Toxicological advances of traditional medicine in 2019

There were many researches concerning toxicology of traditional medicine(TM)and active natural products during the past 12 months.This annual toxicology review summarized target organs of TM like liver,kidney and heart.Safety medication of TM has been concerned to different kinds of people,including infants,children,pregnancy and the postnatal period.Besides rodents,zebrafish embryoes have been regarded as common models to evaluate the safety of TM.New technologies in toxicology focus on rapidly screening and identification of toxins in TM.Multispectral optoacoustic tomography imaging the precise location of TM-induced liver injury with 3D information and integrating serum exosomal microRNA and liver microRNA profiles are used to explain the mechanism of TM-induced hepatotoxicity.Taken together,study on the toxicity mechanism of other target organs,drug safety in elders,new models and methods should be paid attention to in the prevention of TM toxicology in the future.     

Complementary and alternative medicine in European countries legislative framework

Complementary and alternative medicine(CAM)is a set of different diagnostic and therapeutic procedures,as well as the use of natural products for the treatment of patients,derived from previously known traditional methods and enriched with modern scientific knowledge.The present article reviews the available data regarding the use of CAM and the legislation behind it in European countries.The use of CAM is recorded in Europe as a whole and varies between 1070%of the population of individual European countries.At least 300,000 registered CAM providers have been identified in the European Union(EU),of which slightly more than half includes non-medical practitioners.The most practiced discipline is acupuncture,followed by homeopathy.CAM regulation and legislation in Europe is not precisely defined and is constantly striving to find a common approach.Since legal frameworks for CAM are not defined,each European country has its own regulations and legislation.In order to define universal legislation for CAM,the EU created the CAMbrella project,a project of the EU designed to find a unique system that would include the treatment of CAM in Europe.According to the data from CAMbrella,from 39 countries in the EU,17 have general CAM legislations.The status of CAM in Europe is characterized by enormous heterogeneity in all aspects,including terminology,methods,prevalence and ultimately,legal status,regulations and legislation.     

Zebrafish——Useful model for pharmacodynamics and toxicity screening of traditional Chinese medicine

斑马鱼是一种用于生长发育和遗传研究的重要模式生物,过去10余年来,被广泛应用于环境毒物的监测,已经被用于环境中许多化学物质如有害重金属、农药以及卤代芳香烃化合物等致癌物的累积效应和毒性研究。近年来,该模型越来越多地应用于药物筛选和毒理学研究。斑马鱼具有活体、高通量的优点,尤其适用于中药混合物的药效和毒性筛选,在中药新药研究领域具有较广的应用前景。     

Mixed methods research in complementary and alternative medicine:a scoping review

OBJECTIVE:To update the current characteristics about the scope and quality of mixed methods research(MMR)in complementary and alternative medicine(CAM) after nearly 10 years. METHODS:A 5-stage approach for conducting a scoping review was adopted. Articles published on the top 10 journals in CAM with the highest impact factor in 2020 were screened for MMR. Information of included articles were extracted, and then synthesized to illustrate the current state. Methodological quality was evaluated a...     

An example of toxic medicine used in Traditional Chinese Medicine for cancer treatment

<正>An interesting paper “Toxicmedicine used in Traditional Chinese Medicine for cancer treatment: are ion channels involved?”1 was published in the Journal of Traditional Chinese Medicine on August 17 this year. This paper proposed a unique view of the potential role of ion channels in the pharmacological effects of toxic Traditional Chinese Medicine(TCM) for cancer.     

