TABLE 6.

Pharmacological uses of shikonin and its derivatives.

Pharmacological uses	Recent studies	References
Anti-adenovirus	Adenovirus type 3 (AdV3) growth is hindered by 0.0156–1 mM dose of shikonin in vitro with a virus reduction rate of 23.8%–69.1%.	Gao et al. (2011)
Anti-parasite	Shikonin derivative acetylshikonin kills intercellular parasite Leishmania donovani by promoting interleukin IL—10 and IL-12, nitric oxide, and reactive oxygen species (ROS).	Charan Raja et al. (2016)
Hypoglycemia	Hypoglycemia is a condition where the blood sugar level is dropped down. Shikonin was found to be effective in this state by increasing the glucose uptake by myocytes (muscle cells) and adipocytes (fat cells) and having very less effect on protein tyrosine phosphorylation in the cells.	Nigorikawa et al. (2006)
Antioxidant	Cigarette smoke contains a high amount of peroxyl radicals (measured by ESR spectrometry). Peroxy radicals are the main reactive oxygen species (ROS). Shikonin being a better ROS scavenger exerts the scavenging activity against peroxyl radicals, therefore shikonin is an effective antioxidant.	Nishizawa et al. (2005), Hao et al. (2020), Nasrollahzadeh Sabet et al. (2020)
Anti-bacterial	Due to the presence of three hydroxyl groups in shikonin, it acts as free ion scavengers, and the bacteria have their membrane made up of ion gradient hence destroy bacteria membrane and possess high antibacterial activity. Moreover, the ring structure of the shikonin acts as protoplasm toxic and inhibits protein synthesis in bacteria which kills the bacteria. Shikonin has also shown anti-biofilm activity against Listeria monocytogenes.	Li et al. (2021)
Anti-obesity	Shikonin (concentration—1.1 mM) hinder the synthesis of fat droplet and triglyceride in adipocytes cells (3T3-L1) by inhibiting the expression of a gene which are included in lipid metabolism. Shikonin inhibits the regulation of adipocytes cells expressions and as a result, downregulates lipid metabolizing enzymes. Finally reducing fat accumulation.	Jang et al. (2008)
Anti-ear oedema	50–1.0 mg dose of shikonin reduces the oedema, 70% cyclooxygenase-2 expression, and 100% of inducible NO synthase under in vivo by decreasing the translocation of protein kinase, phosphorylation, and activation of ERK. It also hinders the binding of NF-kB-DNA. Hence lessen the inflammatory effect of ear oedema	Andújar et al. (2010)
Anti-diabetic	Shikonin and acetylshikonin offers potential against type II diabetes by showing agonism activities on free fatty acid receptor 4, which is novel target for treating type II diabetes.	Xu et al. (2021)
Anti-Fungal	Shikonin is an antifungal agent against Candida albicans and Aspergillus terreus by inhibiting fungal growth and killing the biofilms by regulating various genes which inhibit hyphae formation.	Yan et al. (2019), Shishodia and Shankar (2020)
Prevent Osteoporosis	Shikonin promotes bone marrow mesenchymal stem cells differentiating into osteoblasts via β-catenin signaling pathway and inhibit the formation of osteoclasts.	Zhou et al. (2021)