Internationalization Of Traditional Chinese Medicine Research Articles

Safety evaluation of traditional Chinese medicine: New era, new strategy

Today, as the use of traditional Chinese medicine (TCM) becomes increasingly widespread globally, TCM is confronted with numerous new safety issues and challenges. In particular, the frequent emergence of safety issues/events such as liver and kidney injury associated with traditionally “non-toxic” TCMs has overturned the traditional understanding of the toxicity and safety of TCM. This has also posed significant challenges to the development and internationalization of TCM. So, how should we understand the situation and problems of TCM safety? How can we scientifically solve the problems in evaluation and risk control of TCM? Our team proposes the following: First, we must keep pace with the times and view the issues of TCM safety in a dialectical manner, without exaggeration or underestimation. Second, we must break through the traditional perception that toxicity only came from the medicine itself, and innovate the theories of TCM toxicity. Third, we must establish precise prevention and control strategies for TCM with different types of toxicity, promoting a shift in the management of TCM safety risks from passive response to scientific and proactive control. On this basis, we have put forward the concept and methodological system of the “New Outlook on TCM Safety”, hoping to provide new theories, strategies, methods, and successful examples for systematically solving the problems in the evaluation and risk control of TCM.

The cognition of standards and standardization concepts and reflection on standardization work of traditional Chinese medicine specialty

In the journey towards the modernization and internationalization of Traditional Chinese Medicine (TCM), standards and standardization emerge as indispensable foundational elements and carry strategic significance. By introducing the concepts of standards and standardization, this article emphasizes their essential roles as the base of modern industry and the core of modernization efforts. It revisits the development plans and national strategies for TCM, highlighting the pivotal role of standardization in the inheritance and innovation within the TCM discipline. The standardization of TCM specialties is underscored for its critical function in both inheriting and innovating, as well as enhancing the international competitiveness of TCM. Through discussing the specific practices in standardizing the TCM specialty of spleen and stomach diseases, the article advocates for strengthening top-level design and advancing the systematic construction of the TCM specialty standards system. It suggests employing a variety of methods, including expert consultations and literature research, to refine the standardization processes of TCM clinical diagnosis and treatment techniques. This approach ensures that the work on specialty standardization not only meets practical needs but also possesses foresight and scientific validity.

Integrated widely targeted metabolomics and network pharmacology revealed quality disparities between Guizhou and conventional producing areas of Codonopsis Radix.

With the internationalization of traditional Chinese medicine, the demand for medicinal and edible Codonopsis Radix (CR) has increased, and its medicinal resources have attracted attention. CR is a well-known traditional Chinese medicine with a long pharmaceutical and edible history. The Guizhou province in China has abundant CR resources, but in the absence of systematic studies on species identification and chemical compositions, the capacity of the capacity of the province to CR resource has not been fully utilized. We used plant morphology and DNA barcoding techniques to identify Luodang (LD) and Weidang (WD) species. To investigate the differences in metabolites between LD and WD, as well as three Chinese Pharmacopeia CRs, and to predict pharmacological mechanisms of action for the dominant differential metabolites, we utilized widely targeted metabolomics and network pharmacology. The results also revealed the material basis for the excellent food properties of both LD and WD. The plant traits and DNA barcoding molecular identification results indicated that Luodang and Weidang from Guizhou were Codonopsis tangshen and Codonopsis pilosula, respectively. Widely targeted metabolomics analysis revealed that a total of 1,116 metabolites from 14 categories, including phenolic acids, lipids, flavonoids, were found in five CRs and shared 1,054 (94.4%) metabolites. LD and WD each contained 3 and 10 dominant differential metabolites, respectively, which were primarily flavonoids and amino acids. Amino acids, phenolic acids, and organic acids play important roles in their excellent food attributes. In CR, eight dominant differential metabolites were discovered for the first time, including isoorientin-7-O-(6″-feruloyl) glucoside, N-formyl-L-methionine, and cyclo (Phe-Glu), among others. Network pharmacology analyses showed that, in LD, dominant differential metabolites were closely related to anti-tumor, cardiovascular disease improvement, nervous system protection, and metabolic disease treatment, whereas in WD, they were closely related to nervous system protection and cardiovascular disease improvement. The species of LD and WD were included in the Chinese Pharmacopeia, and their metabolite profiles were remarkably similar to CR from traditional producing areas. Therefore, LD and WD can be used and promoted medicinally as CR, and they have potential value for new drug development. This study enriched the database of CR compounds and provided a reference for quality control, resource development, and new drug development of CR.

