From Phytochemistry to Drug Discovery: A Systematic Review of Multitarget Pharmacology and Lead Compound Prioritization of Piper crocatum Ruiz & Pav.

Piper crocatum Ruiz & Pav. (Piperaceae), commonly known as red betel, is a medicinal plant widely used in Southeast Asian traditional medicine and has attracted increasing interest due to its diverse pharmacological properties. However, the relationship between its phytochemical constituents, biological activities, molecular mechanisms, and drug discovery potential remains insufficiently integrated. This Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided review aimed to summarize the phytochemical constituents and pharmacological activities of P. crocatum and evaluate their relevance as potential lead structures for drug development. Literature published between 2000 and 2026 was retrieved from Scopus and PubMed. A total of 180 records were identified, and 102 eligible original studies reporting phytochemical and/or biological investigations of P. crocatum were included in the final analysis. Forty compounds have been reported from P. crocatum, including phenolic compounds, neolignans, flavonoids, terpenoids, and phytosterols. These constituents are associated with antimicrobial, antibiofilm, antioxidant, anti-inflammatory, antidiabetic, hepatoprotective, anticancer, and immunomodulatory activities. Mechanistic evidence suggests that these effects involve modulation of oxidative stress, inflammatory signaling, microbial sterol biosynthesis, biofilm-related proteins, and metabolic enzymes such as α-glucosidase and pancreatic lipase. Among the reported compounds, pachypodol, crocatin derivatives, β-sitosterol, and stigmasterol show promising pharmacological profiles and may serve as lead structures for further development. Overall, the chemical diversity and multitarget activities of P. crocatum support its potential as a source of drug discovery candidates. Future studies should prioritize bioassay-guided isolation, molecular target validation, pharmacokinetic evaluation, and structure-activity relationship analysis.