil activation and infiltration&#x2193;</td>
<td valign="middle" align="center">ZO-1&#x2191;, Occludin&#x2191;, Muc2&#x2191;; NF-&#x3ba;B&#x2193;, pro-inflammatory cytokines (TNF-&#x3b1;, IL-6, IL-1&#x3b2;)&#x2193;; Escherichia-Shigella&#x2193;, Ruminococcaceae&#x2191;</td>
<td valign="middle" align="center">Repair the intestinal barrier function;<break/>Anti-inflammatory effects;<break/>Regulate gut microbiota</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B121">121</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Hesperetin</td>
<td valign="middle" align="center">LPS-indueed septie rats</td>
<td valign="middle" align="center">LC3B&#x2193;, LC3-I/LC3-II&#x2193;, CitH3&#x2193;, MPO&#x2193;, NETs&#x2193;</td>
<td valign="middle" align="center">I-FABP&#x2193;, TJs (Occludin, Claudin-1)&#x2191;; TLR4/NF-&#x3ba;B&#x2193;, Nrf2&#x2193;, HO-1&#x2193;, MDA&#x2193;, GSH&#x2193;, LPO&#x2193;, ROS&#x2193;</td>
<td valign="middle" align="center">Repair the intestinal mechanical barrier function;<break/>Reduce oxidative stress;<break/>Reduce autophagy</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B122">122</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Quercetin</td>
<td valign="middle" align="center">DSS-induced mice model of UC; HCT116 cells-inoculated mouse model of CRC</td>
<td valign="middle" align="center">Ahr&#x2191;, Arnt&#x2191;, ROS/Nqo1&#x2193;, NETs&#x2193;; PAD4&#x2193;, Cit-H3&#x2193;, NETs&#x2193;; neutrophil chemotaxis, activation and infiltration&#x2193;</td>
<td valign="middle" align="center">Ahr&#x2191;, NF-&#x3ba;B&#x2193;, pro-inflammatory cytokines&#x2193;, TNF/IL-17/AGE-RAGE&#x2193;, IL1&#x3b2;&#x2193;, IL6&#x2193;, CXCL8&#x2193;, MMP9&#x2193;; Th17 differentiation&#x2193;, Tregs differentiation&#x2191;; TJs&#x2191;; PAD4&#x2193;, IEC apoptosis&#x2193;</td>
<td valign="middle" align="center">Anti-inflammatory effects;<break/>Modulate immune response;<break/>Repair the intestinal barrier function;<break/>Regulate the &#x201c;epithelial-neutrophil&#x201d; interaction</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B123">123</xref>&#x2013;<xref ref-type="bibr" rid="B125">125</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Dihydromyricetin</td>
<td valign="middle" align="center">DSS-induced mice model of acute colitis</td>
<td valign="middle" align="center">HIF-1&#x3b1;/VEGFA&#x2193;, NETs&#x2193;</td>
<td valign="middle" align="center">ZO-1&#x2191;, Occludin&#x2191;</td>
<td valign="middle" align="center">Repair the intestinal barrier function</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B126">126</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Kurarinone</td>
<td valign="middle" align="center">Trinitrobenzene sulfonic acid (TNBS)-induced mice model of colitis</td>
<td valign="middle" align="center">Neutrophil chemotaxis, activation and infiltration&#x2193;</td>
<td valign="middle" align="center">TJs (ZO-1, Ocludin, Claudin, E-cadherin)&#x2191;, goblet cell&#x2191;, mucins&#x2191;; beneficial microbial taxa (Lactobacullus, Lactobacillales and Lactobacillaceae)&#x2191;, harmful microbial taxa (Mollicutes)&#x2193;; Blimp-1&#x2191;, IL-17A&#x2193;, IL-10&#x2191;, pro-inflammatory cytokines&#x2193;</td>
<td valign="middle" align="center">Repair the intestinal barrier function;<break/>Regulate gut microbiota;<break/>Anti-inflammatory effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B127">127</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Catechins</td>
<td valign="middle" align="center">Rats subjected to splanchnic artery occlusion and reperfusion; neutrophils and human colon cancer cell line SW480</td>
<td valign="middle" align="center">STAT3&#x2193;, CXCL8&#x2193;, NETs&#x2193;; neutrophil infiltration&#x2193;</td>
<td valign="middle" align="center">Pro-inflammatory cytokines (TNF-&#x3b1;)&#x2193;, ICAM-1/P-selectin&#x2193;; MDA&#x2193;, ROS&#x2193;</td>
<td valign="middle" align="center">Anti-inflammatory effects;<break/>Reduce oxidative stress</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B128">128</xref>, <xref ref-type="bibr" rid="B129">129</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Glabridin</td>
<td valign="middle" align="center">DSS-induced mice model of colitis and colitis-associated cancer</td>
<td valign="middle" align="center">Neutrophil recruitment, activation and infiltration&#x2193;</td>
<td valign="middle" align="center">P-STAT3&#x2193;, MMPs (MMP1, MMP3)&#x2193;, CXC chemokine (CXCL1, CXCL2)&#x2193;; E-cadherin&#x2191;, EMT&#x2191;</td>
<td valign="middle" align="center">Anti-inflammatory effects;<break/>Repair the intestinal barrier function</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B130">130</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Kaempferol</td>
<td valign="middle" align="center">HCT116 cells-inoculated mouse model of CRC; a murine model of high fat diet-induced obesity and gut inflammation</td>
<td valign="middle" align="center">Neutrophil infiltration&#x2193;</td>
<td valign="middle" align="center">VEGF/Akt/p38&#x2193;, intestinal microvascular endothelial cells&#x2193;; IL1&#x3b2;&#x2193;, IL6&#x2193;, CXCL8&#x2193;, MMP9&#x2193;, TLR4/NF-&#x3ba;B&#x2193;, pro-inflammatory cytokines (MCP-1, TNF-&#x3b1;, IL-6)&#x2193;, chemokines (MCP-1)&#x2193;; Desulfovibrio/Helicobacter&#x2193;, Parasutterella&#x2191;</td>
<td valign="middle" align="center">Improve intestinal microcirculation;<break/>Anti-inflammatory effects;<break/>Regulate gut microbiota</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B125">125</xref>, <xref ref-type="bibr" rid="B131">131</xref>)</td>
</tr>
<tr>
<td valign="middle" rowspan="3" align="center">Glycosides</td>
<td valign="middle" colspan="2" align="center">Ursolic acid</td>
<td valign="middle" align="center">DSS-induced mice model of UC</td>
<td valign="middle" align="center">Neutrophil activation and recruitment&#x2193;</td>
<td valign="middle" align="center">MAPKs&#x2193;, IL-6/STAT3&#x2193;, IL-6&#x2193;, NF-&#x3ba;B&#x2193;, pro-inflammatory cytokines&#x2193;; PI3K&#x2193;, innate immune cells&#x2193;; AMPK/FOXO&#x2193;, ROS&#x2193;; intestinal flora abundance&#x2193;</td>
<td valign="middle" align="center">Anti-inflammatory effects;<break/>Modulate immune response;<break/>Reduce oxidative stress;<break/>Regulate gut microbiota</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B132">132</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Glycyrrhizic acid</td>
<td valign="middle" align="center">AOM/DSS-induced mice model of CAC</td>
<td valign="middle" align="center">PAD4&#x2193;, dsDNA&#x2193;, MPO&#x2193;, ROS&#x2193;, Cit-H3&#x2193;, NETs&#x2193;</td>
<td valign="middle" align="center">CD8+T&#x2193;, PD-1&#x2193;; Occludin&#x2191;, ZO-1&#x2191;</td>
<td valign="middle" align="center">Modulate immune response;<break/>Repair the intestinal barrier function</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B133">133</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Anemoside B4</td>
<td valign="middle" align="center">TNBS-induced model of colitis in rats</td>
<td valign="middle" align="center">Neutrophil accumulation and migration&#x2193;</td>
<td valign="middle" align="center">S100A9&#x2193;, TLR4&#x2193;, MAPK (p38, JNK, ERK)/NF-&#x3ba;B&#x2193;, pro-inflammatory cytokines (IL-1&#x3b2;, IL-6, TNF-&#x3b1;)&#x2193;; apoptotic cells&#x2193;, Bax/cleaved caspase3&#x2191;, Bcl-2&#x2193;</td>
<td valign="middle" align="center">Anti-inflammatory effects;<break/>Repair the intestinal barrier function</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B134">134</xref>)</td>
</tr>
<tr>
<td valign="middle" rowspan="5" align="center">Terpenoids</td>
<td valign="middle" colspan="2" align="center">Menthol</td>
<td valign="middle" align="center">AA-induced model of colitis in rats</td>
<td valign="middle" align="center">MPO&#x2193;, neutrophil activation and infiltration&#x2193;</td>
<td valign="middle" align="center">Calprotectin&#x2193;, pro-inflammatory cytokines (IL-1, IL-6, IL-23 TNF-&#x3b1;)&#x2193;; MDA&#x2193;, GSH&#x2191;</td>
<td valign="middle" align="center">Anti-inflammatory effects;<break/>Reduce oxidative stress</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B135">135</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Angelica oil</td>
<td valign="middle" align="center">DSS-induced mice model of UC</td>
<td valign="middle" align="center">Neutrophil infiltration&#x2193;</td>
<td valign="middle" align="center">S100A8/A9&#x2193;, TJs&#x2191;; NF-&#x3ba;B&#x2193;, pro-inflammatory cytokines (KC (CXCL1), LIX, G-CSF, IL-1&#x3b1;, IL-6, MCP-1)&#x2193;</td>
<td valign="middle" align="center">Repair the intestinal barrier function;<break/>Anti-inflammatory effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B136">136</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Okanagan LEO</td>
<td valign="middle" align="center">A mouse model of acute colitis caused by Citrobacter rodentium</td>
