The genus Commiphora: a review of its traditional uses, phytochemistry and pharmacology

Ethnopharmacological relevance

The resinous exudates of the Commiphora species, known as ‘myrrh’, are used in traditional Chinese medicine for the treatment of trauma, arthritis, fractures and diseases caused by blood stagnation. Myrrh has also been used in the Ayurvedic medical system because of its therapeutic effects against inflammatory diseases, coronary artery diseases, gynecological disease, obesity, etc.

Aim of the review

Based on a comprehensive review of traditional uses, phytochemistry, pharmacological and toxicological data on the genus Commiphora, opportunities for the future research and development as well as the genus’ therapeutic potential are analyzed.

Methods

Information on the Commiphora species was collected via electronic search (using Pubmed, SciFinder, Scirus, Google Scholar and Web of Science) and a library search for articles published in peer-reviewed journals. Furthermore, information also was obtained from some local books on ethnopharmacology. This paper covers the literature, primarily pharmacological, from 2000 to the end of December 2011.

Results

The resinous exudates from the bark of plants of the genus Commiphora are important indigenous medicines, and have a long medicinal application for arthritis, hyperlipidemia, pain, wounds, fractures, blood stagnation, in Ayurvedic medicine, traditional Chinese medicine and other indigenous medical systems. Phytochemical investigation of this genus has resulted in identification of more than 300 secondary metabolites. The isolated metabolites and crude extract have exhibited a wide of in vitro and in vivo pharmacological effects, including antiproliferative, antioxidant, anti-inflammatory and antimicrobial. The bioactive steroids guggulsterones have attracted most attention for their potent hypolipidemic effect targeting farnesoid X receptor, as well as their potent inhibitory effects on tumor cells and anti-inflammatory efficiency.

Conclusions

The resins of Commiphora species have emerged as a good source of the traditional medicines for the treatment of inflammation, arthritis, obesity, microbial infection, wound, pain, fractures, tumor and gastrointestinal diseases. The resin of C. mukul in India and that of C. molmol in Egypt have been developed as anti-hyperlipidemia and antischistosomal agents. Pharmacological results have validated the use of this genus in the traditional medicines. Some bioassays are difficult to reproduce because the plant materials used have not been well identified, therefore analytical protocol and standardization of extracts should be established prior to biological evaluation. Stem, bark and leaf of this genus should receive more attention. Expansion of research materials would provide more opportunities for the discovery of new bioactive principles from the genus Commiphora.     

Riding the wave: South Africa's contribution to ethnopharmacological research over the last 25 years

South Africa is a country with both rich floral biodiversity and cultural diversity. Traditional herbal medicines form an important part of the healthcare of most South Africans, and relies heavily on the use of indigenous plants. This article briefly describes the role South Africa has played in recent years, in contributing to the worldwide increase in research in the field of ethnopharmacology.     

Beyond the myth of expensive clinical study: assessment of traditional medicines

Clinical studies with human subjects represent the only assessment of effectiveness and safety that can translate into medical practice, and national or local health policy. There are several reasons why traditional medicines (in fact medicinal plants and other alternative or complementary medicines) should be subjected to more clinical research with patient observation and follow-up: firstly, this would help to select products of interest for further investigations in ethnopharmacology; secondly, it could translate into immediate recommendations for the population using the assessed local treatments. Contrary to a commonly held myth, clinical studies can be conducted at relatively low cost, if one works with local/regional research institutes and with doctoral students, focusing on meaningful clinical measures rather than sophisticated laboratory analyses. This paper describes special designs of clinical studies, appropriate for traditional medicines and tested in the field, including: the retrospective treatment-outcome population survey, the prognosis- outcome method (with modern physicians observing progress of patients treated by a traditional healer), the dose-escalating prospective study (detecting a dose-response phenomenon in humans). It is suggested that this approach offers the best cost-effective course of action for obtaining maximal benefits from traditional medicines, especially those used for treating endemic diseases.     

Do not put too much value on conventional medicines

About 80% of the population of the developing countries still use traditional medicines for their health care. The rational use of traditional medicines in primary health care should be based on the Guidelines for the Assessment of Herbal Medicines as developed by the World Health Organization (WHO). The protection of intellectual property on traditional medicines should also be based on the guidelines for the protection of intellectual property on traditional medicines to be developed by the World Intellectual Property Organization (WIPO). The knowledge of traditional medicines hidden and lost should be researched and the loss of natural resources used as traditional medicines should be prevented. As a new emerging field in ethnopharmacology, treatment guidelines and evidence-based evaluation guidelines for ethnoergogenics, and protection guidelines of intellectual property for ethnoergogenics should be developed and put into practice according to guidelines of the WHO and WIPO, respectively.     