From evidence-based traditional Chinese medicine to digital-intelligent traditional Chinese medicine: a focus on standards evaluating the clinical efficacy of traditional Chinese medicine

The difficulty in defining the ambiguous “natural language” within the theoretical system of traditional Chinese medicine (TCM), the dynamic evaluation and individual differences of treatment based on syndrome differentiation, as well as “hard-to-quantify” characteristics of subjectiveness in the evaluation of treatment efficacy during the treatment, has resulted in the questioning and limited use of various TCM therapies with extensive application in clinical practice, which also arises from the lack of recognized and scientific evaluation methods. The standards evaluating the clinical efficacy of TCM remain the key bottleneck restricting the modernization and internationalization of TCM. Although the concept of evidence-based medicine was introduced into the field of TCM and applied to the evaluation and exploration of the clinical efficacy of TCM, there is still a lack of systematic methodological tools for its applicability evaluation. The concept of “digital-intelligent TCM” provides a new direction for the exploration of TCM based on the scientific and technological background of the times. It is not antagonistic to evidence-based TCM; instead, it complements and prompts evidence-based TCM to jointly accelerate the standardization of the evaluation of the clinical efficacy of TCM.

Problems and thoughts in clinical safety evaluation of traditional Chinese medicine

Amid the modernization and internationalization of traditional Chinese medicine(TCM), the safety of TCM has attracted much attention. At the moment, the government, scientific research teams, and pharmaceutical enterprises have made great efforts to explore methods and techniques for clinical safety evaluation of TCM. Although considerable achievements have been made, there are still many problems, such as the non-standard terms of adverse reactions of TCM, unclear evaluation indicators, unreasonable judgment methods, lack of evaluation models, out-of-date evaluation standards, and unsound reporting systems. Therefore, it is urgent to further deepen the research mode and method of clinical safety evaluation of TCM. Based on the current national requirements for the life-cycle management of drugs, this study focused on the problems in the five dimensions of clinical safety evaluation of TCM, including normative terms, evaluation modes, judgment methods, evaluation standards, and reporting systems, and proposed suggestions on the development of a life-cycle clinical safety evaluation method that conformed to the characteristics of TCM, hoping to provide a reference for future research.

Perspectives of international multi-center clinical trials on traditional Chinese herbal medicine.

With the introduction of various subjects, such as clinical epidemiology and evidence-based medicine, the qualities and levels of Traditional Chinese Herbal Medicine (TCHM) in China improved substantially, and the processes of internationalization of Traditional Chinese Medicine (TCM) are further accelerated. Since, a variety of drug products in China have been approved for marketing in other countries, and approximately 10 products have submitted the IND application to FDA of United States, of which various Chinese herbal preparations such as compound Danshen dripping pills, Xingling granules, and HMPL-004 have been approved to be investigated in phase III clinical trials. In general, multi-center studies of TCHM are increasing with years, but most of the studies are performed in some certain country, and the actual international multi-center clinical trials are very rare. Number of SCI literatures on multi-center clinical trials of TCHM that published in the recent decade also showed increasing tendency with years, despite the evident reduction in the past 2years due to the influence of COVID-19 pandemic. Of the multi-center clinical trials of TCHM that performed by mainland China and other oversees regions, except for Taiwan, China, nearly 70% were focused on classic Chinese medicinal formulae and Chinese patent medicine, while the other 30% were on dietary supplements and plant extracts. Facing the future, the "human experience" has attracted close attentions from researchers throughout the world. Effectively utilizing the historic "human experience" is an important method to vitalize potential of original scientific and technological resources of TCHM. Performing multi-center clinical trials with high qualities is still an essential method for TCHM in accessing the mainstream medicine market. In addition, it is also required to further improve the evaluation techniques and methods that not only meet the international standards but also meet the characteristics of TCHM. Furthermore, we should also focus on the TCHM specific clinical values and scientific reports.

