Herb-herb Interactions Research Articles

Exploring the synergistic effects of chuanxiong rhizoma and Cyperi rhizoma in eliciting a rapid anti-migraine action based on pharmacodynamics and pharmacokinetics

Ethnopharmacological relevanceHerb-herb combination has been used to maximize the therapeutic efficacy in the theory of traditional Chinese medicine. Chuanxiong rhizoma (called Chuanxiong in Chinese, CX) and Cyperi rhizoma (called Xiangfu in Chinese, XF) have been used alone or in combination (CRCR) to treat migraine dating back to Eastern Jin Dynasty (AD317) of China. But no data demonstrate the possible necessities or advantages of combining CX and XF for migraine. Aim of the studyThis study explores the combination mechanism based on pharmacodynamics and pharmacokinetics. Materials and methodsA nitroglycerin-induced acute migraine model in rats was used to evaluate the anti-migraine effects of CRCR and the individual herbs using behavior, real time polymerase chain reaction and Western blot experiments. The absorption characteristics of active components involved in the anti-migraine action were analyzed by UPLC-MS/MS. ResultsCX and CRCR significantly reversed the abnormal levels of vasoactive substances (5-HT, CGRP, MMP-2 and MMP-9) to normal levels, but XF did not. XF and CRCR significantly decreased the pro-inflammatory cytokines (IL-1β, IL-6, and TNF-a), and increased the anti-inflammatory cytokines (IL-4 and IL-10). CRCR significantly decreased the mRNA expression levels of c-fos, iNos and nNos, and the corresponding protein expression levels of c-Fos, iNOS, and nNOS. CRCR inhibited NOS/NO pathway by downregulating the expression levels of NOS and NO. Furthermore, CRCR significantly increased the intestinal absorption rate and amount, and changed the pharmacokinetic parameters of active components in comparison with the individual herbs. ConclusionsCX had an advantage in regulating vasoactive substances, and XF focused on regulating inflammatory cytokines. CRCR is more effective in treating migraine than the individual herbs by depending on the synergistic action of CX and XF. This research provided some critical evidences on synergistic action between herb-herb interactions, and revealed the potential advantages of herb-herb combination in traditional Chinese medicine.

Use of Cannabinoids by People Who Consume Kratom in the United States.

To estimate lifetime, past-year, and past-month prevalence of kratom, cannabis, and cannabidiol-only product use among adults 18 years and older in the United States, using 2 independent datasets. Utilizing (a) the 2022 National Survey on Drug Use and Health (NSDUH) and (b) a 2022 online national convenience sample of adults who use kratom regularly (from our research group at the National Institute on Drug Abuse [NIDA]), we examined key demographic information as well as lifetime, past-year, and past-month substance use and preferences. Among the full sample of adults from the 2022 NSDUH, the prevalence of lifetime use was 49.69% for cannabis, 34.09% for cannabidiol-only products, and 1.93% for kratom. When solely examining participants who have used kratom, both independent datasets showed higher proportions of cannabis use over the lifetime-92.81% (95% confidence interval: 90.31-95.31) in the NSDUH subset and 92.16% (95% confidence interval: 89.37-94.95) in our NIDA sample. Our study demonstrates that people are co-using kratom with cannabis and/or cannabidiol-only products at the same time or during the same time period, though more research is needed to understand people's motivations and practices for such co-use. Co-use might result in herb-herb interactions that may impact research findings and clinical outcomes for people who use kratom.

