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Hasriadi, Dasuni Wasana PW, Thongphichai W, Samun Y, Sukrong S, Towiwat P. Curcuma latifolia Roscoe extract reverses inflammatory pain in mice and offers a favorable CNS safety profile. JOURNAL OF ETHNOPHARMACOLOGY 2024; 318:116877. [PMID: 37442490 DOI: 10.1016/j.jep.2023.116877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Curcuma latifolia Roscoe, a plant in the Curcuma genus, has been used as a food additive and folk medicine in Thailand to treat pelvic pain and improve premenstrual syndrome. Although it has been used for centuries, no scientific studies have proved its potential effects on inflammatory pain and central nervous system (CNS) safety profiles. AIM OF THE STUDY This study aimed to evaluate the potential effects of the ethanolic extract of C. latifolia rhizome on inflammatory pain in mice, together with its CNS safety profiles. MATERIALS AND METHODS First, network pharmacology was employed to identify the role of bioactive constituents in C. latifolia on inflammatory pain. In addition, in vitro pharmacology was also evaluated to confirm the anti-inflammatory activity of C. latifolia extract at cellular levels in activated macrophages and microglia. Furthermore, the efficacy of the plant extract in attenuating formalin-induced pain-like behaviors in mice was evaluated. Mice were orally administered the extract (125, 250, 500 mg/kg) followed by the measurement of formalin-induced pain-like behaviors. The LABORAS automated behavioral analysis and rotarod test were used to assess potential CNS side effects of C. latifolia extract (500 mg/kg) in mice. RESULTS The results demonstrated that major bioactive constituents present in C. latifolia have the ability to regulate multiple targets, biological processes and pathways associated with inflammatory pain as assessed by network pharmacology. C. latifolia modulated peripheral and central immune cells via reducing proinflammatory mediators (NO, TNF-α, and IL-6). C. latifolia extract improved formalin-induced pain-like behaviors in a dose-dependent manner during phase II of the formalin test. The efficacy of the plant extract at doses of 250 and 500 mg/kg was comparable to that of the positive control (indomethacin 10 mg/kg). Furthermore, the highest therapeutic dose of the extract did not affect motor coordination, exploratory behaviors, general behaviors, and overall well-being of mice, indicating no development of potential CNS adverse effects after administration of the extract. CONCLUSION These findings provide novel perspectives on using C. latifolia extract for pain management, considering its therapeutic efficacy and CNS safety.
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Affiliation(s)
- Hasriadi
- Department of Pharmacology and Physiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, 10330, Bangkok, Thailand.
| | - Peththa Wadu Dasuni Wasana
- Pharmaceutical Sciences and Technology Program, Faculty of Pharmaceutical Sciences, Chulalongkorn University, 10330, Bangkok, Thailand; Department of Pharmacy, Faculty of Allied Health Sciences, University of Ruhuna, Galle, 80000, Sri Lanka.
| | - Wisuwat Thongphichai
- Center of Excellence in DNA Barcoding of Thai Medicinal Plants, Chulalongkorn University, Bangkok, 10330, Thailand.
| | - Yodsagon Samun
- Center of Excellence in DNA Barcoding of Thai Medicinal Plants, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Suchada Sukrong
- Center of Excellence in DNA Barcoding of Thai Medicinal Plants, Chulalongkorn University, Bangkok, 10330, Thailand; Department of Pharmacognosy and Pharmaceutical Botany, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand.
| | - Pasarapa Towiwat
- Department of Pharmacology and Physiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, 10330, Bangkok, Thailand; Natural Products for Ageing and Chronic Diseases Research Unit, Chulalongkorn University, Bangkok, 10330, Thailand.
