Angelica archangelica and its role in traditional medicine: A systematic review of its therapeutic applications

Traditional medicine, as defined by the World Health Organization, encompasses the knowledge, skills, and practices derived from various cultures used for health maintenance and disease treatment. Angelica archangelica (AA) has been used in traditional medicine for its purported healing properties. This systematic review aims to analyze the use of AA as a supplement in treating diseases in humans and animals and to investigate its potential health benefits. The PRISMA 2020 guidelines were followed, and the review was registered in PROSPERO. Six databases were searched, and studies that evaluate AA effects on various pathologies in humans or animals were included. Of the 1092 identified records, 17 studies met the inclusion criteria, with two human studies. Both human studies analyzed symptoms related to overactive bladder and had a double-blind randomized controlled trial design. One found no significant effects of AA on nocturia, however, the second found improvements on daytime voids and quality of life and nearly significant results on nocturia. The remaining animal studies showed that AA had beneficial effects on anxiety, breast cancer growth, gastric ulcers, hepatotoxicity, seizures, fibromyalgia, diabetic neuropathy and asthma, but results varied based on dosage and extract type. The evidence suggests AA supplementation could provide benefits in managing overactive bladder, anxiety, cancer, gastrointestinal issues, liver health, neurological disorders, and respiratory conditions, however, the plant’s effects are influenced by dosage, extract origin, and treatment duration and more human studies are needed to confirm these benefits and determine optimal usage parameters. • Strong therapeutic potential in animal models: Although most of the included studies were conducted in animals, Angelica archangelica showed positive effects against various conditions such as anxiety, breast cancer, gastric ulcers, hepatotoxicity, epilepsy, fibromyalgia, and asthma. However, the beneficial outcomes were dose-dependent and varied based on the type of extract used. • Limited evidence in humans: Only two human studies (a double-blind and triple-blind RCT) were included, which found no significant effects of Angelica archangelica on nocturia but showed significant improvements in other overactive bladder symptoms such as daytime voids, IPSS storage subscore or quality of life. This highlights the urgent need for more clinical trials to validate its potential health benefits in humans. • Bioactive compounds with diverse effects: Angelica archangelica contains compounds such as furanocoumarins (angelicin, imperatorin), flavonoids (isoquercetin), and terpenes, which are known to have anti-inflammatory, antioxidant, neuroprotective, and anticancer properties, potentially explaining its wide range of traditional medicinal uses. • Lack of clinical standardization and methodological limitations: There is no consensus on optimal dosage, exposure time, or the combined effects of Angelica archangelica constituents, which limits its safe and effective clinical use. Furthermore, despite many studies being methodologically sound, most failed to justify sample sizes or apply blinding and confounder control, introducing potential bias.