# The progress on stevia (Stevia rebaudiana Bertoni): chemical composition, pharmacokinetics, pharmacological effects, safety, applications, and biosynthesis

**Authors:** Zhi Peng, Shuang Zhan, Xiulian Yang, Sirui Huang, Huaxue Huang, Wei Wang

PMC · DOI: 10.3389/fnut.2026.1728578 · Frontiers in Nutrition · 2026-02-16

## TL;DR

This review summarizes the chemical makeup, health effects, safety, and uses of stevia, a natural sweetener, based on recent scientific findings.

## Contribution

This paper provides a comprehensive synthesis of multidisciplinary evidence on stevia glycosides, including their pharmacokinetics, pharmacology, and biosynthesis.

## Key findings

- Steviol glycosides are metabolized by gut microbiota, not the upper gastrointestinal tract, resulting in negligible caloric impact.
- Stevia extracts show antioxidant, anti-inflammatory, and protective effects on liver and kidneys through various mechanisms.
- Advanced biosynthetic methods are being developed to produce next-generation steviol glycosides like Rebaudioside M.

## Abstract

Stevia rebaudiana Bertoni (stevia) is renowned for its natural sweetening properties, attributed to a complex phytochemical profile rich in steviol glycosides (SGs), flavonoids, and phenolic compounds.

A systematic search of PubMed, Web of Science, and CNKI (Jan 2005–Sep 2025) using keywords related to Stevia yielded over 17,600 records. After deduplication and screening, around 200 full-text articles were evaluated. Additional key references were identified through citation tracking. Ultimately, over 140 sources were gathered to create a comprehensive overview prioritizing significant evidence.

The findings reveal that SGs are not metabolized in the upper gastrointestinal tract but are hydrolyzed exclusively by gut microbiota to steviol, accounting for their negligible caloric impact. Stevia extracts and their constituents exhibit a broad spectrum of potent pharmacological activities, including antioxidant, anti-inflammatory, anti-hyperglycemic, anti-hyperlipidemic, and hepatorenal protective effects, mediated through diverse molecular mechanisms. Toxicological evaluations confirm the safety of SGs, establishing an Acceptable Daily Intake of 4 mg kg–1 body weight. Beyond sweetening, Stevia finds applications in functional foods, animal feed, and agriculture. Furthermore, advanced biosynthetic strategies are being developed to overcome the sensory limitations of traditional SGs, with a focus on the enzymatic production of next-generation glycosides like Rebaudioside M.

This review integrates multidisciplinary evidence on SGs—encompassing chemistry, pharmacology, toxicology, applications, biosynthesis, and regulation—to create a cohesive synthesis and actionable visual frameworks. These resources aim to offer an evidence-based foundation for industry professionals, regulatory bodies, and researchers to effectively address critical priorities and identified gaps.

## Linked entities

- **Chemicals:** Rebaudioside M (PubChem CID 92023628), steviol (PubChem CID 452967)