Status of Indian medicinal plants in the International Union for Conservation of Nature and the future of Ayurvedic drugs: Shouldn’t think about Ayurvedic fundamentals?

The present market for herbal drugs is estimated about ₹40 billion, which is expected to increase by 16% in next 3–4 years. The current production of many Ayurvedic herbs is less than their market demand, which incentivizes adulteration in the Ayurvedic drug supply chain. The present work aims to highlight the most used Ayurvedic plants that have been listed in the International Union for Conservation of Nature’s “red list” of endangered or vulnerable plants. The future of Ayurvedic medicines from these listed plants is uncertain, as the collection of herbs from their natural habitat is prohibited and their cultivation does not meet market demands. Many of these plants, such as Taxus baccata and T. wallichiana, are endangered and are only grown in their natural habitats; their cultivation in other areas is impractical. This is the present state, and will worsen as demand continues to grow, with increasing populations and increasing adoption of this system of medicine. It is possible that in coming years most of the Ayurvedic drugs will be adulterated, and will cause only side effects rather than the therapeutic effects. The Ayurvedic fundamentals are under-explored areas where the Ayurvedic practitioners and research scientists can work together. The scientific work on the basic principles will unravel many unknown or little-known facts of this ancient science. Hence, the present review emphasizes the conservation of Ayurvedic herbs, minimization of the use of medicinal plants and the promotion of the research based on Ayurvedic fundamentals.     

Phytochemistry and Ethnopharmacology of Epimedium L. Species

Epimedii Folium, a famous Chinese materia medica, is botanically originated from Epimedium L. species. Here Epimedium L. species were reviewed in phytochemistry, ethnopharmacology, ADME (absorption, distribution, metabolism, and excretion), and processing. They have been proven to possess the efficacy on anti-osteoporosis, antitumor, and treating sexual dysfunction in traditional Chinese medicines. More than 270 compounds have been isolated from the plants of Epimedium L., some of which could be metabolized into a series of metabolites after oral absorption by the active enzymes and intestinal microflora leading to various bioactivities. Polyglucosides (epimendins A-C) and the coresponding oligoglycosides (icariin and baohuoside I) play important roles in clinical application.     

两种传统医学:中医学和阿育吠陀的基本原理比较

阿育吠陀是印度的传统医学,在梵文中意为生命的科学。阿育吠陀与中医有相似的特点,这两种系统与其说是科学倒不如说都是旨在提高生活质量的哲学。这两种亚洲传统医学中最常用的草药在使用和特点解释上是相同的,比如药物都有寒热的属性。中医有阴阳五行、脏腑、气血津液的理论体系,阿育吠陀医学有三元体液理论。中医有古代医学典籍《黄帝内经》,包括《素问》和《灵枢》两部分,阿育吠陀有《遮罗迦集》和《妙闻集》。《遮罗迦集》的主要内容是基本理论、草药、治疗原则和预防,这点和《素问》以中医基础理论为主很相似。中医有阴阳理论,而阿育吠陀的理论基础是三个dosha。阿育吠陀的术语如同中医术语一样难以用英语解释。Pitta大概对应中医术语"火"比较合适,Kapha可以对应"痰",Vata可以对应"风",Rasa和中医的"谷气"相似。中医伤寒有六经传变,温病学理论有卫气营血传变。阿育吠陀认为疾病的发展有doshas的积累、doshas加剧发展和doshas溢出三个阶段。中医所重视的血瘀理论,在阿育吠陀看来不是内科的重点问题。针灸在西方的推广、中医师在发达国家开业、中国政府中药出口政策和海外人员来中国学习中医使中医的海外加速发展成为可能。相比而言,印度传统医学阿育吠陀做的还不够。     