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Kim E, Cho MR, Byun SH, A Lim J, Chae S, Choi WK, Kim I, Kim J. Sympathetic predominance before tourniquet deflation is associated with a reduction in arterial blood pressure after tourniquet deflation during total knee arthroplasty. Physiol Res 2021; 70:401-412. [PMID: 33982581 DOI: 10.33549/physiolres.934639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
High dependency of arterial blood pressure (ABP) on enhanced sympathetic activity, which maintains vascular tone, leads to hypotension after hemodynamic insults that blunt the sympathetic activity. Therefore, we hypothesized that sympathovagal balance before tourniquet deflation (TD) determines the extent of a reduction in ABP after TD during total knee arthroplasty (TKA). Fifty-four hypertensive female patients undergoing TKA under spinal anesthesia were analyzed. The sympathovagal balance [low-to-high frequency ratio of heart rate variability (LF/HF)] before TD was defined as (LF/HF during 5 min before TD-preanesthetic LF/HF)/preanesthetic LF/HF (%). An increase in its value represents a shift in sympathovagal balance toward sympathetic predominance. The percent change in the mean ABP (MAP) after TD was defined as (minimum MAP during 10 min after TD-averaged MAP during 5 min before TD)/averaged MAP during 5 min before TD (%). Simple linear regression was performed to assess the correlation between the sympathovagal balance before TD and change in MAP after TD. The correlation was also assessed by multiple linear regression controlling for age, duration of tourniquet inflation, and spinal anesthesia-induced hypotension. Thirty-two minutes (on average) after tourniquet inflation, the MAP was decreased by 12.1 (-3.0 to 47.9) % [mean (range)] upon TD (P<0.001). The sympathovagal balance before TD was negatively proportional to the change in MAP after TD in both simple and multiple linear regression models (R2=0.323 and 0.340, P<0.001). A shift in sympathovagal balance toward sympathetic predominance before TD is associated with a decrease in ABP after TD.
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Affiliation(s)
- E Kim
- Department of Anesthesiology and Pain Medicine, Daegu Catholic University Medical Center, School of Medicine, Daegu Catholic University, Daegu, Republic of Korea.
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Shenxian-Shengmai Oral Liquid Improves Sinoatrial Node Dysfunction through the PKC/NOX-2 Signaling Pathway. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5572140. [PMID: 33936239 PMCID: PMC8055400 DOI: 10.1155/2021/5572140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/23/2021] [Accepted: 03/30/2021] [Indexed: 11/18/2022]
Abstract
Sick sinus syndrome (SSS) is one of the common causes of cardiac syncope and sudden death; the occurrence of SSS is associated with the accumulation of ROS in the sinoatrial node (SAN). Shenxian-shengmai (SXSM) is a traditional Chinese medicine available as oral liquid that causes a significant increase in heart rate. The objective of this study is to observe the improvement of SXSM on SAN function in SSS mice and explore its potential mechanism. In the current study, SSS was simulated in mice by inducing SAN dysfunction using a micro-osmotic pump to inject angiotensin II (Ang II). The mouse model with SSS was used to determine the effect of SXSM on SAN function and to explore its potential mechanism. Furthermore, the HL-1 cell line, derived from mouse atrial myocytes, was used to simulate SAN pacemaker cells. Our results indicated that SXSM significantly increased the heart rate of SSS mice by reducing the AngII-induced accumulation of ROS in the SAN and by inhibiting the expression of HDAC4, thereby reducing the loss of HCN4, a critical component of the cardiac conduction system. MASSON staining revealed a reduction of SAN damage in SSS mice that were treated with SXSM compared with controls. In vitro experiments showed that AngII treatment caused an upregulation of the PKC/NOX-2 signaling pathway in HL-1 cells which could be prevented by pretreatment with SXSM. The protective effect of SXSM was attenuated upon treatment with the PCK agonist PMA. In conclusion, SXSM reduced the AngII-induced accumulation of ROS in the SAN through the PKC/NOX2 signaling pathway, improving the functioning of the SAN and preventing the decrease of heart rate in SSS mice.
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Komolafe K, Komolafe TR, Fatoki TH, Akinmoladun AC, Brai BIC, Olaleye MT, Akindahunsi AA. Coronavirus Disease 2019 and Herbal Therapy: Pertinent Issues Relating to Toxicity and Standardization of Phytopharmaceuticals. REVISTA BRASILEIRA DE FARMACOGNOSIA : ORGAO OFICIAL DA SOCIEDADE BRASILEIRA DE FARMACOGNOSIA 2021; 31:142-161. [PMID: 33727754 PMCID: PMC7951132 DOI: 10.1007/s43450-021-00132-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/19/2021] [Indexed: 12/12/2022]
Abstract
Coronavirus disease 2019 (COVID-19) is a virulent viral disease that has now become a public health emergency of global significance and still without an approved treatment regimen or cure. In the absence of curative drugs and with vaccines development still in progress, alternative approaches to stem the tide of the pandemic are being considered. The potential of a phytotherapeutic approach in the management of the dreaded disease has gained attention, especially in developing countries, with several claims of the development of anti-COVID-19 herbal formulations. This is a plausible approach especially with the increasing acceptance of herbal medicine in both alternative and orthodox medical practices worldwide. Also, the established efficacy of herbal remedies in the treatment of numerous viral diseases including those caused by coronaviruses, as well as diseases with symptoms associated with COVID-19, presents a valid case for serious consideration of herbal medicine in the treatment of COVID-19. However, there are legitimate concerns and daunting challenges with the use of herbs and herbal products. These include issues of quality control, unethical production practice, inadequate information on the composition, use and mechanisms, weak regulatory policies, herb-drug interactions and adverse reactions, and the tendency for abuse. This review discusses the feasibility of intervention with herbal medicine in the COVID-19 pandemic and the need to take proactive measures to protect public health by improving the quality and safety of herbal medicine deployed to combat the disease. Graphical abstract. Supplementary Information The online version contains supplementary material available at 10.1007/s43450-021-00132-x.
