Pharmacological Activities of Ribwort Plantain and its Key Constituents: a Review

Hasan Alauldeen Khalaf; Vahid Reza Askari; Ibrahim S. Abbas

doi:10.32947/ajps.v26i2.1368

Authors

Hasan Alauldeen Khalaf Department of Pharmacognosy and Medicinal Plants, College of Pharmacy, Mustansiriyah University, Baghdad, Iraq
Vahid Reza Askari Patient Safety Research Center, Clinical Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
Ibrahim S. Abbas Department of Pharmacognosy and Medicinal Plants, College of Pharmacy, Mustansiriyah University, Baghdad, Iraq

DOI:

https://doi.org/10.32947/ajps.v26i2.1368

Keywords:

Plantago, lanceolata, verbascoside, aucubin, catalpol, apigenin, luteolin, anticancer

Abstract

Ribwort plantain has shown considerable pharmacological properties that are related to its wide-range secondary metabolites. The present review is aimed to highlight the recent progress on the antimicrobial, anti-inflammatory, antioxidant, neuroprotective, anticancer and wound healing effects of acteoside, aucubin, catalpol, apigenin and luteolin as significant metabolites from this plant.

Functional evidences support their role in the neutralization of reactive oxygen species, inhibition of pathogen attack, wound healing, prevention of tumorigenesis and neuroprotection via anti-apoptotic pathways and blocking pro-inflammatory signaling cascades. By virtue of these actions, the plant is warranted as a candidate for treating several diseases. The bioactivity in these locations is maximized by the action of synergy occurring between constituents in the phytochemical matrix. Mechanistic studies reveal multi-target action such as enzyme inhibition, gene expression control and receptor modulation. Although preclinical evidences indicate the high polypharmacological potential of this plant, full-scale clinical translation will require more phytochemical standardization and human studies. The present work highlights the integrative therapeutic relevance of broadleaf plantain and its metabolites in the treatment of multifactorial diseases.

References

1- Bussmann RW, Paniagua-Zambrana NY, Khutsishvili M, Kikvidze Z, Müller L, Batsatsashvili K, et al. Plantago indica L. Plantago lanceolata L. Plantago major L. Plantago media L. Plantaginaceae. In: Bussmann RW, editor. Ethnobotany of the Caucasus. Cham, Switzerland: Springer; 2024. p. 1-31.

2- Khalaf HAA, Al-deen MFM, Abaas IS. Preliminary Phytochemical and GC-MS analysis of chemical constituents of Iraqi Plantago lanceoleta L. Al Mustansiriyah J Pharm Sci. 2018;18(2):114-21.

3- Khalaf HA, Al-deen MFM, Abaas IS. Determination, isolation, and identification of Aucubin and Verbascoside in the Leaves of Iraqi Plantago lanceolata L. using different detecting methods. Int J Pharm Pharm Sci. 2018;11(2):74-80.

4- Genc Y, Harput US, Saracoglu I. Active compounds isolated from Plantago subulata L. via wound healing and antiinflammatory activity guided studies. J Ethnopharmacol. 2019;241:112030.

5- Abate L, Bachheti RK, Tadesse MG, Bachheti A. Ethnobotanical uses, chemical constituents, and application of Plantago lanceolata L. J Chem. 2022;2022:1532031.

6- Adeli OA, Prasad KDV, Khalaf HA, Hjazi A, Hussien BM, Hussein HA, et al. Phytotherapy in sexual disorder: overview of the most important medicinal plants effective on sexual disorders. Adv Life Sci. 2024;10(4):505-14.

7- Mohamed FMM. Antibacterial activity of Plantago lanceolata and Helichrysum stoechas extracts on Escherichia coli and Pseudomonas aeruginosa. J Basic Appl Sci. 2024; 18:26-32.

8- Lopes I, Campos C, Medeiros R, Cerqueira F. Antimicrobial activity of dimeric flavonoids. Compounds. 2024;4(2):214-29.

