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Transcriptomic perturbation profiles from tumor cell lines serve as the core molecular basis for cancer drug discovery and mechanism of action (MOA) analysis. Traditional Chinese medicine (TCM) holds great anticancer potential, yet the multi-component and multi-target properties pose major challenges for systematic mechanistic investigation. The scarcity of herbal intervention transcriptomic data severely restricts transcriptome-based anticancer TCM research, unlike widely available large-scale chemical compound perturbational datasets. This study aims to establish a predictive framework for herbal transcriptional responses in tumor cell models to address this critical data bottleneck. A transfer learning-based encoder-decoder prediction framework integrated with a self-attention mechanism was developed. The model was pre-trained on large-scale connectivity map compound perturbation datasets with paired baseline transcriptomic profiles, then fine-tuned with limited herbal perturbation data covering 11 herbs across 4 tumor cell lines using a shared gene set as the molecular basis. The model achieved strong predictive performance (mean squared error = 0.1395, R2 = 0.8561, Pearson correlation coefficient = 0.9258), outperforming baseline models with robust generalization to unseen herbal interventions. Transfer learning markedly improved prediction accuracy and stability under data-limited conditions. This framework provides a scalable, cost-effective computational approach for anticancer herbal in silico screening, preliminary MOA exploration, and multi-herb prescription synergistic pattern analysis in cancer drug discovery.
Herbal medicine, a key component of complementary and alternative medicine (CAM), is widely used globally. However, healthcare professionals often lack sufficient knowledge and practical skills in this area, highlighting the need for improved education and evidence-based guidelines. This study aimed to assess physicians' knowledge, attitudes, and practices (KAP) regarding herbal medicine. This cross-sectional study was conducted at Kashan University of Medical Sciences in 2024. A total of 146 physicians, randomly selected from various educational levels, participated. Data were collected using a validated questionnaire assessing KAP related to herbal medicine. Statistical analysis was performed using non-parametric tests in SPSS software SPSS software (version 27.0; IBM Corp., Armonk, NY, USA), with a significance level of P < 0.05. The mean ± SD age of participants was 31.06 ± 8.58 years. Knowledge scores were low (mean: 9.37 ± 5.86), while attitude scores were moderately high (mean: 26.71 ± 4.91), and practice scores were limited (mean: 5.42 ± 4.37). KAP scores were all significantly associated with age (P < 0.001), and physicians who prescribed herbal medicine had significantly higher knowledge (P < 0.001), attitude (P < 0.001), and practice scores (P < 0.001) compared to non-prescribers. Multivariate regression confirmed age and prescribing behavior as independent predictors of higher KAP scores, while gender and job level were not significant contributors. Physicians demonstrated positive attitudes but limited knowledge and practice regarding herbal medicine. These findings emphasize the need to integrate CAM education into medical training and develop evidence-based guidelines to enhance physicians' competence in prescribing herbal medicine.
Herb-induced liver injury (HILI) represents an increasing diagnostic challenge owing to the widespread use of herbal and dietary supplements (HDS), which are frequently consumed without reliable information regarding their composition or safety. Mischaracterized products may obscure causal attributes and mimic primary herbal hepatotoxicity. We report a case series of five patients with suspected HILI at a tertiary university hospital in Bahia, Brazil. Clinical causality was prospectively assessed using the updated Roussel Uclaf Causality Assessment Method (RUCAM, 2016). Most patients present with hepatocellular injury following exposure to commercially available HDS, frequently in the presence of metabolic comorbidities. Analytical authentication of the consumed products revealed substantial label-composition discordance, including negligible amounts of turmeric-derived constituents in a Curcuma longa formulation and multiple undeclared synthetic drugs in a weight-loss product. The integration of structured clinical assessment with product verification refined causal attribution and, in selected cases, supported the reclassification of suspected herbal hepatotoxicity as probable adulteration-related drug-induced liver injury. Product authentication may substantially improve the diagnostic accuracy of suspected HILI and reduce the etiological uncertainty. Incorporating the verification of consumed supplements into hepatology evaluation may help distinguish true herbal hepatotoxicity from adulteration-related liver injury, thereby improving patient safety and pharmacovigilance.
