Harnessing the power of Scutellaria baicalensis: Advances in active compounds and their impact on skeletal system diseases (Review)

Skeletal system diseases (SSDs) encompass a variety of conditions affecting bones, cartilage and joints, including osteoporosis, osteoarthritis, rheumatoid arthritis and osteosarcoma. These diseases significantly impair physical function, rank among the leading causes of disability worldwide, and can even lead to mortality, affecting the lives of hundreds of millions of individuals. Scutellaria baicalensis, a widely used traditional Chinese medicinal herb, is rich in flavonoids, including baicalein, baicalin, wogonin, oroxylin A and wogonoside. Given the increasing prevalence of SSDs and their profound impact on quality of life, existing research highlights the promising therapeutic effects of Scutellaria baicalensis. The present review explores the therapeutic potential of Scutellaria baicalensis and its active compounds in combating SSDs. By investigating their mechanisms of action, the current study highlights how these compounds influence key biological functions, including proliferation, apoptosis, senescence, inflammation, oxidative stress, ferroptosis and autophagy in stem cells, osteoblasts, chondrocytes, osteoclasts and immune cells. Furthermore, it explores critical signaling pathways such as MAPK, NF‑κB, AKT, mTOR, TGF‑β/Smad3, c‑Fos/AP‑1 and Wnt/β‑catenin. The present review also discusses various nanoparticle and microparticle drug delivery systems, including functionalized metal‑organic frameworks, injectable hydrogels and calcium polyphosphate microparticles, which are designed to improve the bioavailability and targeted delivery of active compounds from Scutellaria baicalensis, thereby enhancing their therapeutic efficacy. The current findings underscore the promising role of Scutellaria baicalensis in the management of SSDs, offering valuable insights into innovative treatment strategies and the intricate biological processes involved.