Research progress on the role of Epimedium in chronic bone and joint diseases

Chronic bone and joint diseases severely affect the functional status of bone, cartilage, and soft tissues, thus leading to pain and dysfunction in the affected areas. Patients with these diseases can be treated by conservative methods such as oral medications in the early stages, while surgical interventions are commonly required for those in the advanced stage. As conventional anti-osteoporosis (OP) drugs, anti-inflammatory drugs, painkillers, and immunomodulators may induce side effects and drug resistance in the treatment process, it is necessary to explore new therapeutic drugs for the adjuvant treatment of chronic bone and joint diseases at an early or advanced stage. Epimedium is an herbal medicine in traditional Chinese medicine (TCM) and has been used for more than 2,000 years. As the main active ingredient in this herbal medicine, icariin (ICA) is effective in the treatment of chronic bone and joint diseases. This ingredient can be involved in the pathophysiological process of these diseases via modulating the osteogenic and chondrogenic differentiation of bone marrow mesenchymal stem cells (BMSCs), inhibiting osteoclastogenesis, resisting inflammation, protecting the extracellular matrix (ECM), regulating oxidative stress (OS), and participating in immunomodulation. In this study, the role of Epimedium in the prevention and treatment of chronic bone and joint diseases was systematically reviewed. The results demonstrated that Epimedium can be used as a complementary and alternative medicine for the treatment of chronic bone and joint diseases. In this paper, the mechanism of action and potential application of Epimedium in the prevention and treatment of chronic bone and joint diseases were summarized. These findings may lay a foundation for the further development and clinical application of Epimedium as a medicinal food source.