The antiviral and antimicrobial activities of licorice, a widely-used Chinese herb

Currently, the treatment of pathogenic microbial infections involves the use of a suitable antibiotic or combination of antibiotics. Unfortunately, the development of drug resistance in microbes is a serious problem. Hence it is necessary to find alternative treatments. Traditional Chinese medicines (TCMs) have been widely used since ancient times in China to treat the diseases caused by microbial infections. This suggests that the TCMs can potentially have anti-microbial activity against selected pathogenic microbes. This study firstly focused on the anti-microbial activity of 24 selected TCM extracts and demonstrated anti-microbial activities of several TCM extractss against three reference microbial strains (P. aeruginosa (Gram negative), S. aureus (Gram positive), and C. albicans (Fungus)). Two TCM extracts were shown to have inhibitory activity against P. aeruginosa, 14 TCM extracts were effective against S. aureus, and 3 TCM extracts were effective against the growth of C. albicans. In addition to the development of antibiotics, TCMs also has been used as additives in health products to overcome health problems caused by microbes and improve human body health. For example, body odour is caused by the overgrowth of C. jeikeium. Thus, the treatment of body odour can be achieved by inhibiting the growth of C. jeikeium. This study tested the anti-bacterial activity of 24 selected TCM extracts against C. jeikeium, 10 of which inhibited this bacteria’s growth. Those 10 TCM extracts can be potentially used as resources from which new deodorant ingredients could be developed. From preliminary data, three TCM extracts were selected for further investigation. Of those selected TCM extracts, TARAXACI HERBA (Pu Gong Ying, TH), which had efficacy against P. aeruginosa, was also tested for its ability to inhibit the growth of P. aeruginosa in shampoo. However, results showed that TARAXACI HERBA did not inhibit the growth of P. aeruginosa in the shampoo tested in this project. Cancer is a disease with severe adverse effects. Multiple myeloma (MM) is an incurable blood cancer that has concerned human society for a long time. Although recent chemotherapy advances have successfully improved the overall survival of MM patients, the development of drug resistance to current treatments makes it necessary to develop a new therapy. All three selected TCMs (COPTIDIS RHIZOMA (CR), TARAXACI HERBA (TH), and LONICERAE JAPONICAE FLOS (LJF)) have previously demonstrated anti-cancer or anti-tumour activity and another TCM, which was available in our lab (Xanthium), also has reported anti-cancer activity. Thus, four TCM extracts were tested for their ability to inhibit the proliferation of myeloma cells. Results showed that all four TCM extracts inhibited the cell proliferation of three different myeloma cell line including a bortezomib (BTZ) resistant RPMI cell line. However, only CR and TH have no toxicity to human fibroblast cells when they are killing cancer cells. A further study was conducted to determine whether the cell proliferation inhibition activity of the four TCM extracts is due to the ability to inhibit thioredoxin reductase (TrxR) activity. Although results indicate that all four TCM extracts can have significant effects on the reactive oxygen species (ROS) level in different myeloma cell lines, only treatment with LJF resulted in the inhibition of TrxR activity in myeloma cell lines. In conclusion, this project confirmed the anti-microbial activity of several TCM extracts among the original 24 selected TCMs. Interestingly, three of the TCM originally selected due to their anti-microbial activity are also able to inhibit cell proliferation of myeloma cells, including a BTZ resistant cell line. However, only one TCM extract (LJF) has the ability to inhibit TrxR activity in myeloma cells.

