Schisandra chinensis in noncommunicable disease management: therapeutic prospects within the PPPM framework

Non-communicable diseases (NCDs), including cardiovascular diseases, respiratory disorders, And age-related degenerative diseases, account for 74% of global mortality, imposing heavy burdens on healthcare systems and global sustainable development. Current management strategies face challenges such as poor long-term drug adherence and complex comorbidities. Functional foods and nutraceuticals, particularly those rooted in traditional Chinese medicine (TCM) that embody the "food-medicine homology" principle, have emerged as promising adjuncts for NCD prevention and treatment. Schisandra chinensis (SC) is an edible and medicinal plant with a long history. Rich in bioactive components such as lignans, polysaccharides, and terpenoids, it exhibits multi-targeted pharmacological activities and holds great potential in improving clinical diseases and progressing suboptimal health to optimal, making it a promising candidate for integrated health strategies.

This review aims to synthesize the mechanisms underlying SC's actions in NCD prevention and management, clarify its therapeutic and preventive roles across clinical populations and suboptimal health states, and explore its applications within the framework of predictive, preventive, and personalized medicine (PPPM/3PM).

Preclinical evidence highlights SC's multi-target pharmacological activities, including anti-inflammatory, antioxidant and adaptogenic effects, which are key pathological drivers in the treatment of non-communicable diseases such as cardiovascular diseases, respiratory diseases and age-related degenerative diseases. For clinical populations, SC supports therapeutic goals through liver protection in liver disease management, cancer-assisted immune regulation, neuroprotection, reduction of lung damage, and blood sugar regulation. In suboptimal health individuals characterized by stress-induced fatigue, subclinical inflammation, or impaired elasticity, the adaptive properties of SC offer specific benefits, helping the body resist stress and maintain homeostasis.

SC bridges therapeutic and preventive applications via its multifunctional properties, aligning with PPPM principles by enabling tailored interventions for NCDs and proactive health management. Its safety, multi-target activities, and compatibility with lifestyle medicine highlight its potential as a natural resource for integrated NCD care.

Further clinical trials are needed to validate dosage regimens and efficacy in diverse populations. Standardization of SC quality and exploration of synergistic effects with conventional therapies will facilitate its translation into personalized PPPM strategies.