亚洲的两种传统医学基本原理比较:中医学和阿育吠陀

阿育吠陀是印度传统的医学,在梵文中意为生命的科学。阿育吠陀与中医有些相似的特点,这两种系统与其说是科学倒不如说都是旨在提高生活质量的哲学。这两种亚洲传统医学中最常用的半数草药在使用和特点解释上是相同的,比如药物都有寒热的属性。中医有阴阳五行、脏腑、气血津液的理论体系,阿育吠陀医学有三元体液理论。中医有古代医学典籍《黄帝内经》,包括《素问》和《灵枢》两部分,阿育吠陀有《遮罗迦集》和《妙闻集》。《遮罗迦集》主要内容是基本理论、草药、治疗原则和预防,这点和《素问》以中医基础理论为主很相似。中医有阴阳理论,而阿育吠陀的理论基础是三个dosha。阿育吠陀的术语好像中医术语一样难以用英语解释。Pitta大概对应中医术语火比较合适,Kapha可以对应痰,Vata可以对应风。Rasa和中医的谷气相似。中医伤寒有六经传变,温病学理论有卫气营血传变。阿育吠陀认为疾病的发展有doshas的积累、doshas加剧发展和doshas溢出三个阶段。中医所重视的血瘀理论,在阿育吠陀不认为是内科的重点问题。针灸在西方的推广、中医师在发达国家开业、中国政府中药出口政策和海外人员来中国学习中医使中医的海外加速发展成为可能。相比而言印度传统医学阿育吠陀做的还不够。     

动物药多肽的药效学与分子鉴定研究进展

动物药在传统医学领域占据着重要地位,经过数千年的实践在中国得到广泛应用,其临床应用和药理活性一直是研究的核心。其中,动物来源的蛋白质和肽被认定为其药理作用的重要物质基础。肽类药物有望成为国际药物研发的新热点,动物药因富含潜在药效活性肽而成为备受关注的“宝库”。通过综述现有相关文献,系统总结动物源药物中活性肽的药理功能研究进展。同时,介绍了常见肽的分析鉴定和发现方法,特别强调了液相色谱-质谱联用技术在研究动物源药物肽类成分方面的应用策略和现状,及其在动物源药物中的肽成分研究中显示出的独特优势。该技术在动物源药物真伪鉴别、质量控制及潜在活性肽的筛选等方面具有显著效果,为深入了解动物源药物的作用机制和推动肽类药物的发展提供参考。     

中药复方活性筛选形式与技术研究进展

药物发现是新药研究的重要过程,其中药物活性筛选是决定新药研究成败的关键。本文分析了目前中药复方活性筛选的8种形式,并按历史进程将筛选技术分为传统筛选技术与现代筛选技术,简述了临床前活性药物优化技术、候选药选择技术、分离技术、分子设计、分子水平筛选、生物芯片技术、药物基因组学、药物相互作用分析技术（BIA）、化学和生物信息学结合、中药复方多层区组筛选模式（MBAS模式）等现代筛选技术的特征,并探讨药物发现策略的改变和新技术应用对于中药复方活性筛选研究进程的影响。     

Clinical research on traditional drugs and food items—the potential of comparative effectiveness research for interdisciplinary research

Ethnopharmacological relevance

In the traditional context, herbs are often used as herbal whole system therapies, however, most clinical trials included highly selected patients and applied standardized treatment protocols with the aim to exclude as much bias as possible. These studies have contributed important information on the efficacy of herbal medicine extracts; however, their results are only marginally helpful to understand the value of herbal medicine and food items in a more traditional usual care context.

Methods

The new development of comparative effectiveness research (CER) will be introduced and synergies with ethnopharmacology will be outlined.

Results

CER provides great opportunities for guiding researchers and clinicians in improving management of disease. CER compares two or more health interventions in order to determine which of these options works best for which types of patients in settings that are similar to those in which the intervention will be used in practice. CER uses a broad spectrum of methodologies including randomized pragmatic trials that can also be applied to herbal whole system therapies. Ethnopharmacological research can provide highly relevant information for CER including data on characteristics of typical patients as well as traditional usage including methods of collection, extraction, and preparation. Recommendations for future research on traditional herbal medicine and food items are (1) a systematic cooperation between ethnopharmacology and clinical researchers and (2) a call for more CER on traditional herbal medicines and food items.

Conclusion

Multiple stakeholders, including ethnopharmacologists, should cooperate to identify relevant study questions as well share their knowledge to determine the optimal placement of a clinical trial in the efficacy–effectiveness–continuum.     