Evaluation of blood boosting potentials of combined administration of Vigna unguiculata and Citrus limon ethanol extracts using Wister rat models

The use of traditional herbal medicines started in ancient times. It is estimated that 80% of world population depend on it for solutions to their health challenges. Currently, there has been enormous increase in the use of herbal medicines attributable to their readily availability, affordability, efficacy and good safety profile. This study evaluated the blood boosting potentials of combined administration of Vigna unguiculata and Citrus limon in rat models. Wister rats (135 – 140 g) were used and Vigna unguiculata and Citrus limon were extracted in ethanol. Apart from some preliminary tests, hematology studies were done using standard methods. The parameters tested included red blood cells (RBCs), hemoglobin (Hb), Packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) using hematological analyzer (DxH 560 AL). In the RBC test, combination of Vigna unguculata and Citrus limon recorded a count of 8.07 ± 0.20 x 10-6 on day 15 of treatment. This was highest when compared with the individual administrations which attained 4.04 ± 0.18 and 3.57 ± 0.07 x 10-6 respectively. The combination treatment approached that of the normal control which had RBC count of 8.29 ± 0.13 x10-6. This trend was applicable to other tested parameters. In conclusion, V. unguiculata and C. limon had blood boosting potentials which was more remarkable in the group treated with combination of the two herbs and this was attributed to their phytochemicals such as iron, protein and citric acid as well as their synergistic herb-herb interaction.

Enhanced absorption of prenylated cinnamic acid derivatives from Brazilian green propolis by turmeric in humans and rats.

Prenylated cinnamic acid derivatives are the bioactive components of Brazilian green propolis (BGP). The effect of other botanical components on the pharmacokinetic profiles of these derivatives remains relatively unexplored. In the present study, we investigated the influence of several herbal extracts (turmeric, ginkgo leaf, coffee fruit, soybean, and gotu kola) on the plasma concentrations of cinnamic acid derivatives after BGP consumption. When the herbal extracts were co-administered with BGP in the clinical study, the area under the curve (AUC) values of artepillin C and drupanin, the major BGP components in plasma, were significantly increased by 1.7- and 1.5-fold, respectively, compared to those after BGP administration alone. Among the herbal extracts administered to rats, turmeric extract increased the AUC. Furthermore, a bidirectional transport assay suggested that artepillin C and drupanin are substrates of breast cancer resistance protein (BCRP), a drug elimination transporter. These results suggest that curcumin-containing turmeric extract may increase the plasma concentrations of artepillin C and drupanin via BCRP. Our findings enabled us to estimate the food-herb and herb-herb interactions invivo in foods and herbal medicines containing cinnamic acid derivatives and prenylated compounds.

Safety Aspects of Herb Interactions: Current Understanding and Future Prospects.

The use of herbal medicines is on the rise throughout the world due to their perceived safety profile. However, incidences of herb-drug, herb-herb and herb-food interactions considering safety aspects have opened new arenas for discussion. The current study aims to provide comprehensive insights into the various types of herb interactions, the mechanisms involved, their assessment, and historical developments, keeping herbal safety at the central point of discussion. The authors undertook a focused/targeted literature review and collected data from various databases, including Science Direct, Wiley Online Library, Springer, PubMed, and Google Scholar. Conventional literature on herbal remedies, such as those by the WHO and other international or national organizations. The article considered reviewing the regulations, interaction mechanisms, and detection of herb-herb, herb-drug and herb-food interactions in commonly used yet vital plants, including Glycyrrhiza glabra, Mentha piperita, Aloe barbadensis, Zingiber officinale, Gingko biloba, Withania somnifera, etc. The study found that healthcare professionals worry about patients not informing them about their herbal prescriptions (primarily used with conventional treatment), which can cause herb-drug/herb-food/herb-herb interactions. These interactions were caused by altered pharmacodynamic and pharmacokinetic processes, which might be explained using in-vivo, in-vitro, in-silico, pharmacogenomics, and pharmacogenetics. Nutrivigilance may be the greatest method to monitor herb-food interactions, but its adoption is limited worldwide. This article can serve as a lead for clinicians, guiding them regarding herb-drug, herb-food, and herb-herb interactions induced by commonly consumed plant species. Patients may also be counseled to avoid conventional drugs, botanicals, and foods with a restricted therapeutic window.