9- Bajrai LH, Alharbi AS, El-Day MM, Bafaraj AG, Dwivedi VD, Azhar EI. Identification of antiviral compounds against monkeypox virus profilin-like protein A42R from Plantago lanceolata. Molecules. 2022;27(22):7718.

10- Abebe E, Mekonnen N. In vitro antibacterial activity of Rumex nervosus, Plantago lanceolata, Solanum incanum and Lepidium sativum against selected bacterial pathogens of human and animals. Ethiop Vet J. 2016;20(2):119-31.

11- Alemu F, Andualem B. Antimicrobial potentials of different solvent extracts of Justicia landonoides and Plantago lanceolata against standard and drug resistant human bacterial pathogens. Int J Microbiol Res. 2014;5(1):6-18.

12- Deribew F, Endale M, Melaku Y. Antibacterial and antioxidant phenylpropanoid derivative from the leaves of Plantago lanceolate. Nat Prod Chem Res. 2018;6(315):2.

13- Ersin M, Karahan F, Akgul H, Yildiz S, Yilmaz MA, Ceylan O. Investigation of Plantago lanceolata L.: a multidimensional study on its biochemical profiling, antioxidant capacity, and biological activities. Commun Fac Sci Univ Ankara Ser C Biol. 2025;34(1):76-103.

14- Parveen S, Wahid S, Tayyab M, Sahar S, Sadaf S, Zehra R. Antifungal activity of some plant extracts on some pathogenic fungi. Arch Phytopathol Plant Prot. 2014;47(3):279-84.

15- Jiru TM, Getahun M. Antifungal activity of Plantago lanceolata and Sida ovata leaf extracts against dermatomycotic fungi. Evid Based Complement Alternat Med. 2023; 2023:9957892.

16- LI, Xingchen, et al. Unraveling the efficacy of verbascoside in thwarting MRSA pathogenicity by targeting sortase A. Applied Microbiology and Biotechnology, 2024, 108.1: 360.

17- Şimşek S, Öztürk M, Kahraman H, Yılmaz MA, Ertas A. In Silico and In Vitro Antifungal Investigations of Verbascoside Isolated from Verbascum Ozturkii. ChemistrySelect. 2025;10(17): e202400701.

18- Agampodi VA, Jayasinghe L, Hara N, Fujimoto Y. Antibacterial and anti-inflammatory activity of extracts and major constituents derived from Stachytarpheta indica Linn. leaves and their potential implications for wound healing. Appl Biochem Biotechnol. 2022;194(12):6213-54.

19- Shirley KP, Vera MP, Guerra C, Rojas EE, Alviano DS, Noël CJ, et al. In vitro effects of Plantago major extract, aucubin, and baicalein on Candida albicans biofilm formation, metabolic activity, and cell surface hydrophobicity. J Prosthodont. 2017;26(6):508-15.

20- Senatore F, Rigano D, Formisano C, Grassia A, Basile A, Sorbo S. Phytogrowth-inhibitory and antibacterial activity of Verbascum sinuatum. Fitoterapia. 2007;78(1):1-8.

21- Li P, Su X, Ye Y, Huang J, Shen B, Zhang J. Catalpol inhibits inflammatory response in rat alveolar macrophages infected with influenza virus by downregulating TLR7, MyD88, NF-ΚB, and PLA 2. Int J Clin Exp Med. 2016;9(2).

22- Hanci H, Igan H. Antimicrobial synergistic effects of apigenin,(-)-epigallocatechin-3-gallate, myricetin and luteolin in combination with some antibiotics. Ann Agric Environ Med. 2023;30(1).

23- Men X, Chen Y, Yu C, Li P, Chen Y, Zhang L, et al. Antiviral activity of luteolin against pseudorabies virus in vitro and in vivo. Animals. 2023;13(4):761.

24- Yi L, Li Z, Yuan K, Qu X, Chen J, Wang G, et al. Small molecules blocking the entry of severe acute respiratory syndrome coronavirus into host cells. J Virol. 2004;78(20):11334-9.

25- Raina N, Pahwa R, Thakur VK, Gupta M. Polysaccharide-based hydrogels: New insights and futuristic prospects in wound healing. Int J Biol Macromol. 2022; 223:1586-603.

