Mechanistic Insights into the Therapeutic Effects of Hibiscus Sabdariffa: A Systematic Review

Abstract

Hibiscus sabdariffa L. (roselle) is a widely consumed medicinal plant with a long history of use in traditional medicine. This systematic review critically examines the mechanistic basis underlying its therapeutic effects by integrating evidence from experimental, preclinical, and clinical studies. A systematic literature search was conducted in PubMed, Scopus, Web of Science, Google Scholar, and Science Direct from January 2000 to March 2025. Studies included explored molecular and cellular mechanisms, including antioxidant, anti-inflammatory, cardioprotective, antidiabetic, hepatoprotective, and neuroprotective effects. Findings indicate that bioactive phytochemicals especially anthocyanins, flavonoids, phenolic acids, and organic acids—modulate key pathways such as nuclear factor 2, nuclear factor kappa-light-chain enhacer of activated B cells, mitogen-activated protein kinase and peroxisome proliferator-activated gamma (Nrf2, NF-κB, MAPK, and PPARγ). The pleiotropic activities of H. sabdariffa suggest potential roles in preventing and managing chronic diseases associated with oxidative stress and inflammation. Despite promising preclinical evidence, human clinical trials remain limited, highlighting the need for standardized dosing, pharmacokinetic studies, and long-term safety assessments. This review provides a mechanistic framework supporting the therapeutic relevance of H. sabdariffa and underscores the necessity of rigorous translational research.