REVIEW article
Front. Pharmacol.
Sec. Experimental Pharmacology and Drug Discovery
This article is part of the Research TopicAdvancements in Pharmacological Treatments for Bone Metabolic DiseasesView all 8 articles
Icariin against Osteoporosis: A Review of Advances in Molecular Mechanisms to Biomedical Applications
Provisionally accepted
- 1School of Sports Medicine and Health, Chengdu Sport University, Chengdu, China
- 2School of Life Science, Beijing University of Chinese Medicine, Beijing, China
- 3Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
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Osteoporosis (OP) is characterized by decreased bone mass and deterioration of bone microstructure, significantly increasing fracture risk. Icariin (ICA), a natural compound, has demonstrated efficacy in improving bone microstructure and bone mineral density (BMD) across multiple OP models, with its targeting efficacy enhanced through innovative drug delivery systems. This review systematically summarizes recent advances in ICA research, focusing on its application dosage forms, therapeutic performance in various animal models, and underlying molecular mechanisms. In order to ensure a comprehensive and reliable report, we conducted a systematic search in the core collection of web of science according to PRISMA guidelines, and finally included 182 publications for in-depth analysis. ICA's therapeutic efficacy is enhanced through innovative delivery systems, including traditional Chinese medicine formulations and advanced biomaterials. Studies across postmenopausal, glucocorticoid-induced, aging, and diabetic OP models consistently demonstrate ICA's ability to improve bone microarchitecture and BMD. Mechanistically, ICA exerts dual-regulation effects by promoting osteogenesis while inhibiting osteoclastogenesis, coupled with multi-target actions involving autophagy regulation, anti-inflammatory effects, iron overload mitigation, and oxidative stress reduction. In conclusion, ICA's comprehensive and multi-mechanistic intervention strategy, augmented by advanced delivery systems, presents a natural, safe, and efficacious candidate for OP treatment. This review synthesizes critical advances from molecular mechanisms to biomedical applications, supporting further clinical translation of ICA-based therapies.
Keywords: Icariin, Osteoporosis, bone metabolism, Bone homeostasis, Drug delivery, Molecular mechanisms, Animal Models, Therapeutic application
Received: 19 Aug 2025; Accepted: 10 Nov 2025.
Copyright: © 2025 Fu, Yu, Shengxiong and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Chen Shengxiong, dr.chensx@hotmail.com
Bo Hu, hubohill@163.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.