A review of the botany, traditional uses, phytochemistry, and pharmacology of the Flos Inulae

Plants of the genus Inula have long been used as an ethnomedicine in Asia, Europe, and North America for its high medicinal value and health benefits. Inula japonica Thunb. (I. japonica) and Inula britanica L. (I. britanica) are included in Chinese Pharmacopoeia (2020 edition) as the traditional Chinese medicine Flos inulae (FI). In TCM, FI tastes bitter, pungent, and salt, with warm nature and has the functions of water removal, reduction in nausea, and prevention of vomiting and is often used for cold-related coughs, sputum, wheezing coughs, vomiting, belching and other related diseases. In addition, Inula japonica Thunb is used as a botanical medicine in Korea and Inula britannica L. is also used as a traditional plant medicine in Iran.This paper collects the relevant research literature (1970-2021) and provides a systematic summary of the botany, ethnopharmacology, processing, phytochemistry, pharmacology, toxicity, analytical methods and quality control of FI to explore its potential and expand its scope for better clinical application.Information on Inula japonica Thunb. and Inula britanica L. was collected from scientific databases (1970-2021), including Google Scholar, Baidu Scholar, Springer, PubMed, CNKI and Wan Fang DATA. Information was also collected from classic books of Chinese herbal medicine and Ph.D. and M.Sc. theses.More than 200 chemical compounds have been isolated from Inula japonica Thunb. and Inula britanica L., including sesquiterpenes, flavonoids, volatile oils, triterpenoids, diterpenoid glycosides, monoterpenoids, polysaccharides, steroid and small molecule acids. Based on a wide variety of chemically active ingredients, FI has a wide range of pharmacological effects. Modern pharmacological research has proven that the pharmacological effects of FI include anti-inflammatory, antitumor, antioxidant, antiallergy, antidiabetic, blood lipid reduction, skin whitening, liver protection, anticonstipation, and antinociceptive effects.FI is a very important traditional Chinese herbal medicine with anti-inflammatory antitumor, antioxidant, antiallergy, antidiabetic and other pharmacological effects that can treat a variety of related diseases. This paper summarizes the botany, ethnopharmacology, processing, phytochemistry, pharmacology, toxicity, analytical methods, and quality control of FI. However, the research on the processing, toxicity and quality control of FI is currently too shallow, especially concerning the relationship between the changes in active components before and after processing and the changes in its pharmacological action, which remains unclear. There are few toxicity experiments conducted with FI, so it is impossible to evaluate the safety of FI objectively and impartially. There are also few studies on the material basis and doses of FI causing toxicity and side effects, and more in-depth and concrete researches should be carried out in the future regarding these aspects. Furthermore, to ensure effective and safe clinical medication, we should also pay attention to the mixed use of FI in various regions of China to control the quality of the FI plant.