This study aimed to systematically evaluate the clinical efficacy and safety of nebulised Chinese herbal medicine as an adjunctive therapy for paediatric pneumonia. A comprehensive search was conducted in the PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang, VIP and Chinese Biomedical Literature electronic databases between inception and 1 November 2025. Randomised controlled trials (RCTs) investigating nebulised Chinese herbal medicine as an adjunctive treatment for paediatric pneumonia were included. Two reviewers independently performed literature selection and data extraction and assessed the methodological quality using the Cochrane risk-of-bias tool. Meta-analysis was performed using Stata 17.0 software, and publication bias was assessed using RevMan 5.4. Seventeen RCTs involving 1,764 patients were included. The meta-analysis showed that, compared with conventional Western therapy alone, the combination with nebulised Chinese herbal medicine significantly improved the total clinical effective rate [odds ratio = 3.24, 95% CI: (2.24, 4.68), p < 0.001] and significantly shortened the resolution time of respiratory symptoms [standardised mean difference (SMD) = -1.10, 95% CI: (-1.56, -0.64), p < 0.001], fever resolution time [SMD = -1.01, 95% CI: (-1.59, -0.43), p = 0.0006] and hospital stay duration [SMD = -1.06, 95% CI: (-1.38, -0.73), p < 0.001]. Current evidence suggests that nebulised Chinese herbal medicine combined with conventional Western therapy can significantly improve clinical efficacy, accelerate symptom resolution and shorten the disease course in children with pneumonia. However, due to methodological limitations in the included studies, these findings warrant further validation in larger, rigorously designed trials.
Hypertension is one of the most common non-communicable diseases, and reports indicate that its prevalence is escalating globally due to several factors. Studies in different countries have shown an upsurge in the use of Herbal Medicinal Products (HMPs), including herbal antihypertensive medicines taken by people with hypertension, and 20-80 % of hypertensive patients concurrently use these herbal medicines and conventional antihypertensive medicines or other drugs. The safety and efficacy of the concurrent use of herbal and orthodox medicines are of great concern because of the high possibility of herb-drug interactions. An extensive literature search was undertaken, and the information obtained was subjected to critical analysis. This review aimed to update the available data on HMPs with reproducible evidence-based antihypertensive efficacies. Additionally, the major phytochemical and bioactive constituents of these HMPs were identified along with a discussion of their potential to modulate activities of drug-metabolizing enzymes and drug transport systems, especially Pglycoprotein. More than 50 commonly used medicinal plants from different regions of the world have been documented for their anti-hypertensive activity. Most of these studies used animal models to authenticate the antihypertensive activities of the herbs. In contrast, a few studies on extracts of Hibiscus sabdariffa, Allium sativum, Apium graveolens, Nigella sativa, Linum usitatissimum, and Camellia sinensis involved clinical trials. Potentials for herb-drug interactions varied among the clinically effective HMPs due to the wide variability in their phytochemical constituents. Safety issues in using these HMPs were highlighted by the identification of beneficial or adverse, clinically significant herb-drug interactions.
Due to the self-delivery, self-release, biodegradation, and biocompatibility, Chinese herbal medicine-based self-assembled hydrogels are recognized as promising candidates as wound dressing to dispose diabetic wound. However, most of them consist of single-component that induces dissatisfactory therapeutic effects, imposing obstacles to their widespread applications. Herein, a carrier-free herbal hydrogel fabricated by co-assembly of medicative mangiferin and polydatin is invented for treating MRSA-infected diabetic wound, where π-π stacking and hydrogen bonding guide the formation of the hydrogel. The as-prepared hydrogel is suitable for use as a wound dressing due to its high thermostability, continuous release, biodegradability, and outstanding mechanical properties. Remarkable bacterial suppression and massive bacterial biofilm removal are discerned after applying the co-assembled hydrogel. It also exhibits the capacity to recruit healing-related cells, scavenge ROS, and expedite revascularization. The dysfunction of macrophages is ameliorated, tending to transform to an anti-inflammatory M2 phenotype rather than proinflammatory M1 phenotype. It is these therapeutic efficacies that ascertain high-performance wound restoration in diabetic rats, where bacteria are eradicated, inflammatory are alleviated, re-epithelialization, revascularization, and collagen deposition are accelerated. Notably, the current study not only furnishes a hydrogel wound dressing for healing MRSA-infected diabetic wound, but also opens up new prospects for reformation of herbal-based carrier-free hydrogel.
