Abstract
Paeonol a, pharmacologically active constituent obtained from the root bark of Paeonia suffruticosa has been extensively utilized as a traditional Chinese medicine for the treatment, prevention and control of several diseases for years. Paeonol has been reported to possess key immunomodulatory properties; however, the underlying mechanisms involved in its immunomodulatory and anticancer effects have not been extensively researched due to limitations in terms of design, conduct and interpretation. The present review focuses on both the in vitro and in vivo immunosuppressive and anticancer effects of paeonol and the underlying mechanisms of action. The present literature review aimed to include all the notable findings published on Google Scholar, PubMed, Web of Science, SciFinder and ScienceDirect. Overall, paeonol possesses multifaceted pharmacological activities with potential for use in the development of novel immunomodulator and anticancer therapeutic agents. Paeonol decreases IL-1β expression to repress several inflammatory mediators, such as NO, iNOS, COX2 and PEG2 in the inhibition of the NLRP3 inflammasome, NF-κB, MAPK and TLR4 pathways to provide multiple levels immunosuppression; these effects may be beneficial in immune-related diseases. Furthermore, paeonol inhibits cancer cell growth, proliferation, invasion and metastasis by inducing cell apoptosis and the suppression of the TLR4/NF-κB/STAT3/MAPK/PI3K/AKT/CHOP/VEGF/HIF-1α, pathways. The present review aimed to promote further research to exploit the potential use of paeonol as a novel therapeutic agent for immunomodulation and cancer management.