A comparative study of Salvia miltiorrhiza Radix & Rhizoma raw material and granule products using chromatographic analysis and antioxidant activity

Objective: Granules of herbal extracts are a popular medicinal preparation consumed in traditional Chinese medicine clinical practice. However, their quality and efficacy evaluation are lacking. This study aimed to compare the quality and anti-oxidant activity of Dan Shen (Salvia miltiorrhiza Radix & Rhizoma) granule extracts with their herbal extracts. Methods: Chromatographic method was used to determine the content of 7 marker compounds in the water extracts of the herb compared to that of 12 granule extracts. Agglomerative hierarchical clustering (AHC) and principal component analysis (PCA) distinguished the herbal and granule extracts based on the content of the marker compounds. The antioxidant activities of herbal and granule extracts were evaluated by 2, 2′-azino-bis (3-ethylbenz-thiazoline-6-sulfonic acid) (ABTS), organic chemical compound 2,2-diphenyl-1-picrylhydrazyl (DPPH) and ferric ion reducing antioxidant power (FRAP) assays. Results: The herbal extracts group showed significantly higher contents of salvianolic acid B, sodium danshensu and cryptotanshinone compared with that of the granule group. This corresponded to significantly higher ABTS, DPPH and FRAP (P < .05) activities of the herbal extracts. The AHC and PCA analysis distinguished granule extracts from most herbal extracts predominantly by the content of salvianolic acid B. Conclusion: The results confirm the need for the assessment of granule products so that healthcare practitioners and consumers are better informed of their quality and efficacy

Polysaccharide peptide extract from Coriolus versicolor increased Tmax of tamoxifen and maintained biochemical serum parameters, with no change in the metabolism of tamoxifen in the rat

Background: Polysaccharide peptide (PSP) extract of Coriolus versicolor (L.) Quél. (1886) (Trametes; Polyporaceae) is increasingly used in cancer to support the immune system. However, its interaction with tamoxifen is unknown. Aim of the study: To investigate the effect of a PSP extract on the pharmacokinetics, biochemical parameters, and depletion of tamoxifen. Methods: The pharmacokinetic and biochemical parameters of tamoxifen (20 mg/mL oral single dose and repeated dosing for 12 days) was investigated in female Sprague Dawley rats with or without PSP (340 mg/kg orally for 7 days) (n = 5 per group). Tamoxifen (5 µM) depletion rate with PSP (10–100 μg/mL) was measured in female rat hepatic microsomes in vitro. Results: Compared to tamoxifen alone, the time to reach maximum concentration (Tmax) significantly increased by 228% (4.15 ± 1.15 versus 13.6 ± 2.71 h) in the single tamoxifen dose with PSP and 93% (6 ± 2.17 versus 11.6 ± 0.4 h) in the repeated tamoxifen dosing with PSP (p 0.05). PSP extract did not significantly alter in vitro intrinsic clearance of tamoxifen compared to tamoxifen control. Conclusion: With the increased use of PSP as an adjunct therapy, this study highlights the importance of clinician’s knowledge of its interaction with tamoxifen to avoid compromising clinical actions and enhancing clinical therapy

The mechanisms of Yu Ping Feng San in tracking the cisplatin-resistance by regulating ATP-binding cassette transporter and glutathione S-transferase in lung cancer cells

Cisplatin is one of the first line anti-cancer drugs prescribed for treatment of solid tumors; however, the chemotherapeutic drug resistance is still a major obstacle of cisplatin in treating cancers. Yu Ping Feng San (YPFS), a well-known ancient Chinese herbal combination formula consisting of Astragali Radix, Atractylodis Macrocephalae Rhizoma and Saposhnikoviae Radix, is prescribed as a herbal decoction to treat immune disorders in clinic. To understand the fast-onset action of YPFS as an anti-cancer drug to fight against the drug resistance of cisplatin, we provided detailed analyses of intracellular cisplatin accumulation, cell viability, and expressions and activities of ATP-binding cassette transporters and glutathione S-transferases (GSTs) in YPFS-treated lung cancer cell lines. In cultured A549 or its cisplatin-resistance A549/DDP cells, application of YPFS increased accumulation of intracellular cisplatin, resulting in lower cell viability. In parallel, the activities and expressions of ATP-binding cassette transporters and GSTs were down-regulated in the presence of YPFS. The expression of p65 subunit of NF-κB complex was reduced by treating the cultures with YPFS, leading to a high ratio of Bax/Bcl-2, i.e. increasing the rate of cell death. Prim-O-glucosylcimifugin, one of the abundant ingredients in YPFS, modulated the activity of GSTs, and then elevated cisplatin accumulation, resulting in increased cell apoptosis. The present result supports the notion of YPFS in reversing drug resistance of cisplatin in lung cancer cells by elevating of intracellular cisplatin, and the underlying mechanism may be down regulating the activities and expressions of ATP-binding cassette transporters and GSTs

Understanding interactions between Chinese medicines and pharmaceutical drugs in integrative healthcare

