A comprehensive review of Ilex hainanensis Merr.: Traditional uses, chemical composition, pharmacological properties, toxicity and clinical applications.

Ilex hainanensis Merr. (IHM), also known as Shanlvcha in Chinese, is a traditional folk medicine widely used in the Guangxi, Guangdong, and Hainan provinces of China. It is commonly used to regulate blood pressure and blood lipid levels, and is also effective in treating conditions such as mouth ulcers, sore throats, and various other health issues. In this paper, we conduct a systematic review of the existing research on IHM, including its botanical characteristics, traditional uses, chemical constituents, pharmacological activities, toxicity, clinical studies, and quality control. This review integrates data from both English and Chinese sources, retrieved from databases such as Web of Science, PubMed, SciFinder, and Springer, as well as the Chinese database China National Knowledge Infrastructure. The search terms used include Ilex hainanensis Merr., Folium Ilicis Hainanensis, and Shanlvcha. Existing studies have demonstrated that IHM is rich in diverse chemical constituents, including triterpenes and their saponins, flavonoids and their glycosides, polyphenols, quinones, volatile oils, and other bioactive compounds. These bioactive components exhibit multiple pharmacological activities, such as antihypertensive, anti-atherosclerotic and hypolipidemic effect, amelioration of NAFLD, effects, as well as anticancer, anti-inflammatory, and antibacterial activities. Among these, triterpenoid saponins are the most important active constituents in IHM, as they play a crucial role in improving NAFLD, promoting lipid metabolism, protecting intestinal microenvironment, and regulating bile acid metabolism. By comprehensively summarizing current findings on IHM, this review provides a valuable reference for the rational development and comprehensive utilization of IHM resources in the future.