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Affiliation(s)
- Kayode Komolafe
- Department of Biochemistry, Faculty of Science, Federal University Oye-Ekiti, PMB 373, Oye-Ekiti, Nigeria
| | - Titilope Ruth Komolafe
- Department of Biochemistry, Faculty of Science, Federal University Oye-Ekiti, PMB 373, Oye-Ekiti, Nigeria
- Department of Biochemistry, School of Sciences, The Federal University of Technology, PMB 704, Akure, Nigeria
| | - Toluwase Hezekiah Fatoki
- Department of Biochemistry, School of Sciences, The Federal University of Technology, PMB 704, Akure, Nigeria
| | - Afolabi Clement Akinmoladun
- Department of Biochemistry, School of Sciences, The Federal University of Technology, PMB 704, Akure, Nigeria
| | - Bartholomew I. C. Brai
- Department of Biochemistry, Faculty of Science, Federal University Oye-Ekiti, PMB 373, Oye-Ekiti, Nigeria
| | - Mary Tolulope Olaleye
- Department of Biochemistry, School of Sciences, The Federal University of Technology, PMB 704, Akure, Nigeria
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Yao D, Hu H, Harnett JE, Ung COL. Integrating traditional Chinese medicines into professional community pharmacy practice in China - Key stakeholder perspectives. Eur J Integr Med 2020; 34:101063. [PMID: 32288883 PMCID: PMC7102831 DOI: 10.1016/j.eujim.2020.101063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 02/04/2020] [Accepted: 02/04/2020] [Indexed: 12/17/2022]
Abstract
Introduction In China, Traditional Chinese Medicine (TCM) is an integral part of the health system in parallel with Western medicine (WM). However, pharmacists’ duty of care at this interface has not been fully explored. This qualitative study aimed to explore key stakeholders’ perceptions about the challenges and enablers to pharmacists’ adopting a professional role in patient care associated with the concurrent use of herbal medicines (HMs). Methods Participants were recruited from the expert pool of the National Research Center for Licensed Pharmacist Development using purposive sampling and snowballing. Participants targeted included government, academics and practicing pharmacists. An interview guide was developed following a literature review and face-to-face, audiotaped interviews conducted with key stakeholders. Results Fourteen semi-structured interviews with both practicing pharmacists and key stakeholder representatives were conducted in China in 2017. Thematic analysis identified 6 main themes which focused on how TCM was integrated with WM in China. Participants agreed that pharmacists should at least assume a role in drug safety associated with concurrent use of TCM and WM. However, barriers were identified within the government, education, pharmacy, pharmacist and research sectors, indicating a lack of coordinated strategies to improve this area of healthcare. A lack of clarity in defining the pharmacists’ role in this area and a disconnect between current regulatory standards and education/training system were the prominent themes. Participants looked towards the government to facilitate actions in the development of policies that support pharmacy practice and practice guidelines, and the review of competency standards, and registration criteria as being the most important enablers. Conclusion Guiding principles that outline standards for pharmacy practice regarding HMs in an integrated healthcare system are considered a priority, requiring a joint effort from the government, professional organizations and universities.