Mitigating the Risks of Herb-Drug Interaction among Artisans in Ibadan Metropolis Through Public Health Education Survey

Background: Globally, there has been an increase in the use of herbal medicines with the general misconception that herbal medicines are absolutely effective and safe. Many people often use herbs concomitantly with orthodox medicines and this may lead to fatal complications of herb-drug interactions. This cross-sectional survey assesses the knowledge and attitude of teachers and artisans on the use of herbal medicine and the possible occurrence of herb-herb and herb-drug interactions.
 Method: A semi-structured questionnaire was used which covered demographics, cultural categorization of herbal medicine used, socio-economic factors (SEF), reason(s) for herbal medicine use, knowledge of herb-herb (HHI) and herb-drug interactions (HDI) and, and attitude to herbal medications (AHM) of the respondents. Data were entered into SPSS version 20 and analyzed using descriptive and inferential statistics.
 Results: There were 277 respondents, comprising 93 teachers, 77 drivers, and 107 mechanics. The response rate was 95.1%. Seventy-two (77.4%) teachers, 56 (72.7%) drivers and 101 (94.4%) mechanics use herbal medicine for infectious diseases while 57 (61.3%) teachers, 20 (26.0%) drivers and 83 (77.6%) use herbal medicine for non-infectious diseases. Assessment of SEF shows that a significant number (p=0.04) of participants were encouraged by friends to use herbal medicines while 63 (67.7%) teachers, 57 (74.0%) drivers, and 84 (78.5%) mechanics preferred herbal medicine to hospital management because it is affordable. Assessment of HHI shows 81 (75.7%) mechanics are aware of HHI, whereas 56 (72.7%) drivers and 69 (74.2%) teachers are not. Similarly, majority of the teachers (81, 87.1%) and drivers (47, 61.0%) were not aware of the possible occurrence of HDI while a significant (p=0.03) number (76, 71.0%) of the mechanics were aware.
 Conclusion: The respondents’ awareness of herb-herb and herb-drug interactions was poor. Public awareness program on the potential implications and health impact of herb-herb and herb-drug interactions is highly essential.

The compatibility rationality of Sijunzi decoction based on integrated analysis of tissue distribution and excretion characteristics in spleen deficiency syndrome rats

Ethnopharmacological relevanceAs a classical prescription for treating spleen deficiency syndrome (SDS), Sijunzi decoction (SJZD) is composed of Ginseng Radix et Rhizoma (RG, Panax ginseng C.A.Mey.), Atractylodes Macrocephalae Rhizoma (AM, Atractylodes macrocephala Koidz.), Poria (Poria cocos (Schw.) Wolf) and Glycyrrhizae Radix et Rhizoma Praeparata Cum Melle (GRP, processed from Glycyrrhiza uralensis Fisch., Glycyrrhiza inflata Bat. or Glycyrrhiza glabra L.). The non-polysaccharides (NPSs) are the pharmacodynamic substance basis of SJZD, whose pharmacokinetics in SDS rats were elaborated previously. Further study on their tissue distribution and excretion properties is of significance for understanding the compatibility laws of SJZD. Aim of the studyThe aim was to unravel the tissue distribution and excretion characteristics of NPSs of SJZD in SDS rats, and explore the scientific connotation of SJZD compatibility. Materials and methodsA validated ultrafast liquid chromatography tandem mass spectrometry method was developed for monitoring the accurate dynamics of sixteen components in the tissues, feces and urine of SDS rats. The four incomplete formulae of SJZD were prepared by randomly deleting one herb to uncover the herb-herb interactions. ResultsAll components of NPSs in SJZD were distributed in the tissues, except for ononin in the heart. Among them, glycyrrhetinic acid and atractylenolide III were more abundant in the liver and lung, respectively, while other components were enriched in the ileum, especially saponins. The evaluation of fecal excretion and urinary excretion revealed the low cumulative excretion of all components. The comparative analysis of incomplete formulae indicated that the tissue distribution and excretion became faster after removing Poria from SJZD, while a lack of RG led to slower tissue distribution. The tissue distribution at most time points was reduced when AM was absent. Further comprehensive visualization implied that SJZD compatibility can improve tissue distribution of the NPSs, especially ginsenosides and atractylenolide, at the specific time periods. ConclusionThe tissue distribution and excretion characteristics of NPSs of SJZD were elucidated in current research. Meanwhile, this study proposed new insights into the mechanism of SJZD compatibility rationality.

