Sarcandra glabra: phytochemistry, pharmacological activities, and its role in mucosal immunity and digestive diseases

The incidence of digestive system diseases has been increasing annually, highlighting the need for effective therapeutic agents. Sarcandra glabra (Thunb.) Nakai, a key Chinese herbal medicine, has gained attention for its potential in treating digestive disorders. The purpose of this review is to explore the research progress of Sarcandra glabra and its compound preparations in the treatment of digestive system diseases, so as to promote the further exploration of its pharmacological mechanism and the optimization of its clinical 2024 application. Sarcandra glabra contains a variety of chemical constituents, including sesquiterpenes, coumarins, flavonoids, organic acids, polysaccharides and volatile oils, which endow Sarcandra glabra with a wide range of pharmacological effects, such as antibacterial (against Helicobacter pylori, Shigella, Staphylococcus aureus), anti-inflammatory (via TLR4/NF-κB and MAPK pathways), gastroprotective (through mucosal repair, upregulation of tight junction proteins claudin-1 and occludin, and antioxidant activity), immunomodulatory (via Th17/Treg balance, secretory immunoglobulin A (SIgA) secretion, and dendritic cell activation), and anti-tumor (by inducing apoptosis, cell cycle arrest, and telomerase inhibition). Clinically, S. glabra and its various formulations (injections, tablets, granules, oral liquids) have been used for infectious diarrhea, gastritis, peptic ulcers, and as adjuvant therapy for nasopharyngeal, gastric, and colorectal cancers, showing improvements in clinical symptoms and quality of life. However, most clinical evidence is derived from small-scale, non-randomized, or uncontrolled studies. Short-term use is generally well tolerated, with mild gastrointestinal discomfort being the most common adverse event; toxicological studies indicate low acute toxicity and no mutagenicity, but long-term safety and chronic toxicity data are lacking. Future research should prioritize high-quality randomized controlled trials, systematic pharmacovigilance, and mechanistic studies focusing on gastrointestinal mucosal immunity and gut microbiota modulation. In summary, Sarcandra glabra exhibits multiple pharmacological activities relevant to digestive system diseases, including anti-inflammatory, antibacterial, gastroprotective, and immunomodulatory effects. These properties suggest potential therapeutic value, although current evidence is primarily preclinical or derived from small-scale clinical studies. Further high-quality randomized controlled trials and systematic safety evaluations are needed to confirm its efficacy and establish its role in clinical practice. Through systematic and in-depth research and development, Sarcandra glabra is expected to bring treatment options and hope to more patients.