26- Kurt B, Özay Y, Gülel GT, Özer E, Düz MB, Düz M, et al. Effects of Plantago lanceolata L. extract on full-thickness excisional wound healing in a mouse model. Biotech Histochem. 2018;93(4):249-57.

27- Azam A, Ahmed T, Noman M, Al-Mohaimeed AM, Shah AA, Al-Saidi HMA, et al. Enhanced bactericidal and in vivo wound healing potential of biosynthesized zinc oxide nanoparticles from psyllium mucilage. Appl Organomet Chem. 2023;37(1):e6923.

28- Kanlayavattanakul M, Khongkow M, Lourith N. Wound healing and photoprotection properties of Acanthus ebracteatus Vahl. extracts standardized in verbascoside. Sci Rep. 2024;14(1):1904. doi: 10.1038/s41598-024-52487-5.

29- Lei L, Luo L, Li J, Wang Y, Chen Y, Liang H, et al. The total iridoid glycoside extract of Lamiophlomis rotata Kudo induces M2 macrophage polarization to accelerate wound healing by RAS/p38 MAPK/NF-κB pathway. J Ethnopharmacol. 2023; 307:116193.

30- Kartini K, Islamie R, Handojo CS. Wound healing activity of aucubin on hyperglycemic rat. J Young Pharm. 2018;10(2 Suppl):s136-s139.

31- Ma X, Li Y, Zhang Z, Wang Y, Chen J. Effects of catalpol from Rehmannia glutinosa extract on skin flaps. Plast Reconstr Surg. 2024;153(2):401-10.

32- Li K, Wu L, Jiang J. Apigenin accelerates wound healing in diabetic mice by promoting macrophage M2-type polarization via increasing miR-21 expression. Mol Cell Biochem. 2024;479(11):3119-27.

33- Li Y, Zhang H, Wang X, Chen J, Liu Y. A double network composite hydrogel with self-regulating Cu2+/luteolin release and mechanical modulation for enhanced wound healing. ACS Nano. 2024;18(26):17251-66.

34- Bussmann RW, Sikharulidze S, Tchelidze D, et al. Plantago lanceolata L. Plantago major L. Plantaginaceae. Ethnobotany of the Mountain Regions of Far Eastern Europe: Ural, Northern Caucasus, Turkey, and Iran. Cham: Springer International Publishing; 2020. p. 705-14.

35- Liu Y, Wang J, Zhang L, Li H, Chen X. Aucubin protects against myocardial ischemia-reperfusion injury by regulating STAT3/NF-κB/HMGB-1 pathway. Int J Cardiol. 2024; 400:131800.

36- Yue C, Li Y, Zhang H, Wang X, Liu Y. Aucubin suppresses TLR4/NF‐κB signalling to shift macrophages toward M2 phenotype in glucocorticoid‐associated osteonecrosis of the femoral head. J Cell Mol Med. 2024;28(15):e18583.

37- Wu B, Zhang L, Li J, Wang Y, Chen X. Protective effects of Catalpol to attenuate TNF-α and collagen-induced inflammation in vitro HFLS-RA cells and in vivo mice models for the treatment of rheumatoid arthritis. Clin Rheumatol. 2025;44(3):1041-56.

38- Chao HWH, Chao WWJ, Chao HM. Catalpol Protects Against Retinal Ischemia Through Antioxidation, Anti-Ischemia, Downregulation of β-Catenin, VEGF, and Angiopoietin-2: In Vitro and In Vivo Studies. Int J Mol Sci. 2025;26(9):4019.

39- Dimitrov P, Kostadinova T, Aluani D, Yordanov Y, Odjakova M, Popova M, et al. Plant-derived verbascoside and isoverbascoside regulate Toll-like receptor 2 and 4-driven neutrophils priming and activation. Phytomedicine. 2019; 55:105-18.