Antimalarial activity of medicinal plants used in traditional medicine in S. Tomé and Príncipe islands

The present study investigates the antimalarial activity of 13 medicinal plants used in traditional medicine in S. Tomé and Príncipe (STP) islands in the Gulf of Guinea, aiming at identifying the most effective plants for further research. Fieldwork was carried out with the collaboration of 37 traditional healers from both islands, during an ethnobotanical study, which was conducted from 1993 to 1999. Our results indicate that the traditional healers in STP use several medicinal plants against fever and/or 'malaria' which reveal strong antiparasitic activity in vitro: four of the plant extracts have evident antiplasmodial activity against chloroquine resistant Plasmodium falciparum, with IC(50) values <10 microg/ml, and also revealed hepatic schizontocidal activity (<5-35 microg/ml). In vivo, the extracts caused partial reduction of Plasmodium berghei parasitaemia in mice.     

Medical workers in traditional medicine who sacrificed their lives in the battle against COVID-19 deserve to be remembered forever

China held a national day of mourning on April 4,2020 to commemorate 3,335 victims of the COVID-19 outbreak,including medical workers who sacrificed their lives in the battle against the epidemic[1].April 4 was also Tomb-sweeping Day in China,known as the Qingming Festival,it is an important occasion for the Chinese to visit cemeteries,clean tombs,and mourn their ancestors[2].According to data from the official website of the State Administration of Traditional Chinese Medicine,as of February 17,60,107 confirmed cases had been treated with traditional medicine,accounting for 85.2%,while nearly 4,400 medical personnel from more than 600 traditional Chinese hospitals were sent to Hubei[3].     

Traditional medicine in north Côte-d'Ivoire: screening of 50 medicinal plants for antibacterial activity

Sixty-seven crude ethanol extracts from 50 plants (31 families), which are used in North C?te-d'Ivoire as traditional remedies for bacterial diseases, were screened for in vitro activity against Gram negative (Escherichia coli and Pseudomonas aeruginosa) and Gram positive (Staphylococcus aureus, Enterococcus faecalis, Streptococcus pyogenes and Bacillus subtilis) bacteria. Thirty-one extracts showed antibacterial activity only on Gram positive bacteria. Of these, 10 extracts from 10 plant species had a promising level of activity against bacteria including strains resistant to antibiotics such as aminosides, penicillin M, macrolides, lincosamide and streptrogramin B. The most active was Erythrina senegalensis DC (Fabaceae) followed by Bobgunnia madagascariensis (Desv.) J.H. Kirkbr. & Wiersema (Caesalpinaceae), Waltheria lanceolata R. Br. ex Mast. (Sterculiaceae), Uapaca togoensis Pax. (Euphorbiaceae), Ximenia americana L. (Olacaceae), Khaya senegalensis (Ders.) A. Juss. (Meliaceae), Lannea acida A. Rich. (Anacardiaceae), Cissus populnea Guill. & Perr. (Vitaceae), Keetia hispida (Benth.) Bridson (Rubiaceae) and Ficus thonningii (Miq.) A. Rich. (Moraceae). This is the first report of the antibacterial potency of these 10 plant species on a range of bacteria. The results provided evidence that some of the studied plants might indeed be potential sources of new antibacterial agents, also against some antibiotic-resistant strains.     

Applications of nanoparticles in herbal medicine: zedoary turmeric oil and its active compound β-elemene

Zedoary turmeric oil and its main active ingredient β-elemene are novel plant-derived anticancer agents with long-term clinical application history and low toxicity, which have been approved by the Chinese SFDA to treat different tumors including cancers of the brain, ovary, prostate, breast, lungs, liver, colon, and other tissues. Unfortunately, their hydrophobic properties, poor stabilities and low bioavailabilities seriously hamper their applications in clinic. Therefore, more attention should be paid to develop novel drug delivery systems for zedoary turmeric oil and β-elemene to enhance their overall quality. Recently, increased research has been carried out on a nanoparticle drug delivery system of zedoary turmeric oil and β-elemene to solve their poor aqueous solubilities and low bioavailabilities in vivo with much remarkable achievements springing up in the last decade. This review presents the novel nanoparticle formulations of zedoary turmeric oil and β-elemene and introduces the possible future prospects of their further study.     

