Centella asiatica: Bridging Traditional Therapeutics and Modern Evidence Pharmacological Potential, Clinical Outcomes, and Research Gaps

Abstract

Centella asiatica (L.) Urb., commonly known as gotu kola or Mandukaparni, is a medicinal plant widely investigated in modern phytotherapy. Its therapeutic effects are mainly attributed to pentacyclic triterpenoids, particularly asiaticoside, madecassoside, asiatic acid, and madecassic acid. These compounds may modulate inflammatory pathways, enhance antioxidant defenses through nuclear factor E (Nrf2) signaling, and influence extracellular matrix remodeling. This review summarizes the current evidence regarding the therapeutic applications, mechanisms, efficacy, safety, and research gaps associated with C. asiatica. Available evidence indicates potential benefits in wound healing, scar management, chronic venous insufficiency, and related microangiopathies. However, evidence for cognitive enhancement and anti-aging effects remains inconsistent, with clinical studies limited by small sample sizes, heterogeneous formulations, variable doses, and inadequate standardization of triterpenoid content. The oral bioavailability of its glycosides may also be limited by gastrointestinal metabolism. Although C. asiatica has a generally favorable short-term safety profile, rare cases of hepatotoxicity have been reported, particularly with high-dose use. Overall, C. asiatica shows promising therapeutic potential, especially for wound healing and venous disorders, but stronger clinical evidence is required for neurological and anti-aging applications. Future research should emphasize standardized extracts, dose-ranging studies, pharmacokinetic–pharmacodynamic relationships, and well-designed clinical trials.