A comprehensive review of Schisandra chinensis lignans: pharmacokinetics, pharmacological mechanisms, and future prospects in disease prevention and treatment

Abstract

Lignans derived from Schisandra chinensis have attracted significant attention for their diverse pharmacological activities and clinical potential. This review presents a comprehensive analysis of the pharmacological properties of Schisandra chinensis lignans, including their antioxidant, anti-inflammatory, neuroprotective, hepatoprotective, antibacterial/viral, antidiabetic and anticancer effects. Their multifaceted mechanisms of action hold promise for therapeutic areas such as cancer, neurodegenerative diseases and metabolic disorders, aligning with urgent clinical needs. Additionally, this review explores the pharmacokinetics of these bioactive compounds, highlighting challenges in their absorption, distribution, metabolism and excretion, which impact their bioavailability. Recent advancements in drug delivery systems are discussed, highlighting their potential to enhance therapeutic efficacy in clinical settings. Furthermore, the synergistic effects of combining these lignans with other therapeutic agents are considered a strategy to increase their efficacy. Future research is imperative to identify additional active components and elucidate novel mechanisms of action, paving the way for expanded therapeutic applications and unlocking the full clinical potential of Schisandra chinensis in disease prevention and treatment.

Keywords: Schisandra chinensis; Lignans; Mechanism of action; Novel therapeutics; Pharmacokinetics; Pharmacological properties.

Fig. 1

Chemical structures of major Schisandra chinensis lignans

Fig. 2

Major Schisandra chinensis lignans and their biological activities. The top panel illustrates key lignans found in Schisandra chinensis, including Schisandrin, Schisandrin A, Schisandrin B, Schisandrin C, Gomisin A, Gomisin B, Gomisin C and Gomisin K3. The bottom panel depicts the ingestion of Schisandra chinensis lignans and the major biological activities associated with these lignans, including antioxidant, anticancer, antiaging, antidiabetic, antibacterial/antiviral, hepatoprotective, immunomodulatory, cardioprotective and neuroprotective properties

Fig. 3

Potential effect of Schisandra lignans on drug metabolism in enterocytes. A Under normal conditions, drugs are absorbed into enterocytes, where they undergo metabolism by cytochrome P450 (CYP450) enzymes, resulting in metabolite formation. Some drugs are also subject to efflux by P-glycoprotein (P-gp), which pumps them back into the gut lumen, limiting their bioavailability. B When Schisandra lignans inhibit CYP450 enzymes and P-gp, drug metabolism is reduced, leading to higher drug concentrations in the bloodstream. This decreased metabolism and impaired efflux can result in increased drug bioavailability and toxicity. C Alternatively, Schisandra lignans may induce P-gp expression, leading to enhanced drug efflux back into the gut lumen. This reduces drug absorption and bioavailability, potentially resulting in treatment failure due to insufficient therapeutic drug levels in the bloodstream. Arrows indicate drug movement, metabolism, and efflux

Fig. 4

Strategies to increase the bioavailability and effectiveness of Schisandra chinensis lignans. The upper panel illustrates the synergistic effects of Schisandra chinensis lignans when combined with conventional treatments such as chemotherapy, antibiotics, antiviral drugs, hormone therapy, surgery, and radiation, which contribute to reduced drug toxicity, overcoming drug resistance, and improving survival rates. The lower panel shows the development of novel drug delivery systems, including nanoparticles, liposomes, lipid nanoparticles, phytosomes, polymers and self-emulsifying drug delivery systems, which enhance drug stability, bioavailability, targeted delivery and controlled release while minimizing toxicity to healthy tissues