Combinatorial Ayurvedic Rasayana extracts represent a rich source of bioactive compounds with anticancer potential. Withania somnifera (W) and its dual herbal Rasayana partners-Phyllanthus emblica (WP), Bacopa monnieri (WB), and Ocimum sanctum (WO)-are traditionally used to restore immune function, enhance resilience, and improve systemic health. Their multi-targeted phytoconstituents provide a promising approach for cancer therapy. This study aimed to identify bioactive compounds from W. somnifera and its dual Rasayana extracts, evaluate their in silico binding affinity with cancer-related targets, and assess their in vitro antiproliferative potential compared with cladribine. Phytocompounds were identified by GCMS and pharmacological activities were predicted using PASS-BAS. Molecular docking (Schrodinger- Glide) against 23 cancer-relevant proteins curated from TCGA and COSMIC datasets. Drug-likeness and ADME were evaluated with QikProp 3.0 and SwissADME. Molecular Dynamics (MD) simulations (100 ns, Desmond) were conducted for selected protein-ligand complexes to validate binding stability through RMSD, RMSF, SSE, and protein-ligand interaction analysis. Jurkat E6-1 leukemia cells were treated with W, WP3, WB2, and WO3 extracts for 24 h, and antiproliferative activity assessed via MTT assay. Of 62 screened phytocompounds, four key ligands -Campesterol (W), WP ligand, WB ligand, and Retinol (WO)-based on drug-likeness, pharmacokinetics, and compared with Cladribine. Docking revealed high affinities: WP3 with FAAH (-10), WB2 with PPARD (-9.08) and RBP4 (-9.5), WO3 with PPARA (-9.85) and RBP4 (-10.23), and W with CYP17A1 (-8.74). Enrichment analysis linked these targets to MAPK, JAK-STAT, and PPAR pathways. The MD results of both the complexes (5NUJ-445354 and 4D03-9592405) showed acceptable stability with dynamic adaptability, supporting the robustness of docking predictions. WP3 and WO3 had the highest antiproliferative activity (IC50 20.27 and 20.40 μg/mL) against Jurkat cells at 24hr and at 25 μg/mL. This first integrative in silico-invitro analysis of dual herbal Rasayana extracts reveals multi-target anticancer activity and validates the stability of the key protein-ligand interactions suggesting synergistic therapeutic potential of W. somnifera with P. emblica as promising lead formulations for further drug development.
Methicillin-resistant Staphylococcus aureus (MRSA) compromises chronic wound healing, and growing antibiotic resistance necessitates novel agents that target unconventional bacterial vulnerabilities. To investigate the anti-MRSA efficacy of honokiol and to characterize hexose phosphate transport regulatory protein A (HptA), a regulator of alternative carbon source uptake under nutritional stress, as a therapeutic target. Anti-MRSA activity was evaluated in vitro, with MIC determination. HptA protein was purified, and HptA-honokiol interactions were characterized using molecular docking, bio-layer interferometry, and related techniques. Multi-omics analysis were performed to elucidate metabolic responses. Therapeutic efficacy was assessed in mouse model of MRSA-induced wound infection. Honokiol exhibited moderate anti-MRSA activity with an MIC of 36 µg/ml. Mechanistically, honokiol allosterically locks HptA into a nonfunctional conformation, blocking glucose-6-phosphate uptake under nutrient-limited wound conditions. This induces carbon starvation, redox imbalance, and a ROS burst, leading to membrane damage, DNA fragmentation, and biofilm eradication. Local bacterial clearance subsequently reduced peptidoglycan-driven TLR2/NF-κB activation, attenuated inflammation, and significantly accelerated wound healing in vivo. HptA is identified as a potential antibacterial target against MRSA. By blocking alternative carbon uptake, honokiol induces carbon starvation‑driven lethal stress; lowered bacterial burden then inhibits TLR2/NF‑κB signaling, accelerating wound healing through a localized antibacterial action.