A Systematic Review of Complementary Therapies in Colorectal cancer patients: Summarizing the Current Global Options

Colorectal cancer patients have been experiencing various side effects related to the therapies, both physically and physiologically. Complementary medicine was used to help patients alleviate complaints and increase their quality of life. This systematic review aimed to sort out complementary medicines that could be advised to be used for colorectal cancer patients. Search limitations include the population of colorectal cancer patients, published between 2015 and 2021 and written in English. We found that traditional Chinese medicine, aromatherapy massage, acupuncture, and mindfulness-based stress reduction tests were beneficial in improving patients’ physical and physiological complaints. However, dosing and herb-herb interactions in Chinese traditional medicine and the beneficial persistency effect of other modalities needed further investigation, especially in colorectal cancer patient therapy. Complementary modalities are generally safe; however, some therapies still warrant further investigation to confirm safety and beneficial consistency.

New Insights into Herb-Induced Liver Injury.

Significance: Herbs are widely used worldwide. However, inappropriate use of some of the herbs can lead to herb-induced liver injury (HILI). Intriguingly, HILI incidents are on the rise, and our understanding of the underlying etiologies is in progress, and hence, an update on the current status of incidents as well as our understanding on the etiologies of HILI is appropriate. Recent Advances: HILI reports due to the use of some herbs that are traditionally considered to be safe are also on the rise. Furthermore, HILI due to the use of certain herbs in combination with other herbs (herb-herb interaction [HHI]) or non-herb components (herb-drug interaction [HDI]) has also been reported, suggesting a potentially important new type of inappropriate use of herbs. Critical Issues: Updated overviews focus on the epidemiology, etiology, phenotypes, and risk factors of HILI, as well as HDI and HHI, and analysis on several types of newly reported "toxic" effects of herbs based on types of hepatotoxicity and the HILI mechanisms. Future Directions: HILI will continue to be a significant public health challenge in the near future. In the light of the lack of broadly available guidelines and regulations for proper and safe uses of herbs worldwide, raising the public awareness of HILI will remain one of the most effective measures. In particular, it should include a better understanding of the contributing factors; a more detail subclassification and description of HILI, better characterization of the components/substances that could induce HILI; and development of HILI diagnosis based on the Roussel Uclaf Causality Assessment Method (RUCAM). Antioxid. Redox Signal. 38, 1138-1149.

Study on herb-herb interaction between active components of Plantago asiatica L. seed and Coptis chinensis Franch. rhizoma based on transporters using UHPLC-MS/MS

The combined efficacy in lowering serum lipid levels and increasing kidney protection of Plantago asiatica L. seed (Plantago) and Coptis chinensis Franch. rhizoma (Coptis) is far better than the effects of either herb alone. This finding suggests that there must be some degree of herb-herb interactions (HHI) affect potency. Here, we chose geniposidic acid (GPA), acteoside (ACT), and plantagoamidinic acid A (PLA) as active components in Plantago, and berberine (BBR) as the active component in Coptis, and, using transporter gene-transfected Madin-Darby canine kidney (MDCK) cells in combination with specific substrates and inhibitors, investigated Plantago- Coptis HHIs. We also established a UPLC-MS/MS analytical method to determine substrate content. Results showed that PLA in Plantago was a substrate of rOCT1/2 and rMATE1, and had inhibitory effects on rOCT2 and rMATE1. We also found that ACT is a substrate of rMATE1, but GPA was not a substrate of any transporter that we investigated. When BBR was used as the substrate, the inhibition rate of 10 μM PLA was 53.6% on rOCT2 and 31.5% on rMATE1. The inhibition rates of 30 μM ACT and 30 μM GPA on rMATE1 were 47.0% and 31.0%, respectively. Thus, our findings suggest that GPA, ACT, PLA, and BBR have competitive interactions that are driven by the rOCT2 and rMATE1 transporters. These interactions affect the transport and excretion of compounds and result in efficacy changes after co-administration.

