Botany, traditional applications, phytochemistry, pharmacologic activities, clinical application, and quality control of Dioscoreae Rhizoma: A comprehensive review.

Ethnopharmacological relevance: Dioscoreae Rhizoma (DR), the dried rhizome of Dioscorea opposita Thunb., is commonly referred to as "Shan Yao" in China. It has been extensively used in traditional Chinese medicine as an immunomodulatory agent and an adjuvant therapy in the treatment of cancer. DR has been widely applied in traditional medicines, such as Liuwei Dihuang Concentrated Pills and Shanyao Shenqi Pills.

Aim of this work: This review is intended to provide a comprehensive overview of botany, traditional application, phytochemistry, pharmacologic activities, clinical application, and quality control of DR. Meanwhile, the review focuses on immunomodulatory, anti-hyperglycemic mechanisms, antioxidant and anti-inflammatory provides new perspectives and identifies promising avenues for future studies.

Materials and methods: The review collected information from Web of Science, PubMed, X-MOL, SciFinder, Google Scholar, Researchgate and CNKI from January 1971 to March 2025.

Results: To date, approximately 304 compounds isolated and identified from DR, including 78 polysaccharides, polyphenols (1-59), flavonoids (60-65), terpenoids and steroids (66-80), alkaloids (81-104), organic acids (105-166) and others (167-226). DR demonstrates numerous pharmacological activities, including anti-hyperglycemic, anti-hyperlipidemic, immunomodulatory and anti-tumor effects. Multiple pathways are implicated in the immunomodulatory activities of DR, for example, the TLR4/NF-κB and JAK-STAT signaling pathway. However, the mechanisms responsible for its anti-tumor effects have not been fully elucidated. Furthermore, we summarize the limitations of current research and propose promising future research directions.

Conclusion: This review encompasses a comprehensive overview of DR, covering its botany, traditional applications, phytochemistry, pharmacological activities, clinical applications and quality control of DR. Moreover, research has highlighted DR's broad pharmacological profile, with a notable emphasis on its immunomodulatory properties. While research has predominantly focused on Dioscoreae Rhizoma polysaccharides (DRP), the pharmacological mechanisms of its other compounds have consequently been underexplored.