Women’s preconception health patterns in traditional Chinese medicine as a predictor of fertility outcomes

ObjectiveTo examine the association between traditional Chinese medicine (TCM), preconception health patterns and fertility outcomes.MethodsA community-based prospective cohort study was conducted in China. A total of 3012 newly married women who were willing to conceive within 2 years were enrolled in the study and took National Free Prepregnancy Checkups (NFPC). A reliably structured self-rating scale was used to measure the TCM preconception health patterns of the enrolled women. A 3-year follow-up was conducted to obtain the fertility outcomes, including pregnancy rate, time to pregnancy, spontaneous miscarriage and newborn status. Statistical analyses were conducted using Chi-square or Fisher’s exact tests, logistic regression models, general linear models and the Cox proportional hazard model.ResultsThe fertility outcomes showed no statistic correlations to the terms of NFPC in this population. Approximately a half of the women (46.66%) had unhealthy patterns. Women with qi & blood-deficiency (odds ratio [OR] = 35.19, 95% confidence interval [CI] = 1.55–801.15) or qi-stagnation (OR = 4.55, 95% CI = 0.90–23.06) pattern took a longer time to get pregnant, and those with qi-stagnation (OR = 2.05, 95% CI = 1.1–3.82) or yang-deficiency (OR = 1.91, 95% CI = 1.12–3.25) pattern had a higher risk of spontaneous miscarriage.ConclusionThree unhealthy TCM patterns during the preconception period might be risk factors for low fecundity or poor pregnancy outcomes. The TCM preconception pattern identification may provide a convenient and effective way to screen for potential pregnancy risks beyond the NFPC. Further, appropriate interventions based on the TCM preconception health patterns are needed to improve quality in women’s fecundability and birth outcomes.     

A comparative study on medicinal plants used in Akha's traditional medicine in China and Thailand,cultural coherence or ecological divergence?

AIM OF THE STUDY: The survey aims to study the effect of geographic separation of ethnic groups on local knowledge of medicinal plants used by Akha people in Thailand and China, who were separated 100-120 years ago, to see how different the two geographically distinct but culturally similar groups were in this respect. MATERIALS AND METHODS: Interviewing 10 villagers in each of five Akha villages, three in Thailand and two in China, about which plants they used and how they used them. RESULTS: A total of 95 medicinal plants registered in the five villages only 16 were shared between China and Thailand. Otherwise the use patterns were quite similar with respect to which plant families and plant growth forms were used and also in terms of in which habitats the Akha found their medicinal plants. CONCLUSIONS: The moving to a different site has forced the Akha to find a new set of species, but that when using these new species they have maintained other traditions relating to medicinal plants.     

Preconditioning with the traditional Chinese medicine Huang-Lian-Jie-Du-Tang initiates HIF-1α-dependent neuroprotection against cerebral ischemia in rats

Ethnopharmacological relevance

Huang-Lian-Jie-Du-Tang (HLJDT) is a classical heat-clearing and detoxicating formula of traditional Chinese medicine that is widely used to treat stroke. The present study was designed to investigate the effects of HLJDT preconditioning on neurons under oxygen and glucose deprivation (OGD) and rats subjected to middle cerebral artery occlusion (MCAO).

Materials and methods

A stroke model of rats was obtained through MCAO. Following HLJDT preconditioning, the cerebral infarction volume, cerebral water content, and neurological deficient score were determined. Cerebral cortical neurons cultured in vitro were preconditioned with HLJDT and then subjected to OGD treatment. The release of lactate dehydrogenase (LDH) from neurons was detected. The levels of hypoxia-inducible factor-1α (HIF-1α) and PI3K/Akt signaling were analyzed by western blotting, and the levels of erythropoietin (EPO) and vascular endothelial growth factor (VEGF) in the supernatant of the neurons and the plasma of MCAO rats were measured through a radioimmunological assay. The apoptosis and proliferation of neurons were analyzed by immunohistochemistry.

