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Review

The Role of Astaxanthin as an Antioxidant and Anti-Inflammatory Agent in Human Health: A Systematic Review

by
Giuseppina Malcangi
1,†,
Angelo Michele Inchingolo
1,2,*,†,
Lucia Casamassima
1,
Irma Trilli
1,
Laura Ferrante
1,
Marialuisa Longo
1,
Francesco Inchingolo
1,
Grazia Marinelli
1,
Andrea Palermo
3,
Gianna Dipalma
1,2,*,‡ and
Alessio Danilo Inchingolo
1,‡
1
Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
2
Department of Biomedical, Surgical and Dental Sciences, Milan University, 20122 Milan, Italy
3
Department of Experimental Medicine, University of Salento, 73100 Lecce, Italy
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
‡
These authors also contributed equally to this work.
Int. J. Mol. Sci. 2026, 27(2), 700; https://doi.org/10.3390/ijms27020700
Submission received: 29 November 2025 / Accepted: 7 January 2026 / Published: 9 January 2026
(This article belongs to the Topic Natural Bioactive Compounds as a Promising Approach to Mitigating Oxidative Stress)
Versions Notes

Abstract

This systematic review aimed to summarize the effects of astaxanthin (ASX) supplementation on oxidative stress, inflammation, and metabolic regulation in human studies. A systematic search was conducted in Scopus, Web of Science (WOS), and PubMed for articles published between 2020 and 2025. Fifteen studies involving human participants were included, while in vitro and animal studies were excluded. ASX consistently reduced pro-inflammatory cytokines (IL-6, TNF-α, TGF-β1) and oxidative stress indices while increasing antioxidant capacity (SOD, TAC). Combined ASX and exercise interventions improved body composition, lipid profiles, insulin sensitivity, and immune recovery. In women with Polycystic Ovary Syndrome (PCOS) or endometriosis, ASX downregulated endoplasmic reticulum stress–related apoptotic pathways and improved oocyte and embryo quality. Cardiometabolic and respiratory outcomes showed improved endothelial function and reduced disease severity. Astaxanthin demonstrates broad antioxidant and anti-inflammatory properties, supporting its role as a promising adjunctive therapy for metabolic, reproductive, and cardiovascular health. Further well-designed clinical trials are needed to confirm optimal dosing and mechanisms of action.
Keywords: astaxanthin; antioxidant; anti-inflammatory; oxidative stress astaxanthin; antioxidant; anti-inflammatory; oxidative stress

Share and Cite

MDPI and ACS Style

Malcangi, G.; Inchingolo, A.M.; Casamassima, L.; Trilli, I.; Ferrante, L.; Longo, M.; Inchingolo, F.; Marinelli, G.; Palermo, A.; Dipalma, G.; et al. The Role of Astaxanthin as an Antioxidant and Anti-Inflammatory Agent in Human Health: A Systematic Review. Int. J. Mol. Sci. 2026, 27, 700. https://doi.org/10.3390/ijms27020700

AMA Style

Malcangi G, Inchingolo AM, Casamassima L, Trilli I, Ferrante L, Longo M, Inchingolo F, Marinelli G, Palermo A, Dipalma G, et al. The Role of Astaxanthin as an Antioxidant and Anti-Inflammatory Agent in Human Health: A Systematic Review. International Journal of Molecular Sciences. 2026; 27(2):700. https://doi.org/10.3390/ijms27020700

Chicago/Turabian Style

Malcangi, Giuseppina, Angelo Michele Inchingolo, Lucia Casamassima, Irma Trilli, Laura Ferrante, Marialuisa Longo, Francesco Inchingolo, Grazia Marinelli, Andrea Palermo, Gianna Dipalma, and et al. 2026. "The Role of Astaxanthin as an Antioxidant and Anti-Inflammatory Agent in Human Health: A Systematic Review" International Journal of Molecular Sciences 27, no. 2: 700. https://doi.org/10.3390/ijms27020700

APA Style

Malcangi, G., Inchingolo, A. M., Casamassima, L., Trilli, I., Ferrante, L., Longo, M., Inchingolo, F., Marinelli, G., Palermo, A., Dipalma, G., & Inchingolo, A. D. (2026). The Role of Astaxanthin as an Antioxidant and Anti-Inflammatory Agent in Human Health: A Systematic Review. International Journal of Molecular Sciences, 27(2), 700. https://doi.org/10.3390/ijms27020700

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