Triterpenoids are nature-derived compounds, broadly distributed in plant kingdom in a free form as well as in a form of numerous glycosides. The complex structures of triterpenoids chiefly involve squalene derivatives, lanostanes, cycloartanes, dammaranes, euphanes, tirucallanes, tetranortriterpenoids, quassinoids, lupanes, oleananes, friedelanes, ursanes, hopanes, serratanes and another less known groups. These compounds present interesting and perspective subject for experiments, chemical and biological as well. As it is known from literature data, triterpenoids and their saponins with respect to their multitude pharmacological activities could be involved in several areas such as chemistry, medicine and pharmacology, biomedicine and agrochemical sciences. The special structure of triterpenic skeletons allows to perform numerous chemical transformations in order to obtain many new derivatives with pharmacological activity. Taking under consideration the above data, chemistry, biology and pharmacology of triterpenoids and their saponins appear to be riped for revisiting. Therefore, this special issue aims to review the advances in triterpenoids science during the last decade. Carcinomas are probably the second leading cause of death in humans, so scientists intense their research upon the development of new biological sources with antitumor activity. Medicinal plants are now the most promising sources of new potent substances in cytotoxic drug development. As Csuk presented in his work, such compound of anticancer activity is glycyrrhetinic acid, obtained e.g. from liquorice, known as sweetwood (Glycyrrhiza glabra) and some derivatives obtained from this triterpenic acid. Antitumor activity also exhibits, as presented by Paduch and Kandefer-Szerszeń, other triterpenes, such as: asiatic acid, betulinic acid, boswellic acid, lupeol, oleanolic acid or ursolic acid and their analogs and derivatives. These compounds exhibit a cytotoxicity against a variety of tumor cell lines comparable to some clinically used drugs. Most of them also have important antiviral properties, especially anti-HIV activity, which makes them potentially useful additives to current anti-HIV therapy. Another group of triterpenoids with anticancer and antiviral activity is limonoids family, belonging to tetranortriterpenoids. As Pękala and co-workers present, limonoids are a very valuable group of triterpenoids because of a wide spectrum of biological properties, such as cytotoxic, antimalarial, anti-inflammatory, antifeedant, antiviral, neuroprotective, antimicrobial, antibacterial, antifungal and other activities. Limonoids present rich variety of structures: until 2011, about 1300 limonoids with more than 35 carbon frameworks had been isolated from four families (Meliaceae, Rutaceae, Simaroubaceae, and Cneoraceae). The unique structural features of these terpenoids have attracted continuous attention of chemists and pharmacologists. Triterpenoids often occur as ingredients of daily diet or of herbal products used for therapeutic purposes. These phytochemicals occur in nature in free form or as glycosylated compounds, known as saponins, due to their characteristic foaming properties. Pharmacological activities of saponins are very broad and include numerous directions of action which were discussed in many works. Podolak and Janeczko summarize pharmacological properties of natural, non-glycosylated triterpenoids, that were reported over the last five years. The work discusses e.g. antimicrobial, cytotoxic, anti-inflammatory, antinociceptive, antidiabetic, hepatoprotective, wound healing and other activities of triterpenoids, focusing on less known compounds. Plants remain as the most viable source of triterpenoid saponins. As plants are the source of pharmacologically active saponins and free triterpenoids, it is obvious that the development of new methodologies to improve saponin yields is a significant issue. As Yendo et al. state in their work current challenges to improve triterpenoid saponin production including a better understanding of the signal transduction pathways leading to their accumulation, isolation and heterologous expression of biosynthetic genes, as well as structural and modeling studies of biosynthetic enzymes and their catalytic mechanisms. Some triterpenoids and their semi-synthetic derivatives can be identified as potential therapeutics against neurodegenerative diseases. Ruszkowski and Bobkiewicz-Kozlowska discuss the ability of celastrol, oleanolic acid, ursolic acid, asiatic acid, erythrodiol, and some triterpenoid saponins to protect the brain against neurodegeneration and neuroinflammation processes. The authors focus on triterpenoids as possible drugs to treat or slow the progression of neurodegenerative diseases such as Parkinson’s disease, Alzheimer’s disease, Huntington’s disease, amyotrophic lateral sclerosis and multiple sclerosis (MS). Further, pharmacological activities of naturally-derived triterpenenoids and some of their synthetic derivatives are discussed by Jeong and Bae, Jaworska-Paszel et al. and by Luo et al. The anti-inflammatory effect is a common property of many triterpenoids. Jeong and Bae discuss the anti-inflammatory property of several triterpenoids derived from natural sources and from chemical synthesis. These triterpenoids include avicins, boswellic acid, celastrol, diosgenin, escin, ginsenosides, glycyrrhizin, lupeol, oleanolic acid, platycodon D, saikosaponins, ursolic acid, 2-cyano-3,12-dioxooleana-1,9(11)-dien-28-oic acid (CDDO), and some of their derivatives. Jaworska-Paszel et al. describe anti-inflammatory, antioxidative, antitumor, antileukemic, hepatoprotective, gastroprotective, cardioprotective and many other important pharmacological activities of oleanolic acid. Luo et al. focus on recent advances in enone and NOreleasing derivatives of oleanolic acid with anti-cancer activity. Other compounds exhibiting numerous pharmacological activities are betulin and betulinic acid, both with pentacyclic lupane-type skeleton. Betulin, betulinic acid and their derivatives have been studied in the last decades for their diversified pharmacological activities like anti-HIV, anticancer, antibacterial, anti-inflammatory and many others. In the last few years, great progress had been made on the synthesis and biological activity of triterpenoids derived from betulin and betulinic acid. Shi and co-workers discuss recent research and development in chemistry of betulin and betulinic acid and present recent modification within A-ring, E-ring, both, at the C-3 and at the C-28 position as well as at the C-30 position of betulin and betulinic acid. The authors also present methods of conjunction of the above triterpenes with drugs. Supercritical fluid extraction has been a widely studied green technology to obtain triterpenoids enriched extracts from various vegetable matrices. De Melo and co-workers discuss research advances regarding the supercritical fluid extraction of triterpenoids in terms of biomass sources, operating conditions and their optimization, and modeling. The authors provide overview concerning the recent works (both publications and patents) upon supercritical fluid extraction of plant material leading to triterpenoids with the most important experimental and/or theoretical information. Many families of bioactive natural products are usually extracted from numerous plant sources in low yields. Triterpenic acids belong to a group of the most often studied compounds, mainly because of their abundance in a large number of food and medicinal plants. Domingues et al. in their work present overview of the biogenetic origin of some triterpenic acids, on the analytical extraction and hyphenated methodologies (mainly GC-MS) used on their identification and quantification. The authors also present an overview of the major sources of some triterpenic acids, indicating their potential large scale production pathways, with especial emphasis on abundant agroforestry biomass residues. The future perspectives towards improved therapeutic strategies using these triterpenic acids are also discussed herein. The root bark of the Chinese medicine Tripterygium wilfordii contains a quinone methide triterpenoid - celastrol. Literature data presents, that celastrol is one of the most potent antitumor activity compounds among the natural triterpenoids. Salvador et al. discuss different mechanisms of antitumor activity of celastrol, such as abilities of inhibing proliferation, inducing apoptosis and suppressing invasion and metastasis of tumor cells. The authors also describe the anticancer property of semi-synthetic celastrol derivatives. As they noticed, the quinone methide moiety is required for its antitumor activity. I thank all the contributors or this special issue and hope that the progresses highlighted in the topics covered will inspire more research in this challenging area of organic synthesis. I thank Prof. Atta-ur-Raman for the kind invitation to be the Guest Editor of this issue and all the reviewers for their time and valuable comments. I also thank Ms. Hina Wahaj (Publications Manager, Bentham Science Publishers) for the help in organizing this issue.