The publisher identified, after publication of this article, that Reference No. 100 was incomplete in the reference list. This error has now been corrected. The original article can be found online at: https://www.eurekaselect.com/article/150286 We regret the error and apologize to readers. Details of the correction: Original [100] Costa CJ, Nguyen MTT, Vaziri H, Wu GY. Genetics of gallstone disease and its clinical significance: A narrative review. J Clin Transl Hepatol 2024; 000(000): 000. http://dx.doi.org/10.14218/JCTH.2023.00563 PMID: 38426197 Corrected [100] Costa CJ, Nguyen MTT, Vaziri H, Wu GY. Genetics of gallstone disease and its clinical significance: A narrative review. J Clin Transl Hepatol 2024; 12(3): 316. http://dx.doi.org/10.14218/JCTH.2023.00563 PMID: 38426197.
Areca nut has long been prescribed in Traditional Chinese Medicine for respiratory disorders resembling pulmonary fibrosis (PF). Its classical effects of resolving phlegm and dissipating chest stagnation, documented in Shennong Bencao Jing, align closely with PF's hallmark pathologies of interstitial scarring and excessive collagen accumulation, yet the mechanistic basis for its anti-fibrotic activity remains unelucidated. This study validated the anti-PF efficacy of areca nut procyanidins (ANP) and elucidated their multi-target mechanisms. A multi-faceted approach integrating network pharmacology, molecular docking, and in vivo/vitro experiments was employed. Rat PF models induced by bleomycin were treated with ANP (1, 5, 15 mg/kg) for 28 days. LPS-stimulated 3T6 fibroblasts were used to evaluate cellular mechanisms. Network pharmacology predicted 72 common targets, with enrichment in the TGF-β and MAPK pathways. Molecular docking confirmed strong binding affinity of ANP to TGF-β1 (-8.8 kcal/mol) and Smad3 (-6.8 kcal/mol). In vivo, medium- and high-dose ANP significantly ameliorated lung histopathology, reduced collagen deposition (HYP), and restored antioxidant biomarkers (T-AOC, MPO, GSH). Mechanistically, ANP concurrently suppressed the TGF-β/Smad/ERK signaling cascade, characterized by the downregulation of TGF-β1, p-Smad3/4, and p-ERK, alongside the restoration of the inhibitory Smad7. In vitro, ANP inhibited fibroblast migration, inflammation (IL-1β, TNF-α), and extracellular matrix production. By multi-target inhibition of the TGF-β/Smad/ERK cascade, ANP ameliorates PF, consistent with areca nut's traditional phlegm-resolving and nodule-dissipating properties. Compared with pirfenidone, ANP exhibits superior safety and multi-pathway activity, rendering it a promising botanical therapeutic agent for PF.
