Cardioprotective potential of punicalagin: an evidence-based review

This evidence-based review highlights the cardioprotective potential of punicalagin, a major polyphenolic ellagitannin from Punica granatum L., focusing on its pharmacological mechanisms in cardiovascular disease (CVD) pathogenesis. Preclinical studies demonstrate that punicalagin reduces oxidative stress via Nrf2/HO-1 and AMPK pathways, suppresses inflammatory cytokines (TNF-α, IL-1β, IL-6) through NF-κB and MAPK inhibition, improves endothelial function by upregulating eNOS, and modulates lipid metabolism through ApoB100 binding and cholesterol efflux. Clinical trials further support these effects, showing improvements in lipid profile, blood pressure, and carotid intima-media thickness. Punicalagin's multitarget actions support its translational potential in the management of CVD.