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Affiliation(s)
- Dongning Yao
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Hao Hu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Joanna E Harnett
- The University of Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China.,The University of Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Australia
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Li J, Xiong C, He X, Lu Z, Zhang X, Chen X, Sun W. Using SSR-HRM to Identify Closely Related Species in Herbal Medicine Products: A Case Study on Licorice. Front Pharmacol 2018; 9:407. [PMID: 29740326 PMCID: PMC5928318 DOI: 10.3389/fphar.2018.00407] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 04/09/2018] [Indexed: 12/15/2022] Open
Abstract
Traditional herbal medicines have played important roles in the ways of life of people around the world since ancient times. Despite the advanced medical technology of the modern world, herbal medicines are still used as popular alternatives to synthetic drugs. Due to the increasing demand for herbal medicines, plant species identification has become an important tool to prevent substitution and adulteration. Here we propose a method for biological assessment of the quality of prescribed species in the Chinese Pharmacopoeia by use of high resolution melting (HRM) analysis of microsatellite loci. We tested this method on licorice, a traditional herbal medicine with a long history. Results showed that nine simple sequence repeat (SSR) markers produced distinct melting curve profiles for the five licorice species investigated using HRM analysis. These results were validated by capillary electrophoresis. We applied this protocol to commercially available licorice products, thus enabling the consistent identification of 11 labels with non-declared Glycyrrhiza species. This novel strategy may thus facilitate DNA barcoding as a method of identification of closely related species in herbal medicine products. Based on this study, a brief operating procedure for using the SSR-HRM protocol for herbal authentication is provided.
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Affiliation(s)
- Jingjian Li
- College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou, China
| | - Chao Xiong
- College of Pharmacy, Hubei University of Chinese Medicine, Wuhan, China
| | - Xia He
- College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou, China
| | - Zhaocen Lu
- Guangxi Institute of Botany, The Chinese Academy of Sciences, Guilin, China
| | - Xin Zhang
- College of Biological Science and Engineering, Beifang University of Nationalities, Yinchuan, China
| | - Xiaoyang Chen
- College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou, China
| | - Wei Sun
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
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Teng L, Zu Q, Li G, Yu T, Job KM, Yang X, Di L, Sherwin CM, Enioutina EY. Herbal medicines: challenges in the modern world. Part 3. China and Japan. Expert Rev Clin Pharmacol 2016; 9:1225-33. [PMID: 27232545 DOI: 10.1080/17512433.2016.1195263] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Medicinal plants, and formulations prepared from them, have been used in China and Japan for thousands of years. Nowadays, ancient formulations of Traditional Chinese and Kampo (Japanese) Medicines coexist with Western herbal medicines (HMs) and complement each other. HMs are used for the treatment of mild and chronic diseases, as an adjunct therapy, to improve wellbeing and delay aging, or as healthy (functional) foods. AREAS COVERED This article, a third part in a series of reviews, is focusing on history, use and regulation of the traditional and modern HMs in Japan and China. Materials available from legislative and governmental websites, PubMed and news media were used. Expert commentary: HMs are heavily regulated in both countries, often in a similar manner as conventional pharmaceutical drugs. The majority of herbal formulations are sold as over-the-counter medications supplied with leaflets describing indications and appropriate dosages for patients of different ages. Medical practitioners prescribe herbal formulations that are tailored to the needs of particular patients. Both countries had problems with adverse drug reactions and toxicity of single herbs and herbal formulations that have been investigated by authorities, and some drugs have been removed from the market.
