Prunella vulgaris L. – A Review of its Ethnopharmacology, Phytochemistry, Quality Control and Pharmacological Effects (2024)

Herb-Pairs

TCM couplet, also known as “herb-pairs,” refers to the commonly used and relatively fixed compatibility form of TCM in clinic, and is the smallest unit of prescription (Duan et al., 2009). They are widely used in clinic. From a certain point of view, the compatibility and application of drug pairs are of special significance. The application of this method has the effects of increasing efficiency, reducing toxicity, so it could better play the efficacy of TCM and improve the clinical therapeutic effect (Meng et al., 2009). In the ancient book of “Treasury of Words on the Materia Medica” (Bĕn Căo Huì Yán, 本草汇言) (Ming Dynasty, AD 1368-1644), There are the following records: “Treat primary acute mastitis: Equipartitioned Taraxaci Herba with PVL, and taken by boiling with wine” (Ni, 2005). Modern studies have shown that this drug pairs can increase interleukin-6 (IL-6) level in breast cancer model mice, inhibit the proliferation and promote the apoptosis of breast cancer cells (Tang et al., 2020a). The couplet medicines of Pinellia Ternata and PVL are commonly used in clinical medicine. Ancient and modern physicians had carried out a large number of clinical practices, and found that they had better clinical efficacy for hyperthyroidism, insomnia and depression (Wang et al., 2006; Liu et al., 2009; Liu et al., 2014b).

At present, the clinical application of PVL herb-pairs is also very extensive, but it is mainly guided by the classical theory of TCM. Most of them lack a relatively sophisticated basis for modern pharmacological research. Most studies are not deep enough, and the combination with clinical research is not close enough. Therefore, in the future, the compatibility of PVL should be systematically and deeply studied from the aspects of pharmacodynamic material basis, metabolic process, mechanism of action and clinical compatibility application, Only in this way can we understand it more comprehensively and provide better guidance in its clinical application.

Prescription

Prescriptions select the appropriate drugs under the guidance of the theory of TCM, in accordance with fomula composing principles. After careful consideration of its dosage and usage, it is prepared through proper compatibility (Zuo and Xu, 2016). In this section, we summarize the various prescriptions in the current Chinese Pharmacopoeia (2020 edition) that use PVL as the main drug and briefly list their compositions and functions (Supplementary Table S2).

PVL mainly enters the liver meridian, so it has significant curative effect on breast diseases such as hyperplasia of mammary glands, acute mastitis, breast cancer and other diseases attributed to the liver meridian. In Thoroughly Revised Materia Medica (Bĕn Căo Cóng Xīn, 本草从新, Tang Dynasty, AD 618–907), it is recored that PVL can treat acute mastitis, breast cancer. According to the Yaozh Database (https://db.yaozh.com), there are many kinds of TCM prescriptions and proprietary Chinese medicine prescriptions for the treatment of hyperplasia of mammary glands. Among them, the TCM prescriptions of Ruheyin and Rukuaixiao Decoction, which take PVL as main drug, have definite curative effect on hyperplasia of mammary glands. There are 44 kinds of proprietary Chinese medicine prescriptions for the treatment of hyperplasia of mammary glands, among these, 22 prescriptions contain PVL. Thus, PVL has a high frequency of medication in the clinical treatment of HMG, and to a certain extent, it also shows its important clinical application value.

At present, PVL oral liquid is commonly used in the treatment of hyperplasia of mammary glands, which can relieve breast pain and conducive to dissipation of breast nodules or masses. More in-depth scientific studies are needed in the future to explore the mechanism of PVL for the treatment of breast diseases, so that innovative drugs with low toxicity, economy and high efficiency can be developed.

Dietotherapy History

As a medicinal and edible perennial herb, PVL has been used in China for thousands of years. PVL is first found in “Extension of the Materia Medica” (Bĕn Căo Yăn Yì, 本草衍义) (Song Dynasty, AD 960–1279) as an edible history, that is: “When the leaves are new and tender, they can be eaten as a vegetable and must be washed to remove the bitter water” (Kou, 1990), and then “Materia Medica Arranged According to Pattern” (Zhèng Lèi Bĕn Căo, 证类本草) (Song Dynasty, AD 960–1279) cited the above content. “The Grand Compendium of Materia Medica” (Bĕn Căo Gāng Mù, 本草纲目) (Ming Dynasty, AD 1578) also introduced the edible method of it: “After cleaning the tender seedlings, soak them away and mix them with oil and salt for edible” (Li, 2005). “Food as Materia Medica” (Shí Wù Bĕn Căo, 食物本草) (Ming Dynasty, AD 1368–1644) also pointed out: “PVL is bitter, cold, non-toxic. The seedlings are washed, soaked to remove the bitterness, stirred with oil and salt, and eaten as a pickle with a very delicious taste” (Lu, 2015). Thus, as early as more than a thousand years ago, it has been used as food and vegetable for people to widely eat.

Particularly, it could also be used for food therapy, cooking into “PVL and Lean pork soup,” and other medicinal food, could clear liver and improve vision, dispel heat and eliminate stagnation (Cui, 2020). “PVL and Angelica sinensis Porridge” can be used as a diet to treat breast hyperplasia with good results (Liu and Zhao, 2018). “PVL and Crucian Soup” could treat thyroid adenoma with satisfactory curative effect. The cold nodules disappeared and all the symptoms were eliminated after taking it more than 2months (Cheng, 1980). It had been reported that soup made of PVL and turtle was suitable for patients with malignant lymphoma at all stages (Li, 2009).

The climate in Guangdong Province of China is hot and humid. Drinking herbal tea is an important part of the dietary habits of people there (Mei, 2005). It is precisely because of the dietary habits, so it is necessary to put various TCM into tea. As early as the Ming Dynasty, Sheganqiao tea prescription containing PVL has appeared in “Herbal Huiyan” (本草汇言) with the effect of clearing away heat and detoxifying, detumescence and dispersing after consumption. In modern, Wang Laoji, He Qizheng and other herbal teas added it, using its heat-clearing function to achieve the effect of eliminating dampness and heat, preventing heat and reducing temperature.