Honeysuckle and gardenia are classified as cold-natured traditional Chinese medicinal herbs, with chlorogenic acid and gardenoside recognized as their major bioactive components. Modern pharmacological studies have confirmed their antiviral, anti-inflammatory, antioxidant, and immunomodulatory activities. However, research on the microbial fermentation of traditional Chinese medicine (TCM) for antiviral applications remains limited. This study aimed to investigate the antiviral activity against Goose parvovirus (GPV) of fermented TCM using Lactobacillus isolated from silage feed, and to explore its potential theoretical and practical value. Lactobacillus plantarum was isolated and identified using standard microbiological methods, and its probiotic properties were evaluated. The in vitro antiviral activity of bacterial cells and their metabolites was assessed using cellular models, including the cell counting kit-8 (CCK-8) assay and quantitative PCR (qPCR). High-performance liquid chromatography (HPLC) was employed to analyze changes in active components of TCM following lactic acid fermentation. In addition, network pharmacology and molecular docking analyses were performed to elucidate the potential mechanisms of action. A strain of Lactobacillus plantarum with strong acid and bile salt tolerance (survival rate > 92%) was successfully isolated. The strain effectively inhibited pathogenic bacteria and demonstrated safety in mice. In vitro experiments showed that bacterial metabolites significantly suppressed GPV proliferation. Fermentation markedly increased the contents of active components, including chlorogenic acid and gardenoside, in honeysuckle and gardenia decoctions. Moreover, the fermented mixed decoction exhibited a highly significant anti-GPV effect. Network pharmacology and molecular docking analyses indicated that key active components, such as quercetin, exert antiviral, and anti-inflammatory effects mainly through the regulation of Toll-like receptor-related signaling pathways involving targets such as IL-6 and TNF. This study demonstrates that L. plantarum, TCM, and their fermentation products effectively alleviate GPV infection and improve intestinal barrier function. HPLC and network pharmacology analyses suggest that fermentation-derived active components, including chlorogenic acid, gardenoside, quercetin, and organic acids, may synergistically enhance antiviral and anti-inflammatory effects by modulating IL-6/TNF-related signaling pathways and interacting with the gut microbiota.

