Traditional uses, phytochemistry, pharmacology, and safety concerns of hawthorn (Crataegus genus): A comprehensive review

The genus Crataegus (hawthorn), a member of the Rosaceae family, encompasses several species with broad geographical distribution across the Northern Hemisphere, including Asia, Europe, and the Americas. Hawthorn is recognized as an edible medicinal plant with applications related to strengthening the digestive system, promoting blood circulation, and resolving blood stasis. This study critically summarized the traditional uses, phytochemistry, and pharmacological properties to provide a theoretical basis for further studies on hawthorn and its applications in medicine and food. The available information on hawthorn was gathered from scientific databases (including Google Scholar, Web of Science, PubMed, ScienceDirect, Baidu Scholar, CNKI, online ethnobotanical databases, and ethnobotanical monographs, and considered data from 1952 to 2023). Information about traditional uses, phytochemistry, pharmacology, and safety concerns of the collected data is comprehensively summarized in this paper. The literature review revealed that hawthorn includes more than 1000 species primarily distributed in the northern temperate zone. Traditional uses of hawthorn have lasted for millennia in Asia, Europe, and the Americas. Within the past decade, 337 chemical compounds, including flavonoids, lignans, fatty acids and organic acids, monoterpenoids and sesquiterpenoids, terpenoids and steroids, have been identified from hawthorn. Modern pharmacological studies have confirmed numerous bioactivities, such as cardiovascular system influence, antitumor activity, hepatoprotective activity, antimicrobial properties, immunomodulatory functions, and anti-inflammatory activities. Additionally, evaluations have indicated that hawthorn lacks toxicity. Based on its traditional uses, chemical composition, and pharmacological studies, hawthorn has significant potential as a medicinal and edible plant with a diverse range of pharmacological activities. Traditional uses of the hawthorn include the treatment of indigestion, dysmenorrhea, and osteoporosis. However, modern pharmacological research primarily focuses on its cardiovascular and cerebrovascular system effects, antitumor effects, and liver protection properties. Currently, there is a lack of correlative research involving its traditional uses and pharmacological activities. Moreover, phytochemical and pharmacological research has yet to focus on many types of hawthorn with traditional applications. Therefore, it is imperative to research the genus Crataegus extensively.