In the 21st century, the public are more informed, mainly via the Internet, about health and medical products and have become more knowledgeable about matters relating to their health conditions and well-being in curing and preventing illnesses. They often self-medicate themselves with various health products and over-the-counter (OTC) medicines apart from prescribed pharmaceutical drugs (PD). Some of those non-prescribed products may have doubtful quality control and contain harmful additives or unchecked ingredients; thus their usefulness is in doubt. The increasing popularity world-wide of using Chinese medicines (CM) and related OTC functional products has raised concerns over their concomitant use with PD and the consequential adverse effects. In most cases the alleged causes of adverse effects are linked with herbal sources, although the authorised information on the interactions between CM-PD is not plentiful in the literature. There is an urgent need for such a data base. The future professionals in health and medical care should be knowledgeable or aware of what their patients have been taking or given. In actual practice the patients may receive both treatments intentionally or unintentionally, with or without the awareness of the practitioner. In these situations a reliable database for interactions between CM-PD will be extremely useful for consultation when treatment problems appear or during emergency situations. Their combining of medications may be involved with possible outcomes of adverse reactions or beneficial effects. Such a database will be welcomed by both practitioners of herbal medicines and orthodox medicine practitioners in the emerging trend of integrative medicine. The author has been involved in various research projects of basic and clinical aspects in mainly CM among other herbal and PD. Examples will be given largely on those related to these disciplines as illustrations in this overview

A personal view on how to research into linking TCM with conventional medicine concepts

Traditional Chinese medicine (TCM) and Western medicine (WM) have evolved in different cultural settings throughout history and have led to two different ways of providing healthcare and researching science and medicine. WM is currently facing the challenge of increasing costs and decreasing new effective drugs. How best to research to integrate the best of both paradigms to provide healthcare

An overview on safety issues of interactions between traditional herbal medicines and pharmaceutical medicines

The increasing popularity world-wide of using herbal medicinal materials (HMM) from ethnic traditional medicine such as the widely used Chinese materia medica (CMM) or other ethnic herbal medicines and related proprietary health products (PHP), functional food and prescription herbal medicines has raised concerns over their concomitant use with pharmaceutical medicines (PHARMED) and the consequential adverse effects. In most cases the alleged causes of adverse effects are linked with herbal substances, although the authoritive information on the interactions between HMM/PHP and PHARMED is not plentiful in the literature. There is an urgent need for such a data base. In the 21st century, the public are more informed, from the Internet, about health and medical products and become more knowledgeable about matters relating to their health conditions and well-being in curing and preventing illnesses. They often self-medicate themselves with various health products as well as those over-the-counter (OTC) PHARMED. Some of theses products may have doubtful quality control and contain harmful additives or unchecked ingredients. The future professionals in health and medical care should be knowledgeable or aware of what their patients have been taking or given. Their combining medications may be involved with possible outcomes of adverse reactions or beneficial effects. In actual practice the patients may receive both treatments intentionally or unintentionally, with or without the awareness of the practitioner. In these situations an available authoritive database for interactions between HMM/PHP or prescribed PHARMED will be extremely useful for consultation when treatment problems appear or during emergency situations. Such a database will be welcomed by both practitioners of herbal medicines and orthodox medicine (OM) practitioners. The author has been involved in various research projects of basic and clinical aspects in mainly Chinese medicines among other herbal and pharmaceutical medicines hence examples will be given largely on those related to these disciplines as illustrations in this overview. It is envisaged that some of the safety issues and all other aspects discussed in the following texts are also relevant to other traditional or ethnic medicines

Evolution of herbal medicines in Europe and its relationship with modern medicine

The histories of Western orthodox medicine (OM) and herbal medicine (HM) are inextricably intertwined because until the nineteenth century, with the advent of synthetic chemistry, all drugs were obtained from natural sources, and mostly from plants. Europe has always been well-connected to other parts of the world, via trade, colonization, and immigration, so its systems of medicine have evolved from the traditional medical practices of many ethnic groups and ancient civilizations from various parts of the world. These may differ widely in their philosophies and practical adaptations but often have herbal drugs in common: For example, ginger is used in almost all forms of traditional medicine, including European HM, despite being a tropical plant. European herbal medicine now uses plants from all over the world and especially China, India, South East Asia, and the Americas

An overview on adverse drug reactions to traditional Chinese medicines

Although TCM has played an indispensable role in maintaining the health of people in China and several Asian regions, its biomedical/scientific value remains largely not understood according to the biomedical and OM concept. Many existing reports are often inconclusive due to the often less stringent research design according to the general OM norm of clinical trials. This deficiency has led to criticism domestically in China and worldwide

[In Press] Xiaoke Pill (消渴丸) and anti-diabetic drugs : a review on clinical evidence of possible herb-drug interactions

Objective: To critically analyze the clinically-based evidence of herb-drug interaction on Xiaoke Pill (消渴丸) and its concomitant use with anti-diabetic drugs. Methods: MEDLINE, EMBASE, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Allied and Complementary Medicine Database (AMED), International Pharmaceutical Abstracts (IPA), Chinese BioMedical Literature Database (CBM), Traditional Chinese Medical Database System (TCMDS), China National Knowledge Infrastructure Database (CNKI) and Wangfang Databases were searched. Levels of Evidence and Severity Level of Interaction were used to evaluate the quality of the included studies. Results: A total of 27 studies published in Chinese, including 2 randomized controlled trials, 3 case series and 22 case reports, were included. Eighteen herbdrug interactions were reported involving Xiaoke Pill as monotherapy, while 6 herb-drug interactions occurred associated with Xiaoke Pill in combination with anti-diabetic drugs. The clinical results of herb-drug interaction of Xiaoke Pill were reported as additive blood glucose-lowering effects with anti-diabetic drugs, including benefifi cial and adverse hypoglycemic effects, anaphylactic shock and severe hair loss. Of these interactions 82.8% were reported to be associated with potential deterioration of the patients’ conditions including hypoglycemic coma, stroke, mental disorder and even death. Conclusions: This review helped establish the clinically-based evidence about herb-drug interaction of Xiaoke Pill and its concomitant use with anti-diabetic drugs. The fifi ndings would help arouse the awareness of both health professionals and the general public to avoid the adverse herb-drug interactions of Xiaoke Pill in healthcare and community settings