See related article, pages 1973–1979. The lack of effective and widely applicable pharmacological treatments for ischemic stroke patients may explain a growing interest in traditional medicines, for which extensive observational and anecdotal experience has accumulated over the past thousand years. The World Health Organization (WHO) defines traditional medicine as “health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses or maintain well-being”.1 Unlike Western medicine, which focuses on disease, traditional medicine takes the approach that the body provides external clues to an internal imbalance that can be addressed by interventions such as herbs and acupuncture (holistic treatment approach).2 According to a 2003 WHO report,1 traditional medicine is very popular in all developing countries, and its use is rapidly increasing in industrialized countries. For example, traditional herbal preparations account for 30% to 50% of the total medicinal consumption in China. In Europe, North America and other industrialized regions, over 50% of the population have used traditional medicine at least once. The global market for herbal medicines currently stands at over US $60 billion annually and is growing steadily.1 In recent years, several reviews have been published on the effect and potential benefits of traditional Eastern medicine in stroke.3–7 It has been suggested that some herbal medicines, or their products, may improve microcirculation in the brain,4,8 protect against ischemic reperfusion injury,8,9 possess neuroprotective properties3,4 and inhibit apoptosis,10 thus justifying their use in ischemic stroke patients. However, unlike industrially manufactured pharmacological drugs used in Western medicine, the active (potent) components of herbal medicines often have not been specified and measured precisely, although there have been recent attempts to regulate dosages and use of …

A review of the ethnopharmacology, phytochemistry, pharmacology, and quality control of Scutellaria barbata D. Don