Этические аспекты фитотерапии

The review is devoted to safety issues of herbal medicinal products. Apart from the most known adverse effects such as allergic reactions and irritation ofmucous membranes, use of a number of herbal medicines results in hormonal disturbances, organotoxic reactions and CNS disturbances. The problem of intoxication is pressing in case of uncontrolled administration of herbal remedies, which is often accompanied by a carefree attitude towards them as natural and thus safe agents. This assurance is developed in the result of non-ethical advertising of dietary supplements in mass media. Finally, an important factor of safe therapy is comprehensive accounting of potential herb-herb and herb-drug interactions. The purpose of the article is to attract attention to a weighted attitude towards phytotherapy concerning its safety both in administration of traditional herbal medicinal products by doctors and during self-treatment bypatients.

Drug-polysaccharide/herb interactions and compatibility rationality of Sijunzi decoction based on comprehensive pharmacokinetic screening for multi-components in rats with spleen deficiency syndrome

Ethnopharmacological relevanceSijunzi decoction (SJZD) is composed of four herbs, namely Ginseng Radix et Rhizoma (RG, Panax ginseng C.A.Mey.), Atractylodes Macrocephalae Rhizoma (AM, Atractylodes macrocephala Koidz.), Poria (Poria cocos (Schw.) Wolf), and Glycyrrhizae Radix et Rhizoma Praeparata Cum Melle (GRP, derived from Glycyrrhiza uralensis Fisch., Glycyrrhiza inflata Bat. or Glycyrrhiza glabra L.) based on the compatibility theory of traditional Chinese medicine (TCM), which is a classical formula for the treatment of spleen deficiency syndrome (SDS) in TCM. The polysaccharides and non-polysaccharides (NPSs) composition represented by flavonoids, saponins and terpenoids are the important pharmacodynamic material basis of SJZD. Aim of the studyThe aim of this study was to investigate the pharmacokinetic characteristics of SJZD in normal rats and SDS rats, and explore the potential interactions between NPSs and polysaccharides in SJZD, as well as the compatibility rationality of SJZD. Materials and methodsSDS model was established by oral administration of Radix Rhei (Rheum officinale Baill.) extract, loaded swimming, and intermittent fasting. A rapid, sensitive and reliable ultrafast liquid chromatography tandem mass spectrometry (UFLC–MS/MS) method was developed for the simultaneous analysis of fifteen representative compounds in rat plasma to investigate the differences in pharmacokinetics between normal and SDS rats. The SJZD-NPS samples were prepared by removing the polysaccharides of SJZD to explore the interactions between NPSs and polysaccharides of SJZD. According to the compatibility theory of TCM, four incomplete formulae of SJZD were obtained by randomly removing an herb (also called 'que fang' in TCM), and their pharmacokinetic differences were compared to elucidate the rationality of SJZD compatibility with oral administration to SDS rats. ResultsThe established UFLC–MS/MS method showed perfect performance in simultaneously analyzing fifteen compounds of SJZD in rat plasma. Compared with normal rats, the absorption efficiency of NPSs in SDS rats was lower, accompanied by the prolonged residence time (Cmax and AUC0-t reduced, while MRT0-t increased). Polysaccharides have the potential to enhance intestinal metabolism of glycosides among these components, thereby contributing to the circulating distribution of corresponding metabolites (e.g. aglycones). Furthermore, the compatibility of the four herbs in SJZD could alter their pharmacokinetic characteristics, and potentially improve the absorption of the effective components of RG and AM, which is in accordance with the principle that “monarch” and “minister” herbs play a major role in TCM. In detail, the improved absorption of ginsenosides was mainly regulated by GRP (the “guide” herb in SJZD), together with the effects of AM (“minister” herb) and Poria (“adjuvant” herb) on the pharmacokinetics of components in GRP, implying that herb-herb interactions existed in SJZD and demonstrated the compatibility rationality of SJZD potentially. ConclusionThis study laid a solid foundation for revealing the pharmacodynamic material basis and subsequent action mechanism of SJZD, as well as provided new insights into the compatibility of SJZD. The comprehensive pharmacokinetic approach adopted in the current research also provides a valuable strategy for TCM formulae research.