<td valign="middle" align="center">MIP-2&#x3b1;&#x2193;, neutrophil infiltration&#x2193;</td>
<td valign="middle" align="center">Pro-inflammatory cytokines (TNF-&#x3b1;, IFN-&#x3b3;, IL-22)&#x2193;, iNOS&#x2193;; Firmicutes (segmented filamentous bacteria)&#x2191;; Th17&#x2191;</td>
<td valign="middle" align="center">Anti-inflammatory effects;<break/>Regulate gut microbiota;<break/>Modulate immune response</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B137">137</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Nerolidol</td>
<td valign="middle" align="center">AA-induced model of colitis in rats</td>
<td valign="middle" align="center">Neutrophil migration and infiltration&#x2193;</td>
<td valign="middle" align="center">SOD&#x2191;, CAT&#x2191;, free radical&#x2193;, MDA&#x2193;, GSH&#x2191;; LOX-1/IL-1&#x3b2;&#x2193;, TLR4/NF-&#x3ba;B&#x2193;, AMPK/Nrf-2/HO-1&#x2193;, pro-inflammatory cytokines (IL-1&#x3b2;, IL-6, IL-23)&#x2193;</td>
<td valign="middle" align="center">Reduce oxidative stress;<break/>Anti-inflammatory effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B138">138</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Tripterygium wilfordii polycoride</td>
<td valign="middle" align="center">DSS-induced mice model of UC</td>
<td valign="middle" align="center">Neutrophil migration and infiltration&#x2193;</td>
<td valign="middle" align="center">NADPH oxidases&#x2193;, ROS&#x2193;; NLRP3 inflammasome&#x2193;, ASC&#x2193;, caspase-1&#x2193;, pro-inflammatory cytokines&#x2193;</td>
<td valign="middle" align="center">Reduce oxidative stress;<break/>Anti-pyroptotic effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B139">139</xref>)</td>
</tr>
<tr>
<td valign="middle" rowspan="4" align="center">Microbiota-derived metabolites</td>
<td valign="middle" rowspan="2" align="center">Short-chain fatty acids</td>
<td valign="middle" align="center">Butyrate</td>
<td valign="middle" align="center">DSS-induced mice model of colitis; acute murine C. jejuni-induced enterocolitis; cefoperazone-pretreated mice model</td>
<td valign="middle" align="center">HDAC&#x2193;, MPO&#x2193;, ROS&#x2193;, NETs&#x2193;; neutrophil recruitment and infiltration&#x2193;</td>
<td valign="middle" align="center">NF-&#x3ba;B&#x2193;, MCP-1/IL-6&#x2191;, pro-inflammatory cytokine (TNF-&#x3b1;, IL-8)&#x2193;, anti-inflammatory cytokines (IL-10, IL-22)&#x2191;; TJs (Claudin-3, Occludin, ZO-1)&#x2191;, intestinal mucus&#x2191;; GPR43&#x2191;</td>
<td valign="middle" align="center">Anti-inflammatory effects;<break/>Repair the intestinal barrier function;<break/>Regulate the &#x201c;microbiota-neutrophil&#x201d; interaction</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B140">140</xref>&#x2013;<xref ref-type="bibr" rid="B142">142</xref>)</td>
</tr>
<tr>
<td valign="middle" align="center">Acetate</td>
<td valign="middle" align="center">DSS-induced mice model of colitis; VD-deficient animal models</td>
<td valign="middle" align="center">Neutrophil recruitment and infiltration&#x2193;; neutrophil&#x2191;</td>
<td valign="middle" align="center">HDAC&#x2193;, Treg&#x2193;, IgA&#x2191;; CXCL2&#x2191;, CXCR2&#x2193;; Cetobacterium&#x2191;, acetate&#x2191;, IL-22&#x2191;</td>
<td valign="middle" align="center">Repair the intestinal barrier function;<break/>Regulate the &#x201c;endothelial - neutrophil&#x201d; interaction;<break/>Regulate gut microbiota</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B143">143</xref>, <xref ref-type="bibr" rid="B144">144</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Microalgae</td>
<td valign="middle" align="center">Soybean meal-induced zebrafish model</td>
<td valign="middle" align="center">Neutrophil infiltration&#x2193;</td>
<td valign="middle" align="center">Globet&#x2191;, mucus secretion&#x2191;</td>
<td valign="middle" align="center">Repair the intestinal barrier function</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B145">145</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Altechromone A</td>
<td valign="middle" align="center">TNBS-induced zebrafish model of IBD</td>
<td valign="middle" align="center">Neutrophil recruitment and migration&#x2193;</td>
<td valign="middle" align="center">STAT3/NLRP3&#x2193;, NF-&#x3ba;B&#x2193;, pro-inflammatory cytokines (IL18)&#x2193;; NO&#x2193;, ROS&#x2193;</td>
<td valign="middle" align="center">Anti-inflammatory effects;<break/>Reduce oxidative stress</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B146">146</xref>)</td>
</tr>
<tr>
<td valign="middle" rowspan="10" align="center">Natural medicinal materials</td>
<td valign="middle" colspan="2" align="center">Aucklandiae Radix</td>
<td valign="middle" align="center">DSS-induced mice model of UC</td>
<td valign="middle" align="center">Neutrophil&#x2193;</td>
<td valign="middle" align="center">PKM2&#x2193;, NF-&#x3ba;B/NLRP3&#x2193;, Foxp3&#x2193;, Treg differentiation&#x2191;, Th17 differentiation&#x2193;, pro-inflammatory cytokines (IL-6, TNF-&#x3b1;, IL-1&#x3b2;)&#x2193;</td>
<td valign="middle" align="center">Anti-inflammatory effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B147">147</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Tiliae Flos</td>
<td valign="middle" align="center">LPS-stimulated human neutrophils model</td>
<td valign="middle" align="center">Neutrophil apoptosis&#x2191;</td>
<td valign="middle" align="center">SCFAs&#x2191;, NF-&#x3ba;B&#x2193;, pro-inflammatory cytokines (TNF-&#x3b1;)&#x2193;</td>
<td valign="middle" align="center">Anti-inflammatory effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B148">148</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Phyllanthus niruri Linn</td>
<td valign="middle" align="center">1, 2 DMH-induced model of CRC in rats</td>
<td valign="middle" align="center">Neutrophil activation&#x2193;</td>
<td valign="middle" align="center">CTL&#x2191;, NK&#x2191;, apoptotic cells&#x2191;, TNF-&#x3b1;&#x2193;, interferon&#x2193;</td>
<td valign="middle" align="center">Anti-inflammatory effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B149">149</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Ethanol extract of cicer arietinum</td>
<td valign="middle" align="center">DSS-induced mice model of colitis</td>
<td valign="middle" align="center">Neutrophil activation&#x2193;</td>
<td valign="middle" align="center">NF-&#x3ba;B/STAT3&#x2193;, IL-6&#x2193;, IL-1&#x3b2;&#x2193;, TNF-&#x3b1;&#x2193;, COX-2&#x2193;, iNOS&#x2193;</td>
<td valign="middle" align="center">Anti-inflammatory effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B150">150</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Black raspberries</td>
<td valign="middle" align="center">A mouse model of colorectal cancer (Apc<sup>Min/+</sup>)</td>
<td valign="middle" align="center">Neutrophil activation and infiltration&#x2193;</td>
<td valign="middle" align="center">FFAR2&#x2191;, cAMP-PKA-CREB/Wnt&#x2193;, HDAC&#x2193;, acetyl-H3&#x2191;, the negative regulators (DKK3, SOX17)&#x2191;; IL-1&#x3b2;&#x2193;, IL-6&#x2193;, TNF-&#x3b1;&#x2193;</td>
<td valign="middle" align="center">Anti-cancer effects;<break/>Anti-inflammatory effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B151">151</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Hydroethanolic extract of fritillariae thunbergii Bulbus</td>
<td valign="middle" align="center">DSS-induced mice model of UC</td>
<td valign="middle" align="center">Neutrophil&#x2193;</td>
<td valign="middle" align="center">TJs (ZO-1, Occludin)&#x2191;, goblet cell&#x2191;; MMP-9&#x2193;, pro-inflammatory cytokines and chemokines (IL-1&#x3b2;, IL-8, TGF-&#x3b2;)&#x2193;</td>
<td valign="middle" align="center">Repair the intestinal barrier function;<break/>Anti-inflammatory effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B152">152</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Ilex rotunda Thunb.</td>
<td valign="middle" align="center">DSS-induced mice model of UC</td>
<td valign="middle" align="center">Neutrophil activation and infiltration&#x2193;</td>
<td valign="middle" align="center">TJs (Occludin, Claudin-1, ZO-1)&#x2191;; OSM&#x2193;, OSMR&#x2193;, STAT3/p-STAT3&#x2193;, TLR4/NF-&#x3ba;B&#x2193;, pro-inflammatory cytokines (IFN-&#x3b3;, IL-1&#x3b2;, IL-6)&#x2193;</td>
<td valign="middle" align="center">Repair the intestinal barrier function;<break/>Anti-inflammatory effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B153">153</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Hydroalcoholic extract of Araucaria sp.</td>
<td valign="middle" align="center">TNBS-induced model of colitis in rats</td>
<td valign="middle" align="center">Neutrophil activation and migration&#x2193;</td>
<td valign="middle" align="center">NF-&#x3ba;B&#x2193;, pro-inflammatory cytokines&#x2193;; acidic and neutral mucins&#x2191;; lipid peroxidation&#x2193;, GST&#x2191;, GSH&#x2191;, MDA&#x2193;</td>