To the Editor: Colorectal cancer is one of the most common cancers worldwide, and chronic inflammation caused by colitis, especially ulcerative colitis, increases the risk of colorectal cancer. Compared with sporadic colorectal cancer whose hallmark is constitutive activation of Wingless/β-catenin signaling and the adenoma-carcinoma sequence, p53 and K-ras mutations, which occur earlier, adenomatous polyposis coli occurs later during the progression of colitis-associated colorectal cancer (CAC). Surgery and chemotherapy are the preferred treatments of CAC, but long-term use of first-line chemotherapy agents such as 5-fluorouracil or irinotecan is limited by drug resistance or adverse reactions. Therefore, it is necessary for us to identify "green" drugs. Traditional Chinese medicines (TCMs) are complex and diverse and are found in nature. The anti-inflammatory, antibacterial, antiviral, antioxidant, antitumor, antiradiation, and immunomodulatory activity of TCMs have been extensively studied. TCMs are more able than synthesized drugs to prevent inflammation from progressing to cancer. This review summarizes the advantages of TCMs for treating CAC. With increase of the severity of the inflammation, the risk of cancer development increases. Nuclear factor kappa-B (NF-κB), P53, and the cyclooxygenase-2/prostaglandin E2 signaling pathways are known to be involved in the pathogenesis of CAC. Accumulation of reactive oxygen species causes oxidative stress and destroys DNA, proteins, and lipids, leading to tumors. Most TCMs have anti-inflammatory activity that participates in the prevention or treatment of CAC. Wogonoside administration leads to the return of downstream inflammatory factors such as interleukin (IL)-1β, IL-6, and tumor necrosis factor-alpha (TNF-α) levels close to normal. Wogonoside also reduces neutrophil and macrophage infiltration in CAC.[1] Betaine administration inhibited inflammatory-related cytokines such as TNF-α, IL-6, inducible nitric oxide (NO) synthase, reactive oxygen species, and cyclooxygenase-2. Apple polysaccharide extract is effective as chemoprevention by inhibiting NF-κB-mediated inflammation pathways in colorectal cancer. Inhibition of inflammation in cancer may be key in treating CAC with TCMs. Activation of NF-κB and its signal pathways regulate cell proliferation and apoptosis by up-regulating the expression of cyclins and Bcl-2 family members. Honokiol, a biphenolic compound found in Magnolia grandiflora, induces ferroptosis in colon cancer cells by reducing glutathione peroxidase 4 activity. An ethanol extract of Aster glehni, reduced nuclear factor NF-κB activation by phosphorylation and degradation of inhibitor of kappa Bα, leading to inhibition of NF-κB p65 nuclear translocation. The evidence indicated that A. glehni may have promise as a protective agent against CAC by suppression of the NF-κB signaling pathway. Oral administration of an ethanol extract of Tuber aestivum sprouts significantly decreased the expression of the β-catenin-related cyclin D1 and c-Myc genes in colon tissue from mice with azoxymethane (AOM)/dextran sulfate sodium (DSS)-induced CAC. Low-dose bufalin effectively suppressed tumorigenesis in colorectal cancer models, accompanied by attenuated epithelial cell proliferation (i.e., lower cyclin A, cyclin D1, and cyclin E levels, and higher p21 and p27 levels) and promoted apoptosis (i.e., lower Bcl-2, Bcl-xL, and survivin levels, and higher Bax and Bak levels).[2] TCMs such as wogonoside and Rhizopus nigricans may have superior effectiveness against CAC because they inhibit cell proliferation and promote apoptosis. The host intestinal immune system restrains bacteria, and under normal conditions limits the entry of bacteria into the intestinal epithelium. The gut microbiota interacts with immune cells in the intestinal mucosa to promote the development and maintenance of the immune system. Microbial overstimulation may lead to inappropriate activation of intestinal immune cells and the development of intestinal inflammation. In an AOM/DSS-induced CAC mouse model, the probiotics Alloprevotella, Bacteroides, and Lactobacillus were decreased and the pathogenic bacteria Muribaculaceae, Proteobacteria, Citrobacter, Akkermansia, and Klebsiella were increased. The imbalance led to inflammation and weakening of intestinal barrier function.[3] Enriching probiotics and reducing the abundance of pathogenic bacteria are considered to be useful in the treatment of CAC. For example, isoliquiritigenin reduces the abundance of genera including Escherichia and Enterococcus, which are opportunistic pathogens and increased the levels of probiotics like Butyricicoccus, Clostridium, and Ruminococcus to protect mice from AOM/DSS-induced CAC.[4]Lactobacillus bulgaricus is a widely used probiotic bacterium, was found to inhibit tumor progression and intestinal inflammation in an AOM/DSS-induced CAC mouse model, with reduction of IL-6, TNF-α, IL-17, IL-23, and IL-1β. Recent studies have identified potentially effective CAC treatments that act by improving the intestinal microenvironment, including antibiotics, probiotics, prebiotics, and fecal microbiota transplantation. TNF-α induces a variety of cellular responses by interacting with transmembrane receptors. TNF-α antagonists inhibit CAC growth in AOM/DSS-treated mice. The IL-23/T-helper 17 pathway is involved in the pathophysiology of CAC. Previous studies have shown reduced tumor development in AOM/DSS-treated IL-17A-deficient mice with CAC. The IL-6/IL-6R axis is active in immune cell recruitment and T cell survival and differentiation. Silibinin, dietary cocoa, and Rhizoma Paridis total saponins protected against CAC in mice by inhibiting the IL-6/signal transducer and activator of the transcription 3 protein signaling pathway. Synergistic combinations of TCMs with chemotherapy agents are seen as promising methods to treat CAC by overcoming the weaknesses of single-target drugs.[5] Curcumin combined with resveratrol inhibited the growth of CAC cells more strongly than either agent alone, which was attributed to the enhancement of anti-proliferation and pro-apoptosis activity. Other studies investigated the effects of TCMs as modulators for chemotherapy. Ursolic acid, a pentacyclic triterpenoid found in holy basil, was found to enhance the anticancer effects of capecitabine through inhibition of NF-κB. Curcumin combined with FOLFOX had superior anticancer effectiveness by downregulating epidermal growth factor receptors and insulin-like growth factor-1R signaling. Recent advances in TCMs-induced prevention and therapy of CAC are discussed here and the comprehensive information are shown in Supplementary Table 1, https://links.lww.com/CM9/B515.We aimed to supply new approaches in CAC treatment using TCMs, and TCMs can block the progress from inflammation to cancer, not only inhibits cancer cell growth. This correspondence may uncover the tip of the iceberg of mechanisms underlying TCMs for treating CAC that have not been extensively studied. The huge potential of TCMs may provide new insights into drug design and CAC therapy, especially in preventing the progression from inflammation to cancer. Funding This work was supported by the Basic Scientific research Project of the Liaoning Province Education Department (Grant No. LJKZ0832). Conflicts of interest None.