Triterpenoids

The terpenoids in PVL are mainly triterpenoids. Triterpenoids are a group of terpenes with a parent nucleus consisting of 30 carbon atoms. They exist in plants in free form or in the form of glycoside combined with sugar or in ester form. There are three main types of triterpenoids in PVL, including oleanane, ursane and lupane, respectively. Triterpenoids are the major active ingredients of PVL and its pharmacological activities such as anti-inflammatory, antibacterial, liver protection, anti-diabetes, anti-cancer, and anti-virus (Feng et al., 2011a; Jie et al., 2013; Zhou et al., 2013; Zhang et al., 2015; Pan, 2018b; Li et al., 2019a). In this part, a total of 87 triterpenoid constituents are isolated and identified, the chemical stractures of triterpenoids are particularly shown in Tables 1–6.

TABLE 1

Chemical structures of triterpenes isolated from PVL─Part I.

	Groups	R1	R2	R3	R4	R5	R6
	(26) Methyl ursolate	H	βOH	Me	Me	Me	H
	(28) Methyl oleanolate	H	βOH	Me	Me	H	Me
	(73) Methyl 2α,3α-dihydroxyurs-12-en-28-oate	OH	αOH	Me	Me	Me	H
	(32) Methyl 3-epimaslinate	OH	αOH	Me	Me	H	Me
	(75) Methyl 2α,3α,24-trihydroxyursa-12,20 (30)-dien-28-oate	OH	αOH	Me	CH2OH	Me	H
	(33) Methyl 2α-hydroxyursolate	OH	βOH	Me	Me	Me	H
	(29) Methyl maslinate	OH	βOH	Me	Me	H	Me
	(76) Methyl 2α,3α,23-trihydroxyolean-12-en-28-oate	OH	αOH	CH2OH	Me	H	Me
(Kojima and Ogura)	(77) Methyl 2α,3α,24-trihydroxyolean-12-en-28-oate	OH	αOH	Me	CH2OH	H	Me

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TABLE 6

Chemical structures of triterpenes isolated from PVL─Part VI.

	Groups	R1	R2	R3	R4	R5	R6
	(52) 2α,3α-24-trihydroxyursa-12-en-28-oic acid-28-O-β-D-glucopyranoside	OH	αOH	CH2OH	Glc	H	CH3
	(70) 2α,3β,19α,24-tetrahydroxyurs-12-en-28-oic acid-28-β-D-glucopyranoside	OH	βOH	CH2OH	Glc	OH	CH3
	(55) 2α,3α,19α-trihydroxyurs-12-en-28-oic acid-28-β-D-glucopyranoside	OH	αOH	CH3	Glc	OH	CH3
	(56) 2α,3α,19α-trihydroxyurs-12-en-28-oic acid-28-β-D-glucopyranosyl-(1→2)-β-D-glucopyranoside	OH	αOH	CH3	Glc (1–2)Glc	OH	CH3
(Yu et al.)	(82) Rotundic acid 28-O-α-D-glueopyranosyl (1→6)-β-D-glueopyranoside	H	βOH	CH3	Glc (1–6)Glc	OH	OH

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TABLE 2

Chemical structures of triterpenes isolated from PVL─Part II.

	Groups	R1	R2	R3	R4
	(22) Pruvuloside A	αOH	CH3	CH3	Glc2-Glc
	(19) Niga-ichigoside F1	βOH	CH2OH	CH3	Glc
	(20) Niga-ichigoside F2	αOH	CH2OH	CH3	Glc
(Zhang and Yang)	(23) Pruvuloside B	αOH	CH3	CH2OH	Glc

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TABLE 3

Chemical structures of triterpenes isolated from PVL─Part III.

	Groups	R1	R2	R3
	(45) 2α,3α,24-trihydroxyursa-12,20 (30)-dien-28-oic acid	CH2OH	CH3	CH2
	(49) 2α,3α,24-trihydroxyolean-12-en-28oic acid	CH2OH	H	CH3CH2CH3
	(51) 2α,3α,24-trihydroxy-12-en-28-ursolic acid	CH2OH	CH3	CH3CH3
	(61) 2α,3β-dihydroxy-12-en-28-ursolic acid	H	H	CH3CH2CH3
(Wang et al.)	(62) 2α,3β-dihydroxy-12-en-28-oleanolic acid)	H	CH3	CH3CH3

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TABLE 4

Chemical structures of triterpenes isolated from PVL─Part IV.

	Groups	R1	R2	R3	R4	R5	R6	R7	R8	R9
	(3) Maslinic acid	αOH	αOH	CH3	CH3	H	CH3	αOH	CH3	H
	(48) 2α,3α,23-trihydroxy-12-en-28-ursolic acid	αOH	βOH	CH3	CH3	H	H	H	CH3	CH3
	(54) 2α,3α,19α-trihydroxyurs-12-en-28-oic acid	αOH	αOH	CH2OH	CH3	H	CH3	αOH	CH3	H
	(57) 2α,3α,19α,23-tetrahydroxyurs-12en-28oic acid	αOH	αOH	CH2OH	CH3	H	CH3	H	CH3	H
	(59) 2α,3α,19α,24-tetrahydroxyurs-12en-28oic acid 28-O-D-glucopyranoside	αOH	βOH	CH2OH	CH3	Glc	CH3	αOH	CH3	H
(Lee et al.)	(69) 2α,3β,19α,24-tetrahydroxyurs-12en-28oic acid 28-O-D-glucopyranoside	αOH	αOH	CH2OH	CH3	Glc	CH3	αOH	CH3	H

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TABLE 5

Chemical structures of triterpenes isolated from PVL─Part V.