Evaluation of Biofilm Inhibitory Efficacy of Bacopa monnieri, Acalypha indica and Calotropis gigantea Extracts and their Combination Against Wound Colonizing Bacteria Pseudomonas aeruginosa and Staphylococcus Aureus

Key factors in compromised wound healing primarily include bacterial colonization and infection. Extensive use of systemic antibiotics, preferred choice of treatment for clinically infected wounds, is often accompanied with emergence of bacterial resistance. Quorum sensing (QS), density dependent chemical communication, is emerging as a promising area of research since most infectious microorganisms operate this mechanism to realize their pathogenic potential. Foregoing research indicates the potential of studying medicinal plant extracts/components and their combinations as vital inhibitors of QS regulated virulence factors’ production. Our study aims to understand the potential of three plant extracts and their combinations as vital inhibitors of QS regulated virulence factor’s production by two wound pathogens and to achieve this our objectives are to perform their violacein inhibitory (on C. violaceum) and biofilm inhibitory properties (on Pseudomonas aeruginosa and Staphylococcus aureus). Minimum inhibitory concentration (MIC) of aqueous plant extracts against P aeruginosa and S aureus was performed (two-fold serial microdilution). Violacein inhibition was assayed using agar well diffusion while biofilm inhibition by crystal violet method. Organisms presented 5mg/ml (Bacopa monnieri ), 2.5mg/ml (Acalypha indica), and 2.5mg/ml (Calotropis gigantea) as MIC. Three sets of individual extract concentrations (sub-MIC in μg/ml) and their corresponding combinations were used for this study. Extracts exhibited more significant (P<0.0001) violacein inhibition in combination than individually. Biofilm inhibition by extracts' combination was also significantly (P<0.001) higher than that of individual extracts indicating a possible positive herb-herb interaction of phytoconstituents (synergistic or complementary). The relative decrease in response to individual extracts in higher concentrations (set 'c') by both organisms point to possible recalcitrance behavior generally exhibited by bacteria on exposure to higher antibacterial agents. The improved antibiofilm efficacy exhibited by this novel combination may serve as an alternative approach in managing wound colonization by biofilm-producing bacteria and hence faster-wound healing.

A qualitative investigation of the perceptions of complementary and alternative medicine among adults in Hawaiʻi

BackgroundComplementary and alternative medicine (CAM) is defined as a group of diverse medical and healthcare practices outside of conventional medicine modalities. The use of CAM is steadily increasing despite gaps in the scientific evidence supporting its use and the challenges of its regulation and integration into conventional healthcare practices. In this context, perceptions concerning CAM become important. The purpose of this study is to identify the perceptions of CAM among adult residents of Hawaiʻi.MethodsTwo researchers conducted audio-recorded interviews at the University of Hawaiʻi Mānoa (UHM) campus. Participants were over the age of 18, spoke English fluently, and self-identified as Hawaiʻi residents. Interviews were conducted to the point of data saturation and audio recordings were transcribed verbatim. Researchers collaboratively developed a codebook and used NVivo 12 to analyze transcripts. New codes were added as required. Inter-rater reliability was determined by calculating Cohen’s kappa coefficient. Key themes were identified by both researchers individually and then discussed and evaluated together.ResultsParticipants were mostly female, white, and affiliated with UHM. Perceptions were categorized as positive, negative, and neutral. The majority of participants had positive perceptions of CAM with few reporting negative perceptions. The positive perceptions were related to CAM’s perceived effectiveness, the desirability of CAM compared to conventional medicine, and CAM’s ability to foster well-being. Negative perceptions were attributed to the lack of scientific evidence and ineffective outcomes of CAM use. Neutral perceptions of CAM related to its safety and natural characteristics.ConclusionsThe study found mainly positive perceptions of CAM among Hawaiʻi residents. Use of CAM is on the rise despite CAM lacking robust empirical evidence demonstrating efficacy across various medical conditions. With insufficient data and understanding of current medical literature, CAM users place themselves at risk for harmful herb-herb and herb-drug interactions. These findings have implications for healthcare providers of both conventional medicine and CAM traditions.