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Affiliation(s)
- Lida Teng
- a Department of Drug Policy & Management, Graduate School of Pharmaceutical Sciences , The University of Tokyo , Tokyo , Japan
| | - Qiang Zu
- b School of Pharmacy , Nanjing University of Chinese Medicine , Nanjing , China.,c Jiangsu Engineering Research Center for Efficient Delivery System of Traditional Chinese Medicine , Nanjing , China.,d Nanjing Engineering Research Center for Industrialization Traditional Chinese Medicine Pellets , Nanjing , China
| | - Gangzhou Li
- e Division of Clinical Pharmacology, the Department of Pediatrics , University of Utah School of Medicine , Salt Lake City , UT , USA
| | - Tian Yu
- e Division of Clinical Pharmacology, the Department of Pediatrics , University of Utah School of Medicine , Salt Lake City , UT , USA
| | - Kathleen M Job
- e Division of Clinical Pharmacology, the Department of Pediatrics , University of Utah School of Medicine , Salt Lake City , UT , USA
| | - Xiaoyan Yang
- f Division of Pharmaceutical Sciences, School of Pharmacy , University of Missouri-Kansas City , Kansas City , MI , USA
| | - Liuqing Di
- b School of Pharmacy , Nanjing University of Chinese Medicine , Nanjing , China.,c Jiangsu Engineering Research Center for Efficient Delivery System of Traditional Chinese Medicine , Nanjing , China.,d Nanjing Engineering Research Center for Industrialization Traditional Chinese Medicine Pellets , Nanjing , China
| | - Catherine Mt Sherwin
- e Division of Clinical Pharmacology, the Department of Pediatrics , University of Utah School of Medicine , Salt Lake City , UT , USA.,g Department of Pharmacology and Toxicology , University of Utah , Salt Lake City , UT , USA
| | - Elena Y Enioutina
- e Division of Clinical Pharmacology, the Department of Pediatrics , University of Utah School of Medicine , Salt Lake City , UT , USA.,h Division of Microbiology and Immunology, the Department of Pathology , University of Utah School of Medicine , Salt Lake City , UT , USA
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Wei P, Huo HL, Ma QH, Li HC, Xing XF, Tan XM, Luo JB. Pharmacokinetic comparisons of five ephedrine alkaloids following oral administration of four different Mahuang-Guizhi herb-pair aqueous extracts ratios in rats. JOURNAL OF ETHNOPHARMACOLOGY 2014; 155:642-648. [PMID: 24929107 DOI: 10.1016/j.jep.2014.05.065] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 05/23/2014] [Accepted: 05/31/2014] [Indexed: 06/03/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Herba Ephedra (Mahuang in Chinese), is derived from dried Ephedra sinica Stapf stems and has been widely used to treat the common cold, coughs, asthma, and edema for thousands of years. The Mahuang-Guizhi herb-pair is a famous formula composed of Mahuang and Ramulus Cinnamomi (Guizhi in Chinese, the dried twig of Cinnamomum cassia Presl.), used to improve pharmacological effects and reduce toxicity. In order to investigate the influence of Mahuang-Guizhi herb-pair ratios on bioavailability, the plasma pharmacokinetics profiles of five ephedrine alkaloids were compared following oral administration of four different ratios to rats. MATERIALS AND METHODS Sprague-Dawley rats were randomly assigned to four groups and orally administered Mahuang-Guizhi (ratios 3:0; 3:1; 3:2; 3:4, w/w). Assays for five ephedrine alkaloids (ephedrine, pseudoephedrine, methylephedrine, norephedrine, and norpseudoephedrine) were developed and validated using ultra-high-performance liquid chromatography tandem mass spectrometry coupled with liquid-liquid extraction. RESULTS Key pharmacokinetic parameters of the five ephedrine alkaloids (maximal plasma concentration, mean residence time, and half-life) were significantly different (p<0.05) after oral administration of Mahuang-Guizhi herb-pair ratios, as compared to those of Mahuang. CONCLUSION Ephedrine alkaloid pharmacokinetic differences in rat plasma could help explain previous findings of pharmacological and toxicity differences between Mahuang and Mahuang-Guizhi herb-pair preparations. These results could facilitate future studies to increase the efficacy and decrease the toxicity of Mahuang and Guizhi.
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Affiliation(s)
- Ping Wei
- School of Chinese Medical Sciences, Southern Medical University, 510515 Guangzhou, PR China
| | - Hui-ling Huo
- School of Chinese Medical Sciences, Southern Medical University, 510515 Guangzhou, PR China
| | - Qing-hai Ma
- School of Chinese Medical Sciences, Southern Medical University, 510515 Guangzhou, PR China
| | - Han-cheng Li
- School of Chinese Medical Sciences, Southern Medical University, 510515 Guangzhou, PR China
| | - Xue-feng Xing
- School of Chinese Medical Sciences, Southern Medical University, 510515 Guangzhou, PR China; Guangdong Province Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou, PR China.
| | - Xiao-mei Tan
- School of Chinese Medical Sciences, Southern Medical University, 510515 Guangzhou, PR China; Guangdong Province Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou, PR China
| | - Jia-bo Luo
- School of Chinese Medical Sciences, Southern Medical University, 510515 Guangzhou, PR China; Guangdong Province Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou, PR China.
