Evidence-Based Complementary and Alternative Medicine

Review Article

Cynanchum paniculatum and Its Major Active Constituents for Inflammatory-Related Diseases: A Review of Traditional Use, Multiple Pathway Modulations, and Clinical Applications

Table 1

Pharmacological actions of Cynanchum paniculatum and its major active constituents in inflammatory-related diseases.


System of diseases	Name of diseases	Related targets and pathways	References

Respiratory	Asthma	IFN-γ↑, IL-4↓, IL-13↓, TLR4/NF-κB signaling, MAPK signaling	[32, 49]
	Lung acute injury	IL-6↓, MCP-1↓, HMGB1↓, NF-κB p65↓, TNF-α↓	[50, 52]
	Cigarette smoke-induced pulmonary inflammation	MAPKs/NF-κB signaling, IL-8↓, ROS↓	[31]
	Lung fibrosis	TGF-β1-induced MAPKs/Smad3 signaling	[51]

Cardiovascular	Epirubicin-induced heart injury	miR-1↓, PI3K/Akt/mTOR pathway, NF-κB signaling	[55]
	Atherosclerosis	SR-A↓, TC↓, TG↓, LCL-C↓, MDA-LDL↓, CRP↓, ICAM-1↓, VCAM-1↓, MCP-1↓	[58–61]
	Chronic gastritis	Clinical, Helicobacter pylori↓	[63]
	Irritable bowel syndrome	Clinical, pain↓	[65, 66]

Hepatobiliary	Chronic hepatitis B	HBsAg↓, HBeAg↓	[68]
	Acute alcohol-induced liver injury	SIRT1/Nrf2/NF-κB signaling	[69]
	Acetaminophen-induced hepatotoxicity	Antioxidative, ALT↓, AST↓, p-JNK↓, TNF-α↓, MCP-1↓, IL-1β↓, IL-6↓, NF-κB signaling pathway	[77]
	Liver fibrosis	Hepatic stellate cells↓, NF-κB signaling, TGF-β/Smad3 signaling, MMP-1↓, MMP-9↓	[74–76]

Urogenital	Renal injury and renal toxicity	ER stress↓, oxidative stress↓, NF-κB signaling↓, AMPK signaling↓, GSK-3 signaling pathway↓, IL-1β↓, TNF-α↓, ICAM-1↓, VEGF↓, Nrf2↑, HO-1↑	[56, 78]
Urogenital	Chronic pelvic inflammation	IL-1β↓, TNF-α↓, ICAM-1↓, VEGF↓	[56]

Neurological	Neuronal cytotoxicity	NF-κB signaling↓, MAPK signaling↓	[26, 80–83]
Neurological	Cerebral ischemia-reperfusion injury	TLR2↓, TLR4↓	[84]

Musculoskeletal	Osteoarthritis, soft tissue injury, trauma	PGE2↓, IL-1β↓, NO↓, NF-κB signaling↓	[3, 6, 8, 30, 86]
Musculoskeletal	Periodontitis	Nrf2/NF-κB/NFATc1 signaling	[87, 88]

Rheumatological	Rheumatoid arthritis	FOXO3↑, miR-155↓, NF-κB signaling	[89, 90]

Dermatological	Solar ultraviolet-induced skin inflammation	TOPK↓, p-p38↓, JNKs↓, MSK1↓, histone H2AX↓, IL-6↓, TNF-α	[92]
	Psoriasis	MyD88↓, TLR8↓	[93]
	Dermatosis	Clinical	[95]
	Eczema	Clinical	[94]

Malignant	Breast cancer	CXCL4/CXCR3-B signaling, apoptosis↑	[103]
	Colon cancer	RUNX3↑, intracellular Ca²⁺↑, apoptosis↑, PGE2↓, COX-2↓	[98, 106]
	Esophageal cancer	Bcl-2/Bax↓, apoptosis↑	[108, 109]
	Gastric cancer	ERBB2↓, NF-κB signaling, MMP-2↓, MMP-9↓	[97, 100, 102]
	Liver cancer	NF-κB signaling	[107]
	Melanoma	TNF-α-activated NF-κB and IL-6-activated STAT3 signaling	[99, 101]
	Ovarian cancer	VEGF↓, HIF-1α↓, PI3K/Akt pathway	[105, 110]
	Pancreatic cancer	TGF-β1/SMAD signaling	[112]
	Prostate cancer	Apoptosis↑, caspase-3↑, −8↑, −9↑, PI3K/Akt pathway	[111]