Strobilanthes cusia (Nees) Kuntze, a multifunctional traditional Chinese medicinal plant, and its herbal medicines: a comprehensive review

Ethnopharmacological relevance: Strobilanthes cusia (Nees) Kuntze (SCK, Malan), a traditional Chinese medicinal plant, has long applied to detoxification, defervescence, detumescence and antiphlogosis. "Southern Banlangen" (Rhizoma et Radix Baphicacanthis Cusiae, RRBC), root and rhizome of SCK, is widely used for treatment of many epidemic diseases. Malanye (Sourthern Daqingye), stem and leaf of SCK, is an antipyretic-alexipharmic drug frequently-used in southern China. Qingdai (Indigo Naturalis, IN), a processed product of SCK, is always applied to dermatoses in the folk.

Aim of the review: In order to elucidate the historical uses, recent advances and pharmaceutical prospects of SCK, we summarized roundly in aspects of history, processing method, chemical constitution, quality control, pharmacological activity and toxicity. Some deficiencies in current studies and research directions in the future are also discussed. This is the first comprehensive review of SCK and its herbal medicines, which may be of some help for further research.

Methodology: Comprehensive analysis was conducted on the basis of academic papers, pharmaceutical monographs, ancient medicinal works, and drug standards of China. All available information on SCK and its herbal medicines was collected by using the keywords such as "Strobilanthes cusia", "Southern Banlangen", "indirubin", "tryptanthrin" through different electronic databases including NCBI Pubmed, Google Scholar, Chinese National Knowledge Infrastructure and so on. Pharmacopoeia of China and some ancient works were obtained from National Digital Library of China.

Result: Medicinal uses of SCK were already described by famous ancient researchers. Because of vague description, plant species in some works cannot be confirmed. Literature demonstrated that multiple components including total 36 alkaloids and 35 glycosides, the main bioactive components of SCK, were found in SCK and its herbal medicines. Modern studies indicated that SCK and some of its components had multiple pharmacological effects including resistance to cancer, remission of inflammation, suppression of microorganisms, relief of dermatoses, and so on. However, studies on pharmacology, pharmacokinetics, and quality control are still not enough.

Conclusion: A number of reports suggested that SCK and its processed medicines could be promising drug candidates for multiple diseases especially promyelocytic leukemia, ulcerative colitis (UC) and psoriasis. However, bioactive activities of most components, especially glycosides should still be explored further. It is crucial to elucidate the in-depth molecular mechanisms, and pharmacokinetic characteristics of main components in those herbal medicines. Moreover, to ensure the effectiveness of clinical medication, future studies should undoubtedly give the priority to clarifying the effective compositions of SCK, and then a measurement standard of those indicators should be protocolled to establish a comprehensive quality evaluation mode.

Keywords: Indigo Naturalis; Rhizoma et Radix Baphicacanthis Cusiae; Traditional Chinese Medicine; ethnopharmacology; pharmacology; phytochemistry; quality control.