TCMSID: a simplified integrated database for drug discovery from traditional chinese medicine

Traditional Chinese Medicine (TCM) has been widely used in the treatment of various diseases for millennia. In the modernization process of TCM, TCM ingredient databases are playing more and more important roles. However, most of the existing TCM ingredient databases do not provide simplification function for extracting key ingredients in each herb or formula, which hinders the research on the mechanism of actions of the ingredients in TCM databases. The lack of quality control and standardization of the data in most of these existing databases is also a prominent disadvantage. Therefore, we developed a Traditional Chinese Medicine Simplified Integrated Database (TCMSID) with high storage, high quality and standardization. The database includes 499 herbs registered in the Chinese pharmacopeia with 20,015 ingredients, 3270 targets as well as corresponding detailed information. TCMSID is not only a database of herbal ingredients, but also a TCM simplification platform. Key ingredients from TCM herbs are available to be screened out and regarded as representatives to explore the mechanism of TCM herbs by implementing multi-tool target prediction and multilevel network construction. TCMSID provides abundant data sources and analysis platforms for TCM simplification and drug discovery, which is expected to promote modernization and internationalization of TCM and enhance its international status in the future. TCMSID is freely available at https://tcm.scbdd.com.

Multi-omics approaches for in-depth understanding of therapeutic mechanism for Traditional Chinese Medicine.

Traditional Chinese Medicine (TCM) is extensively utilized in clinical practice due to its therapeutic and preventative treatments for various diseases. With the development of high-throughput sequencing and systems biology, TCM research was transformed from traditional experiment-based approaches to a combination of experiment-based and omics-based approaches. Numerous academics have explored the therapeutic mechanism of TCM formula by omics approaches, shifting TCM research from the "one-target, one-drug" to "multi-targets, multi-components" paradigm, which has greatly boosted the digitalization and internationalization of TCM. In this review, we concentrated on multi-omics approaches in principles and applications to gain a better understanding of TCM formulas against various diseases from several aspects. We first summarized frequently used TCM quality assessment methods, and suggested that incorporating both chemical and biological ingredients analytical methods could lead to a more comprehensive assessment of TCM. Secondly, we emphasized the significance of multi-omics approaches in deciphering the therapeutic mechanism of TCM formulas. Thirdly, we focused on TCM network analysis, which plays a vital role in TCM-diseases interaction, and serves for new drug discovery. Finally, as an essential source for storing multi-omics data, we evaluated and compared several TCM databases in terms of completeness and reliability. In summary, multi-omics approaches have infiltrated many aspects of TCM research. With the accumulation of omics data and data-mining resources, deeper understandings of the therapeutic mechanism of TCM have been acquired or will be gained in the future.

Multiobjective Differential Evolution Clustering Algorithm Based on Multimedia Information in Working Mechanism Innovation for Traditional Chinese Medicine

Aiming at working mechanism innovation for traditional Chinese medicine, a multiobjective differential evolution clustering algorithm based on multimedia information is proposed and applied. In promoting the international development of the traditional Chinese medicine industry, R&D innovation and working mechanism innovation must be paid attention to. This paper takes a specific Chinese medicine company as an example, combined with differential evolution clustering algorithm to effectively help Chinese medicine enterprises choose a more suitable innovation model. This paper starts with specific cases and carries out research from the microperspective of traditional Chinese medicine enterprises. It believes that in the process of international development, traditional Chinese medicine enterprises must base on overseas investment in R&D and innovation, strengthen self-help innovation, further enhance their R&D stamina through working mechanism innovation, gradually open overseas markets, and realize the internationalization of traditional Chinese medicine.