Senecio scandens Buch.-Ham.: A review on its ethnopharmacology, phytochemistry, pharmacology, and toxicity

Rabdosia rubescens (Hemsl.) H. Hara: A Potent Anti-Tumor Herbal Remedy - Botany, Phytochemistry, and Clinical Breakthroughs

Licorice has been a common Chinese medicine for thousands of years, which has good medicinal value and nutritional value. Is widely apply to traditional Chinese medicine. Many studies have shown that licorice contains more than 20 triterpenoids and nearly 300 flavonoids. According to the literature, licorice has many activities such as antibacterial, antiviral, antioxidant, and anticancer. It not only directly inactivates the virus, but also inhibits its adsorption. However, glycyrrhizin, glycyrrhetinic acid, glycyrrhiza polysaccharide and glycyrrhiza flavonoids are the main components of licorice which possess antiviral and antimicrobial activities. Among them, glycyrrhizin has many pharmacological activities, such as antiviral, anti-inflammatory, anti-tumor, antibacterial and many other activities. This paper provides a summary of antiviral activities of glycyrrhizin. This active ingredients and possible mechanisms are summarized in detail. The results showed that glycyrrhizin was widely used in antiviral field, but its material basis and mechanism of action were not perfect and unified. A large number of literatures about glycyrrhizin anti-virus were reviewed and analyzed, and it was suggested that more different ways should be adopted to study it, so as to provide a broader theoretical basis for developing new antivirus drugs of glycyrrhizin. It is hoped that this review will be helpful to further study the potential therapeutic effect of glycyrrhizin as an antiviral drug.

Alkaloids in genus stephania (Menispermaceae): A comprehensive review of its ethnopharmacology, phytochemistry, pharmacology and toxicology

Immunomodulatory effect of traditional Chinese medicine in infectious diseases.