	Groups	R1	R2	R3	R4	R5	R6	R7	R8	R9
	(84) 2,3,24-trihydroxyolean-12-en-28-oic acid	OH	OH	CH3	CH2OH	CH3	CH3	H	H	H
	(83) 2,3,24-trihydroxyurs-12-en-28-oic acid	OH	OH	CH3	CH2OH	CH3	H	H	CH3	H
	(42) 3β,22α-dihydroxyolean-12-en-28-oic acid	H	βOH	CH3	CH3	CH3	CH3	H	H	αOH
	(43) 3β,22α-dihydroxyurs-12-en-28-oic acid	H	βOH	CH3	CH3	CH3	H	H	CH3	αOH
(Yang et al.)	(87) 22-hydroxy-3-oxoleana-12-en-28-oic acid	H	=O	CH3	CH3	CH3	CH3	H	H	H

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Oleanolic acid (1), Ursolic acid (2) and β-Amyrin (4, isolated from this genus for the first time) were isolated from PVL, and they proved that (1) and (2) and their saponines both have anti-hypertensive activity, and the saponines have anti-cardiac arrhythmic activity (He et al., 1985). Japanese scholar Kojima et al. isolated a new triterpene, methyl 2α,3α,24-trihydroxyolean-12-en-28-oate (76) (Kojima and Ogura, 1986). Subsequently, three new pentacyclic triterpenoids (73, 74, 80) and two new hexacyclic triterpenoids (78, 79) were isolated as their methyl esters (Kojima et al., 1987; Kojima et al., 1988). Zhang et al. isolated two new ursane triterpenoid saponins pruvuloside A and B (22, 23) (Zhang and Yang, 1995). Two new compounds, vulgarsaponin A and B (24, 25), were isolated from the dried fruitspikes of PVL (Wang et al., 1999; Tian et al., 2000). Similarly, a new triterpenoid saponin established to be prunelloside A (21) was isolated (Zhang et al., 2008). South Korean scholar Byun et al. first isolated euscaphic acid (6) and 3β-Hydroxyolean-5,12-diene (39) from the spikes of PVL. Furthermore, they proved that (39) exhibited significant cytotoxic activity against human colon adenoblastoma (HT-29) (Byun et al., 2007). Korean scholar Lee et al. isolated and identified (3), (54), (57), (58), (69), and proved ursolic acid exhibited moderate cytotoxic activity against A549, SK-OV-3, SK-MEL-2, and HCT15 cells (Lee et al., 2008). Du et al. isolated a new, unusual ^∆11(12) triterpene, 3β,13β-dihydroxyolic-11-ene-28-oic acid (44) with anti-complementary activity against the classical pathway and the alternative pathway (Du et al., 2012). Yu et al. investigated the methanol extract from the spikes of it, and led to the isolation of two new pentacyclic triterpenoid glycosides Vulgasides I (17) and II (18) (Yu et al., 2015).

Sterols

Sterols are steroids containing hydroxyl groups. They are all based on cyclopentane phenanthrene. The Sterols in PVL are mostly phytosterols and their saponins, such as sitosterol and stigmasterol. Daucosterol (90) was first isolated from the dichloromethane extract of PVL (He et al., 1985). Kojima et al. obtained α-spinasterol (91) and stigmast-7-enol (95) from the stems and leaves of PVL (Kojima and Ogura, 1986). Meng et al. isolated β-sitosterol (93), (22E,20S,24S)-stigmasta-7,22-diene-3-one (100), in which compound (100) was obtained from this genus for the first time (Meng and He, 1995). Tian et al.first isolated stigmasterol (88) and stigmast-7-en-3β-ol (96) (Tian et al., 2000). Lou et al. isolated a new C²¹ steroidal glycoside, named qingyangshengenin-3-O-β-D-digitoxopyranoside (97) and a known steroidal glycoside qinyangshengenin-3-O-β-D-oleandropyranosyl-(1→4)-β-D-cymaropyranosyl-(1→4)-β-D-digitoxopyranoside (98) (Lou et al., 2015). South Korean scholar Choi et al. isolated spinasterone (89), 5-stigmasta-7, 22-dien-3-ol (99) (Choi et al., 2016). The corresponding chemical structures are shown in Table 7.

TABLE 7

Chemical structures of sterols isolated from PVL.

(95) Stigmast-7-enol	(91) α-Spinasterol	(89) Spinasterone
(93) β-Sitosterol	(88) Stigmasterol	(96) Stigmast-7-en-3β-ol
(90) Daucosterol	(97) Qingyangshengenin-3-O-β-D-digitoxopyranoside	(98) Qinyangshengenin-3-O-β-D-oleandropyranosyl-(1→4)-β-D-cymaropyranosyl-(1→4)-β-D-digitoxopyranoside

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Flavonoids

Flavonoids are a series of compounds composed of two phenolic hydroxyl benzene rings (A and B rings) connected by central tricarbon atoms. The basic nucleus of flavonoids is 2-phenylchromone. The flavonoids in PVL can be divided into flavone, flavanonole, and flavanone according to their chemical structures. The isolated compounds and their corresponding structures are shown in Table 8. PVL total flavonoids have a wide range of biological and pharmacological activities, such as anti-tumor, anti-oxidation, free radical scavenging, anti-inflammation, inhibiting osteoporosis, and improving osteoarthritis (Yan et al., 2012; Liu et al., 2014a; Li et al., 2019c; Shao et al., 2019; Song et al., 2020; Lu et al., 2022).

TABLE 8

Chemical structures of flavonoids isolated from PVL.

(132) Quercetin	(134) Luteolin	(136) Wogonin
(130) Rutin	(137) hom*oorientin	(135) Cynaroside
(143 ) Quercetin-3-O-glucoside	(145) Kaempferol-3-O-glucoside	(133) Quercitrin
(138) Hesperidin

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Dmitruk et al., (1987) isolated luteolin (134), hom*oorientin (137) and cynaroside (135) from the ethanol extract of the aboveground part of it, in which compound (134) was first isolated. Zhang et al. isolated quercetin-3-O-glucoside (143), kaempferol-3-O-glucoside (145) from the methanol extract of it from France (Zhang and Yang, 1995). Wang et al. isolated rutin (130), quercetin (132), hesperidin (138), quercetin-3-O-β-D-galactoside (140) and quercetin-3-O-β-D- glucoside (141) from dried ears. Among them, compound (138) and (141) were isolated from this genus for the first time (Wang et al., 1999; Wang et al., 2008). Subsequently, Gai et al. isolated kaempferol-3-O-β-D-glucoside (146) from 70% ethanol extract of it (Gai et al., 2010). Zhang et al. identified acacetin-7-O-β-D-glucopyranoside (149) from the dried ear, which was isolated from this genus for the first time (Zhang et al., 2008). Korean scholar Lee et al. isolated from the aerial part quercetin-3-O-β-D-glucopyranoside (142), kaempferol-3-O-β-D-glucopyranoside (147), quercertin-3-O-α-L-rhamnopyranosyl (1→6)-β-D-glucopranoside (144), kaempferol 3-O-α-L-rhamnopyranosyl (1→6)-β-D-glucopranoside (148) (Lee et al., 2008). And then, the following compounds wogonin (136), quercitrin (133) were isolated and identified by different scholars (Gai et al., 2010; Yu et al., 2012).