Results

HLJDT preconditioning significantly reduced the cerebral infarction volume and cerebral water content and ameliorated the neurological deficient score of MCAO rats. In addition, HLJDT preconditioning protected neurons against OGD. Increased HIF-1α, EPO, and VEGF levels and the activation of PI3K/Akt signaling were observed as a result of HLJDT preconditioning. Furthermore, HLJDT preconditioning was found to inhibit ischemia-induced neuron apoptosis and to promote neuron proliferation under conditions of ischemia/reperfusion.

Conclusion

Both rats and neurons subjected to HLJDT preconditioning were able to resist ischemia/reperfusion or hypoxia injury through the inhibition of apoptosis and the enhancement of proliferation, and these effects were primarily dependent on the activation of the PI3K/Akt signaling pathway and HIF-1α.     

The role of herbometallic preparations in traditional medicine – A review on mica drug processing and pharmaceutical applications

Ethnopharmocological relevance

Biotite mica enriched with Fe²⁺ ions are widely used as a major mineral ingredient in traditional pharmaceutical science of alchemy (Rasashastra). Abhrak bhasma (mica ash), a pharmaceutical product containing treated mica, is utilized, for example, in Ayurvedic treatments for ailments such as gastritis, renal disease, skin disease and mainly in rejuvenation formulations. However, the untreated mica minerals may be harmful when used directly, as they carry considerably high amounts of trace-elements that can cause undesirable effects in the human body. In order to remove toxic factors and produce readily absorbable materials having high nutrient capacity, specific thermal and chemical treatments (purification, detoxification, particle size reduction and incineration) are performed during the preparation of Rasashastra. This review evaluates the chemical and pharmacological aspects of mica ash as well as the technological aspects of mica ash production.

Materials and methods

The detailed literature review on the chemistry and scientific basis of mica ash, its preparation techniques, mica alterations and pharmaceutical applications was carried out by using published Ayurvedic text books and research articles, available from Science Direct, on mica minerals, mica ash and their physico-chemical alteration processes and pharmacological applications.

Results

During the purification and detoxification procedures, heating followed by quenching (in ionic medium) influences the structural distortion and the development of stress-induced cracks and spallations of the micaceous plates. Thus, the efficient diffusion of the external medium takes place at successive heating and quenching steps. Acidic organic liquids and animal byproducts can enhance the cation exchange capacity and solubility of mica. Further, these natural compounds facilitate the removal of toxic-elements in the structure. When treated-mica and paddy husks are tied up in a cloth and squeezed, particle size reduction and further detoxification takes place. Leaching out of oxidized iron coatings is accelerated when the mixtures are immersed in acidic media, by which the filtrate is enriched with oxidized iron-silicate particles. These nano-oxide particles are converted into a more favorable oxidation form for human consumption when the herbometallic mixture is incinerated in closed vessels. Recent analytical data reveals that major and minor elements in mica ash are within the limits of pharmacopoeial standards for Ayurvedic formulations. Further, recent studies show that mica ash has hypoglycemic, hepatoprotective, anthelminthic and antimicrobial properties.

Conclusions

Chemical and structural modifications in mica occur during mica-based drug preparation in traditional medicine. Purification steps particularly influence the structural distortion while heating and quenching can form nano-size particles. Carboxylic acids and other organic molecules present in quenching media serve as chemical modifiers of mica. At the same time the toxic elements are leached out from mica to the quenching media through an ion exchange process. Mica ash has been successfully used for treating liver, kidney and skin related ailments in traditional medicine, and mica ash alone or its herbo-metallic formulations have different applications. Further, the recent toxicological and analytical studies validate the traditional uses of mica ash and mica ash bearing products. Further scientific studies are needed to fully establish that mica-based pharmaceuticals are safe and devoid of toxic and long term side effects.     