## Full-text entities

- **Genes:** Lep (leptin) [NCBI Gene 25608] {aka OB, obese}, Adipoq (adiponectin, C1Q and collagen domain containing) [NCBI Gene 11450] {aka 30kDa, APN, Acdc, Acrp30, Ad, Adid}, Cat (catalase) [NCBI Gene 24248] {aka CS1, Cas1, Cat01, Catl, Cs-1}, TRPM5 (transient receptor potential cation channel subfamily M member 5) [NCBI Gene 29850] {aka LTRPC5, MTR1}, STX4 (syntaxin 4) [NCBI Gene 6810] {aka DFNB123, STX4A, p35-2}, Hmox1 (heme oxygenase 1) [NCBI Gene 15368] {aka D8Wsu38e, HO-1, HO1, Hemox, Hmox, Hsp32}, ESR2 (estrogen receptor 2) [NCBI Gene 2100] {aka ER-BETA, ESR-BETA, ESRB, ESTRB, Erb, NR3A2}, BAX (BCL2 associated X, apoptosis regulator) [NCBI Gene 581] {aka BCL2L4}, CYP4F3 (cytochrome P450 family 4 subfamily F member 3) [NCBI Gene 4051] {aka CPF3, CYP4F, CYPIVF3, LTB4H}, Nfkb1 (nuclear factor of kappa light polypeptide gene enhancer in B cells 1, p105) [NCBI Gene 18033] {aka NF-KB1, NF-kappaB, NF-kappaB1, p105, p50, p50/p105}, Nfe2l2 (nuclear factor, erythroid derived 2, like 2) [NCBI Gene 18024] {aka Nrf2}, Lepr (leptin receptor) [NCBI Gene 24536] {aka Fa}, Il1b (interleukin 1 beta) [NCBI Gene 24494] {aka IL-1F2}, Tnf (tumor necrosis factor) [NCBI Gene 24835] {aka RATTNF, TNF-alpha, Tnfa}, TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, Il6 (interleukin 6) [NCBI Gene 24498] {aka ILg6, Ifnb2}, Ppara (peroxisome proliferator activated receptor alpha) [NCBI Gene 25747] {aka PPAR}, IRS1 (insulin receptor substrate 1) [NCBI Gene 3667] {aka HIRS-1}, Pik3r1 (phosphoinositide-3-kinase regulatory subunit 1) [NCBI Gene 18708] {aka PI3K, p50alpha, p55alpha, p85alpha}, TP53 (tumor protein p53) [NCBI Gene 7157] {aka BCC7, BMFS5, LFS1, P53, TRP53}, Ctnnb1 (catenin beta 1) [NCBI Gene 84353] {aka Catnb}, SNAP23 (synaptosome associated protein 23) [NCBI Gene 8773] {aka HsT17016, SNAP-23, SNAP23A, SNAP23B}, ACE (angiotensin I converting enzyme) [NCBI Gene 1636] {aka ACE1, CD143, DCP, DCP1}, Tgfb1 (transforming growth factor, beta 1) [NCBI Gene 59086] {aka Tgfb}, Lep (leptin) [NCBI Gene 16846] {aka ob, obese}, Aqp2 (aquaporin 2) [NCBI Gene 25386] {aka AQP-2, aquaporin-2}, INSR (insulin receptor) [NCBI Gene 3643] {aka CD220, HHF5}, Keap1 (Kelch-like ECH-associated protein 1) [NCBI Gene 117519] {aka Inrf2}, Slc2a2 (solute carrier family 2 member 2) [NCBI Gene 25351] {aka GTT2, Glut2}, TGFB1 (transforming growth factor beta 1) [NCBI Gene 7040] {aka CAEND1, CED, DPD1, IBDIMDE, LAP, TGF-beta1}, SULT1E1 (sulfotransferase family 1E member 1) [NCBI Gene 6783] {aka EST, EST-1, ST1E1, STE}, Sqstm1 (sequestosome 1) [NCBI Gene 113894] {aka Osi, ZIP, ZIP3}, SLC2A4 (solute carrier family 2 member 4) [NCBI Gene 6517] {aka GLUT4}, PIK3R1 (phosphoinositide-3-kinase regulatory subunit 1) [NCBI Gene 5295] {aka AGM7, GRB1, IMD36, p85, p85-ALPHA, p85alpha}, MAPK1 (mitogen-activated protein kinase 1) [NCBI Gene 5594] {aka ERK, ERK-2, ERK2, ERT1, MAPK2, NS13}, BCL2 (BCL2 apoptosis regulator) [NCBI Gene 596] {aka Bcl-2, PPP1R50}, Tyms (thymidylate synthetase) [NCBI Gene 29261], PPARA (peroxisome proliferator activated receptor alpha) [NCBI Gene 5465] {aka NR1C1, PPAR, PPAR-alpha, PPARalpha, hPPAR}, Nfe2l2 (NFE2 like bZIP transcription factor 2) [NCBI Gene 83619], H3P16 (H3 histone pseudogene 16) [NCBI Gene 644914] {aka H3.6, H3F3AP6, p21}, NFKBIA (NFKB inhibitor alpha) [NCBI Gene 4792] {aka EDAID2, IKBA, MAD-3, NFKBI}, PMAIP1 (phorbol-12-myristate-13-acetate-induced protein 1) [NCBI Gene 5366] {aka APR, NOXA}, ESR1 (estrogen receptor 1) [NCBI Gene 2099] {aka ER, ESR, ESRA, ESTRR, Era, NR3A1}, tor (tortured) [NCBI Gene 21977], Wnt2 (Wnt family member 2) [NCBI Gene 114487] {aka Wnt}, SLC2A1 (solute carrier family 2 member 1) [NCBI Gene 6513] {aka CSE, DYT17, DYT18, DYT9, EIG12, GLUT}, Akt1 (Akt serine/threonine kinase 1) [NCBI Gene 11651] {aka Akt, LTR-akt, PKB, PKB/Akt, PKBalpha, Rac}, Stat3 (signal transducer and activator of transcription 3) [NCBI Gene 20848] {aka 1110034C02Rik, Aprf}, GSK3B (glycogen synthase kinase 3 beta) [NCBI Gene 2932]
