The “habitat-phytochemistry-pharmacological effect” nexus: a multidimensional review of ethnomedicinal Salvia in China

Background The genus Salvia L. constitutes a core medicinal resource in China’s diverse ethnic medical systems. However, a systematic and comparative understanding of how ecological adaptation-particularly among high-altitude ethnomedicinal species-translates into specific ethnomedicinal value remains lacking. Objective To address this gap, we developed and validated a “habitat-phytochemistry-pharmacological effect” linkage model, testing the hypothesis that environmental stressors driven by altitudinal gradients induce chemical differentiation among Salvia species, which in turn underlies their distinct pharmacological properties and traditional therapeutic uses. Methods We conducted a multidimensional analysis of 32 Salvia species documented in the Dictionary of Chinese Ethnic Medicine . This integrated systematic literature review, verification of altitudinal distributions using the Global Biodiversity Information Facility (GBIF), phenological characterization based on the Flora of China, and phytochemical profiling cross-referenced with the Human Metabolome Database (HMDB) and PubChem. Results These species are used by 17 ethnic minority groups in China, primarily for cardiovascular and cerebrovascular diseases, gynecological disorders, and wound healing, guided by the principles of “activating blood circulation to resolve stasis” and “clearing heat and detoxifying.” Our findings support the habitat-adaptation hypothesis: biologically, species diverge into spring-flowering types (low-altitude, used predominantly by Miao and Zhuang communities) and summer-flowering types (high-altitude; widely employed in Tibetan medicine). Chemically, this divergence corresponds to marked compositional differences-low-altitude species are enriched in flavonoids, whereas high-altitude species accumulate higher levels of phenolic acids, consistent with adaptive responses to intense UV radiation at elevation. Functional compartmentalization was also observed: roots preferentially accumulate lipophilic diterpenoid quinones (associated with antitumor and antiplatelet effects) and hydrophilic phenolic acids (linked to antioxidant and antifibrotic activities), while aerial parts are rich in flavonoids (antibacterial and antitussive) and triterpenoids (immunomodulatory). Pharmacologically, Salvia species exhibit broad bioactivities - including anticancer, anti - inflammatory, hepatoprotective, and cardioprotective effects - mediated by multiple compound classes (terpenoids, phenolic acids, polysaccharides) acting through diverse pathways. Clinical evidence further corroborates a direct alignment between traditional efficacy concepts and molecular mechanisms: “activating blood circulation to resolve stasis” corresponds to diterpenoid quinone–mediated antitumor activity, and “clearing heat and detoxifying” aligns with phenolic acid-driven anti-inflammatory effects. Conclusion This study successfully validates the “habitat-phytochemistry-pharmacological effect” linkage model, demonstrating a strong correlation between the ethnomedicinal value of Salvia species and their ecological traits, phytochemical profiles, and pharmacological actions. The model provides a robust framework for ethnopharmacology-guided natural product discovery. Future work should prioritize mechanistic studies of key active constituents and rigorous pharmacological validation of their traditional uses.