中药复方活性筛选形式与技术研究进展

药物发现是新药研究的重要过程，其中药物活性筛选是决定新药研究成败的关键。本文分析了目前中药复方活性筛选的8种形式，并按历史进程将筛选技术分为传统筛选技术与现代筛选技术，简述了临床前活性药物优化技术、候选药选择技术、分离技术、分子设计、分子水平筛选、生物芯片技术、药物基因组学、药物相互作用分析技术(BIA)、化学和生物信息学结合、中药复方多层区组筛选模式(MBAS模式)等现代筛选技术的特征，并探讨药物发现策略的改变和新技术应用对于中药复方活性筛选研究进程的影响。     

Ayurveda and gynecological disorders

The science of life--Ayurveda is practiced in India since time immemorial. Besides being cheap and easily available Ayurvedic drugs are considered safe. Moreover, there is surge in the interest in Ayurveda due to quest of alternative medicines. Many of the gynecological disorders being not reported to the physicians, are treated with household remedies in India. The science of Ayurveda deals with these issues in a systematic manner as evident from the classification of diseases available and the number of plant drugs or the combinations thereof available for the treatment. In the present article, Ayurvedic herbal formulations and single plant drugs used traditionally in treatment of gynecological disorders are described.     

The Ayurvedic medicine Clitoria ternatea--from traditional use to scientific assessment

Clitoria ternatea L. (CT) (Family: Fabaceae) commonly known as 'Butterfly pea', a traditional Ayurvedic medicine, has been used for centuries as a memory enhancer, nootropic, antistress, anxiolytic, antidepressant, anticonvulsant, tranquilizing and sedative agent. A wide range of secondary metabolites including triterpenoids, flavonol glycosides, anthocyanins and steroids has been isolated from Clitoria ternatea Linn. Its extracts possess a wide range of pharmacological activities including antimicrobial, antipyretic, anti-inflammatory, analgesic, diuretic, local anesthetic, antidiabetic, insecticidal, blood platelet aggregation-inhibiting and for use as a vascular smooth muscle relaxing properties. This plant has a long use in traditional Ayurvedic medicine for several diseases and the scientific studies has reconfirmed those with modern relevance. This review is an effort to explore the chemical constituents, pharmacological and toxicity studies of CT, which have long been in clinical use in Ayurvedic system of medicine along with a critical appraisal of its future ethnopharmacological potential in view of many recent findings of importance on this well known plant species.     

藏医药与印度传统医药对三果汤传统应用及现代研究概述

来源于印度的三果汤由余甘子、诃子和毛诃子组成,它不仅是使用频率最高的著名印度传统药配方,而且还是二十五味余甘子丸等众多常用藏药复方的基础方,被收载于《中华人民共和国卫生部药品标准.藏药(第一册)》(1995年版)中。近年来,我国和印度学者对三果汤化学、药理研究和临床应用均取得了成果,尤其在抗疲劳、抗氧化、防治高原红细胞增多症等方面,三果汤均具有一定的治疗和预防保健作用。对此,本文介绍了三果汤在印度传统医药和藏医药应用中的异同,并对三果汤的化学成分、质量控制、药理作用、临床应用和现代制剂开发利用情况进行了总结,提出要在学习借鉴印度传统医学经验基础上,应结合藏医药、印度传统医药理论和临床特点,开展体现传统医药整体性的三果汤药效物质基础和配伍规律的现代研究。     

Phyllanthus amarus: ethnomedicinal uses, phytochemistry and pharmacology: a review

Ethnopharmacological relevance

Phyllanthus amarus Schum. &; Thonn. belongs to the family Euphorbiaceae is a small herb well known for its medicinal properties and widely used worldwide. P. amarus is an important plant of Indian Ayurvedic system of medicine which is used in the problems of stomach, genitourinary system, liver, kidney and spleen. It is bitter, astringent, stomachic, diuretic, febrifuge and antiseptic. The whole plant is used in gonorrhea, menorrhagia and other genital affections. It is useful in gastropathy, diarrhoea, dysentery, intermittent fevers, ophthalmopathy, scabies, ulcers and wounds.

Materials and methods

The present review covers a literature across from 1980 to 2011. Some information collected from traditional Ayurvedic texts and published literature on ethanomedicinal uses of Phyllanthus amarus in different countries worldwide.