Breast cancer is the most common malignant tumor among women globally. While traditional treatments are effective, they are associated with numerous side effects. In recent years, traditional Chinese herbal decoctions have garnered attention as adjunctive therapeutic approaches. This study employs a network meta-analysis to evaluate the efficacy and safety of various Chinese herbal decoctions in breast cancer treatment. A systematic search was conducted across PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wan fang, and VIP databases for randomized controlled trials comparing the efficacy and safety of different Chinese herbal decoctions in breast cancer patients, up to 20 December 2025. Quality assessment was performed using the Risk of Bias 2.0 tool. Network meta-analysis was conducted using R 4.5.1. A total of 68 articles involving 4,708 patients were included, meta-analysis results suggest that compared with the control group, for objective response rate YHHYT [OR = 4.76, 95%CrI (1.25, 25)] ranked first in cumulative probability (81.42%). Regarding disease control rate, BZT demonstrated an [OR = 5.77, 95%CrI (1.59, 29)] and ranked first in cumulative probability (74.66%). For CD4+/CD8+, FJHQT [MD= MD = 0.69, 95%CrI (0.2, 1.17)] achieved an 88.00% cumulative probability ranking, finally, regarding nausea and vomiting relief BZT [OR = 0.25, 95%CrI (0.1, 0.57)] ranked first in cumulative probability (75.67%). This study employed a network meta-analysis to evaluate the efficacy of multiple Chinese herbal decoctions in breast cancer treatment. Results demonstrated that these decoctions exhibited significant therapeutic effects in enhancing target response rates, disease control rates, and immune function (CD4+/CD8+ ratio) among breast cancer patients, while also alleviating chemotherapy side effects such as nausea and vomiting. https://www.crd.york.ac.uk/PROSPERO/view/CRD420261279914, identifier CRD420261279914.
Fibrotic diseases represent a major global health burden, with current therapies often limited by modest efficacy and substantial side effects. Traditional Chinese medicine (TCM) provides a rich yet underexplored reservoir for anti-fibrotic drug discovery, valued for its chemical diversity and extensive clinical history. Nonetheless, conventional approaches to deriving therapeutics from these multi-component formulas face significant challenges, including low tissue selectivity, limited target specificity, suboptimal scaffold optimization, and incomplete cross-scale validation. Here, we summarize recent advances in discovering TCM-derived anti-fibrotic compounds and highlight emerging strategies, including tissue-oriented active compound discovery, fibrosis-target mining, scaffold optimization guided by targets and biosynthesis, and cross-scale validation. Building on these developments, we introduce the Smart Herbal-based Innovation and Translational Engine (SHINE), an intelligent discovery platform that prioritizes promising herbal candidates using modern computational and experimental methods; innovative development of optimized compounds or novel derivatives; a translational pipeline to unite preclinical findings and clinical validation; and a closed-loop feedback system where real-world evidence continuously informs drug repositioning and secondary development. SHINE bridges TCM principles with state-of-the-art drug discovery technologies, enabling the development of well-defined, mechanism-based small-molecule candidates from classical formulas. By integrating empirical herbal knowledge with advanced multi-omics, artificial intelligence, and biosynthetic engineering, SHINE aims to deliver first-in-class anti-fibrotic therapeutics with defined targets, improved safety, and demonstrable clinical efficacy.
Torsades de pointes (TdP) is a life-threatening form of polymorphic ventricular tachycardia (VT) that develops in the context of QT interval prolongation. Although many prescription medications are recognized as QT-prolonging agents, the arrhythmogenic risks associated with non-FDA-approved products, such as over-the-counter (OTC) and herbal supplements, are less understood. The widespread availability of these supplements online has led to increased use as holistic alternatives to conventional pharmacologic therapy. While certain supplements may offer potential benefits for chronic diseases, most remain non-FDA-approved and lack robust randomized clinical trials to assess their safety and adverse effect profiles. Here, we present the case of a 36-year-old woman who developed a prolonged QT interval of unknown origin and subsequently suffered cardiac arrest due to TdP. It was only immediately prior to a planned invasive procedure that the patient disclosed several months of berberine use, a herbal supplement purchased online. Following discontinuation of berberine, her symptoms and EKG abnormalities resolved completely. This case underscores the unknown and potentially fatal risks associated with OTC supplements promoted as holistic alternatives to medication. Increased patient education and physician awareness regarding the prevalence and dangers of supplement use are essential for ensuring patient safety and improving outcomes.
