Research Progress Of Total Glycosides Of Cistanche in The Treatment Of Osteoporosis
Jul 14, 2025
Abstract：Glycosides of cistanche (GCs), as a natural active substance extracted from cistanche, show promising applications in the treatment of osteoporosis (OP). In this paper, we reviewed the studies on the mechanisms related to the improvement of OP by GCs. In terms of antioxidant effects, GCs have antioxidant functions, which can scavenge free radicals in the body and reduce the damage of oxidative stress on bones. GCs can inhibit the release of inflammatory mediators and reduce the level of inflammatory response, thus reducing the inflammatory response in OP.GCs can promote the proliferation and differentiation of osteoblasts, inhibit osteoclast activity, increase bone density and reduce the risk of fracture. In addition, GCs can directly or indirectly affect osteoblast and osteoclast activity and regulate bone metabolism in vivo by regulating sex hormone levels, regulating the balance of calcium and phosphorus metabolism, etc. GCs can regulate bone metabolism in vivo by regulating the level of osteoprotegerin (OPG)/receptor activator of nuclear factor-κB ligand (GCs). OPG/receptor activator of nuclear factor-κB ligand (RANKL)/receptor activator of nuclear factor-κB (RANK), Wnt/β-catenin and other signaling pathways, which inhibit bone resorption and promote bone formation. GCs have been shown to have a GCs have shown good therapeutic effects in the treatment of OP, and have good safety and tolerability. GCs have significant therapeutic effects and broad application prospects in improving OP, and in-depth research on the pharmacological mechanism of GCs is of great significance, with a view to finding innovative drugs that are safe and effective in the treatment of OP.
Key words： Osteoporosis;Glycosides of cistanche; Bone metabolism
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Osteoporosis (OP) is a prevalent metabolic bone disorder characterized by progressive bone mass loss, microarchitectural deterioration, and increased fracture risk [1,2]. The most severe complication of OP is osteoporotic fracture, which not only impairs quality of life but can also be life-threatening in older individuals [3,4].
OP is classified as primary (related to aging, sex, and genetics) and secondary (associated with diseases or medications). Its incidence increases with age, particularly in the elderly. According to China's seventh national census, over 264 million people are aged 60 and above, comprising 18.7% of the population [5]. With the aging population expanding rapidly, OP prevention and management have become urgent public health challenges.
In addition to aging, lifestyle factors (e.g., physical inactivity, smoking, excessive alcohol consumption), nutritional deficiencies (e.g., calcium and vitamin D), and certain diseases and medications (e.g., diabetes, hyperthyroidism, corticosteroids) contribute to OP risk [6,7].
Limitations of Current Therapies and the Rise of Herbal Alternatives
Conventional treatments for OP include pharmacological interventions (calcium supplements, vitamin D, hormones), lifestyle modifications, and surgical options in severe cases [8,9]. However, long-term use of synthetic drugs often causes adverse effects, prompting researchers and natural health product developers to explore plant-based alternatives with better safety profiles.
Cistanche: A Promising Desert Herb for Bone Health
Cistanche, known as the "Ginseng of the Desert," is a prized herb in traditional Chinese medicine (TCM), predominantly found in arid regions of Northwest China [10]. Its stems and roots are rich in bioactive compounds, including phenylethanoid glycosides, lignans, polysaccharides, and volatile components [11,15].
Traditionally used to tonify kidney yang and replenish essence, Cistanche is also recognized for its effects in strengthening bones, enhancing immunity, and promoting longevity [12–14]. Modern research supports its ability to increase bone mineral density, stimulate osteoblast activity, and support fracture healing, making it a natural candidate for osteoporosis management.
Mechanisms of Action: How GCs from Cistanche Improve Osteoporosis
1. Antioxidant Effects
Studies have shown that polysaccharides from Cistanche deserticola exhibit potent antioxidant effects. In D-galactose-induced aging mouse models, Cistanche polysaccharides increased the expression of glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) while reducing malondialdehyde (MDA) levels [16–21]. These changes suggest a role in reducing oxidative stress, which is a known contributor to bone loss and aging-related degeneration.
2. Anti-Inflammatory Activity
GCs can inhibit the release of inflammatory mediators such as prostaglandins and leukotrienes, both of which are involved in OP pathogenesis [22,23]. Elevated levels of interleukin-6 (IL-6) and nitric oxide (NO) are commonly found in osteoporotic patients and indicate systemic inflammation. Research demonstrates that GCs significantly reduce these markers, alleviating inflammation and enhancing bone health [24,25].
3. Regulation of Bone Metabolism
The balance between osteoblasts (bone-forming cells) and osteoclasts (bone-resorbing cells) is vital for maintaining bone homeostasis. Disruption of this balance underlies most OP cases [26]. GCs have been shown to:
Promote osteoblast proliferation and differentiation
Inhibit osteoclast activity
Increase bone mineral density (BMD)
In accelerated OP mouse models, GCs increased bone morphogenetic protein-2 (BMP-2) expression and improved serum bone Gla-protein (BGP) levels, indicating enhanced osteogenic activity [27].
In ovariectomized rats (a common postmenopausal OP model), GCs improved TGF-β1 levels, reduced IL-1β, and significantly increased femoral BMD. Histological analysis revealed well-formed bone trabeculae and healed fractures, confirming GCs' role in bone regeneration and OP fracture recovery [28,29].
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Conclusion: A Natural, Evidence-Based Strategy for OP Management
From a product development and natural health perspective, Cistanche glycosides offer a compelling alternative to synthetic drugs in the prevention and treatment of osteoporosis. Their multi-targeted effects-antioxidant, anti-inflammatory, and bone-regulatory-align with the holistic principles of herbal medicine and modern functional product innovation.
As demand for organic, plant-derived bone health supplements grows, Cistanche-based formulations provide a scientifically supported, traditional yet modern solution for aging populations worldwide.