<td valign="middle" align="center">Anti-inflammatory effects;<break/>Repair the intestinal barrier function;<break/>Reduce oxidative stress</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B154">154</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Bixa orellana Leaf</td>
<td valign="middle" align="center">AA-induced model of UC in rats</td>
<td valign="middle" align="center">Neutrophil infiltration&#x2193;</td>
<td valign="middle" align="center">SOD&#x2191;, CAT&#x2191;, GSH&#x2191;, MDA&#x2193;, nitrite&#x2193;, cyclooxygenase and lipooxygenase&#x2193;, ROS&#x2193;</td>
<td valign="middle" align="center">Reduce oxidative stress</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B155">155</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">A phytopharmaceutical combining sage and bitter apple</td>
<td valign="middle" align="center">DSS-induced mice model of colitis</td>
<td valign="middle" align="center">MPO&#x2193;, neutrophil&#x2193;</td>
<td valign="middle" align="center">TJs (Claudin-1, Claudin-4, ZO-1)&#x2191;, goblet cell&#x2191;; chemokines (CXCL-1/KC)&#x2193;, pro-inflammatory cytokines and chemokines (COX-2, IgA)&#x2193;, anti-inflammatory cytokine (IL-10)&#x2191;</td>
<td valign="middle" align="center">Repair the intestinal barrier function;<break/>Anti-inflammatory effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B156">156</xref>)</td>
</tr>
<tr>
<td valign="middle" rowspan="6" align="center">Traditional Chinese medicine compounds</td>
<td valign="middle" colspan="2" align="center">Wu-Mei-Wan</td>
<td valign="middle" align="center">TNBS-induced mice model of colitis</td>
<td valign="middle" align="center">Neutrophil infiltration&#x2193;</td>
<td valign="middle" align="center">OGT&#x2191;, OGA&#x2193;, RIPK3O-GLC Nacylation&#x2191;, RIPK3&#x2193;, necrosome&#x2193;; pro-inflammatory cytokines (IL-1&#x3b2;, IL-6, TNF-&#x3b1;, IFN-&#x3b3;)&#x2193;</td>
<td valign="middle" align="center">Inhibit necroptotic apoptosis;<break/>Anti-inflammatory effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B157">157</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Huang Qin Decoction</td>
<td valign="middle" align="center">AOM/DSS-induced mice model of colitis-associated cancer</td>
<td valign="middle" align="center">PAD4&#x2193;, NETs&#x2193;; neutrophil infiltration&#x2193;</td>
<td valign="middle" align="center">ZO-1&#x2191;, occludin&#x2191;; TNF-&#x3b1;, IL-1&#x3b2;&#x2193;</td>
<td valign="middle" align="center">Repair the intestinal barrier function;<break/>Anti-inflammatory effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B158">158</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Qu-Yu-Jie-Du Decoction</td>
<td valign="middle" align="center">DSS-induced mice model of colitis</td>
<td valign="middle" align="center">Neutrophil infiltration&#x2193;</td>
<td valign="middle" align="center">Nrf2&#x2191;, HO-1&#x2191;; pro-inflammatory cytokines (IL-1&#x3b2;, IL-6, TNF-&#x3b1;, TGF-&#x3b2;)&#x2193;, chemokines (CCL2, CXCL2)&#x2193;</td>
<td valign="middle" align="center">Reduce oxidative stress;<break/>Anti-inflammatory effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B159">159</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Huanglian Ganjiang Decoction</td>
<td valign="middle" align="center">DSS-induced mice model of acute colitis</td>
<td valign="middle" align="center">Neutrophil&#x2193;</td>
<td valign="middle" align="center">TJs (occludin, claudin-1)&#x2191;; pro-inflammatory cytokines (IL-6, IL-10, TNF-&#x3b1;, IFN-&#x3b3;)&#x2193;</td>
<td valign="middle" align="center">Repair the intestinal barrier function;<break/>Anti-inflammatory effects</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B160">160</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Pulsatilla decoction</td>
<td valign="middle" align="center">DSS-induced mice model of colitis</td>
<td valign="middle" align="center">PAD4&#x2193;, Cit-H3&#x2193;, MPO&#x2193;, NETs&#x2193;; MMP-7&#x2193;, neutrophil activation and infiltration&#x2193;</td>
<td valign="middle" align="center">IL-6&#x2191;, TJs&#x2191;, mucus secretion&#x2191;; pro-inflammatory cytokines (TNF-&#x3b1;, IL-1&#x3b2;, IL-6)&#x2193;, anti-inflammatory cytokines (IL-4, IL-10)&#x2191;, chemokines (CXCL1, CXCL2)&#x2193;; Ly6G&#x2193;, ROS&#x2193;</td>
<td valign="middle" align="center">Repair the intestinal barrier function;<break/>Anti-inflammatory effects;<break/>Reduce oxidative stress</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B161">161</xref>, <xref ref-type="bibr" rid="B162">162</xref>)</td>
</tr>
<tr>
<td valign="middle" colspan="2" align="center">Sijunzi Decoction</td>
<td valign="middle" align="center">DSS-induced mice model of UC</td>
<td valign="middle" align="center">NETs&#x2193;; neutrophil infiltration&#x2193;</td>
<td valign="middle" align="center">Pro-inflammatory cytokines (IL-1&#x3b2;, TNF)&#x2193;, anti-inflammatory cytokines&#x2191;; ROS&#x2193;; MIR200C-3p&#x2191;</td>
<td valign="middle" align="center">Anti-inflammatory effects;<break/>Reduce oxidative stress;<break/>Repair the intestinal barrier function</td>
<td valign="middle" align="center">(<xref ref-type="bibr" rid="B163">163</xref>)</td>
</tr>
</tbody>
</table>
</table-wrap>
<sec id="s4_1_1">
<label>4.1.1</label>
<title>Berberine</title>
<p>Berberine (BBR) is a natural isoquinoline alkaloid mainly isolated from <italic>Berberis aquifolium</italic> Pursh, <italic>Berberis vulgaris</italic> L, and <italic>Coptis chinensis</italic> Franch (<xref ref-type="bibr" rid="B164">164</xref>). BBR inhibited the nuclear translocation of neutrophil elastase (NE) and the subsequent formation of NETs by inhibiting the interaction of linc00668 with NE, which was highly enriched in IECs derived exosomes, thereby effectively regulating the IECs-neutrophil interaction (<xref ref-type="bibr" rid="B86">86</xref>). Additionally, BBR reduced intestinal bacteria &#x3b2;-glucuronidase (GUS)-producing bacteria and decreased SN38G conversion to SN38 (the active metabolite of CPT11), thus indirectly reducing neutrophil overactivation and infiltration (<xref ref-type="bibr" rid="B103">103</xref>).</p>
</sec>
<sec id="s4_1_2">
<label>4.1.2</label>
<title>Berbamine</title>
<p>Berbamine (BBM), a bisbenzylisoquinoline alkaloid extracted from Chinese herbal medicine <italic>Berberis vulgaris</italic> L, has been shown to inhibit the formation of NETs after significantly reducing expression of PAD4 in the colon (<xref ref-type="bibr" rid="B104">104</xref>). Moreover, BBM attenuated the release of Cit-H3, MPO and NE, which were NETs-associated products (<xref ref-type="bibr" rid="B165">165</xref>, <xref ref-type="bibr" rid="B166">166</xref>).</p>
</sec>
<sec id="s4_1_3">
<label>4.1.3</label>
<title>Lycopodium</title>
<p>Lycopodium (LYCO), a member of the <italic>Lycopodiaceae</italic> family, is enriched in alkaloids and triterpenoids. By restoring the endogenous antioxidants or decreasing the levels of IL-1&#x3b2; and IL-23, LYCO diminished the release of ROS, MPO and free radicals (<xref ref-type="bibr" rid="B105">105</xref>, <xref ref-type="bibr" rid="B166">166</xref>). Ultimately, the suppression of ROS inhibited NF-&#x3ba;B signaling and attenuated neutrophil-associated inflammation in the intestinal mucosa (<xref ref-type="bibr" rid="B105">105</xref>).</p>
</sec>
<sec id="s4_1_4">
<label>4.1.4</label>
<title>Tetramethylpyrazine</title>
<p>Tetramethylpyrazine, a pyrazine alkaloid derived from the traditional Chinese medicine Chuanxiong, has been demonstrated to reduce neutrophil infiltration in intestinal tissue by decreasing MPO activity and improving intestinal microcirculation (<xref ref-type="bibr" rid="B106">106</xref>).</p>
</sec>
<sec id="s4_1_5">
<label>4.1.5</label>
<title>Lemairamin (Wgx-50)</title>
<p>Lemairamin (Wgx-50), a hydroxylamine compound extracted from Sichuan pepper, belongs to the isoquinoline alkaloid class. It inhibited AKT signaling, which could cause reduced expression of pro-inflammatory cytokines, comprising IL-1&#x3b2;, IL-6, CXCL8a, and TNF-&#x3b1;. Then, Wgx-50 directly suppressed neutrophil recruitment to sites of intestinal injury (<xref ref-type="bibr" rid="B107">107</xref>).</p>
</sec>
<sec id="s4_1_6">
<label>4.1.6</label>
<title>Cavidine</title>
<p>Cavidine, isolated from <italic>Corydalis</italic> impatiens, is an isoquinoline alkaloid. Cavidine enhanced the activities of SOD and GSH to reduce the release of ROS. Furthermore, it inhibited the NF-&#x3ba;B signaling pathway, which was involved in the reduced transcription and release of TNF-&#x3b1; and IL-6, thereby mitigating neutrophil-associated inflammation (<xref ref-type="bibr" rid="B108">108</xref>).</p>
</sec>
</sec>
<sec id="s4_2">
<label>4.2</label>
<title>Quinones</title>
