{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T09:03:29Z","timestamp":1789549409743,"version":"build-2803163510"},"reference-count":168,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p>Icariin (ICA), the principal flavonoid from Epimedii Folium, aligns with traditional Chinese medicine indications of tonifying kidney-yang and strengthening bone. Prior reviews mostly catalog ICA\u2019s preclinical neuroprotective, anti-fibrotic, anti-tumor, and osteoprotective effects, but lack evidence stratification. Here, we establish an evidence-stratified framework to evaluate ICA\u2019s structure\u2013activity relationships, pharmacokinetics, and safety profiles, explicitly distinguishing preclinical pharmacological actions from unproven clinical efficacy. We delineate translational barriers including interspecies pharmacokinetic gaps, poor bioavailability, and flawed trial designs, and assess delivery systems to address these limitations. This work bridges traditional Chinese medicine practice with graded modern evidence, providing a translational roadmap to guide ICA\u2019s rational clinical development.<\/jats:p>","DOI":"10.3389\/fphar.2026.1832264","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T08:08:24Z","timestamp":1789546104000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Icariin: from preclinical promise to clinical reality\u2014a critical evidence-based assessment"],"prefix":"10.3389","volume":"17","author":[{"given":"Chengjuan","family":"Gu","sequence":"first","affiliation":[{"name":"Department of Basic Medical College, Gansu University of Chinese Medicine","place":["Lanzhou, Gansu, China"]},{"name":"Shenzhen Hospital, Guangzhou University of Chinese Medicine","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Lin","sequence":"additional","affiliation":[{"name":"The Second Clinical College of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaobo","family":"Wang","sequence":"additional","affiliation":[{"name":"Guang\u2019anmen Hospital, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengtian","family":"Li","sequence":"additional","affiliation":[{"name":"Guang\u2019anmen Hospital, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Du","sequence":"additional","affiliation":[{"name":"Shenzhen Hospital, Guangzhou University of Chinese Medicine","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingrong","family":"Lai","sequence":"additional","affiliation":[{"name":"Shenzhen Hospital, Guangzhou University of Chinese Medicine","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Qiao","sequence":"additional","affiliation":[{"name":"Guang\u2019anmen Hospital, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Wang","sequence":"additional","affiliation":[{"name":"Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Wang","sequence":"additional","affiliation":[{"name":"Guang\u2019anmen Hospital, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolin","family":"Tong","sequence":"additional","affiliation":[{"name":"Guang\u2019anmen Hospital, China Academy of Chinese Medical Sciences","place":["Beijing, China"]},{"name":"Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"616","DOI":"10.1016\/j.pharep.2017.02.016","article-title":"Icariin protects against thioacetamide-induced liver fibrosis in rats: implication of anti-angiogenic and anti-autophagic properties","volume":"69","author":"Algandaby","year":"2017","journal-title":"Pharmacol. 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