- **Diseases:** tubular necrosis (MESH:D007683), Tumor (MESH:D009369), metabolic dysbiosis (MESH:D064806), Diabetes (MESH:D003920), liver cirrhosis (MESH:D008103), LGL leukemia (MESH:D054066), hepatorenal (MESH:D006530), CKD (MESH:D051436), Chronic inflammation (MESH:D007249), liver or kidney diseases (MESH:D008107), injury (MESH:D014947), metabolic syndrome (MESH:D024821), hyperglycemia (MESH:D006943), bitter taste (MESH:D013651), hyperlipidemia (MESH:D006949), fibrosis (MESH:D005355), gastroenteritis (MESH:D005759), pancreatic cancer (MESH:D010190), genetic (MESH:D030342), acute and chronic diseases (MESH:D000208), weight gain (MESH:D015430), hepatic steatosis (MESH:D005234), skin tumor (MESH:D012878), obese (MESH:D009765), gastric cancer (MESH:D013274), autoimmune disorders (MESH:D001327), mammary adenoma (MESH:D000236), carcinogenic effects (MESH:D065606), diarrhea (MESH:D003967), cardiovascular diseases (MESH:D002318), infection (MESH:D007239), glomerular hypertrophy (MESH:D006984), acute liver injury (MESH:D017114), toxicity (MESH:D064420), bone loss (MESH:D001847), insulin resistance (MESH:D007333), tumor suppressor (OMIM:601308), caries (MESH:D003731), diarrheal (MESH:D004403), Carcinogenic (MESH:D011230), hypertension (MESH:D006973), hyperglycemic (MESH:D006944), atherosclerosis (MESH:D050197), colorectal cancer (MESH:D015179), hepatocellular carcinoma (MESH:D006528), periodontal disease (MESH:D010510), necrosis (MESH:D009336), tissue damage (MESH:D017695), bladder cancer (MESH:D001749), T2DM (MESH:D003924), inflammatory cytokine (MESH:D000080424), irritable bowel syndrome (MESH:D043183), kidney injury (MESH:D007674), inflammatory bowel disease (MESH:D015212), breast cancer (MESH:D001943), liver and kidney damage (MESH:D056486), ovarian cancer (MESH:D010051), liver injury (MESH:D017093), allergic diseases (MESH:D004342), Type 1 diabetes mellitus (MESH:D003922)
- **Chemicals:** bilirubin (MESH:D001663), polysaccharide (MESH:D011134), Steviol (MESH:C012042), TPA (MESH:D013755), quercetin (MESH:D011794), uric acid (MESH:D014527), ciprofloxacin (MESH:D002939), CCl4 (MESH:D002251), ester (MESH:D004952), TG (MESH:D014280), rutin (MESH:D012431), carbon (MESH:D002244), sucralose (MESH:C026285), methanol (MESH:D000432), maltodextrin (MESH:C008315), sugar (MESH:D000073893), CaCl2 (MESH:D002122), glycolipid (MESH:D006017), aglycone (MESH:C458179), inulin (MESH:D007444), alkaloids (MESH:D000470), adenine (MESH:D000225), gentamicin (MESH:D005839), cholesterol (MESH:D002784), Ethanol (MESH:D000431), quinic acid (MESH:D011801), D-galactose (MESH:D005690), sodium hydroxide (MESH:D012972), blood glucose (MESH:D001786), 5-fluorouracil (MESH:D005472), purines (MESH:D011687), water (MESH:D014867), zinc oxide (MESH:D015034), 7,12-dimethylbenz[a]anthracene (MESH:D015127), dulcoside A (MESH:C524469), kaempferol (MESH:C006552), allulose (MESH:C003243), phenolic acid (MESH:C017616), AA (MESH:D016718), rebaudioside A (MESH:C025474), STZ (MESH:D013311), apigenin (MESH:D047310), aspartame (MESH:D001218), fluoride (MESH:D005459), essential oils (MESH:D009822), sophorose (MESH:C003328), butyrate (MESH:D002087), amino acids (MESH:D000596), propionate (MESH:D011422), isochlorogenic acid (MESH:C469310), MDA (MESH:D008315), acetone (MESH:D000096), carbohydrate (MESH:D002241), malachite green (MESH:C005095), Ethyl acetate (MESH:C007650), H2O2 (MESH:D006861), isosteviol (MESH:C515747), Ca2+ (-), hexane (MESH:D006586), TA102 (MESH:C000613803)
