A multi-target shield: Protective roles of Scutellaria baicalensis flavonoids in heavy metal-induced organ damage

Environmental exposure to toxic heavy metals, including cadmium, lead and mercury, represents a significant global health concern, contributing to the pathogenesis of multi-organ dysfunction through interconnected mechanisms of oxidative stress, chronic inflammation and apoptotic cell death. While chelation therapy remains a conventional mainstay, its limitations underscore the need for complementary strategies that mitigate secondary cellular damage. This review synthesizes current evidence demonstrating that Scutellaria baicalensis Georgi (Huang Qin) and its principal flavonoids, including baicalein, baicalin and wogonin, function as multi-target cytoprotective agents against heavy metal toxicity. Their mechanisms, which include the activation of the nuclear factor erythroid 2-related factor 2/Kelch-like enoyl-CoA hydratase-associated protein 1/antioxidant response element antioxidant pathway, suppression of the nuclear factor-κB and nucleotide-binding leucine-rich repeat receptor family pyrin domain-containing 3 inflammasome-driven inflammatory cascades, and inhibition of mitochondrial and endoplasmic reticulum stress-mediated apoptosis, were systematically delineated. In addition, their roles in attenuating fibrotic signaling, protecting tissue barrier integrity and regulating gut microbiota were explored. The evidence, compiled from in vitro and in vivo studies, reveals consistent efficacy in protecting the hepatic, nervous, cardiovascular, renal, reproductive, endocrine and musculoskeletal systems. By integrating this mechanistic framework with the documented clinical applications of S. baicalensis flavonoids in related inflammatory pathologies, this review highlights their significant potential as therapeutic and preventive agents for heavy metal-related health disorders and advocates for their translation into targeted clinical strategies. Please cite this article as: Li YF, Liang YF, Liu J, Wang H, Ma YL. A multi-target shield: Protective roles of Scutellaria baicalensis flavonoids in heavy metal-induced organ damage. J Integr Med. 2026; Epub ahead of print.