Herbal medicine: Who cares? The changing views on medicinal plants and their roles in British lifestyle

Herbal medicines are not only widely used but also contentious health care products. Currently, little is known about the products' place in people's health care strategies and their views about such products. The aims of the study are to gain insight into the public's perception of herbal medicine/general use of herbs for health, as well as on the growing of plants for medicine. Core to the research was a survey that covered participants' views about herbal medicines. Data were collected online and from visitors at the Eden Project, as well as some other garden events. Survey responses were categorized and analysed using Qualtrics. Overall, 408 participants participated though numbers varied across questions. Results show that herbal medicines are popular, particularly amongst the 36‐ to 55‐year‐old age group. Participants mostly used herbal medicines for minor self‐limiting conditions. Popular reasons for use included that plant medicines are natural and have fewer side effects, as well as for a few changing relationship with conventional medicines. Around a third of participants grew their own plants for health care. This is the first larger U.K.‐based survey indicating a wide use of such products, and it is therefore recommended that there is an increase in quality control and wider regulation. Access to high‐quality products should be prioritized.     

Nevada: the first state that fully legalized acupuncture and Chinese medicine in the Unites States——In memory of Arthur Steinberg,Yee Kung Lok and Jim Joyce who made it happen

<正>1 Introduction In the United States,the largest groups of acupuncture or traditional Chinese medicine(TCM)practitioners settled and still remain in California and New York,as these two states historically have the largest,most concentrated Asian populations.The TCM practitioners originally worked in a legal gray-zone,sometimes even being treated as illegal practitioners by the local governments,since     

Chinese herbal medicine resources：Where we stand

In recent years, the development of Chinese herbal medicine (CHM) has been challenged by shortages of CHM resources and drug safety concerns related to end products. There have been significant efforts by Chinese scholars to tackle these challenges, which are revealed by analyzing the research trend of CHM resources via surveying Chinese Traditional and Herbal Drugs (Zhong Cao Yao), a representative journal in CHM. Our study focused on 781 articles in CHM resources from 2013 to 2018 and included four subject areas: germplasm resources, quality analysis and evaluation, cultivation, and bioengineering of CHM. Discussion and prospective for future investigations were also presented, including: construct the core germplasm of medicinal plants and expand germplasms; combine molecular research with field experiments and promote the deeper study of cultivation of CHM plants; improve the quality evaluation method of CHM and strengthen the identification of Chinese patented medicines; promote the sustainable development of CHM resources by utilizing bioengineering and synthetic biology. This study helps international scholars understand the status quo of CHM research and provides theoretical support for the healthy, modern, and international development of CHM, and it will facilitate the sustainable development of the traditional Chinese medicine industry.     

In vitro screening on β-amyloid peptide production of plants used in traditional medicine for cognitive disorders

Aim of the study

The aim of the study was to investigate the activity on β-amyloid peptide production of crude extracts of 9 plant species traditionally used in Benin or in Madagascar for the treatment of cognitive disorders, in order to select candidates for Alzheimer's disease treatment.

Materials and methods

For each species, hexane, dichloromethane, ethyl-acetate and water extracts were tested, at non-toxic concentrations, on CHO cells overexpressing the human neuronal β-amyloid peptide precursor (APP695) to measure variations of APP processing (by Western-blotting) and, for the most active, of Aβ-amyloid production (by ECLIA).

Results

We observed, at non-toxic concentrations, a significant increase in CTF/APP ratio with Oldenlandia affinis cyclotide-enriched fraction, Prosopis africana EtOAc extract, Pterocarpus erinaceus aqueous extract and Trichilia emetica hexane extract. We also showed that the Pterocarpus erinaceus extract significantly decreased Aβ production, displaying effects similar to those of DAPT (γ-secretase inhibitor) on APP processing, but may act on another inhibition site.

Conclusion

These active extracts are worth further studies to isolate the compounds responsible for the observed activities, to analyze their mode of action and determine their clinical potentials.