<p>Quinones are a class of aromatic organic compounds with six carbon atom cyclic diketone structure containing two double bonds in traditional Chinese medicine. According to their chemical structures, they are mainly divided into four types: benzoquinone, naphthoquinone, phenanthraquinone, and anthraquinone. These compounds have significant biological activities, possessing antioxidant, antibacterial, and antitumor properties activities.</p>
<sec id="s4_2_1">
<label>4.2.1</label>
<title>Tanshinone IIA</title>
<p>Tanshinone IIA, a phenanthrenequinone compound derived from <italic>Salvia miltiorrhiza</italic>, attenuated the NF-&#x3ba;B signaling pathway and resulted in a reduction in the transcription and release of pro-inflammatory cytokines, then mitigating neutrophil-associated inflammation and ROS release (<xref ref-type="bibr" rid="B109">109</xref>).</p>
</sec>
<sec id="s4_2_2">
<label>4.2.2</label>
<title>Rhein</title>
<p>Rhein, an anthraquinone compound derived from rhubarb. It concurrently reduced the production of pro-inflammatory cytokines and cleaved IL-1&#x3b2; by suppressing NF-&#x3ba;B signaling and the assembly of the NLRP3 inflammasome, ultimately exerting anti-pyroptotic effects and mitigating neutrophil-mediated inflammation (<xref ref-type="bibr" rid="B110">110</xref>).</p>
</sec>
</sec>
<sec id="s4_3">
<label>4.3</label>
<title>Polysaccharides</title>
<p>Polysaccharides, large biomolecules formed by the condensation and dehydration of monosaccharide units, are essential carbohydrates with complex molecular structures. It is important to distinguish between pathogen-derived polysaccharides such as LPS, and the plant-derived or fungal-derived polysaccharides discussed herein. LPS, a unique component of Gram-negative bacterial cell walls, is a potent pro-inflammatory molecule. It induces an inflammatory response by stimulating host cells to produce a large number of inflammatory cytokines (<xref ref-type="bibr" rid="B167">167</xref>). In contrast, the polysaccharides from medicinal plants or fungi (e.g., <italic>Atractylodes macrocephalae</italic>, <italic>Grifola frondosa</italic>) typically exhibit a range of physiological functions, comprising antioxidant, immune-modulatory, anti-infective, etc, thereby exerting protective effects in intestinal inflammation.</p>
<sec id="s4_3_1">
<label>4.3.1</label>
<title><italic>Atractylodes macrocephalae</italic> Koidz. and <italic>Grifola frondosa</italic> polysaccharides</title>
<p>Polysaccharide is an effective component of <italic>Atractylodes macrocephalae</italic> Koidz. (AMP), which is a homologous plant of invigorating spleen and replenishing qi. <italic>Grifola frondosa</italic>, a medicinal and edible fungus, contains <italic>Grifola frondosa</italic> polysaccharides (GFPs) as main active components. The polysaccharides from AMP and GFPs directly inhibited neutrophil infiltration, migration and aggregation, together suppressing the levels of inflammatory cytokines in the colonic mucosa (<xref ref-type="bibr" rid="B111">111</xref>, <xref ref-type="bibr" rid="B113">113</xref>). Moreover, AMP modulated gut microbiota composition to lower pro-inflammatory signals like LPS, which achieved microbiota-neutrophil interactions (<xref ref-type="bibr" rid="B111">111</xref>).</p>
</sec>
<sec id="s4_3_2">
<label>4.3.2</label>
<title><italic>Agaricus blazei</italic> Murill polysaccharides</title>
<p><italic>Agaricus blazei</italic> Murill polysaccharides (ABPs) are the principal bioactive constituents of Agaricus blazei fruiting bodies, and ABP1 is the major component in ABPs. ABP1 increased the abundance of SCFA-producing bacteria, and promoted elevated butyrate levels, subsequently impeding neutrophil recruitment and modulating microbiota-neutrophil interactions (<xref ref-type="bibr" rid="B112">112</xref>).</p>
</sec>
</sec>
<sec id="s4_4">
<label>4.4</label>
<title>Polyphenols</title>
<p>Polyphenols are a class of compounds widely present in natural products with multiple benzene rings and hydroxyl functional groups in their chemical structure, including flavonoids, flavonols, phenolic acids, phenylpropanoids, and anthocyanins. Polyphenols have a variety of pharmacological activities, containing antioxidant, anti-inflammatory, antibacterial and so on.</p>
<sec id="s4_4_1">
<label>4.4.1</label>
<title>Forsythiaside A</title>
<p>Forsythiaside A, a phenylethanolic glycoside primarily isolated from <italic>Forsythia suspensa</italic> (Thunb.) Vahl, could downregulate the expression of PAD4 in colon neutrophils. This modulation led to a reduction in the levels of Cit-H3 and MPO, as well as in the expression of pro-inflammatory cytokines. Ultimately, the reduction attenuated the formation of NETs and alleviated colonic neutrophil infiltration (<xref ref-type="bibr" rid="B114">114</xref>).</p>
</sec>
<sec id="s4_4_2">
<label>4.4.2</label>
<title>Isochlorogenic acid A</title>
<p>Isochlorogenic acid A (ICGA-A), a dicaffeoylquinic acid, is abundantly present in various medicinal plants and vegetables. It has been shown to inhibit the STAT3/NF-&#x3ba;B pathway, then attenuating neutrophil activation and infiltration (<xref ref-type="bibr" rid="B115">115</xref>).</p>
</sec>
<sec id="s4_4_3">
<label>4.4.3</label>
<title>Chlorogenic acid</title>
<p>Chlorogenic acid (ChA) is a natural polyphenol predominantly found in coffee and various other plants. On one hand, it inhibited the NF-&#x3ba;B/p65 to decrease neutrophil infiltration (<xref ref-type="bibr" rid="B116">116</xref>, <xref ref-type="bibr" rid="B168">168</xref>). On the other hand, it increased the relative abundance of Akkermansia in the intestine, and improved the integrity of the mucus layer through extracellular vesicles derived from Akkermansia mucosae (<xref ref-type="bibr" rid="B169">169</xref>). Concurrently, ChA inhibited the production of 4-HPA, interfered with JAK2/STAT3 signaling, and downregulated CXCL3 transcription, resulting in reduced recruitment of PMN-MDSC in CRC (<xref ref-type="bibr" rid="B117">117</xref>).</p>
</sec>
<sec id="s4_4_4">
<label>4.4.4</label>
<title>Curcumin</title>
<p>Curcumin, the bioactive natural polyphenol, is a substance derived from the rhizome of <italic>Curcuma longa</italic>. It reduced MPO activity, and limited the release of ROS (<xref ref-type="bibr" rid="B118">118</xref>, <xref ref-type="bibr" rid="B119">119</xref>). Moreover, Curcumin exerted inhibitory effects on the activation of the Bcl-6-Syk-BLNK signaling pathway, promoted the conversion of naive B cells into memory B cells, restored the balance between pro-inflammatory and anti-inflammatory factors, and reduced CXCR3 expression. All contributed to a reduction in neutrophil recruitment to the colon (<xref ref-type="bibr" rid="B120">120</xref>, <xref ref-type="bibr" rid="B170">170</xref>).</p>
</sec>
<sec id="s4_4_5">
<label>4.4.5</label>
<title>Astragalin</title>
<p>Astragalin (AG), a natural flavonoid found in <italic>Moringa oleifera</italic>, <italic>Radix astragali</italic>, <italic>Morus alba</italic>, and <italic>Cassia alata</italic> (<xref ref-type="bibr" rid="B171">171</xref>), suppressed NF-&#x3ba;B pathway, reduced the expression of pro-inflammatory cytokines, then inhibiting neutrophil infiltration in the colon. In addition, AG attenuated TLR4-mediated signaling, which was modulated by the abundance of intestine bacteria, leading to inhibiting neutrophil activation (<xref ref-type="bibr" rid="B121">121</xref>).</p>
</sec>
<sec id="s4_4_6">
<label>4.4.6</label>
<title>Hesperetin</title>
<p>Hesperetin, one of the major flavonoids with multiple biological activities, regulated the TLR4/NF-&#x3ba;B signaling pathway and concurrently inhibited the expression of LC3B, resulting in a reduced LC3-I/LC3-II ratio in neutrophils. In the meantime, Hesperetin decreased NETs formation and Cit-H3 production via the ROS/autophagy pathway (<xref ref-type="bibr" rid="B122">122</xref>).</p>
</sec>
<sec id="s4_4_7">
<label>4.4.7</label>
<title>Quercetin</title>
<p>Quercetin (QUE) is a natural flavonoid widely found in fruits and Chinese herbal medicines. Through activating AhR, QUE involved the upregulation of Arnt, reduced ROS and Nqo1 production, which caused an inhibition of NETs formation. Additionally, QUE has been observed to suppress IL-6 expression, decrease Th17 differentiation and neutrophil activation, thus mitigating tissue damage. It mitigated neutrophil-induced IECs apoptosis by inhibiting NF-&#x3ba;B activation and reducing PAD4-mediated NETosis, thereby modulating the detrimental &#x201c;IECs-neutrophil&#x201d; crosstalk (<xref ref-type="bibr" rid="B123">123</xref>, <xref ref-type="bibr" rid="B124">124</xref>). Furthermore, QUE downregulated the expression of key inflammatory factors (IL1&#x3b2;, CXCL8, and MMP9), inhibiting neutrophil activation and infiltration, as well as suppressing tumor growth in CRC (<xref ref-type="bibr" rid="B125">125</xref>).</p>
</sec>
<sec id="s4_4_8">
<label>4.4.8</label>
<title>Dihydromyricetin</title>
