Nutritional and Pharmacological Significance of Pomegranate (Punica granatum L): A Comprehensive Narrative Review

Pomegranate (Punica granatum L) is a rich source of bioactive compounds, including punicalagin, ellagic acid, anthocyanins, and urolithins, which contribute to its broad pharmacological potential. This review summarizes evidence from in vitro and in vivo experiments, as well as clinical studies, highlighting pomegranate's therapeutic effects in inflammation, metabolic disorders, cancer, cardiovascular disease, neurodegeneration, microbial infections, and skin conditions. Mechanistic insights show modulation of pathways such as nuclear factor-kappa B (NF-κB), mitogen-activated protein kinase (MAPK), alpha serine/threonine-protein kinase (AKT1), and nuclear factor erythroid 2-related factor 2 (Nrf2). Notably, punicalagin exhibits antifungal activity via sterol 14-demethylase P450 (CYP51) inhibition, supported by molecular docking studies. While evidence supports the promising bioactivity of pomegranate compounds, their clinical application is hindered by low and variable bioavailability, inconsistent dosing and formulations, and limited data on adverse effects largely due to interindividual differences in gut microbiota metabolism of punicalagin into urolithins. Although pomegranate demonstrates an excellent safety profile with minimal reported adverse events, further long-term, well-designed clinical trials are essential to validate its efficacy, determine optimal dosing, and enable standardized therapeutic use. This review contributes to the discourse on the medicinal value of pomegranate, offering a comprehensive understanding of its role in addressing diverse health conditions and highlighting the importance of integrating medicinal plants such as pomegranate into modern nutrition and clinical practice.