Phenylpropanoids

Phenylpropanoids are naturally occurring compound consisting of a class of benzene rings connected with three straight-chain carbons (C6-C3 groups). Phenylpropanoids in PVL are mainly phenylpropionic acids and coumarins, and their corresponding structures are shown in Table 9. The active ingredient rosmarinic acid in PVL has been proved to have a variety of pharmacological effects, such as anti-invasion, anti-oxidant, anti-inflammatory and immune regulation (Zdařilová et al., 2009; Xu et al., 2010b; Djivanovna et al., 2018). Dmitruk et al. isolated three coumarin compounds from the ethanol extract of the epigeal parts of it: umbelliferone (107), scopoletin (106), and esculetin (108) (Dmitruk, 1986). Wang et al. isolated ethyl caffeate (103, for the first time from this genus), rosmarinic acid (110) and its derivatives methyl rosmarinate (111), ethyl rosmarinate (113), butyl rosmarinate (114). Meanwhile, 3, 4, α-trihydroxy-butyl phenylpropionate (126) and 3,4, α-trihydroxy-methyl phenylpropionate (127) were isolated from this genus (Wang et al., 1999; Wang et al., 2000; Wang et al., 2001). Yan et al. isolated and identified caffeic acid-3-O-glucoside (104), trans-salviaflaside methyl ester (118), trans-salviaflaside (119), (-)-syringaresinol-4-O-β-D-glucopyranoside (128) (Yan et al., 2016). Gu et al. isolated Danshensu (120) from the spikes of it for the first time. Then Gai et al. isolated methyl 3,4-dihydroxyphenyl lactate (121) and ethyl 3,4-dihydroxyphenyl lactate (122) from 70% ethanol extract (Gu et al., 2007; Gai et al., 2010). Later, researchers have successively isolated and identified different chemical constituents such as: caffeic acid (101), caffeic acid-O-hexoside (105), p-hydroxycinnamic acid (124) and so on (Tian et al., 2000; Lee et al., 2008; Yang et al., 2016).

TABLE 9

Chemical structures of phenylpropanoids isolated from PVL.

(107) Umbelliferone	(106) Scopoletin	(108) Esculetin
(109) Coniferaldehyde	(117) Sinapaldehyde	(123) 4-allyl-2,6-dimethoxyphenol
(103) Ethyl caffeate	(126) 3,4, α-trihydroxy-butyl phenylpropionate	(120) Danshensu
(127) 3,4, α-trihydroxy-methyl phenylpropionate	(102) Chlorogenic acid	(101) Caffeic acid
(116) Salviaflaside	(112) Rosmarinic acid	(128) (-)-syringaresinol-4-O-β-D-glucopyranoside
(115) Ethyl rosmarinate	(114) Butyl rosmarinate	(113) Methyl rosmarinate

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Volatile Oils

Volatile oils, also known as essential oils, are aromatic, volatile liquids obtained from plant material through steam distillation and named after the plant from which they are derived. The volatile oil of PVL mainly includes terpenes (monoterpenes, sesquiterpenes and their oxygenated derivatives), small molecule aliphatic compounds and aromatic compounds.

A large number of pharmacological experiments have shown that volatile oil has pharmacological activities such as anti-inflammatory, antioxidant, antifungal, antitumor, and has a variety of applications in medicine (Lei, 2019; Lawson et al., 2020; Mak and Walsh, 2021). Yang et al.used GC/FT-IR technology to analyze the components of the essential oil of it, and the main components were identified as 1,8-cineol (223) (44.827%), β-pinene (192) (15.736%), linalyl acetate (213) (4.187%), α-phellandrene (189) (5.578%) (Yang et al., 1988). Wang et al. used GC-MS to analyze the components of volatile oil from the spikes of domestic PVL, and identified 12 compounds (224, 227, 234, 235, and 243–250) (Wang et al., 1994). Iranian scholar Morteza et al. extracted volatile oil from the aerial part of dried flowering spikes, and identified 32 components. The main components were Selin-11-en-4-α-ol (237) (14.9%), cis-eudesma-6,11-diene (220) (9.4%), 1,10-di-epi-cubenol (222) (8.0%), spathulenol (184) (5.8%) and Geracrene D (183) (5.1%) (Morteza-Semnani et al., 2006). Yang et al. carried out qualitative and quantitative analysis of volatile components in different parts of it, and the result showed that 145 components were identified, of which compound (-)-Thujopsen (182), α-Calacorene (188), Sinapaldehyde (202), Ferruginol (204) and some other volatile oils were found in PVL (Yang and Zhao, 2019). Chemical structures of volatile oils isolated from PVL were shown in Table 10.

TABLE 10

Chemical structures of volatile oils isolated from PVL.

(191) α-Pinene	(192) β-Pinene	(199) D-Limonene	(189) α-Phellandrene	(223) 1,8-Cineol
(205) cis-Isoeugenol	(216) Bornyl acetate	(200) Vanillin	(197) β-Elemene	(215) Methyl salicylate
(111) 3,4-Dihydrocoumarin	(110) Coumarin	(194) β-Curcumene	(193) β-Bisabolol	(206) 4-Vinylguaiacol
(237) Selin-11-en-4-α-ol	(184) Spathulenol	(182) (-)-Thujopsen	(196) β-Bourbonene	(202) Sinapaldehyde
(195) β-Copaene	(188) α-Calacorene	(190) α-Muurolol	(183) Germacrene D	(198) δ-Amorphene
(181) Cuparene	(188) α-Chamigrene	(185) α-Patchoulene	(186) α-Cedrene	(204) Ferruginol