<p>Dihydromyricetin, a flavonoid derived from the herb <italic>Ampelopsis grossedentata</italic>, targeted neutrophils and inhibited the HIF-1&#x3b1;/VEGFA signaling pathway, thus reducing the formation of NETs (<xref ref-type="bibr" rid="B126">126</xref>).</p>
</sec>
<sec id="s4_4_9">
<label>4.4.9</label>
<title>Kurarinone</title>
<p>Kurarinone, a major flavonoid compound from the dried roots of <italic>Sophora flavescens</italic>, restored gut microbiota and upregulated Blimp-1. These effects decreased IL-17A secretion by Th17 cells and increased IL-10 expression, preventing neutrophil infiltration and reducing neutrophil chemotaxis and activation (<xref ref-type="bibr" rid="B127">127</xref>).</p>
</sec>
<sec id="s4_4_10">
<label>4.4.10</label>
<title>Catechins</title>
<p>Green tea and black tea contain polyphenolic compounds, particularly catechins, such as epigallocatechin-3-gallate (EGCG). Catechins reduced TNF-&#x3b1; levels, significantly downregulated ICAM-1 and P-selectin expression, as well as decreased lipid peroxidation products like MDA. These actions inhibited ROS production and reduced neutrophil infiltration (<xref ref-type="bibr" rid="B128">128</xref>). EGCG suppressed NETs formation by modulating the STAT3/CXCL8 signaling pathway, afterwards inhibiting the migration and invasion of colorectal cancer (<xref ref-type="bibr" rid="B129">129</xref>).</p>
</sec>
<sec id="s4_4_11">
<label>4.4.11</label>
<title>Glabridin</title>
<p>Glabridin is a flavonoids compound isolated from <italic>Glycyrrhiza glabra</italic> L. It inhibited the phosphorylation of the transcription factor STAT3, leading to the downregulation of MMP1 and MMP3 expression. By suppressing MMPs, Glabridin decreased the release of CXCL1 and CXCL2, thus reducing neutrophil migration and infiltration (<xref ref-type="bibr" rid="B130">130</xref>).</p>
</sec>
<sec id="s4_4_12">
<label>4.4.12</label>
<title>Kaempferol</title>
<p>Kaempferol, a major flavonol widely found in various fruits and vegetables, downregulated the expression of key inflammatory mediators (IL-1&#x3b2;, CXCL8, and MMP9), then reducing neutrophil infiltration and activation while inhibiting tumor growth in CRC (<xref ref-type="bibr" rid="B125">125</xref>). Additionally, Kaempferol decreased TLR4/NF-&#x3ba;B pathway activation, which reduced the expression of chemokines and pro-inflammatory cytokines, subsequently inhibiting neutrophil infiltration in colitis (<xref ref-type="bibr" rid="B131">131</xref>).</p>
</sec>
</sec>
<sec id="s4_5">
<label>4.5</label>
<title>Glycosides</title>
<p>Glycosides are compounds formed by the glycosidic linkage between the carbon atoms of sugar or sugar derivatives and non-sugar substances, which have antioxidant, anti-inflammatory, anti-cancer and other biological activities. According to the structural types of aglycones, they are most commonly divided into cyanogen glycosides, phenolic glycosides, alcohol glycosides, anthracene glycosides, flavone glycosides, saponins, cardiac glycosides, coumarin glycosides and iridoid glycosides.</p>
<sec id="s4_5_1">
<label>4.5.1</label>
<title>Ursolic acid</title>
<p>Ursolic acid (UA), a naturally occurring pentacyclic triterpenoid carboxylic acid, is extracted from various medicinal plants and foods (<xref ref-type="bibr" rid="B172">172</xref>). UA has been shown to downregulate the PI3K signaling pathway, and suppress early immune responses triggered by neutrophils via the IL-6/STAT3 signaling pathway. It inhibited the activation of the NF-&#x3ba;B pathway, subsequently inhibiting the recruitment and activation of neutrophils at inflammation sites induced by chemokines. Furthermore, UA reduced ROS generated through activating the AMPK/FOXO signalling pathway in fatty acid metabolism. This multifaceted action alleviated oxidative stress mediated by neutrophils (<xref ref-type="bibr" rid="B132">132</xref>).</p>
</sec>
<sec id="s4_5_2">
<label>4.5.2</label>
<title>Glycyrrhizic acid</title>
<p>Glycyrrhizic acid (GA), a natural pentacyclic triterpenoid compound derived from licorice, could significantly reduce dsDNA, MPO-DNA complexes, ROS and Cit-H3 by inhibiting the enzymatic activity of PAD4. This action resulted in a marked decrease in the formation of NETs (<xref ref-type="bibr" rid="B133">133</xref>).</p>
</sec>
<sec id="s4_5_3">
<label>4.5.3</label>
<title>Anemoside B4</title>
<p>Anemoside B4 is the predominant triterpenoid saponin isolated from <italic>Pulsatilla chinensis</italic>. It decreased TLR4 activation by inhibiting S100A9 expression, subsequently suppressing the activation of MAPK (p38, JNK, ERK) and NF-&#x3ba;B signaling pathways. The effects resulted in suppressing the migration and accumulation of neutrophils in the colon directly or indirectly (<xref ref-type="bibr" rid="B134">134</xref>).</p>
</sec>
</sec>
<sec id="s4_6">
<label>4.6</label>
<title>Terpenoids</title>
<p>Terpenoids are a general term for all polymers of isoprene and their derivatives, with a general formula (C5H8)n. In addition to existing as terpene hydrocarbons, they also form a wide variety of oxygen-containing derivatives. Terpenoids have diverse pharmacological activities, such as antibacterial, antitumor, anti-inflammatory, and coronary artery dilation.</p>
<sec id="s4_6_1">
<label>4.6.1</label>
<title>Menthol and nerolidol</title>
<p>Menthol, a monocyclic monoterpene, serves as the primary active ingredient in the peppermint plant, while nerolidol is a naturally occurring aliphatic sesquiterpene alcohol. Both compounds have been demonstrated to reduce MPO activity, inhibit neutrophil activation, and diminish infiltration by enhancing tissue levels of SOD and CAT, reducing the formation of lipid peroxides and MDA, and restoring GSH bioavailability (<xref ref-type="bibr" rid="B135">135</xref>, <xref ref-type="bibr" rid="B138">138</xref>).</p>
</sec>
<sec id="s4_6_2">
<label>4.6.2</label>
<title>Angelica oil</title>
<p>Volatile Angelica oil (AO) has been identified as a significant constituent of Angelica sinensis. AO mitigated the activation of the TLR4/NF-&#x3ba;B pathway, resulting in a reduction in cytokine production, simultaneously suppressing neutrophil infiltration in the colon (<xref ref-type="bibr" rid="B136">136</xref>).</p>
</sec>
<sec id="s4_6_3">
<label>4.6.3</label>
<title>Okanagan lavender essential oil</title>
<p>A unique blend of essential oils derived from lavender is referred to as Okanagan Lavender Essential Oil (OLEO). OLEO inhibited MIP-2&#x3b1;-mediated neutrophil infiltration into intestinal crypts (<xref ref-type="bibr" rid="B137">137</xref>).</p>
</sec>
<sec id="s4_6_4">
<label>4.6.4</label>
<title><italic>Tripterygium wilfordii</italic> polycoride</title>
<p><italic>Tripterygium wilfordii</italic> polycoride (TWP), the primary active compound of <italic>Tripterygium wilfordii</italic>, consists predominantly of diterpenoid and triterpenoid compounds. TWP has been demonstrated to significantly decrease NADPH oxidase activity and ROS production. It inhibited the activation of NLRP3 inflammasome, ASC and caspase-1, which ultimately reduced neutrophil infiltration via the inhibition of pyroptosis (<xref ref-type="bibr" rid="B139">139</xref>).</p>
</sec>
</sec>
<sec id="s4_7">
<label>4.7</label>
<title>Microbiota-derived metabolites</title>
<sec id="s4_7_1">
<label>4.7.1</label>
<title>Short-chain fatty acids</title>
<p>Short-chain fatty acids (SCFAs), major metabolites derived from gut microbiota, play a beneficial role in gastrointestinal health. The principal SCFAs, including acetate, propionate and butyrate, constitute more than 95% of the total SCFA content in feces.</p>
<sec id="s4_7_1_1">
<label>4.7.1.1</label>
<title>Butyrate</title>
<p>By downregulating HDAC activity, butyrate reduced the release of MPO and ROS to inhibit the formation of NETs, and suppressed neutrophil migration induced by IL-8 (<xref ref-type="bibr" rid="B140">140</xref>). Meanwhile, butyrate suppressed NF-&#x3ba;B signaling pathway and the secretion of pro-inflammatory cytokines such as TNF-&#x3b1; with increased levels of MCP-1 and IL-6. These combined actions culminated in reduced neutrophil infiltration (<xref ref-type="bibr" rid="B141">141</xref>). For one thing, butyrate could induce neutrophil recruitment through the direct signaling of GPR43, for another, it could indirectly regulate neutrophils through the activation of other types of immune cells (<xref ref-type="bibr" rid="B142">142</xref>).</p>
</sec>
<sec id="s4_7_1_2">
<label>4.7.1.2</label>
<title>Acetate</title>
<p>Acetate upregulated CXCL2 protein expression and downregulated its receptor CXCR2 on colonic neutrophils, thereby inhibiting neutrophil recruitment and infiltration (<xref ref-type="bibr" rid="B143">143</xref>). It also delayed neutrophil apoptosis through FABP4 (<xref ref-type="bibr" rid="B110">110</xref>). Moreover, vitamin D encouraged the proliferation of acetate-producing bacteria, particularly <italic>Cetobacterium</italic>. The resulting increase in acetate enhanced IL-22 expression, which in turn stimulated neutrophil production (<xref ref-type="bibr" rid="B144">144</xref>).</p>