Current status and development strategy of ISO/TC 249 standards for Chinese materia medica

The internationalization of traditional Chinese medicine(TCM) is one of the strategic development objectives in China, which has been incorporated into the national strategy as an important part of the Belt and Road Initiative development strategy. As the basis and prerequisite of TCM development, Chinese materia medica(CMM) has a direct impact on the internationalization of TCM. The International Organization for Standardization(ISO) is a global organization composed of national standardization bodies, and the ISO standards impact the world's economy, trade, communication and cooperation. Based on a brief introduction to ISO/Traditional Chinese Medicine Technical Committee(ISO/TC 249), this study elaborates the necessity of establishing ISO standards for CMM and analyzes the current status and challenges faced by the formulation of international standards for CMM. Finally, this study puts forward the development strategy of international standards for CMM. Specifically, efforts should be made to develop top-level design with international market demands as the guidance and improve the quality of standards to accelerate the transformation of domestic high-quality standards into international standards. Moreover, measures should be taken to give full play to the positive role of enterprises in the formulation of standards, vigorously cultivate compound talents for international standardization of TCM, and constantly strengthen international cooperation. The experience and thinking are of guiding significance for the scientific, efficient and reasonable formulation of high-quality ISO standards for CMM in the future.

Reflections on Traditional Chinese Medicine Culture Teaching in the Context of International Chinese Education

With the development of the times, both international Chinese education and traditional Chinese medicine have ushered in not only great potential development opportunities, but also various challenges. Traditional Chinese medicine culture has gradually gained international recognition, and many foreign students are now choosing to study traditional Chinese medicine. Therefore, the development of international Chinese education needs to embody traditional Chinese medicine culture teaching, which can promote the internationalization of traditional Chinese medicine. At the same time, encountering problems such as cultural differences ensue the need for improving the teaching system, which lacks teaching practice. On this basis, strategies such as exploring the teaching mode of traditional Chinese medicine culture, cultivating a team of high-quality international Chinese teachers, and creating experience courses with characteristics of traditional Chinese medicine culture have been put forward, so as to enhance the teaching of traditional Chinese medicine culture and promote the development of international Chinese education.

Traditional Chinese medicine network pharmacology: development in new era under guidance of network pharmacology evaluation method guidance

Traditional Chinese medicine(TCM) has unique advantages in the prevention and treatment of diseases owing to its holistic view and more than 2 000 years of experience in the clinical use of natural medicine. The "holistic" characteristic of TCM gives birth to a new generation of research paradigm featuring "network" and "system", which has been developing rapidly in the era of biomedical big data and artificial intelligence. Network pharmacology, a representative research field, provides new ideas and methods for the research of the interdiscipline of artificial intelligence and medicine, the analysis of massive biomedical data, and the transformation from data to knowledge. TCM plays an important role in proposing the core theory of "network target" and promoting the establishment and development of network pharmacology, and has taken the lead in formulating the first international standard of network pharmacology--Network Pharmacology Evaluation Method Guidance. In terms of theory, network target can systematically link drugs and diseases and quantitatively interpret the overall regulatory mechanism of drugs. In the aspect of method, network pharmacology is developing towards a research model that combines computational, experimental, and clinical approaches. This review introduces the resent important progress of TCM network pharmacology in predicting drug targets, understanding the biological basis of drugs and diseases, and searching for disease and syndrome biomarkers. Under the guidance of Network Pharmacology Evaluation Method Guidance, the development of network pharmacology is expected to become more and more standardized and healthy. Network target will help produce more high-quality research outcomes in TCM and effectively boost the modernization and internationalization of TCM.

A combined quality evaluation method that integrates chemical constituents, appearance traits and origins of raw Rehmanniae Radix pieces.