40- Ahmed SA, Khan MI, Alhumaydhi FA, Alharbi M, Alsaiari AA, Alzahrani AK, et al. Verbascoside as a potential SGLT2 inhibitor in diabetic nephropathy: Targeting AMPK activation to suppress NOX4/NF-κB signaling and attenuate inflammation and fibrosis. Int Immunopharmacol. 2025; 158:114825.

41- Paliwal A, Jain D. Evaluation of Immunomodulatory Potential of Two Naturally Occurring Bioactive Flavonoids: Luteolin & Apigenin. Front Health Inform. 2024;13(7).

42- Kadi A, Alharbi M, Alzahrani AK, et al. Integrative study of Plantago lanceolata L.: phytochemical properties and therapeutic effects on cancer, diabetes, and Alzheimer's disease. Nat Prod Res. 2025.

43- Hjazi A, Alsaadi SM, Al-Jubouri SM, et al. CDKN2B-AS1 as a novel therapeutic target in cancer: Mechanism and clinical perspective. Biochem Pharmacol. 2023; 213:115627.

44- Budzianowska A, Skrzypczak-Pietraszek E, Pietraszek J. Cytotoxic effect of phenylethanoid glycosides isolated from Plantago lanceolata L. Life. 2023;13(2):556.

45- Rahamouz-Haghighi S, Mohammadi A, Shamsaie-Mehrejan M, Hosseini S. Phytochemical screening and cytotoxicity assessment of Plantago lanceolata L. root extracts on colorectal cancer cell lines and brine shrimp larvae and determination of the median lethal dose in mice. S Afr J Bot. 2022; 149:740-7.

46- Rahamouz-Haghighi S, Sharafi A. Biocompatibility, cytotoxicity and phytochemical analysis of Plantago lanceolata L. aerial extracts: in vitro and in vivo study. Era's J Med Res. 2024;11(1).

47- Yücer R, Schröder A, Topçu G, Efferth T. Identification of anti-inflammatory and anti-cancer compounds targeting the NF-κB-NLRP3 inflammasome pathway from a phytochemical library of the Sideritis genus. J Ethnopharmacol. 2025; 338:119074.

48- Ren Y, Li J, Wang X, Chen Y, Zhang L. The anti-tumor efficacy of verbascoside on ovarian cancer via facilitating CCN1-AKT/NF-κB pathway-mediated M1 macrophage polarization. Front Oncol. 2022; 12:901922.

49- Cabatit KA, Carandang LJ, Saragpon DJ, Minalang K, Paulin J, Devanadera MK, et al. Assessment of Cytotoxicity, Impact on Cell Migration and Apoptotic Modulation of Acteoside and Plantamajoside on Human Breast Adenocarcinoma (MCF-7). Asian Pac J Cancer Prev. 2025;26(3):925.

50- Khalaf HAA, Jasim RA, Ibrahim IT. Verbascoside—A review of its antitumor activities. Pharmacol Pharm. 2021;12(6):109-26.‏

51- Deng Y, Wang J, Li H, Zhang L, Chen X. Optimization of different extraction methods for phenolic compound verbascoside from Chinese Olea europaea leaves using deep eutectic solvents: impact on antioxidant and anticancer activities. Molecules. 2024;29(17):4219.

52- Nakshatra U, Jayaraman S, Veeraraghavan VP, Murali R. Molecular Mechanisms Underlying the Anticancer Activity of Verbacoside Against Human Lung Adeno Carcinoma (A549) Cells Via Modulating Apoptotic Signalling. Tex Int J Public Health. 2025 Jan 31; a special Issue.

53- Chittasupho C, Samee W, Mangmool S, Karuna N, Anuchapreeda S, Okonogi S, et al. Phytochemical Characterization and Anticancer Activity of Clerodendrum chinense Leaf Extract Against Breast and Cervical Cancer Cells. Int J Mol Sci. 2025;26(6):2729.

54- Wen L, Li Y, Zhang H, Wang X, Chen J, Liu Y, et al. Synergistic and toxicity-reducing effects of acteoside as an adjuvant therapy of oxaliplatin against hepatocellular carcinoma. Int J Oncol. 2025;66(6):45.