Hepatocellular carcinoma (HCC) is a lethal liver malignancy associated with substantial morbidity and mortality and remains a major socioeconomic burden worldwide. Given the high risk associated with HCC, novel therapeutic approaches are urgently needed. Angelica sinensis is a traditional Chinese herbal remedy that contains bioactive phytochemicals with promising anticancer properties, making it a potential candidate for evaluation in HCC. This study integrated computational network pharmacology, molecular docking, and in vitro cellular assays to elucidate the mechanisms by which A. sinensis exerts anti-HCC effects in Hep-G2 cells. Phytochemicals were identified using the Traditional Chinese Medicine Systems Pharmacology database and filtered according to drug-likeness and oral bioavailability criteria. Key compounds (β-sitosterol, alpha-cephalin, sitogluside, and stigmasterol) were further analyzed using the SuperPred Target Prediction tool to predict potential targets. HCC-related targets were curated from GeneCards and refined using the GeneCards Inferred Functionality Score. The overlap between compound-related and disease-specific targets was used to construct a protein-protein interaction network using STRING, which was subsequently visualized in Cytoscape to identify hub genes. Molecular docking between stigmasterol and the top 3 hub genes was evaluated using the CB-Dock2 online server, and all preparations were performed in BIOVIA Discovery Studio. In vitro, Hep-G2 cells were treated with varying concentrations (0, 25, 50, 100, and 200 µg/mL) of A. sinensis extract. Cell viability, clonogenic potential, apoptosis induction, and migratory capacity were evaluated using the MTT assay, clonogenic assay, Annexin V/PI staining, and Transwell migration assay, respectively. Western blotting was used to assess the expression of key hub proteins in Hep-G2 cells. In silico analysis identified an initial pool of 126 phytochemicals, which was refined to 4 key compounds yielding 139 unique targets. Intersection with HCC-related targets produced 123 common targets, generating a network comprising 119 nodes and 520 edges. STAT3, NFKB1, and TLR4 were identified as pivotal hub genes. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses of the hub genes demonstrated significant enrichment in HCC-related pathways and biological processes. Molecular docking indicated a strong binding affinity of stigmasterol to STAT3, NFKB1, and TLR4, with binding energies of -7.8, -6.9, and -6.9 kcal/mol, respectively. In vitro assays showed a dose-dependent reduction in Hep-G2 cell viability and colony formation, significant induction of apoptosis, and marked inhibition of migration. Western blotting confirmed significant downregulation of STAT3, NFKB1, and TLR4 expression at higher extract concentrations. This study concluded that A. sinensis herbal extract was predicted to exert potent antiproliferative effects against HCC through the possible modulation of key signaling pathways and the targeting of hub genes, supporting its potential for further therapeutic development.
This study investigated how congruence between pictogram complexity and typographic complexity influences visual processing and perceived appropriateness in multimodal communication. Drawing on theories of visual communication, legibility and aesthetic perception, the study examined whether simple or complex pictograms harmonise more effectively with sans-serif or serif typefaces. Ninety participants viewed stimuli from three thematic categories (cobbler, herbal pharmacy and gluten-free restaurant), while their eye movements were recorded using a Tobii Pro Fusion eye-tracking device. Measures included reading time, fixation count and saccade count, together with subjective evaluations of pictogram-typeface suitability. The results show that reading time was the most sensitive indicator of formal congruence. In the cobbler and gluten-free restaurant categories, simple pictograms increased reading time with sans-serif typography but decreased it with serif typography. In the herbal pharmacy category, simple pictograms and sans-serif typography independently supported faster reading performance. Subjective evaluations showed no significant differences between combinations, indicating that participants perceived all pairings as similarly appropriate despite measurable differences in processing efficiency. The findings suggest that the effectiveness of pictogram-typeface combinations depends on both formal complexity and thematic context. Eye-tracking proved valuable for revealing subtle cognitive processing differences not reflected in subjective judgements.