The quality control of Chinese herbal medicine is a current challenge for the internationalization of traditional Chinese medicine. Traditional quality evaluation methods lack quantitative analysis, while modern quality evaluation methods ignore the origins and appearance traits. Therefore, an integrated quality evaluation method is urgent in need. Raw Rehmanniae Radix (RRR) is commonly used in Chinese herbal medicine. At present, much attention has been drwan towards its quality control, which however is limited by the existing quality evaluation methods. The present study was designed to establish a comprehensive and practical method for the quality evaluation and control of RRR pieces based on its chemical constituents, appearance traits and origins. Thirty-three batches of RRR pieces were collected from six provinces, while high-performance liquid chromatography (HPLC) was applied to determine the following five constituents, including catalpol, rehmannioside A, rehmannioside D, leonuride and verbascoside in RRR pieces. Their appearance traits were quantitatively observed. Furthermore, correlation analysis, principal components analysis (PCA), cluster analysis and t-test were performed to evaluate the qualities of RRR pieces. These batches of RRR pieces were divided into three categories: samples from Henan province, samples from Shandong and Shanxi provinces, and those from other provinces. Furthermore, the chemical constituents and appearance traits of RRR pieces were significantly different from diverse origins. The combined method of chemical contituents, appearance traits and origins can distinguish RRR pieces with different qualities, which provides basic reference for the quality control of Chinese herbal medicine.

A Novel Research Technology to Explore the Mystery of Traditional Chinese Medicine: Optogenetics

Traditional Chinese medicine (TCM) is gaining increasing popularity worldwide for the function of health promotion and adjuvant therapy. However, the world's understanding of TCM is far from enough, which seriously limits the modernization and internationalization of TCM. Therefore, modern and efficient analytical methods are urgently needed to understand the mechanism of TCM. Optogenetics is one of the most prevalent technologies in the 21st century and has been used to explore life science, especially neuroscience. It already has had great influences in the study of neural circuits and animal models of mental diseases and was named “Method of the Year” by the Nature Methods journal in 2010. Increased interests occurred in the applications of optogenetics to explore a myriad of medical and mental health disorders. However, it has not so far been noticed by TCM researchers. We elaborated on an idea that introducing this technique into the field of TCM research to improve diagnosis, treatments, and evaluating the therapeutic effects. In this review, we made a systematic prospect in the theory, feasibility, and application of TCM optogenetics. We mainly focused on applying optogenetic methodologies to make a more comprehensive understanding of TCM.

Key factors influencing the TCM nomenclature in international standards

Amid the globalization of traditional Chinese medicine (TCM), the English translation of related texts is in full swing. Several representative international organizations in fields regarding standardization and healthcare, one after another, have published a series of international standards for TCM nomenclature. With these efforts, the internationalization of TCM has been dramatically advanced. When selecting parallel texts for reference, translators need to be aware of key factors influencing the English translation of TCM terms in international standards, including the distinctive characteristics of this discipline and relevant influences of international standard makers. In this way, proper standards and reasonable English expression can be chosen for specific terms, thus stimulating the effective use of TCM nomenclature with consensus.

Quantitative knowledge presentation models of traditional Chinese medicine (TCM): A review.

Modern computer technology sheds light on new ways of innovating Traditional Chinese Medicine (TCM). One method that gets increasing attention is the quantitative research method, which makes use of data mining and artificial intelligence technology as well as the mathematical principles in the research on rationales, academic viewpoints of famous doctors of TCM, dialectical treatment by TCM, clinical technology of TCM, the patterns of TCM prescriptions, clinical curative effects of TCM and other aspects. This paper reviews the methods, means, progress and achievements of quantitative research on TCM. In the core database of the Web of Science, "Traditional Chinese Medicine", "Computational Science" and "Mathematical Computational Biology" are selected as the main retrieval fields, and the retrieval time interval from 1999 to 2019 is used to collect relevant literature. It is found that researchers from China Academy of Chinese Medical Sciences, Zhejiang University, Chinese Academy of Sciences and other institutes have opened up new methods of research on TCM since 2009, with quantitative methods and knowledge presentation models. The adopted tools mainly consist of text mining, knowledge discovery, technologies of the TCM database, data mining and drug discovery through TCM calculation, etc. In the future, research on quantitative models of TCM will focus on solving the heterogeneity and incompleteness of big data of TCM, establishing standardized treatment systems, and promoting the development of modernization and internationalization of TCM.