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Organic Acids

Organic acids are widely distributed in leaves, roots, especially in fruits. Fatty acids are common organic acids in PVL, such as linoleic acid (171), linolenic acid (170) and arachidic acid (165), which are essential fatty acids for human body. Besides, there also exists malonic acid (157), pentadecanoic acid (160), palmitoleic acid (167) (Tian et al., 2000; Yang and Zhao, 2019). Aromatic organic acids such as benzoic acid (154), 4-Hydroxybenzoic acid (169) (Tian et al., 2000; Zheng, 2012; Yang and Zhao, 2019). Except for a few free fatty acids, Fatty acids are mostly esterified with glycerol or waxed with higher alcohols such as palmitic acid ethyl ester (162), methyl linolenate (173), monopalmitin (168) (Yang and Zhao, 2019). Some organic acids are the components of resin such as dehydroabietic acid (172) (Yang and Zhao, 2019). Tian et al. isolated and identified four fatty acid compounds from the methylation of lipophilic part of it, which were stearic acid (163), oleic acid (164), palmitic acid (161), behenic acid (166) (Tian et al., 2000). A new phenolic glycosides, gentisic acid 5-O-β-D-(6′-salicylyl)-glucopyranoside (179), was isolated for the first time by Gu et al. (Gu et al., 2011). Zheng et al. isolated anti-tuberculosis active components methyl 3,4-dihydroxybenzoate 178) (Zheng, 2012). Bai et al. isolated cyclopentaneacetic acid 158) from the spikes of it (Bai et al., 2015). Subsequently, citric acid (150), gluconic acid (152), protocatechuic acid 153) and malic acid 156) were isolated from water extract of PVL by Liang et al., and the contents were 14.8%, 8.2%, 1.8% and 3.9%, respectively (Liang et al., 2013).

Polysaccharides

Polysaccharides are composed of more than 10 monosaccharides linked by glycosidic bonds, widely distributed in nature. Polysaccharides is one of important active components in PVL, Domestic and foreign scholars have done a lot of work on the extraction, purification and structural analysis of it, and have confirmed its antioxidant and scavenging free radicals, immune regulatory activity, antiviral and antitumor (Xu et al., 1999; Fang et al., 2005b; Xiong and Li, 2010; Hao et al., 2020).

Jordanian scholar Tebba et al. isolated a sulfated polysaccharide (prunellin) with anti-HIV activity from the aqueous extract, with a molecular weight of about 10kDa. And proved to us that its monosaccharide composition was glucose, galactose, xylose, gluconic acid, galactose acid and galactose amine (Tabba et al., 1989). Zhang isolated and purified the polysaccharide PP2 and confirmed that it was composed of rhamnose, arabinose, mannose, glucose, galactose and other monosaccharides (Zhang, 2006). A new heterpolysaccharide exhibited stable immune activities, meanwhile, called PVL-P1 (1,750kDa), was isolated from the fruit clusters of PVL, and consisted of arabinose, xylose, mannose, glucose, and galactose with molar percentages of 28.37, 54.67, 5.61, 5.46, and 5.89%, respectively. The main linkage types of PVL-P1 were proved to be (1→5)-linked α-L-Ara, (1→)-linked α-L-Ara, (1→3)-linked α-D-xyl, (1→3)-linked β-D-Gal, (1→3,6)-linked β-D-Gal, (1→3,6)-linked α-D-Man and (1→6)-linked α-D-Glc (Li et al., 2015).

Not long after that, a sulphated polysaccharide PSP-2B (32kDa) with a sulfate content of 10.59% was isolated from aqueous extracts of it, the major sugars comprising PSP-2B are arabinose, galactose and mannose, in addition to small amounts of glucose and uronic acids. The framework of PSP-2B is speculated to be a branched arabinogalactomannan, and the side chains are terminated primarily by the Araf residues. Moreover, its activity against HSV was demonstrated by a series of experiments (Ma et al., 2016). Subsequently, Du et al. isolated two branched acidic polysaccharides (PW-PS1 and PW-PS2) with anticomplement activity. PW-PS1 was composed of Ara, Xyl, and 4-methoxy-Glc A in a ratio of 1.0:2.6:0.8, and the main linkages of the sugar residues of PW-PS1 included terminal β-D-Xylp, 1,4-linked β-D-Xylp, 1,3-linked α-D-Arap, 1,3,5-linked α-D-Arap, and terminal 4-methoxy-α-D-Glcp A. PW-PS2 was composed of Rha, Ara, Xyl, Gal, and Gal A in a ratio of 0.6:1.0:1.3:1.8:3.4, and the main linkages between the sugar residues of PW-PS2 included terminal Araf, 1,4-linked β-D-Xylp, 1,3-linked α-D-Rhap, terminal α-D-Galp, and 1,4,6-linked α-D-Galp (Du et al., 2016).

Others

Except for the seven chemical components described above, many other chemical constituents have been found in PVL, such as autantiamide acetate belonging to oligopeptide, and some quinone compounds: tanshinone I, rhein, chrysophanic acid, 2-hydroxyl-3-methyanraquinone (Gu et al., 2007; Xu et al., 2010a), Of course, in addition to these substances, alkaloids, inorganic salts, vitamins, resins, tannins, proteins and lipids are also present in it.

To date, hundreds of phytochemicals have been isolated and purified from PVL, and their biological activities have also been verified. However, this research mainly focuses on triterpenoids and flavonoids and polysaccharides, while for other chemicals such as phenylpropanoids, organic acids and volatile oil research is still relatively scarce. Therefore, further research is still required. New technologies such as identification, separation and purification of plant chemicals are continuously used to focus on the biological effects and structure-activity relationships of plant chemicals. Actively carrying out scientific and technological research and development in the field of plant chemical substances, giving full play to the advantages of traditional Chinese medicine resources in China, and combining advanced biochemical engineering and genetic engineering technology will be an important breakthrough direction to improve the development level of clinical drugs and health food of PVL.

Anti-Tumor

Early on, Chen et al. carried out a series of cell experiments in vitro, found that PVL extract could induce Jurkat cell apoptosis by down-regulating Bcl-2 protein and up-regulating Bax protein, thereby inhibiting the growth of Jurkat human T lymphoma cell (Chen et al., 2009). Some researchers found that the 60% ethanol extract of PVL had a chemopreventive effect on non-small cell lung cancer, and its mechanism of action may be related to promoting apoptosis and regulating cell cycle (Feng et al., 2010a). Thereafter, PVL aqueous extract was found to inhibit the invasion and migration of human liver carcinoma HepG2, Huh-7 and Hep3B cells via attenuating matrix metalloproteinases (Kim et al., 2012). And another thing, especially, the ethyl acetate extract of endophytic fungi from PVL exhibited a growth-suppressive activity on gastric cancer in vitro and in vivo (Tan et al., 2015).