Acute lung injury (ALI) is a severe clinical syndrome involving inflammatory damage to pulmonary cells, often progressing to acute respiratory distress syndrome (ARDS) with a crude incidence and mortality rate. Despite advances in supportive care, no definitive pharmacological treatment exists. The role of the gut microbiota in immune homeostasis and the gut-lung axis have motivated research into its association with ALI/ARDS. Probiotics, prebiotics, and traditional Chinese herbal medicines have been shown to alleviate ALI/ARDS by modulating gut microbiota. However, the variability among individuals and the complexity of the microbial ecosystem present significant challenges to research and drug development. The integration of multi-omics with artificial intelligence (AI) holds considerable potential for identifying therapeutic targets. This review summarizes the interactions between the gut microbiota and the gut-lung axis in cases of ALI and ARDS. It also discusses the mechanisms through which probiotics, prebiotics, fecal microbiota transplantation (FMT), and traditional Chinese herbal medicines (TCHMs) can intervene, with the aim of developing safer and more effective therapeutic strategies.
This study aims to achieve a cross-cultural consolidation of the local and traditional knowledge in order to contribute to an understanding of these knowledge systems and to guide bioprospecting on Panax spp. Documentation-based taxonomic revision was performed to define the current accepted species in Panax. Historic uses of Panax spp. used in China was compiled using historical herbal literature. A cross-cultural ethnobotanical assembly was performed to compile the traditional uses of Panax spp. globally. With a network-based integration, the scattered local and traditional knowledge was consolidated and evaluated. Currently, the genus Panax comprises 14 accepted species, mainly distributed in East Asia and eastern North America, all of which are used locally as traditional food and/or medicine. Four species are recorded in Chinese historical herbals. Eight species and one variety are used by 25 of the Chinese ethnic minorities. Beyond China, there are ten species and two varieties used traditionally in 12 countries. General health promotion functions are frequently mentioned. In different biocultural backgrounds, the used species and usages varied greatly, and even the same species can be used differently. For the first time, this study archives a comprehensive understanding on the health benefits of global Panax spp. and provides solid evidence for their versatility in maintaining human health from the perspective of ethnobotany.
Extracellular vesicles derived from Traditional Chinese Medicine represent a growing research Frontier. However, no consensus exists regarding the definition, quantification, and reporting of administered doses. This methodological issue continues to compromise study reproducibility. This article draws on a comprehensive analysis of recent and foundational literature on TCM-derived extracellular vesicles. Analysis shows marked differences in measurement units, reporting formats, and magnitude ranges for both in vitro and in vivo dosing. Vesicle yields also vary considerably depending on plant species, extraction method, and harvest season. The inconsistency of dose reporting and the incomparability of yield data together impede clinical translation. Further examination identifies three root causes: inherent fluctuations from batch-to-batch variability of herbal materials, the prolonged absence of quantitative standards for plant vesicles, and - as a core conceptual finding - the divergent dosing logic arising from the dual identity of vesicles as both pharmacologically active entities and nanocarriers. Based on these findings, this article proposes several standardization pathways. These include establishing multi-dimensional reporting norms for dose and yield, constructing species-specific efficacy equivalent systems, and bridging the metrological gap between traditional herbal dosage and modern nanomedicine dosing.
Kratom (Mitragyna speciosa) is an herbal supplement that has gained popularity for its opioid-like and stimulant effects. Despite its widespread use, the U.S. Food and Drug Administration has issued warnings about its potential toxicity and the risk of cardiovascular and neurological complications. While a range of neurological effects has been reported, its link to ischemic stroke remains unclear. We report a 39-year-old man who developed an embolic stroke of undetermined source (ESUS) after using kratom daily for two years, with no other identifiable risk factors. The patient demonstrated transient ischemia of the middle cerebral artery that resolved spontaneously, associated with multifocal ischemic infarcts on MRI. Extensive cardiac, vascular, and hypercoagulable testing failed to identify an alternative cause. To our knowledge, this is the first reported case of ESUS in the context of chronic kratom use. This case highlights a potential association between long-term kratom consumption and ischemic stroke and underscores the need for further studies to better understand its cerebrovascular effects and possible mechanisms.