Implications for herbal polypharmacy: coumarin-induced hepatotoxicity increased through common herbal phytochemicals astragaloside IV and atractylenolide I

Hepatotoxicity is a well-known adverse effect of many substances, with toxicity often resulting from interactions of drugs with other drug-like substances. With the increased availability of complementary and alternative medicines, including herbal medicines, the likelihood of adverse interactions between drugs and drug-like substances in herbs increases. However, the impact of potential herb-herb interactions is little understood. To assess the potential of two cytochrome P450 enzyme modulating phytochemicals common to many herbal medicines, atractylenolide I (ATR-I) and astragaloside IV (AST-IV), to interact with coumarin, another phytochemical common in many foods, a hepatocyte function model with a liver carcinoma cell line, HepG2, was exposed to these agents. To determine the effects of cytochrome P450 modulation by these phytochemicals certain cells were induced with rifampicin to induce cytochrome P450. Increasing concentrations of ATR-I combined with a fixed, nontoxic concentration of coumarin (200 µM), demonstrated significant additive interactions. 300 µM ATR-I produced a 31% reduction in cell viability (p < 0.01) with coumarin in rifampicin uninduced cells. In rifampicin-induced cells, ATR-I (100–300 µM) produced a significant reduction in cell viability (p < 0.01) with coumarin (200 µM). AST-IV with fixed coumarin (200 µM) showed 27% toxicity at 300 µM AST-IV in rifampicin uninduced cells (p < 0.05) and 30% toxicity in rifampicin induced cells (p < 0.05). However, when fixed coumarin and AST-IV were combined with increasing concentrations of ATR-I no further significant increase in toxicity was observed (p > 0.05). These results demonstrate the potential toxic interactive capabilities of common traditional Chinese herbal medicine phytochemicals and underline the potential importance of coumarin-mediated toxicity.

Ethnomedicinal documentation of polyherbal formulations and other folk medicines in Aurora, Zamboanga del Sur, Philippines

Abstract. Pucot JR, Demayo CG. 2021. Ethnomedicinal documentation of polyherbal formulations and other folk medicines in Aurora, Zamboanga del Sur, Philippines. Biodiversitas 22: 5331-5343. In Aurora-a rural municipality in western Mindanao, Philippines, wide patronization of folk medicines has been observed, and polyherbal formulations are one of the treatments used. However, knowledge of these formulations has not been documented, imposing a threat that might lead to its eventual loss. The lack of baseline information on these formulations also stagnates its development, and the danger of possible herb-herb interactions might remain high. Therefore, this study aims to compile polyherbal formulations and other folk medicine used by the healers and locals of Aurora and assess the utilization and knowledge of these indigenous practices with implications for its conservation and strengthening localized folk medicine pharmacovigilance. Through purposive and snowball sampling, a total of 23 key informants volunteered and were interviewed using semi-structured questionnaires. Knowledge and practices about medicinal plants were analyzed using descriptive statistics. A total of 34 polyherbal formulations and ten other folk medicines were recorded. Most of the plant species used belonged to the Poaceae family (14 species), Arecaceae, and Musaceae families (10 species each) and were mainly utilized for bughat, pasmo, and kabuhi-illnesses linked with cultural beliefs. The concept of synergism was also observed when it comes to folk medicine usage. It is recommended that more surveys of polyherbal medicines be conducted along with chemical profiling and pharmacological investigations, especially in the rural areas where these folk medicines are still widely utilized.