</sec>
</sec>
<sec id="s4_7_2">
<label>4.7.2</label>
<title>Microalgae</title>
<p>Microalgae represent a diverse group of microorganisms that include diatoms, dinoflagellates, and flagellates. Microalgae reduced soybean meal-induced neutrophil infiltration by increasing goblet cell numbers and enhancing mucus secretion (<xref ref-type="bibr" rid="B145">145</xref>).</p>
</sec>
<sec id="s4_7_3">
<label>4.7.3</label>
<title>Altechromone A</title>
<p>Altechromone A could be isolated from the marine-derived fungus <italic>Penicillium chrysogenum</italic> (<xref ref-type="bibr" rid="B173">173</xref>). This compound inhibited both the STAT3 and NLRP3 pathways. This led to decreased expression of pro-inflammatory genes and reduced release of NO and ROS, resulting in limited neutrophil migration and accumulation (<xref ref-type="bibr" rid="B146">146</xref>).</p>
</sec>
</sec>
<sec id="s4_8">
<label>4.8</label>
<title>Natural medicinal materials</title>
<sec id="s4_8_1">
<label>4.8.1</label>
<title>Aucklandiae Radix</title>
<p>In Chinese Pharmacopoeia, costunolide is the principal active constituent of Aucklandiae Radix. It promoted the differentiation of Treg cells and reduced the differentiation of Th17 cells through downregulating PKM2 expression, which subsequently diminished the accumulation of neutrophils in the intestinal tract (<xref ref-type="bibr" rid="B147">147</xref>).</p>
</sec>
<sec id="s4_8_2">
<label>4.8.2</label>
<title>Tiliae Flos</title>
<p>The pharmacological activity of <italic>Tiliae Flos</italic> is primarily attributed to its flavonoid, saponin, and phenolic acid constituents. Its extract has been shown to elevate SCFA levels, inhibit NF-&#x3ba;B signaling, and suppress TNF-&#x3b1; production, inducing neutrophil apoptosis (<xref ref-type="bibr" rid="B148">148</xref>).</p>
</sec>
<sec id="s4_8_3">
<label>4.8.3</label>
<title>Phyllanthus niruri Linn</title>
<p><italic>Phyllanthus niruri Linn</italic> comprises active phytochemicals in various parts, including flavonoids, alkaloids, terpenoids, lignin, polyphenols, tannins, coumarin and saponins. It increased the expression of cytotoxic T lymphocytes and NK cells, also elevated the number of apoptotic cells to reduce respiratory burst and the release of TNF-&#x3b1; and interferon-induced proteins. Collectively, the process finally inhibited the pro-inflammatory functions of intestinal neutrophils (<xref ref-type="bibr" rid="B149">149</xref>).</p>
</sec>
<sec id="s4_8_4">
<label>4.8.4</label>
<title><italic>Cicer arietinum</italic> L.</title>
<p><italic>Cicer arietinum</italic> L. (CEE) is known for its high lysine content. The ethanol extract of CEE inhibited NF-&#x3ba;B/STAT3 signaling pathways, causing reduced expression of IL-6, IL-1&#x3b2;, TNF-&#x3b1;, COX-2 and iNOS, and ultimately inhibiting neutrophil activation (<xref ref-type="bibr" rid="B150">150</xref>).</p>
</sec>
<sec id="s4_8_5">
<label>4.8.5</label>
<title>Black raspberries</title>
<p>Black raspberries are rich in soluble fiber, which undergoes colonic fermentation to produce SCFAs. It upregulated FFAR2 expression and inhibited both the cAMP-PKA-CREB and Wnt signaling pathways, resulting in decreased infiltration of GR-1<sup>+</sup> neutrophils within intestinal polyps (<xref ref-type="bibr" rid="B151">151</xref>).</p>
</sec>
<sec id="s4_8_6">
<label>4.8.6</label>
<title><italic>Fritillariae thunbergii</italic> Bulbus</title>
<p>Phytochemical investigations of <italic>Fritillariae thunbergii</italic> Bulbus (FTB) have identified several bioactive alkaloids, containing sipeimine, peiminine, and yibeissine. Hydroethanolic extract of FTB decreased neutrophil infiltration into intestinal tissues and modulated extracellular matrix remodeling by suppressing MMP-9 activity during inflammation (<xref ref-type="bibr" rid="B152">152</xref>).</p>
</sec>
<sec id="s4_8_7">
<label>4.8.7</label>
<title><italic>Ilex rotunda</italic> Thunb.</title>
<p>Ziyuglycoside I, Ziyuglycoside II, syringin, and pedunculoside are the main active components of <italic>Ilex rotunda</italic> Thunb. (IR). The primary active components downregulated the expression of OSM and OSMR proteins, inhibiting the activation of STAT3 pathway. IR also suppressed the TLR4/NF-&#x3ba;B signaling pathway, thus mitigating neutrophil activation and infiltration (<xref ref-type="bibr" rid="B153">153</xref>).</p>
</sec>
<sec id="s4_8_8">
<label>4.8.8</label>
<title>Hydroalcoholic extract of <italic>Araucaria</italic> sp.</title>
<p><italic>Araucaria</italic> sp. is a hypropolis species particularly rich in labdane diterpenes. Its hydroalcoholic extract attenuated oxidative stress by reducing lipid peroxidation and preserving GST enzyme activity, along with inhibiting MPO activity and chemotactic migration, thereby leading to a significant reduction in neutrophil numbers (<xref ref-type="bibr" rid="B154">154</xref>).</p>
</sec>
<sec id="s4_8_9">
<label>4.8.9</label>
<title><italic>Bixa orellana</italic> leaf hydroethanolic extract</title>
<p>The hydroethanolic extract of <italic>Bixa orellana</italic> modulated oxidative stress through the direct scavenging of ROS or inhibition of cyclooxygenase and lipoxygenase enzymes, contributing to a reduction in neutrophil infiltration (<xref ref-type="bibr" rid="B155">155</xref>).</p>
</sec>
<sec id="s4_8_10">
<label>4.8.10</label>
<title>A phytopharmaceutical combining sage and bitter apple</title>
<p>A phytopharmaceutical combining sage and bitter apple reduced the expression of neutrophil chemokine CXCL1/KC in colon tissue. It also inhibited MPO activity and the expression of pro-inflammatory cytokines and chemokines, promoted expression of the anti-inflammatory cytokines, which further mitigated neutrophil infiltration (<xref ref-type="bibr" rid="B156">156</xref>).</p>
</sec>
</sec>
<sec id="s4_9">
<label>4.9</label>
<title>Traditional Chinese medicine compounds</title>
<sec id="s4_9_1">
<label>4.9.1</label>
<title>Wu-Mei-Wan</title>
<p>Wu-Mei-Wan formula reduced RIPK3 activation, necrosome formation, and the levels of IL-1&#x3b2;, IL-6, TNF-&#x3b1; and IFN-&#x3b3; to inhibit neutrophil necrotic apoptosis and neutrophil infiltration (<xref ref-type="bibr" rid="B157">157</xref>).</p>
</sec>
<sec id="s4_9_2">
<label>4.9.2</label>
<title>Huang Qin decoction</title>
<p>Huang Qin Decoction inhibited the formation of NETs by downregulating the expression of PAD4. Besides, it alleviated neutrophil infiltration in the colon caused by TNF-&#x3b1; and IL-1&#x3b2; (<xref ref-type="bibr" rid="B158">158</xref>).</p>
</sec>
<sec id="s4_9_3">
<label>4.9.3</label>
<title>Qu-Yu-Jie-Du decoction</title>
<p>Qu-Yu-Jie-Du Decoction downregulated the expression of CCL2 and CXCL2 in colon tissues, then reducing local neutrophil infiltration (<xref ref-type="bibr" rid="B159">159</xref>).</p>
</sec>
<sec id="s4_9_4">
<label>4.9.4</label>
<title>Huanglian Ganjiang decoction</title>
<p>Alkaloids such as berberine, berberrubine, oxyberberine are the main ingredients in cold-natured medicine CP extracts in Huanglian Ganjiang Decoction. By contrast, volatile oil is the main active constituent in hot-natured medicine AZ. CP reduced production of pro-inflammatory cytokines and neutrophil infiltration while AZ exerted advantages in regulating neutrophils by enhancing the production of anti-inflammatory immune cells and cytokines (<xref ref-type="bibr" rid="B160">160</xref>).</p>
</sec>
<sec id="s4_9_5">
<label>4.9.5</label>
<title>Pulsatilla decoction</title>
<p>Pulsatilla decoction (PD) reduced MMP-7 expression and decreased neutrophil infiltration to suppress intestinal inflammation (<xref ref-type="bibr" rid="B161">161</xref>). Simultaneously, the n-butanol extract of PD reduced the levels of chemokines CXCL1 and CXCL2, inhibited Ly6G expression and ROS generation, effectively decreasing neutrophil infiltration and activation. It led to the suppression of key proteins involved in NETs formation (MPO, PAD4, Cit-H3), resulting in diminished NETs release (<xref ref-type="bibr" rid="B162">162</xref>).</p>
</sec>
<sec id="s4_9_6">
<label>4.9.6</label>
<title>Sijunzi decoction</title>
<p>The practical components of Sijunzi Decoction (SJZ) may be ginsenoside Rh2, isoflavones and formononetin. SJZ targeted IL1&#x3b2; and TNF to decrease ROS production and reduced intestinal NETs formation. Meanwhile, it upregulated MIR200C-3p, enhancing intestinal mucosal barrier function and reducing neutrophil infiltration (<xref ref-type="bibr" rid="B163">163</xref>).</p>
</sec>
</sec>
<sec id="s4_10">
<label>4.10</label>
<title>Additional information</title>
