Dendrobium officinale (DO) is a well-recognized medicinal and edible plant with a long history of application in traditional medicinal practices across China and Southeast Asia. Recent studies have demonstrated that DO is abundant in diverse bioactive compounds, including polysaccharides (DOP), flavonoids, alkaloids, and bibenzyls thought to exert a range of pharmacological effects, such as anti-tumor and immunomodulatory effects. However, our comprehensive understanding of two key aspects-pharmacological functions and biosynthetic mechanisms-of DO's major constituents remains limited, especially when considered within the clinical contexts of traditional use. To address this gap, this study reviews DO's historical applications, clinical effects, and related formulations through an analysis of ancient texts spanning nearly two millennia-with special attention to region-specific traditional medical texts. This provides a historical and empirical foundation for further exploration of its modern pharmacological potential. Given the central role of DOP in DO's biological activities, this paper further summarizes its therapeutic applications across various diseases and the underlying mechanisms, with special emphasis on structure-activity relationships. This focus is particularly important because the structural characteristics of DOP are highly dependent on extraction and analytical methods, which have contributed to inconsistencies in pharmacological findings over the past two decades. Finally, the review highlights recent advances in the understanding of the in vivo biosynthesis and regulatory mechanisms of the major bioactive components in DO, with a particular focus on molecular regulation and responses to agricultural interventions. These factors are critical for the production of high-quality DO. Overall, this study develops a comprehensive knowledge framework that connects DO's traditional applications of DO to its two key research areas: pharmacological functions and quality formation. We anticipate this framework will offer clear guidance for future research from a clinical perspective.

Interactions between macrophages and adipocytes in adipose tissue are critical for the regulation of energy metabolism and obesity. Macrophage polarization induced by cold or other stimulations can drive metabolic reprogramming of adipocytes, browning, and thermogenesis. Accordingly, investigating the roles of macrophages and adipocytes in the maintenance of energy homeostasis is critical for the development of novel therapeutic approaches specifically targeting macrophages in metabolic disorders such as obesity. Current review outlines macrophage polarization not only regulates the release of central nervous system and inflammatory factors, but controls mitochondrial function, and other factor that induce metabolic reprogramming of adipocytes and maintain energy homeostasis. We also emphasized on how the adipocytes conversely motivate the polarization of macrophage. Exploring the interactions between adipocytes and macrophages may provide new therapeutic strategies for the management of obesity-related metabolic diseases.