The mechanism of floral mutation including double flowers in plant species can be explained by the ABCDE model which represents the relationship between MADS-box transcription factor genes and floral morphogenesis. The ornamental importance of Cyclamen led to the creation of double-flowered cultivars caused by the repression of AG-like gene expression in whorl 3. Modifications in these genes also influence the accumulation of different bioactive compounds depending on species and/or variety. In antiquity, cyclamen plants were recognized for their therapeutic qualities and later gained importance due to their content in saponins, which have been reported to exhibit anti-cancer, anti-inflammatory and antibacterial effects, and also to alleviate symptoms in acute rhinosinusitis patients. Furthermore, the extracts and isolated compounds are used as treatments in a wide range of diseases. In this review, we describe the transcription factors and their role in the development and ABCDE model formation of organs which led to the development of double-petal and fragrant varieties. Additionally, we describe the potential mechanisms of action underlying the therapeutic effects of saponin extracts against cancers and inflammatory disorders and their potential as a pharmacological agent in clinical studies.
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