<p>To facilitate a systematic comparison of therapeutic effects, the aforementioned natural products are categorized according to their respective mechanisms of action (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Table&#xa0;1</bold></xref>). The classification is based primarily on neutrophil-related functional regulatory pathways, including ROS production, NETs formation, degranulation, secretion of inflammatory factors (thereby stimulating other immune cells), neutrophil apoptosis or pyroptosis, chemotaxis, tissue infiltration, and recruitment. Furthermore, experimental data from multiple models involving these natural products have been consolidated (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Table&#xa0;2</bold></xref>), revealing their dose&#x2013;response relationships and toxicity profiles. Natural products typically exhibit multi-target and synergistic regulatory features, with ROS, NETs, and the NF-&#x3ba;B pathway representing the core regulatory mechanisms involved. In contrast, research on other regulatory pathways remains relatively limited. The collected studies primarily consisted of <italic>in vivo</italic> animal experiments using various administration routes, among which oral administration was the most common. Nevertheless, comprehensive safety evaluations&#x2014;particularly detailed toxicity profiles&#x2014;are still lacking for most of these natural products, highlighting a significant gap that warrants further investigation. The compiled information is expected to provide a valuable reference for future drug development and mechanistic studies.</p>
</sec>
</sec>
<sec id="s5">
<label>5</label>
<title>Novel therapeutic strategies targeting neutrophils</title>
<sec id="s5_1">
<label>5.1</label>
<title>Based on nanotechnology</title>
<sec id="s5_1_1">
<label>5.1.1</label>
<title>Nanomedicine delivery systems</title>
<p>Neutrophils have been widely used in developing various drug-delivery systems because they can quickly respond to inflammatory signals, migrate across the endothelium, and penetrate deep tissues (<xref ref-type="bibr" rid="B174">174</xref>, <xref ref-type="bibr" rid="B175">175</xref>). In recent years, neutrophil-targeted nanodrug precise delivery systems have emerged. Notably, promising results have been observed in models of IBD and CRC (<xref ref-type="fig" rid="f4"><bold>Figure&#xa0;4</bold></xref>).</p>
<fig id="f4" position="float">
<label>Figure&#xa0;4</label>
<caption>
<p>The figure illustrates the latest methods of regulating neutrophil function through nanotechnology and engineered cell strategies.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-16-1754107-g004.tif">
<alt-text content-type="machine-generated">Diagram titled “New Strategies for Targeting Neutrophils” divided into two sections: Nanotechnology and Engineered Cells.   Nanotechnology section includes: a. Receptor-mediated drug delivery using drug carriers and ligands. b. Drug delivery via extracellular vesicles from herbs and intestinal bacteria.  Engineered Cells section includes: c. Small molecule drugs extending the lifespan of neutrophils. d. Gene editing and small molecules in induced pluripotent stem cell differentiation targeting neutrophils.</alt-text>
</graphic></fig>
<p><bold>Receptor-mediated neutrophil targeting</bold>.</p>
<p>Another strategy is receptor-mediated targeting. By modifying the surface of drug carriers with ligands that bind to specific markers on neutrophils, drugs can be directly delivered to neutrophils in circulation or at sites of inflammation, thereby exploiting neutrophils for drug transport (<xref ref-type="bibr" rid="B176">176</xref>). The strategy demonstrated that targeting neutrophil receptors or enzymes can significantly enhance delivery precision. Drugs are released only around activated neutrophils under disease conditions, thereby avoiding broad immunosuppression of resting neutrophils.</p>
<p><bold>Extracellular vesicles</bold>.</p>
<p>Extracellular vesicles (EVs) are nanoscale vesicles secreted by cells that can carry proteins, lipids, and nucleic acids, playing crucial roles in intercellular communication and immune regulation (<xref ref-type="bibr" rid="B177">177</xref>). EVs, owing to their stability and biocompatibility, can enhance the stability of natural products and prevent their rapid degradation <italic>in vivo</italic> (<xref ref-type="bibr" rid="B177">177</xref>). A typical example is exosome-like nanoparticles derived from Coptidis chinensis (Cc-ELNs). In a DSS-induced colitis mouse model, Cc-ELNs selectively accumulated at inflammatory sites, significantly reduced neutrophil infiltration, and effectively inhibited NETs formation by delivering abundant miR-5106 to downregulate Slc39a2 expression and restore zinc homeostasis in neutrophils (<xref ref-type="bibr" rid="B178">178</xref>). In addition, Yang Yi et&#xa0;al. reported that outer membrane vesicles secreted by the gut commensal Bacteroides fragilis can be taken up by neutrophils. By delivering miR-5119, they downregulate PD-L1 expression, which inhibits GSDMD-mediated NETs formation, ultimately alleviating DSS-induced colitis symptoms and promoting intestinal stem cell repair (<xref ref-type="bibr" rid="B179">179</xref>). This finding revealed a unique mechanism by which microbe-derived vesicles intervene in inflammation through the regulation of NETs formation.</p>
<p><bold>Other nanodrug delivery systems</bold>.</p>
<p>As research progresses, an increasing number of nanodrug delivery systems have been developed, including self-assembled nanodelivery systems of natural products, nanosuspensions, nanoliposomes, polymeric micelles, microemulsions/self-emulsifying systems, and solid lipid nanoparticles (<xref ref-type="bibr" rid="B180">180</xref>, <xref ref-type="bibr" rid="B181">181</xref>). Importantly, many of these nanosystems exhibit preferential accumulation in inflamed intestinal tissues.</p>
<p>As an example, during decoction, the traditional Chinese medicine formula QY305 can self-assemble into nanoscale subunit structures termed N-QY305, which could inhibit neutrophil chemotaxis toward CXCL2 in colonic tissues (<xref ref-type="bibr" rid="B180">180</xref>). Similarly, binary self-assembly of curcumin and glycyrrhizic acid into nanospheres, when incorporated into an inulin hydrogel for oral administration, exhibits favorable gel formation and colon enzyme-triggered drug release (<xref ref-type="bibr" rid="B182">182</xref>). Although the application of these technologies in neutrophil-targeted therapy is still nascent, integrating natural product-based nanodelivery systems with neutrophil-targeted carriers represents a promising future direction for the treatment of intestinal disorders such as IBD and even CRC (<xref ref-type="bibr" rid="B181">181</xref>).</p>
</sec>
<sec id="s5_1_2">
<label>5.1.2</label>
<title>Other nanotechnologies</title>
<p>Beyond conventional nanodrug delivery, emerging nanotechnology strategies aimed at clearing NETs show therapeutic potential. While DNase I can degrade NETs and alleviate intestinal inflammation, its clinical utility is limited by intrinsic instability and rapid clearance. To overcome these limitations, Wang et&#xa0;al. developed a stable DNase nanozyme (DNase-NZ) that retained prolonged enzymatic activity and exerted superior efficacy in colitis mice compared to free DNase (<xref ref-type="bibr" rid="B183">183</xref>). In a similar vein, Dong et&#xa0;al. designed an oral delivery system for staphylococcal nuclease (SNase) that enabled localized NETs degradation in the colon and promoted mucosal repair (<xref ref-type="bibr" rid="B184">184</xref>). These advances underscore the promise of nanotechnology-enabled NETs clearance as an adjunctive therapy for intestinal immune disorders.</p>
</sec>
</sec>
<sec id="s5_2">
<label>5.2</label>
<title>Engineered cell drug delivery</title>
<p>Engineered neutrophil-based drug delivery leverages multidisciplinary strategies to transform these cells into sophisticated therapeutic carriers. Key innovations are as follows: Genetic engineering, exemplified by generating chimeric antigen receptor-expressing neutrophils from human-induced pluripotent stem cells via CRISPR/Cas9, enable specific tumor targeting without provoking inflammation (<xref ref-type="bibr" rid="B185">185</xref>). Chemical and surface modification, where small molecules or conjugated functional groups are used to extend neutrophil lifespan and enhance targeting precision (<xref ref-type="bibr" rid="B186">186</xref>, <xref ref-type="bibr" rid="B187">187</xref>). Functional mimicry, such as introducing artificial receptors like hM4Di into myeloid cells to bestow chemotactic responsiveness to inert ligands, thereby augmenting directional migration and bacterial phagocytosis (<xref ref-type="bibr" rid="B188">188</xref>). By integrating active targeting, programmable drug release, and intrinsic immune functions, these engineered or neutrophil-mimetic cells achieved amplified specificity, reduced off-target effects, and improved therapeutic efficacy compared with conventional nanocarriers.</p>