55- Cui M, Chen P. Aucubin induces apoptotic cell death through caspase-dependent pathways in human osteosarcoma MG-63 cells. Pharmacogn Mag. 2025;21(1):243-55.

56- Lang X, Li Y, Zhang H, Wang X, Chen J. The mechanism of catalpol to improve oxidative damage of dermal fibroblasts based on Nrf2/HO-1 signaling pathway. Drug Des Devel Ther. 2024;18:2287-97.

57- Li X, Wang Y, Chen J, Zhang L, Liu Y. Potential anticancer effects and toxicity of flavones luteolin and apigenin in vivo. J Environ Sci Health C. 2025:1-37.

58- Chiu YJ, Lee CY, Lin CY, Chen YC, Hsu CC. A neuroprotective action of quercetin and apigenin through inhibiting aggregation of Aβ and activation of TRKB signaling in a cellular experiment. Biomol Ther. 2023;31(3):285.

59- Jiang ZB, Wang WJ, Xu C, Xie YJ, Wang XR, Zhang YZ, et al. Luteolin and its derivative apigenin suppress the inducible PD-L1 expression to improve anti-tumor immunity in KRAS-mutant lung cancer. Cancer Lett. 2021; 515:36-48.

60- Dalar A, Türker M, Konczak I. Antioxidant capacity and phenolic constituents of Malva neglecta Wallr. and Plantago lanceolata L. from Eastern Anatolia Region of Turkey. J Herb Med. 2012 Jun;2(2):42-51.

61- Baradaran Rahimi V, Askari VR, Hosseini M, Yousefsani BS, Sadeghnia HR. Antiinflammatory and anti‐cancer activities of pomegranate and its constituent, ellagic acid: Evidence from cellular, animal, and clinical studies. Phytother Res. 2020 Apr;34(4):685-720.

62- Bahadori MB, Sarikurkcu C, Kocak MS, Calapoglu M, Uren MC, Ceylan O. Plantago lanceolata as a source of health-beneficial phytochemicals: phenolics profile and antioxidant capacity. Food Biosci. 2020;34:100536.‏

63- Shah MZ, Guan ZH, Din AU, Ali A, Rehman AU, Jan K, et al. Synthesis of silver nanoparticles using Plantago lanceolata extract and assessing their antibacterial and antioxidant activities. Sci Rep. 2021;11(1):20754.

64- Kalantari A, Kósa D, Nemes D, Ujhelyi Z, Fehér P, Vecsernyés M, et al. Self-nanoemulsifying drug delivery systems containing Plantago lanceolata—an assessment of their antioxidant and antiinflammatory effects. Molecules. 2017;22(10):1773.

65- Chahardehi AM, Arefnezhad R, Pourbafrani A, Tajik L, Asadi SA, Salehi H, et al. MicroRNAs modulation by curcumin, catalpol, and other natural products in Alzheimer’s disease: a review. Mol Biol Rep. 2025;52(1):445.

66- Liu Y, Wu D, Hua H, Mei S, Yan X, Xu X, et al. IGF-1 signaling pathway activation promotes axonal regeneration and repair: a mechanism study on catalpol-induced functional recovery after ischemic stroke. J Ethnopharmacol. 2025; 348:119808.

67- Lee YJ, Cho B, Kwon D, Kim Y, An S, Kang S, et al. Catalpol promotes the generation of cerebral organoids with oRGs through activation of STAT3 signaling. Bioeng Transl Med. 2025;10(3):e10746.

68- Zheng XZ, Yu HY, Chen YR, Fang JS. Aucubin mitigates the elevation of microglial aerobic glycolysis and inflammation in diabetic neuropathic pain via aldose reductase. World J Diabetes. 2025 May;16(5):103915.

69- Li L, Yang X, Cai Z, Yin B, Jiang W. Aucubin regulates allergic airway inflammation in ovalbumin-induced allergic asthma in mice by controlling Th2 cytokines. Pharmacogn Mag. 2025 Jan 1; [Epub ahead of print].