- **Species:** Caenorhabditis elegans (species) [taxon 6239], Mus musculus (house mouse, species) [taxon 10090], Yarrowia lipolytica (species) [taxon 4952], Canis lupus familiaris (dog, subspecies) [taxon 9615], Saccharomyces cerevisiae (baker's yeast, species) [taxon 4932], Streptococcus mutans (species) [taxon 1309], Escherichia coli O78 (serogroup) [taxon 2072463], Stevia rebaudiana (species) [taxon 55670], Candida albicans (species) [taxon 5476], Streptococcus sobrinus (species) [taxon 1310], Escherichia coli (E. coli, species) [taxon 562], Sus scrofa (pig, species) [taxon 9823], Lactobacillus acidophilus (species) [taxon 1579], Salmonella enterica subsp. enterica serovar Typhimurium (no rank) [taxon 90371], Enterococcus faecalis (species) [taxon 1351], Ligilactobacillus apodemi (species) [taxon 307126], Staphylococcus aureus (species) [taxon 1280], Rattus norvegicus (brown rat, species) [taxon 10116], human gammaherpesvirus 4 (Epstein Barr virus, no rank) [taxon 10376], Bacteria Latreille et al. 1825 (Bacteria stick insect, genus) [taxon 629395], Bacteroides (genus) [taxon 816], Homo sapiens (human, species) [taxon 9606], Porphyromonas gingivalis (species) [taxon 837], Stevia (genus) [taxon 55669], Gallus gallus (bantam, species) [taxon 9031], Rotavirus (genus) [taxon 10912], gut metagenome (species) [taxon 749906], Bacillus (genus) [taxon 55087], Cavia porcellus (domestic guinea pig, species) [taxon 10141]
- **Mutations:** L200A, T284S, M88L
- **Cell lines:** MKN-45 — Homo sapiens (Human), Gastric adenocarcinoma, Cancer cell line (CVCL_0434), Raji lymphoma — Homo sapiens (Human), EBV-related Burkitt lymphoma, Cancer cell line (CVCL_0511), CHL — Cricetulus griseus (Chinese hamster), Spontaneously immortalized cell line (CVCL_0212), HepG2 — Homo sapiens (Human), Hepatoblastoma, Cancer cell line (CVCL_0027), MGC-803 — Homo sapiens (Human), Hybrid cell line (CVCL_5334), HCT-8 — Homo sapiens (Human), Colon adenocarcinoma, Cancer cell line (CVCL_2478), MCF-7 — Homo sapiens (Human), Invasive breast carcinoma of no special type, Cancer cell line (CVCL_0031), HCT-116 — Homo sapiens (Human), Colon carcinoma, Cancer cell line (CVCL_0291), MDA-MB-231 — Homo sapiens (Human), Breast adenocarcinoma, Cancer cell line (CVCL_0062), TM677 — Cricetulus griseus (Chinese hamster), Spontaneously immortalized cell line (CVCL_4593), Caco-2 — Homo sapiens (Human), Colon adenocarcinoma, Cancer cell line (CVCL_0025), HGC-27 — Homo sapiens (Human), Gastric carcinoma, Cancer cell line (CVCL_1279), SKOV3 — Homo sapiens (Human), Ovarian serous cystadenocarcinoma, Cancer cell line (CVCL_0532)

## Full text

_Full body text omitted from this summary view._ Fetch the complete paper as Markdown: https://tomesphere.com/paper/PMC12950799/full.md

## Figures

6 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12950799/full.md

## References

151 references — full list in the complete paper: https://tomesphere.com/paper/PMC12950799/full.md

---
Source: https://tomesphere.com/paper/PMC12950799