Evidence Based Evaluation of Pharmacological Activity and Herb-Herb interaction of Organic Extracts of Certain Natural Anti- Diabetic Mixtures

Evidence Based Evaluation of Pharmacological Activity and Herb-Herb interaction of Organic Extracts of Certain Natural Anti- Diabetic Mixtures

The potential side effects of herbal preparations in domestic animals

A recent series of deaths in previously healthy dogs in Victoria, Australia associated with the ingestion of raw meat contaminated by indospicine derived from native Australian plants of the Indigofera species draws attention to the potential that exists for herbal toxicity in domestic animals. Although the efficacy of herbal remedies generally remains unproven in domestic animals, herbal preparations are being increasingly used as supplements and treatments. Issues with incorrect ingredients, inadequate processing, faulty, incomplete or inaccurate product labelling, contamination with toxins, adulteration with undeclared pharmaceutical agents and herb-herb interactions are well recognized as causes of adverse effects in humans. However, apart from of the effects of noxious weed species, the literature on herbal toxicity in domestic animals is sparse. Thus, the forensic evaluation of cases of suspected poisoning in domestic animals should also encompass an accurate description the type and dose of any herbal preparations that may have been recently administered.

Acute and Sub-acute Toxicity study of Amrtadi Churna

Amrtadi Churna is an Ayurvedic polyherbal formulation containing three herbs viz., Amalaki (Emblica officinalis), Gokshur (Tribulus terrestris) and Guduchi (Tinospora cordifolia). It is prescribed in India for immunomodulation and treating hyperacidity. The present work reports the acute and sub-acute toxicity assessment of Amrtadi Churna on experimental animals to rule whether it might produce toxicity on herb-herb interactions by combining its ingredient. The results showed that, the single administration of high dose (5000 mg/kg) of the Churna neither induced mortality nor any adverse toxicity signs in rats, suggesting its practically non-toxic nature in the therapeutic doses. Sub-acute toxicity testing results of hematology, serum biochemistry and organ histology showed that the product did not induce any toxic signs at the tested dose levels. However, it produced an apparently harmless hyperbilirubinemia without any signs of liver damage. There were no major gender specific variations except a few hematological parameters. It was concluded that, Amrtadi Churna could be relatively safe at therapeutic dose levels, ruling out any serious side effects by the interaction of its three herbal ingredients.

Comprehensive review of hepatotoxicity associated with traditional Indian Ayurvedic herbs.

With growing antipathy toward conventional prescription drugs due to the fear of adverse events, the general and patient populations have been increasingly using complementary and alternative medications (CAMs) for managing acute and chronic diseases. The general misconception is that natural herbal-based preparations are devoid of toxicity, and hence short- and long-term use remain justified among people as well as the CAM practitioners who prescribe these medicines. In this regard, Ayurvedic herbal medications have become one of the most utilized in the East, specifically the Indian sub-continent, with increasing use in the West. Recent well-performed observational studies have confirmed the hepatotoxic potential of Ayurvedic drugs. Toxicity stems from direct effects or from indirect effects through herbal metabolites, unknown herb-herb and herb-drug interactions, adulteration of Ayurvedic drugs with other prescription medicines, and contamination due to poor manufacturing practices. In this exhaustive review, we present details on their hepatotoxic potential, discuss the mechanisms, clinical presentation, liver histology and patient outcomes of certain commonly used Ayurvedic herbs which will serve as a knowledge bank for physicians caring for liver disease patients, to support early identification and treatment of those who present with CAM-induced liver injury.