70- Amalia L, Murwanti R, Hertiani T. Unveilling aucubin’s pharmacological landscape: a bibliometric study on antioxidant and anti-inflammatory activities. Maj Farmaseutik. 2025;21(1).‏

71- Yelwantge V, Chauhan V. Phytochemical Characterization, In-Vitro Antioxidant Activity, and Molecular Docking of Quercetin, Rutin and Apigenin. J Drug Deliv Ther. 2025;15(4).

72- Tiwari R, Tiwari G, Semwal BC, Amudha S, Soni SL, Rudrangi SRS, et al. Luteolin-encapsulated polymeric micelles for anti-inflammatory and neuroprotective applications: an in vivo study. BioNanoScience. 2025;15(3):1-22.

73- Li Y, Zhang Y, Zhang X, Lu W, Liu X, Hu M, et al. Aucubin exerts anti-osteoporotic effects by promoting osteoblast differentiation. Aging (Albany NY). 2020 Feb;12(3):2226-45.

74- Zheng Y, Sun R, Yang H, Gu T, Han M, Yu C, et al. Aucubin promotes BMSCs proliferation and differentiation of postmenopausal osteoporosis patients by regulating ferroptosis and BMP2 signalling. J Cell Mol Med. 2025;29(2):e70288.

75- Akyer SP, Karagur ER, Ata MT, Toprak EK, Donmez AC, Donmez BO. Verbascoside inhibits/repairs the damage of LPS-induced inflammation by regulating apoptosis, oxidative stress, and bone remodeling. Curr Issues Mol Biol. 2023 Nov;45(11):8755-66.

76- Kan YN, Wang XW, Chen HF, Gao XJ, Huang X, Xie JM. Comparison of effects of calcium and chlorogenic acid intervention on bone and intestinal injury in cadmium-exposed growing rats. Food Health. 2025;7(2):10.

77- Liu Q, Zhang S, Shi L, Shi J, Sun C, Wang J, et al. Osteogenic induction and anti‐inflammatory effects of calcium‐chlorogenic acid nanoparticles remodel the osteoimmunology microenvironment for accelerating bone repair. Adv Healthc Mater. 2024;13(29):2401114.

78- Sukkho T, Khanongnuch C, Lumyong S, Ruangsuriya J, Apichai S, Surh YJ, et al. Osteoprotective activity of Sambucus javanica Reinw Ex Blume subsp. javanica leaf extracts by suppressing ROS production. Antioxidants. 2025;14(3):252.

79- Usatiuc LO, Pop RM, Adrian S, Pârvu M, Țicolea M, Uifălean A, et al. Multitargeted Effects of Plantago ovata Ethanol Extract in Experimental Rat Streptozotocin-Induced Diabetes Mellitus and Letrozole-Induced Polycystic Ovary Syndrome. Int J Mol Sci. 2025;26(10):4712.

80- Zhao J, Tan Y, Feng Z, Zhou Y, Wang F, Zhou G, et al. Catalpol attenuates polycystic ovarian syndrome by regulating sirtuin 1 mediated NF-κB signaling pathway. Reprod Biol. 2022 Sep;22(3):100671.

81- Samani SL, Yadi M, Aflatoonian B, Zarehmehrjerdi F, Hafizibarjin Z, Rezvani ME, et al. Beneficial effects of apigenin on ovarian histological changes and angiogenesis gene expression in rat model of polycystic ovary syndrome. Naunyn Schmiedebergs Arch Pharmacol. 2025;398(3):2641-9.

82- Sudhakaran G, Gopi S, Priya S, Pachaiappan R, Soundharrajan I, Almutairi BO, et al. Apigenin regulates bisphenol-A induced polycystic ovarian syndrome (PCOS) symptoms in-vivo zebrafish. Reprod Sci. 2025;32(6):1912-25.

83- Alsabah AS, Jasim GA. Antitumor activity of Convolvulus arvensis L. methanolic extract in mice. Int J Pharm Res. 2020;12(2).