A survey of web resources and tools for the study of TCM network pharmacology

BackgroundTraditional Chinese medicine (TCM) treats diseases in a holistic manner, while TCM formulae are multi‐component, multi‐target agents at the molecular level. Thus there are many parallels between the key ideas of TCM pharmacology and network pharmacology. These years, TCM network pharmacology has developed as an interdisciplinary of TCM science and network pharmacology, which studies the mechanism of TCM at the molecular level and in the context of biological networks. It provides a new research paradigm that can use modern biomedical science to interpret the mechanism of TCM, which is promising to accelerate the modernization and internationalization of TCM.ResultsIn this paper we introduce state‐of‐the‐art free data sources, web servers and softwares that can be used in the TCM network pharmacology, including databases of TCM, drug targets and diseases, web servers for the prediction of drug targets, and tools for network and functional analysis.ConclusionsThis review could help experimental pharmacologists make better use of the existing data and methods in their study of TCM.

The Quest for the Modernization and Internationalization of Traditional Chinese Medicine

The Quest for the Modernization and Internationalization of Traditional Chinese Medicine

Safety Research in Traditional Chinese Medicine: Methods, Applications, and Outlook

Abstract Traditional Chinese medicine (TCM) is a medical system that has collected and summarized abundant clinical experience over its long history of more than 2000 years. However, the frequent occurrence of TCM-induced adverse reactions has hindered the modernization and internationalization of TCM, while attracting increasing attention from around the world. Unlike chemical drugs and biological agents, the difficulties involved in research on the toxicity and safety of TCM mainly include the complexity of its components and the unpredictability of drug–body interactions. Much of TCM, which has overall therapeutic effects, has the typical mechanisms of multiple components, multiple pathways, and multiple targets. While considering the gradualness and unpredictability of TCM toxicity, the ambiguity of toxicants and safe dosage, and individual differences during long-term TCM administration, we have systematically established key techniques for the toxicity assessment of TCM. These techniques mainly include TCM toxicity discovery in an early phase, based on a combination of drug toxicology genomics and metabolomics; methods to identify dose–toxicity relationships in TCM; and integrated techniques for the exploration of TCM interactions, such as fast-screening tests based on drug-metabolizing enzymes and receptor pathways. In particular, we have developed a new technical system for TCM safety evaluation using molecular toxicology, which has been validated well in research on TCM compatibility contraindication, quality control, and allergen discovery. The application of this key technical platform is introduced here in detail. This application includes model organisms, toxicant biomarkers, a magnetic suspension technique, and the application of network toxicology and computational toxicology in research on the toxicity of Fructus toosendan, Semen cassiae, Polygonum multiflorum, and Fructus psoraleae.

Generalized science of Chinese material medica-from preventive treatment of disease to Chinese medicine health industry

Based on the systematic summary of the results of the fourth general survey of traditional Chinese medicine resources, the cultivation of large varieties of Chinese material medica and the latest research on health industrial development, the novel concepts and scientific connotations of generalized science of Chinese material medica are put forward, and the basic ideas and methods of a new Chinese medicine academic system, the cultivation system of large varieties of Chinese medicinal materials and the application system of the large health industry are constructed. This kind of generalized science of Chinese material medica, rooted in the traditional Chinese culture and the theory of "preventive treatment of disease", can avoid the narrow prospect induced by the increasing specialization and refinement of knowledge of science of Chinese material medica. It will play an important role in the modernization, industrialization, internationalization of traditional Chinese medicine.