Morinda officinalis in the prevention and treatment of osteoporosis: A comprehensive review.

ETHNOPHARMACOLOGICAL RELEVANCE: Morinda officinalis Radix (MOR), a traditional Chinese medicinal herb used as both medicine and food, has long been used to tonify kidney function and has attracted increasing attention for its potential benefits in bone metabolic disorders. AIM OF THE STUDY: This review provides a comprehensive and up-to-date overview of the ethnopharmacological applications, phytochemistry, pharmacological activities, pharmacokinetics, safety profile, and quality control of MOR in the prevention and treatment of osteoporosis. MATERIALS AND METHODS: A systematic literature search was conducted in Web of Science, PubMed, China National Knowledge Infrastructure (CNKI), and the National Science and Technology Library (NSTL). Studies on the traditional applications, clinical effects, phytochemistey, pharmacology, pharmacokinetics, toxicology, and quality control of MOR in relation to osteoporosis were included. After screening, 215 eligible publications were analyzed. RESULTS: In Traditional Chinese Medicine, MOR is believed to exert anti-osteoporotic effects by regulating kidney and liver functions. Eleven clinical trials, mainly involving herbal combinations, reported beneficial effects in patients with primary osteoporosis, with on evident adverse reactions. More than 190 compounds have been identified in MOR, with polysaccharides, iridoids, and anthraquinones as the major constituents and priority candidate quality markers. Experimental studies indicate that extracts and active compounds improve bone homeostasis by modulating osteoblast-osteoclast coupling. Pharmacokinetic evidence suggests wide tissue distribution after oral administration, influenced by sex and processing methods. Toxicological evaluations demonstrate a generally favorable safety profile. CONCLUSION: MOR exhibits multi-targeted anti-osteoporotic effects with promising therapeutic potential. Future research should emphasize well-designed clinical trials of MOR monotherapy, integrated multi-omics approaches, and develop advanced delivery systems to facilitate clinical translation and drug development.