84- Shi X, Li Y, Zhang Y, Wang J, Liu Z, Chen H, et al. Luteolin and its analog luteolin-7-methylether from Leonurus japonicus Houtt suppress aromatase-mediated estrogen biosynthesis to alleviate polycystic ovary syndrome by the inhibition of tumor progression locus 2. J Ethnopharmacol. 2024; 331:118279.

85- Abbasi A, Moradi M, Ghanbari M, Ghanbari S, Zare S. Antibacterial Activity of Herbal Plantago major and Plantago lanceolata extracts on Pseudomonas aeruginosa with emphasis on Exotoxin A gene expression and Bioinformatics approach. Jundishapur J Microbiol. 2022;15(5):e123456.

86- Laanet P, Vaher M, Borovkova M, Vasar E, Toom M, Kulp M, et al. Plantago major and Plantago lanceolata exhibit antioxidant and Borrelia burgdorferi inhibiting activities. Int J Mol Sci. 2024 Jun 26;25(13):7112.

87- Kováč I, Kováčová M, Varga M, Hodorová I. Plantago lanceolata L. water extract induces transition of fibroblasts into myofibroblasts and increases tensile strength of healing skin wounds. J Pharm Pharmacol. 2015;67(1):117-25.‏

88- Vigo E, Cepeda A, Gualillo O, Perez-Fernandez R. In-vitro anti-inflammatory activity of Pinus sylvestris and Plantago lanceolata extracts: effect on inducible NOS, COX-1, COX-2 and their products in J774A.1 murine macrophages. J Pharm Pharmacol. 2005 Mar;57(3):383-91.‏

89- Aly SH, El Hassab MA, El-Hossary EM, Al-Rashood ST, Eskandrani RO, Eldehna WM. Iridoid glycosides of Plantago: botany, chemistry, bioactivity, and metabolism. In: Ramawat KG, Mérillon JM, editors. Natural Products: Phytochemistry, Botany, Metabolism of Alkaloids, Phenolics and Terpenes. Berlin, Heidelberg: Springer Berlin Heidelberg; 2025. p. 1-43.

90- Al Mosawie EAH, Al Maliky WKS. Hepatoprotective activity of Plantago lanceolata aqueous extract on albino female mice. REDVET Rev Electron Vet. 2022;23(3):326-34.

91- Al-Mosawie EAH, Al-Maliky WKS. Anti-tumor activity of Plantago lanceolata aqueous extract in vitro and genotoxicity by micronucleus assay in vivo. Ibn AL-Haitham J Pure Appl Sci. 2023;36(1):52-8.

92- Fleer H, Verspohl EJ. Antispasmodic activity of an extract from Plantago lanceolata L. and some isolated compounds. Phytomedicine. 2007 Jun;14(6):409-15.

93- Manisali E, Adiyil R, Dinçer ZY, Zikşahna K, Ihamur M. Evaluation of the cytotoxic effects of Plantago lanceolata L. extract and its combinations with chemotherapeutic agents on lung cancer cells. Int J Basic Clin Stud. 2025;14(1):68-79.

94- Rahamouz-Haghighi S, Sharafi A. Biocompatibility, cytotoxicity and phytochemical analysis of Plantago lanceolata L. aerial extracts: in vitro and in vivo study. Era's J Med Res. 2024;11(1).

95- Jasim GA, Alsabah AS. Cytotoxic effect of Silybum marianum (L.) Gaertn extract against MCF7 and Iraqi AMJ13 breast cancer cell lines. Lat Am J Pharm. 2021;40(1):213-23.

96- Jawad RA, Mshimesh BAR, Al-Mayah QS, Al-Alloosh F. The Incidence of acute Neurotoxicity among some Iraqi colorectal cancer patients treated with oxaliplatin-based chemotherapy. Al Mustansiriyah J Pharm Sci. 2025;25(3):280-90.

97- Rahamouz-Haghighi S, Mohammadi E, Shamsaie-Mehrejan M, Hosseini S. Phytochemical screening and cytotoxicity assessment of Plantago lanceolata L. root extracts on colorectal cancer cell lines and brine shrimp larvae and determination of the median lethal dose in mice. S Afr J Bot. 2022; 149:740-7.