</sec>
</sec>
<sec id="s6" sec-type="discussion">
<label>6</label>
<title>Discussion</title>
<p>This review has systematically summarized the compelling evidence that numerous natural products can precisely modulate the plasticity and function of intestinal neutrophils, thereby ameliorating inflammation and tissue damage in conditions such as IBD and CRC. The extraction of alkaloids, quinones, polysaccharides, polyphenols, glycosides, terpenoids, microbiota-derived metabolites compounds from natural sources has been investigated. We detail their multi-targeted influences on key neutrophil processes, encompassing migration, NETs formation, cytokine release, and oxidative metabolism. Furthermore, we have discussed the underlying molecular mechanisms behind these immunomodulatory actions, as well as the potential of emerging neutrophil-targeted strategies, to enhance the delivery and efficacy of natural products.</p>
<p>The bidirectional regulation of neutrophil function by natural compounds still faces multifaceted challenges in translating from basic biological research to clinical applications. Despite recent advances in single-cell sequencing that have identified several functionally distinct neutrophil subsets in the intestinal mucosa, our understanding of neutrophil heterogeneity remains incomplete, particularly with regard to the dynamic mechanisms and regulatory circuits governing their phenotypic plasticity under different disease contexts (<xref ref-type="bibr" rid="B10">10</xref>, <xref ref-type="bibr" rid="B43">43</xref>). Current data derive primarily from limited disease models and tissue sources, necessitating more comprehensive single-cell analyses across diverse intestinal immune disorders. The precise relationship between circulation and tissue-resident&#xa0;intestinal neutrophils remains inadequately defined, with&#xa0;insufficient evidence on their trafficking dynamics and functional transitions. Moreover, the regulatory mechanisms governing neutrophil maturation and phenotypic specialization within the intestinal microenvironment require further investigation.Additionally, several challenges remain. The lack of clear definitions of bioavailability, metabolic conversion, effective tissue concentration, and precise molecular targets hinders their clinical translation.</p>
<p>Nevertheless, natural product research targeting intestinal neutrophils remains relatively conservative and limited in scope. The therapeutic mode of action for natural products is characterized by multi-target network regulation, yet the systematic mapping of their mechanism networks remains in its infancy (<xref ref-type="bibr" rid="B189">189</xref>). Indeed, research primarily focuses on superficial interactions between the gut microbiota, the epithelial, and neutrophils, with restricted exploration of interactions involving other immune cells. Next, therapeutic mechanisms continue to be narrowly concentrated on key targets such as NETs, NF-&#x3ba;B inflammatory cascades, pyroptosis and oxidative stress. Lastly, research on novel delivery methods for natural products targeting neutrophils remains scarce. In current studies, the common approach is to use conventional oral or injectable administration routes, and there is little exploration of innovative delivery methods like nanocarriers and targeted delivery systems for regulating neutrophils with natural products. The status quo imposes limitations on the potential of natural products in the treatment of intestinal immune disorders. It is imperative that further research be conducted on innovative delivery methods with a view to broadening their clinical application prospects.</p>
<p>Looking forward, future research should focus on several key directions. First, a deeper understanding of the molecular mechanisms governing neutrophil heterogeneity and natural product interactions is essential. Mechanistic investigations must advance beyond phenomenological observations to elucidate the molecular determinants of neutrophil heterogeneity and the precise interaction networks through which natural products exert their immunomodulatory effects (<xref ref-type="bibr" rid="B10">10</xref>, <xref ref-type="bibr" rid="B43">43</xref>). Second, the integration of compounds with cutting-edge biotechnologies faces inherent challenges, including inherent heterogeneity, lack of standardized separation and characterization protocols, unclear <italic>in vivo</italic> pharmacokinetics, and obstacles in scalable production and storage stability (<xref ref-type="bibr" rid="B190">190</xref>, <xref ref-type="bibr" rid="B191">191</xref>). Advanced delivery systems should be optimized to enhance the specificity and accuracy of drug delivery to the intestinal neutrophil, and to ensure functionality, sustained safety and stability (<xref ref-type="bibr" rid="B183">183</xref>, <xref ref-type="bibr" rid="B184">184</xref>). Third, rigorous preclinical and clinical studies are needed to validate the efficacy and safety of natural products, either as monotherapies or in combination with conventional treatments (<xref ref-type="bibr" rid="B192">192</xref>, <xref ref-type="bibr" rid="B193">193</xref>). Collectively, natural products represent a valuable resource for developing next-generation neutrophil-targeted therapies. These suggestions might usher in a new paradigm of developing novel therapies targeting intestinal neutrophils for patients.</p>
</sec>
<sec id="s7" sec-type="conclusions">
<label>7</label>
<title>Conclusion</title>
<p>This review summarizes the heterogeneity and plasticity of intestinal neutrophils and their dynamic interactions with the microbiota, epithelial barrier, and other immune cells. We compile current evidence demonstrating how natural products modulate neutrophil activation, migration, NETs formation, inflammatory signaling, pyroptosis, and oxidative stress. We further evaluate the therapeutic efficacy and safety of natural products, and highlight emerging neutrophil-targeted technologies to enhance the delivery and efficacy. Collectively, these findings highlight the significant potential of natural products as integrative immunomodulatory interventions targeting intestinal neutrophils.</p>
</sec>
</body>
<back>
<sec id="s8" sec-type="author-contributions">
<title>Author contributions</title>
<p>RK: Writing &#x2013; original draft, Writing &#x2013; review &amp; editing. AS: Writing &#x2013; original draft, Writing &#x2013; review &amp; editing. JY: Writing &#x2013; review &amp; editing, Writing &#x2013; original draft, Data curation. LC: Data curation, Writing &#x2013; original draft. WS: Data curation, Writing &#x2013; original draft. YC: Funding acquisition, Writing &#x2013; review &amp; editing, Supervision. FK: Funding acquisition, Writing &#x2013; review &amp; editing, Supervision.</p></sec>
<sec id="s10" sec-type="COI-statement">
<title>Conflict of interest</title>
<p>The authors declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p></sec>
<sec id="s11" sec-type="ai-statement">
<title>Generative AI statement</title>
<p>The author(s) declared that generative AI was not used in the creation of this manuscript.</p>
<p>Any alternative text (alt text) provided alongside figures in this article has been generated by Frontiers with the support of artificial intelligence and reasonable efforts have been made to ensure accuracy, including review by the authors wherever possible. If&#xa0;you identify any issues, please contact us.</p></sec>
<sec id="s12" sec-type="disclaimer">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p></sec>
<sec id="s13" sec-type="supplementary-material">
<title>Supplementary material</title>
<p>The Supplementary Material for this article can be found online at: <ext-link ext-link-type="uri" xlink:href="https://www.frontiersin.org/articles/10.3389/fimmu.2025.1754107/full#supplementary-material">https://www.frontiersin.org/articles/10.3389/fimmu.2025.1754107/full#supplementary-material</ext-link></p>
<supplementary-material xlink:href="DataSheet1.docx" id="SM1" mimetype="application/vnd.openxmlformats-officedocument.wordprocessingml.document"/></sec>
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<fn id="n1" fn-type="custom" custom-type="edited-by">
<p>Edited by: <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1505646">Haiqiang Yao</ext-link>, Beijing University of Chinese Medicine, China</p></fn>
<fn id="n2" fn-type="custom" custom-type="reviewed-by">
<p>Reviewed by: <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/3301407">Xingwei Ding</ext-link>, Nanchang University, China</p>
<p><ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/3308386">Hideyuki Masui</ext-link>, Hirakata Kousai Hospital, Japan</p></fn>
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