Objective：Type 2 diabetes is becoming a pandemic disorder and its alarming increase in prevalence of either microvascular or macrovascular disease raises significant concerns. As the same in Taiwan, type 2 diabetes mellitus (DM) is one of the most prevalent and fastest growing diseases. Traditional Chinese medicine (TCM) as a unique traditional therapy for various ailments has been used in Taiwan for over hundreds of years. The consumption of Chinese herbal products (CHPs) is increasing exponentially in Taiwan. However, the scientific evidence is lacking and there is an urgent requirement for detailed pharmacoepidemiological information on CHP usage. The aim of the study is to explore the demographics and utilization patterns between Chinese herbal products (CHPs) users and non-users among people with diabetes and to determine how frequent the concurrent use of hypoglycemic drugs with CHPs on a nationwide level in real practice. We believe that this study provides evidence-based information for formulating appropriate management strategies of drug safety and integrative medicine. Methods：The usage, frequency of services, and CHP prescribed among diabetic patients using hypoglycemic drugs were evaluated, recruited from a randomly sampled cohort of 1,000,000 beneficiaries from the National Health Insurance Research Database. The logistic regression method was employed to estimate the odds ratios (ORs) for the co-prescription of a CHP and hypoglycemic drugs. In addition, to investigate the incidence rate of consuming traditional Chinese medicine among diabetic patients with newly diagnosed end-stage renal disease (ESRD) from 1998 to 2008 in Taiwan. Result: 77.9 percent (n = 31,289) of diabetic patients utilized traditional Chinese medicine (TCM) during the 11-year study period. Most type 2 diabetic patients also received western medicine (WM) treatment, and only 8.4 percent (n = 3,370 ) never used WM. Females, regular salary earners, and living in Central and Kaohsiung city were more likely to consume CHPs and hypoglycemic drugs concurrently. Among concurrent users, “symptoms, signs, and ill-defined conditions” (612,380 visits) was the most frequent major disease category for concurrent use hypoglycemic drugs and CHPs. Most type 2 diabetes diabetes patients took two hypoglycaemic agents (n = 13,609, 33.9％) in WM treatment. Metformin plus Sulfonylureas (n = 11,636, 29.0％) and Liu-Wei-Di-Huang-Wan were the most prescribed hypoglycemic drugs and Chinese formula, respectively. In comparison with control group, there was a lower incidence rate (ESRDs/ 1,000 person-years) of the traditional Chinese medicine users (TCM nonusers, n = 14.5, male, n = 15.6, female, n = 12.6; TCM users, n = 3.9, male, n = 5.0, female, n = 2.8). Discussion: the utilization of TCM among adults with type 2 diabetes in Taiwan during the study period appeared to be high compared with previous findings. TCM as a unique traditional therapy for various ailments which has been used in Taiwan for over hundreds of years may be the main contributor to the high prevalence of TCM usage among type 2 diabetic subjects. Moreover, TCM treatment has been covered by the NHI system. Unsurprisingly, the prevalence of CHP for treating type 2 diabetes among adults is comparatively higher in Taiwan than in other countries. However, we inferred that TCM for type 2 diabetes in Taiwan was generally used as adjuncts to diabetes treatment, rather than as replacements for it. Further analysis found that TCM doctors tended to use Chinese herbal medicine (CHMs) to deal with diabetes and gastrointestinal disorders which might be the uncomfortable side effects of diabetes drugs. And the present study indicated that acupuncture in Taiwan was used by this population mainly for diseases of the musculoskeletal system and connective tissue (Diseases of the musculoskeletal system and connective tissue ICD-9 code 710-739). In comparison with control group, utilization of traditional Chinese medicine had the protective effect and lowing inducing diabetic nephropathy, but the active components need to be determined accurately. Conclusions：During the 11-year study period, 77.9 percent of type 2 diabetic patients utilized traditional Chinese medicine (TCM), and only 8.4 percent never used WM in Taiwan. Hence, we inferred that TCM for type 2 diabetes in Taiwan was generally used as adjuncts to diabetes treatment, rather than as replacements for it. Liu-Wei-Di-Huang-Wan and its derivatives are the most frequent prescribed formulas by TCM doctors in Taiwan for type 2 diabetic patients. Utilization of traditional Chinese medicine had the protective effect and lowing inducing diabetic nephropathy (incidence rate: TCM nonusers, n = 14.5; TCM users, n = 3.9). Although some evidence does support the use TCM to treat diabetes, the results from the current study could have been confounded by placebo effect, emphasizing the need for well conducted, double-blind, randomized, placebo-controlled studies to further evaluate the efficacy of TCM on patients with type 2 diabetes.

Licorice is one of the oldest and most frequently used herbs in traditional Chinese medicine. It contains more than 20 triterpenoids and 300 flavonoids. In recent years, a lot of studies have reported that the active compounds isolated from licorice possess antitumor, antimicrobial, antiviral, anti-inflammatory, immunoregulatory, and several other activities that contribute to the recovery and protection of the nervous, alimentary, respiratory, endocrine, and cardiovascular systems. In this paper, nine different pharmacological activities of licorice are summarized. The active compounds responsible for these pharmacological activities, the molecular mechanisms, and in vivo and in vitro studies are listed in detail. Furthermore, the clinical therapeutics and toxicity studies of licorice are also discussed. We hope this work can provide a basis for further studies concerning with the safe and effective use of licorice.

Lactoferrin (LF) is an iron-binding secretory protein, which is distributed in the secondary granules of polynuclear lymphocytes as well as in the milk produced by female mammals. Although it has multiple functions, for example antimicrobial, immunomodulatory, antiviral, and anti-tumor metastasis activities, the receptors responsible for these activities are not fully understood. In this study, the binding epitopes for human LF were first isolated from a hexameric random peptide library displayed on T7 phage. Interestingly, two of the four isolated peptides had a representative cell adhesion motif, Arg-Gly-Asp (RGD), implying that human LF interacts with proteins with the RGD motif. We found that human LF bound to the RGD-containing human extracellular matrix proteins, fibronectin and vitronectin. Furthermore, human LF inhibited cell adhesion to these matrix proteins in a concentration-dependent manner but not to the RGD-independent cell adhesion molecule like laminin or collagen. These results indicate that a function of human LF is to block the various interactions between the cell surface and adhesion molecules. This may explain the multifunctionality of LF.

Potential multifunctional components explored in Chinese herbal medicine against hepatitis B combining multi-target affinity ultrafiltration HPLC/MS