Not only that, with the exception of extracts, many of the active ingredients from PVL also exhibited significant antitumor activity in recent years. Feng et al. established cell-line-derived xenograft (CDX) mouse models to evaluate the in vivo anti-lung adenocarcinoma activity of PVL polysaccharid, and found that it could dramatically increase the thymus index and spleen of tumor-bearing mice index (Feng et al., 2010c). Yang et al. found that hyperoside in PVL could induce apoptosis of human NSCLC A549 cells through mitochondrial apoptotic pathway (Yang et al., 2017). Şahin et al. found that rosmarinic acid in PVL had different degree inhibitory effect on cell proliferation in pancreas (PANC-1), prostate (PC-3), colon (HT-29) and breast (MDAMB 436) and GBM (T98G) cell lines (Şahin et al., 2017). Oleanolic acid from PVL, was proved to induce apoptosis of lung adenocarcinoma cells by down-regulating the expression of Bcl-2 and up-regulating the expression of Bax and Bad (Feng et al., 2011b). In addition, Yang et al. proved through experiments that the protocatechuic aldehyde and caffeic acid derived from PVL exhibited obvious cytotoxicity to Michigan Cancer Foundation-7 (MCF-7) cell (Yang et al., 2020).

Anti-Viral

As early as 1986, the powerful inhibitory effect of PVL polysaccharide on HIV in vitro has been proved by Tabba et al. (Tabba et al., 1989), although its mechanism has not been elucidated. Later, Yao et al. found that the PVL extract inhibited HlV-1 replication in the lymphoid cell line MT-4, monocytoid cell line U937, and peripheral blood mononuclear cells, it antagonized HV-1 infection of susceptible cells by preventing infection attachment to the CD4 receptor (Yao et al., 1992). Subsquently, the in vitro and in vivo anti-HSV activities of the PVL polysaccharide (PPS-2b) were characterized by Zhang et al. The in vivo activities of PPS-2b is demonstrated in two animal infection models, Mechanism studies showed that PPS-2b inactivated HSV-1 directly, blocked HSV-1 binding to Vero cells, and inhibited HSV-1 penetration into Vero cells (Zhang et al., 2007).

Moreover, Ao et al. demonstrated that PVL aqueous extract displayed potent inhibitory effect on SCoV-2 SP (including SPG614 mutant) pseudotyped virus (SCoV-2-SP-PVs) mediated infections, and found that it was able to directly interrupt SCoV2–SP binding to its receptor ACE2 and block the viral entry step (Ao et al., 2021). Similarly, Zhang et al. also demonstrated that PVL aqueous extract displayed a potent inhibitory effect on EBOV-GP pseudotyped virus (EBOV-GP-V)-mediated infection in HUVEC and macrophage cell lines. Mechanism studies showed that anti-Ebola virus activity occurred via binding directly to EBOV-GP pseudotyped virus and blocking the early viral events (Zhang et al., 2016). Li et al. studied anti- Zika virus activity of PVL aqueous extract at animal and cell levels. It was found that it could inhibit the cell lesions caused by Zika virus to a certain extent, inhibit the nucleic acid replication and protein expression of Zika virus, and may play an antiviral role by directly killing Zika virus or inhibiting virus recognition and entry into host cells (Li et al., 2020b). Likewise, Modern pharmacological studies have shown that PVL has significant inhibitory effects on equine infectious anemia virus, infectious hematopoietic necrosis virus, respiratory syncytial virus and influenza A virus apart from the above mentioned viruses (Brindley et al., 2009; Tian et al., 2011; Huang, 2016; Li et al., 2019b). For more information, Supplementary Table S4.

Anti-Bacterial

The emergence and spread of bacterial resistance have made the infection caused by multidrug-resistant bacteria a serious problem (Jiang S. et al., 2020). In vitro experiments showed that PVL had certain inhibitory effects on Escherichia coli, Staphylococcus aureus, Bacillus subtilis, Penicillium sp., Aspergillus niger and Pseudomonas aeruginosa (Wang et al., 2004; Dong et al., 2005; Yang et al., 2013a). Lin et al. took the bacterial vaginitis model of rats and discussed the antibacterial effect of PVL aqueous extract in vivo for the first time. The results showed that PVL could significantly resist bacterial vaginitis in rats caused by mixed infection of Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa in a dose-dependent manner (Lin et al., 2011). Hu et al. found that the extracts obtained by three different extraction methods of PVL had inhibitory effect on Staphylococcus aureus, Staphylococcus epidermidis and Propionibacterium acnes, and the effect intensity was water extract > ethanol extract > ultrasonic extract. Its antibacterial mechanism is related to the permeability of cell wall and cell membrane (Hu et al., 2015). Interestingly, a related study showed that the total phenol value of water extract was higher, followed by ethanol extract and methanol extract, and the total phenol content was negatively correlated with antibacterial activity. Ethanol extract had the best antibacterial activity against the tested microorganisms (Mahboubi et al., 2015). In addition, some researchers also revealed that triterpenoid saponins of PVL inhibited Escherichia coli, and petroleum ether extracts of PVL roots inhibited Staphylococcus aureus, S. pneumonia, Enterococcus faecalis and K. pneumonia strains (Pan, 2018a; Dar et al., 2022). Based on the existing research, PVL has shown a variety of antibacterial activities, but the research on it is not deep enough. With the deepening of research, it is hoped that the effective antibacterial components of PVL can be found to lay the foundation for the development of new antibacterial drugs.

Anti-Oxidant

Many studies have shown that PVL has an obvious antioxidant capacity in vitro, which makes it possible to increase its application as a natural antioxidant in the food and drug industries (Lugasi et al., 2006; Sárosi and Bernath, 2008). Zhang et al. found that flavonoids in PVL had obvious antioxidant activity in vitro and could significantly scavenge DPPH and OH radicals (Zhang et al., 2011). Song et al. found that different extracts of PVL had certain antioxidant activity. Among them, 70% ethanol extract had relatively high DPPH, OH scavenging activity and lipid peroxidation inhibition activity, aqueous extract had the highest O₂⁻·scavenging activity (Song et al., 2016). Zhu et al. manifested that the half-scavenging rate (IC₅₀) of PVL polyphenols to DPPH radical were 4.59μg/ml, and that of polyphenols to OH radical were 5.52μg/ml, indicating that it had strong scavenging free radicals ability (Zhu et al., 2018).

