Quisqualis indica: A critical review of phytochemicals, therapeutic potential, and translational challenges

Abstract

Quisqualis indica L. is a promising medicinal plant due to its diverse pharmacological activities and phytochemical composition. Although it has long been used in Asian and African ethnomedicine to treat gastrointestinal issues, metabolic problems, parasite infections, and inflammatory disorders, current research on its therapeutic potential is fragmented and methodologically inconsistent. This review critically evaluates the current literature on the phytochemistry, pharmacological activities, and therapeutic potential of Q. indica, focusing on the mechanistic functions of the plant's main bioactive components, flavonoids, polyphenols, tannins, cucurbitacin derivatives, trigonelline, and quisqualic acid. A systematic literature search following PRISMA 2020 guidelines was conducted using PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar (database inception to 30 June 2026). Of 642 records identified, 154 duplicates were removed; 488 records were screened, 140 full-text articles were assessed for eligibility, and 76 studies were ultimately included in the qualitative synthesis. Experimental results show that Q. indica has significant antioxidant, anticancer, antibacterial, anti-inflammatory, antimalarial, anti-obesity, and neuropharmacological activities by regulating oxidative stress, apoptosis, inflammatory mediators, microbial growth, and metabolic signalling pathways. However, a detailed evaluation of the existing data finds severe flaws, such as insufficient phytochemical standardisation, inconsistent extraction methodologies, an overreliance on in vitro and animal models, and a scarcity of quality clinical trials. A paucity of evidence on pharmacokinetics, bioavailability, long-term toxicity, and herb-drug interactions further limits translational applicability. Despite these limitations, combining advanced analytical techniques, nanotechnology-based delivery technologies, and mechanism-driven pharmacological research may enhance the therapeutic potential of compounds obtained from Q. indica. Overall, this review stresses Q. indica's therapeutic significance while highlighting significant research gaps that must be addressed before its bioactive constituents can be translated into evidence-based phytopharmaceutical medicines.