From nature to novelty: Enhancing rosmarinic acid's therapeutic potential through smart molecular design

Rosmarinic acid (RA), a naturally occurring ester of caffeic acid and 3,4-dihydroxyphenyllactic acid, is widely distributed in medicinal plants of the Lamiaceae families. It has attracted considerable attention due to its broad spectrum of pharmacological properties, including strong antioxidant, anti-inflammatory, antiviral, neuroprotective, and anticancer activities. Nevertheless, the therapeutic application of RA has been hampered by poor cell membrane penetration ability, and limited oral bioavailability. To address these challenges, extensive efforts have been devoted to the chemical modification of RA, leading to a wide range of semi-synthetic and fully synthetic derivatives. This review systematically summarizes and evaluates the bioactivity of current RA derivatives. We highlight how different structural modifications, such as esterification, amidation, dimerization, ring expansion, alkyl chain elongation, and metal coordination, can enhance pharmacological potency or improve pharmacokinetic behavior. A comparative "Relative Activity" assessment is also introduced to unify cross-study evaluations by directly comparing the activity of derivatives with the parent compound. Moreover, we discuss structure-activity relationships and underlying mechanisms, with emphasis on the therapeutic relevance of RA derivatives in oxidative stress, inflammation, cancer progression, viral infection, and metabolic disorders. Finally, we outline future perspectives on the rational development of RA-based drug candidates and their potential application in multifunctional theranostic systems.