Some related studies have shown that high antiradical, antioxidant (SOD), and low hydrolytic activity resides in the 50% ethanol extract of PVL, and rosmarinic acid, not flavonoids is indicative of the major contribution (Djivanovna et al., 2018). Xia et al. proved that the ethyl acetate fraction of PVL aqueous extract had relatively high content of total flavonoids, total phenolic acids and total triterpenoids, with high scavenging ceapacity of DPPH (3.1 ± 0.38) mmolL⁻¹g⁻¹ DW and FRAP (2.56 ± 0.35) mmolL⁻¹g⁻¹ DW (Xia et al., 2018b). Tan et al. found that PVL had protective effect on acute restraint stress injury in mice. It could significantly reduce the content of H₂O₂, MDA and protein carbonyl in the brain tissue of mice, and enhance the activity of SOD (p < 0.05, p < 0.01). It further proved that total flavonoids of PVL had the strongest antioxidant capacity, which was 2.79 times of total triterpenoids and 56.7 times of polysaccharides (Tan et al., 2016). Studies have shown that 60% ethanol extract of PVL (P-60) had strong in vitro antioxidant activity, and can also significantly inhibit the tumor growth, increasing SOD activity and reducing MDA content in serum of tumor-bearing mice. P-60 contains major active compounds such as caffeic acid, rosmarinic acid, rutin and quercetin. Therefore, it can be speculated that total phenols played an important role in antioxidant activity for inhibition of tumor growth (Feng et al., 2010b).

Anti-Inflammatory and Immunoregulation

Previous studies have shown that polysaccharide fraction of PVL exhibits both immune stimulatory and anti-inflammatory effects against microbial invasion (Fang et al., 2005b). Zdařilová et al. found that rosmarinic acid (RA) in PVL inhibited up-regulation of IL-1β, IL-6, TNF-α and suppressed expression of iNOS on LPS-induced inflammation in human gingival fibroblasts. They speculated that the effect was presumably linked to anti-inflammatory activitity and use of RA may be relevant in modulating the inflammation process (Zdařilová et al., 2009). Xie et al. found that total triterpenoids from PVL (TTP) could inhibit the secretion of PGE2, TNF-α and IL-6 in LPS-stimulated RAW264.7 cells, and significantly inhibit the gene expression of Jak2 and Stat3. The rusults indicated that TTP had a certain anti-inflammatory effect, and the production of this effect might be related to the Jak/Stat pathway (Xie et al., 2013). Li et al. found that PVL aqueous extract (PVAE) could improve the inflammatory lesions of cornea in allergic conjunctivitis rats, significantly reduce the expression of NLRP3, Caspase-l, and IL-1β inflammatory proteins in corneal tissue, and alleviate the degree of liver edema. Its anti-inflammatory mechanism might be related to NLRP3/Caspase1/IL-1β pathway (Li et al., 2020a). Lin et al. demonstrated Fallopia Japonica extract (FJE) and PVL extract (PVE) might have a therapeutic effect on myopia. In vitro study manifested FJE + PVE reduced lL-6, IL-8, and TNF-α expression in RPE cells, inhibited inflammation by attenuating the phosphorylation of AKT and NF-κB pathway. Besides, they also inhibited myopia-related TGF-β1, MMP-2, NF-κB expression while increasing type I collagen expression in MFD induced hamster model (Lin et al., 2021). Guo et al. found that PVL had anti-inflammatory and immunoregulatory effects on EAT rats. The thyroid volume, thyroiditis inflammation score and serum thyroglobulin antibody levels of EAT rats were attenuated by PV treatment. Mechanism studies manifested that PVL could attenuates EAT by inhibiting HMGB1/TLR9 Signaling (Guo et al., 2021). For more information, Supplementary Table S4.

Hypotensive, Hypoglycemic and Hypolipidemic

PVL is a TCM with great application and research value for the treatment of hypertension, hyperglycemia and hyperlipidemia, and its efficacy in these diseases has been verified at the clinical level. Accordingly, many scholars have been attracted to explore and study its pharmacological effects (Ma et al., 2014; Li et al., 2016a; Hong, 2020; Yu et al., 2021). Li et al. found that long-term administration of PVL ethanol extract (PVE) could alleviate the weight loss and polydipsia of diabetic ICR mice. High and low doses of PVE (8, 4g/kg) could significantly reduce the serum triglyceride, cholesterol, LDL content of diabetic mice and increase HDL content. The results showed that PVE had better hypoglycemic potential (Li et al., 2006). Subsequently, related research found that PVL aqueous extract could inhibit the mRNA expression of α-glucosidase, SGLT-1, GLUT-2 and Na⁺-K⁺-ATPase in Caco-2 cells to delay carbohydrate hydrolysis and influence glucose uptake, thereby, lowering postprandial blood glucose levels (Wu et al., 2010). PVL might prevent development of diabetic atherosclerosis, related experiments showed PVL aqueous extract (PVE) suppressed hyperglycemia and diabetic vascular dysfunction in HFHC diet-db/db mice (Hwang et al., 2012).

