Introduction Alpine woody plants are deeply embedded in traditional healthcare systems across the Southern European Alps, where multiple organs—including leaves, bark, fruits, buds, and flowers—are used to manage respiratory, musculoskeletal, gastrointestinal, dermatological, metabolic, cardiovascular, and urogenital disorders. This systematic review synthesizes ethnopharmacological uses, evaluates phytochemical and pharmacological evidence, and contextualizes the ecosystem functions of woody plant species native to the European Alps. Methods Following PRISMA guidelines, Web of Science, Scopus, and PubMed were systematically searched for peer-reviewed studies published up to May 2025. Data from 281 eligible sources were harmonized, covering 54 woody species (28 trees, 26 shrubs; 25 families). Extracted variables included ecological distribution, harvested organs, phytochemical classes, and experimentally validated bioactivities. Therapeutic indications were mapped using the International Classification of Primary Care (ICPC-2). Results Phytochemical profiles were predominantly characterized by phenolic acids, flavonoids, anthocyanins, tannins, terpenoids, alkaloids, and saponins. These compounds underpin convergent anti-inflammatory, antimicrobial, antioxidant, antidiabetic, vasoprotective, and cytotoxic activities demonstrated in vitro and in vivo. Beyond medicinal relevance, the same species contribute to soil stabilization, hydrological regulation, carbon sequestration, and the preservation of biocultural landscapes. However, climate-driven range shifts, land-use intensification, commercial overharvesting, and limited pharmacokinetic and toxicological data constrain both sustainability and clinical translation. Discussion High-priority taxa and critical knowledge gaps were identified. An integrated research framework is proposed, combining standardized green extraction technologies, high-resolution metabolomics, longitudinal ecological monitoring, participatory documentation of traditional knowledge, and equitable benefit-sharing mechanisms. Such integration is necessary to advance evidence-based phytotherapy while ensuring sustainable stewardship of Alpine woody ecosystems.
Orlando et al. (Tue,) studied this question.