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Ekor M. The growing use of herbal medicines: issues relating to adverse reactions and challenges in monitoring safety. Front Pharmacol 2014; 4:177. [PMID: 24454289 PMCID: PMC3887317 DOI: 10.3389/fphar.2013.00177] [Citation(s) in RCA: 1224] [Impact Index Per Article: 122.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 12/23/2013] [Indexed: 12/11/2022] Open
Abstract
The use of herbal medicinal products and supplements has increased tremendously over the past three decades with not less than 80% of people worldwide relying on them for some part of primary healthcare. Although therapies involving these agents have shown promising potential with the efficacy of a good number of herbal products clearly established, many of them remain untested and their use are either poorly monitored or not even monitored at all. The consequence of this is an inadequate knowledge of their mode of action, potential adverse reactions, contraindications, and interactions with existing orthodox pharmaceuticals and functional foods to promote both safe and rational use of these agents. Since safety continues to be a major issue with the use of herbal remedies, it becomes imperative, therefore, that relevant regulatory authorities put in place appropriate measures to protect public health by ensuring that all herbal medicines are safe and of suitable quality. This review discusses toxicity-related issues and major safety concerns arising from the use of herbal medicinal products and also highlights some important challenges associated with effective monitoring of their safety.
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Affiliation(s)
- Martins Ekor
- Department of Pharmacology, School of Medical Sciences, University of Cape Coast Cape Coast, Ghana
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Kainuma M, Furusyo N, Ando SI, Mukae H, Ogawa E, Toyoda K, Murata M, Hayashi J. Nocturnal Difference in the Ultra Low Frequency Band of Heart Rate Variability in Patients Stratified by Kampo Medicine Prescription. Circ J 2014; 78:1924-7. [DOI: 10.1253/circj.cj-14-0362] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Mosaburo Kainuma
- Community Medicine Education Unit, Graduate School of Medical Sciences, Kyushu University
- Department of General Internal Medicine, Kyushu University Hospital
| | - Norihiro Furusyo
- Department of General Internal Medicine, Kyushu University Hospital
| | | | - Haru Mukae
- Department of General Internal Medicine, Kyushu University Hospital
| | - Eiichi Ogawa
- Department of General Internal Medicine, Kyushu University Hospital
| | - Kazuhiro Toyoda
- Department of General Internal Medicine, Kyushu University Hospital
| | - Masayuki Murata
- Department of General Internal Medicine, Kyushu University Hospital
| | - Jun Hayashi
- Center of Kyushu General Medicine, Haradoi Hospital
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Kim EJY, Chen Y, Huang JQ, Li KM, Razmovski-Naumovski V, Poon J, Chan K, Roufogalis BD, McLachlan AJ, Mo SL, Yang D, Yao M, Liu Z, Liu J, Li GQ. Evidence-based toxicity evaluation and scheduling of Chinese herbal medicines. JOURNAL OF ETHNOPHARMACOLOGY 2013; 146:40-61. [PMID: 23286904 DOI: 10.1016/j.jep.2012.12.027] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 12/19/2012] [Accepted: 12/19/2012] [Indexed: 05/19/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE While there is an increasing number of toxicity report cases and toxicological studies on Chinese herbal medicines, the guidelines for toxicity evaluation and scheduling of Chinese herbal medicines are lacking. AIM The aim of this study was to review the current literature on potentially toxic Chinese herbal medicines, and to develop a scheduling platform which will inform an evidence-based regulatory framework for these medicines in the community. MATERIALS AND METHODS The Australian and Chinese regulations were used as a starting point to compile a list of potentially toxic herbs. Systematic literature searches of botanical and pharmaceutical Latin name, English and Chinese names and suspected toxic chemicals were conducted on Medline, PubMed and Chinese CNKI databases. RESULTS Seventy-four Chinese herbal medicines were identified and five of them were selected for detailed study. Preclinical and clinical data were summarised at six levels. Based on the evaluation criteria, which included risk-benefit analysis, severity of toxic effects and clinical and preclinical data, four regulatory classes were proposed: Prohibited for medicinal usage, which are those with high toxicity and can lead to injury or death, e.g., aristolochia; Restricted for medicinal usage, e.g., aconite, asarum, and ephedra; Required warning label, e.g., coltsfoot; and Over-the-counter herbs for those herbs with a safe toxicity profile. CONCLUSION Chinese herbal medicines should be scheduled based on a set of evaluation criteria, to ensure their safe use and to satisfy the need for access to the herbs. The current Chinese and Australian regulation of Chinese herbal medicines should be updated to restrict the access of some potentially toxic herbs to Chinese medicine practitioners who are qualified through registration.
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Affiliation(s)
- Ellie J Y Kim
- Faculty of Pharmacy, The University of Sydney, Sydney, NSW 2006, Australia
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