Morinda officinalis , a traditional Chinese medicinal herb, has been used for centuries to enhance bone strength. This scoping review was conducted to comprehensively map and synthesise existing evidence regarding the osteoprotective effects of M. officinalis and the mechanisms through which these effects may occur. A systematic search was conducted using PubMed, Scopus, Web of Science, China National Knowledge Infrastructure, Wanfang, and the Chinese Science and Technology Journal Database, up to November 2025. Seventy-one studies that met the inclusion criteria were analysed. The findings revealed that M. officinalis and its bioactive constituents exert dual osteoprotective actions by promoting bone formation and inhibiting bone resorption. Key bioactive constituents of M. officinalis , including polysaccharides, anthraquinones, iridoid glycosides, and oligosaccharides, were shown to modulate critical signalling pathways such as Wnt/β-catenin, bone morphogenetic protein, Smad, receptor activator of nuclear factor kappa B ligand/osteoprotegerin, p38 mitogen-activated protein kinase, and nuclear factor kappa-B pathways. In cellular models, these constituents were found to enhance osteoblast proliferation, differentiation, and mineralisation, while suppressing the formation of, and inducing apoptosis in, osteoclasts. In animal models, particularly in rodents with ovariectomy-induced osteoporosis, treatment with M. officinalis was consistently associated with improvements in bone mineral density, the restoration of bone microarchitecture, enhanced biomechanical strength, and reductions in inflammation and oxidative stress. Preliminary clinical studies reported that M. officinalis decoction increased bone mineral density and improved bone turnover markers in individuals with osteoporosis. In conclusion, M. officinalis exhibits a multi-constituent and multi-target profile, offering a promising therapeutic approach in osteoporosis through the synergistic actions of its diverse bioactive constituents. Although the preclinical evidence is substantial, high-quality and large-scale clinical trials are required to confirm its efficacy and safety in humans.
Chen et al. (Sun,) studied this question.