Previous studies have shown that total alkaloids of compound PVL could relax rat thoracic aorta in a concentration-dependent manner, and the vasodilation effect was not endothelium-dependent. The mechanism may be related to the inhibition of intracellular calcium release and extracellular calcium influx (Que et al., 2015). Wang et al. found that PVL combined with Uncaria rhynchophylla could reduce the systolic blood pressure of spontaneously hypertensive rats and control the myocardial hypertrophy caused by hypertension. Its mechanism was preliminarily believed to be related to the decrease of ANG II, and ET content in serum and the increase of CGRP content in serum (Wang et al., 2017). In order to explore the feasibility of treating obesity with PVL, the effects of PVL on body weight and blood lipid of obese C57BL/6J male mice induced by high sugar high fat diet were studied in vivo. It was found that PVL could effectively reduce TG, TC, LDL, and increase HDL (p < 0.05) (Li et al., 2016b). Before and after this, some scholars studied the inhibitory activity of PVL on pancreatic lipase, and identified several extracts and monomer compounds with potential antagonistic effects on pancreatic lipase through in vitro screening. Zheng et al. proved that when the concentration of PVL methanol extract was 200μg/ml, the inhibitory effect on pancreatic lipase was 74.7%, the monomer compound quercetin showed good activity (27.4%) at the final concentration of 25μg/ml, followed by luteolin, and the activity was 17.3% (Zheng et al., 2010). Chen et al. screened four possible pancreatic lipase inhibitors from 80% ethanol extract of PVL, which were caffeic acid, rutin, hesperidin, ursolic acid (Chen et al., 2018). For more information, Supplementary Table S4.

Hepatoprotective

In the past few decades, studies have shown that complex prescription PVL exhibits a protective effect on acute liver injury induced by CCl₄ in mice. It could significantly reduce the increase of serum ALT and AST in mice with acute liver injury induced by CCl₄, and alleviate the damage of CCl₄ on liver cells (Feng et al., 2011c). Soon afterwards, some scholars found that total triterpenoids from PVL could reduce the activities of ALT and AST in serum of rats with acute liver injury, reduce the level of MDA in liver hom*ogenate, increase the levels of SOD and GSH-Px, and inhibit the expression of CYP2E1 in liver tissue, and its mechanism might be related to the inhibition of lipid peroxidation and CYP2E1 expression (Zhang et al., 2012). Deng et al. found that PVL could significantly improve the metabolic disorder of liver injury induced by alcohol, and could significantly reduce the contents of inflammatory factors (TNF-α, IL-6, IL-1β) and liver function marker enzymes (ALT, AST, and ALP) in serum, which were mainly regulated by phenylalanine, tyrosine, and tryptophan biosynthesis pathways (Deng et al., 2021). Furthermore, related studies have also shown that sulfate polysaccharide from PVL has a protective effect on isoniazid-induced liver injury in mice, and its mechanism might be related to antioxidant stress response and reducing inflammatory response (Wang et al., 2021). Cui et al. demonstrated that total triterpenoids from PVL alleviated fulminant hepatic liver failure in mice by inhibiting over-activated MEK/ERK signaling pathway and inflammatory response (Cui and Ren, 2015). Tian et al. found that PVL could improve the symptoms of autoimmune hepatitis (AIH) mice through anti-inflammatory and anti-apoptotic effects. The results showed that it decreased the expression of pro-inflammatory cytokines IFN-γ and IL-17A, increased the expression of anti-inflammatory cytokines TGF-β, and decreased the expression of BAX and caspase-3 (Tian et al., 2020). For more information, Supplementary Table S4.

Others

PVL also had multiple effects such as hypnosis, choleretic, antidepressant, anti-renal calculi, improving osteoporosis, and alleviating memory impairment in rats caused by scopolamine (Huang et al., 2013; Liu et al., 2017a; He et al., 2017; Qu et al., 2017; Guo et al., 2020; Xi et al., 2020), whereas, the research on pharmacological effects of PVL is currently imperfect. This is mainly reflected in the following points with possible improvements. First of all, some pharmacological experiments lack a reasonable control, such as whether the positive or negative control is needed. Secondly, only one dose group is set up without the investigation of dose dependence, and it is easy to ignore the minimum effective dose, safe dose and minimum toxicity dose. Thirdly, the number of pharmacological indicators is too little, which is easy to cause the neglect of the potential mechanism of action. Fourthly, only the study of crude substances of TCM is carried out without the comparison of monomer compounds. Finally, In addition to obtaining intuitive index evaluation through animal experiments and clinical experiments, it should also be combined with new technologies and methods of molecular biology, cell biology and histology to further explore its intrinsic activity mechanism. precisely because of these reasons, it is more necessary to conduct in-depth, comprehensive and detailed research and exploration in future until the pharmacological mechanism can be fully clarified, which helps to understand and master the drug effect, so as to better guide the clinical rational use of TCM and lay a clinical foundation for the development of new drugs.

PVL

Prunella vulgaris L

TCM

traditional Chinese medicine

HIV

human immunodeficiency virus

HSV

herpes simplex virus

CD4

cluster of differentiation 4

gp120

glycoprotein 120

MIC

minimum inhibitory concentration

BHT

butylated hydroxytoluene

SOD

superoxide dismutase

DPPH

2,2-diphenyl-1-picrylhydrazyl

FRAP

ferric reducing antioxidant power

MDA

malondialdehyde

LPS

lipopolysaccharide

iNOS

inducible nitric oxide synthase

TNF-α

tumor necrosis factor-α

IL-1β

interleukin 1β

IL-6

interleukin 6

PGE2

prostaglandin E2

NLRP3

NACHT, LRR and PYD domains-containing protein 3

Caspase-1

cysteinyl aspartate specific proteinase 1

MFD

monocular form deprivation

AKT

attenuating the phosphorylation of protein kinase B

NF-κB

nuclear factor kappa-light-chain-enhancer of activated B

PBS

phosphate-buffered saline

MCP-1

monocyte chemoattractant protein-1

HMGB1

high-mobility group box-1

ALT

alanine aminotransferase

ALP

alkaline phosphatase

AST

aspartate transaminase

CYP2E1

cytochrome P4502E1

MHV

mouse hepatitis virus

IFN-γ

γ-interferon

TGF-β

transforming growth factor-β

BAX

Bcl-2-associated X

Bcl-2

B-cell lymphoma-2

SGLT-1

sodium glucose cotransporters 1

GLUT-2

facilitativeglucosetransporters 2

LDL

low-density lipoprotein

HDL

high-density lipoprotein

LDL-C

low-density lipoprotein cholesterol

HDL-C

high-density lipoprotein cholesterol

ICAM-1

intercellular adhesion molecules-1

VCAM-1

vascular cell adhesion molecule-1

ET-1

endothelin-1

eNOS

endothelial nitric oxide synthase

ANG II

angiotensin II

CGRP

calcitonin gene-related petide

TC

total cholesterol

TG

triglycerides

MFD

monocular form deprivation

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