Results

Phytochemical studies have shown the presence of many valuable compounds such as lignans, flavonoids, hydrolysable tannins (ellagitannins), polyphenols, triterpenes, sterols and alkaloids. The extracts and the compounds isolated from P. amarus show a wide spectrum of pharmacological activities including antiviral, antibacterial, antiplasmodial, anti-inflammatory, antimalarial, antimicrobial, anticancer, antidiabetic, hypolipidemic, antioxidant, hepatoprotective nephroprotective and diurectic properties.

Conclusion

The present review summarizes information concerning the morphology, ecology, ethnopharmacology, phytochemistry, biological activities, clinical applications and toxicological reports of P. amarus. This review aims at gathering the research work undertaken till date on this plant in order to provide sufficient baseline information for future works and commercial exploitation.     

中药药理规范研究的思考＊

用现代科学技术与方法对中药的药效、活性成分及作用机制进行研究始于上世纪20年代,从最初采用经典的植物化学模式对单味药进行研究,逐渐拓展到对药性理论、中药复方、配伍规律、治法治则及中医药理论的探讨,希望揭示中医药防治疾病的科学内涵,实现指导临床合理安全用药、发现新药、丰富和发展中医药理论的作用。近一个世纪以来,中药药理研究在理论、方法和技术上不规范,虽然取得了重要进展和大量研究成果,但也存在许多亟待解决的科学问题。本文试通过系统地梳理中药药理研究的成功经验和存在的问题,提出中药药理规范研究的定义,及其两个创新（思想创新和理论创新）和两个规范（方法规范和技术规范）。中药药理规范研究是创新前提下的规范以及规范基础上的创新辩证统一体,是创新—规范—再创新的不断循环发展。中药药理规范研究的提出希望能推动中药药理学学科向着更加规范、合理、科学的方向发展。     

基于斑马鱼M-Act/Tox一体化评价的抗骨质疏松中药高效筛选思路与方法

日益显现的壮骨中药肝损伤问题为临床应用带来挑战,抗骨质疏松中药筛选有必要兼顾有效性与安全性,而代谢转化至关效应与毒性,故全面考虑代谢-效/毒一体的筛选具有意义。评价模型和化合物(含代谢物)数量严重制约早期在体、高效筛选。参考课题组前期相关研究及国内外文献,提出斑马鱼代谢模型、骨质疏松模型及毒性评价法有机整合可建立M-Act/Tox(metabolism-action/toxicity)一体化的抗骨质疏松中药高效筛选法。突破量微成分无法在体、高效及一体化评价的难点和盲点,实现基于体内过程且兼顾有效性与安全性的全方位抗骨质疏松中药高效筛选,对加速发现安全有效的抗骨质疏松创新中药具有意义。     

利水中药功效发挥与水通道蛋白之间的关系

近年来,水通道蛋白的发现及其研究使人们对"水"代谢的生理及病理过程有了更加深入的了解;并且长期以来,对于"利水中药"的研究缺乏分子层面的靶点,难以进行深入的、定量化的研究;而水通道蛋白的发现成为诠释"利水中药"发挥其功效机制的新的靶分子。通过水通道蛋白,可以理解中药"利水"功效的内在涵义,还可以对"利水"这一作用进行量化研究。目前,众多学者已经运用水通道蛋白研究成果在中医药领域开展了一系列的研究,并且取得了一定的进展。该文通过水通道蛋白这一靶分子来探讨"利水"中药功效的发挥做一综述。     

Discussion on evolution of Mongolian medicinal material names and countermeasures for standardization

Mongolian pharmacy is an important part of traditional medicine for the Chinese nation, with a long history and a complete theoretical system. The Mongolian people have accumulated and summarized the types and usage of Mongolian medicines in the practice of fighting against diseases over a long history. Mongolian medicinal resources are rich and diverse, the processing is self-contained, and the methods of medication are scientific and reasonable. Mongolian pharmacy not only has a deep historical relationship with traditional Chinese medicine but has also absorbed the essence of ancient Tibetan and Indian Ayurvedic medicine in the process of its development. We can identify the historical traces of the continuous exchange, communication, and integration of various ethnic medicinal cultures from the names of Mongolian medicinal materials. Because of the differences in languages and cultures of the various ethnic groups, the names of Mongolian medicinal materials have undergone a long historical period of evolution. These need to be further standardized owing to complications caused by the existence of synonyms and homonyms.