Review Article

Rebalancing the inflammatory trajectory from inflammatory bowel disease to colitis-associated colorectal cancer via artemisinin-based multitarget therapy

Shi-jun He1, Mei-lin Tang2,3, Li Chen4,5, Jian-ping Zuo4,5, Han-chen Xu6,7, Ze-min Lin6,7
1 Innovation Research Institute of Traditional Chinese Medicine, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
2 Shanghai Pudong Hospital
3 Pharmacophenomics Laboratory Human Phenome Institute, Fudan University, Shanghai 201203, China
4 School of Pharmacy, University of Chinese Academy of Sciences, Beijing 100049, China
5 Laboratory of Immunopharmacology, State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
6 Institute of Digestive Diseases, Longhua Hospital, China-Canada Center of Research for Digestive Diseases (ccCRDD), Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
7 State Key Laboratory of Integration and Innovation of Classic Formula and Modern Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
Correspondence to: Shi-jun He: heshijun@shutcm.edu.cn, Han-chen Xu: hcxu@shutcm.edu.cn, Ze-min Lin: linzemin@simm.ac.cn,
DOI: 10.1038/s41401-025-01747-9
Received: 18 September 2025
Accepted: 26 December 2025
Advance online: 5 February 2026

Abstract

Inflammatory bowel disease (IBD) comprises Crohn’s disease and ulcerative colitis, and that is a major risk factor for colitis-associated colorectal cancer (CAC), a distinct and aggressive malignancy driven by chronic intestinal inflammation. Artemisinins, a group of sesquiterpene lactones derived from Artemisia annua, have emerged as promising therapeutic candidates for IBD due to their potent anti-inflammatory and anticancer properties. In this review, we summarize the current evidence that artemisinins exert diverse pharmacological actions including modulation of immune responses, reduction of oxidative stress, preservation of epithelial barrier function, and suppression of oncogenic signaling relevant to IBD and CAC. We also introduce the recent progress in formulation strategies designed to enhance the bioavailability, tissue specificity, and therapeutic efficacy of artemisinin-based agents. By bridging traditional medical philosophy with modern pharmacological insights, artemisinins represent a versatile platform for preventing and treating inflammation-driven colorectal cancer. This review offers a comprehensive overview of their translational potential in addressing the IBD-CAC continuum.
Keywords: inflammatory bowel disease; colorectal cancer; artemisinins; anti-inflammatory therapeutics; immune modulation; carcinogenesis

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