Herbal Medicine Today: Clinical and Research Issues

Abstract

Herbal medicine is the use of medicinal plants for prevention and treatment of diseases: it ranges from traditional and popular medicines of every country to the use of standardized and tritated herbal extracts. Generally cultural rootedness enduring and widespread use in a Traditional Medical System may indicate safety, but not efficacy of treatments, especially in herbal medicine where tradition is almost completely based on remedies containing active principles at very low and ultra low concentrations, or relying on magical-energetic principles.In the age of globalization and of the so-called ‘plate world’, assessing the ‘transferability’ of treatments between different cultures is not a relevant goal for clinical research, while are the assessment of efficacy and safety that should be based on the regular patterns of mainstream clinical medicine.The other black box of herbal-based treatments is the lack of definite and complete information about the composition of extracts. Herbal derived remedies need a powerful and deep assessment of their pharmacological qualities and safety that actually can be realized by new biologic technologies like pharmacogenomic, metabolomic and microarray methology. Because of the large and growing use of natural derived substances in all over the world, it is not wise to rely also on the tradition or supposed millenarian beliefs; explanatory and pragmatic studies are useful and should be considered complementary in the acquisition of reliable data both for health caregiver and patients.

Attitudes towards complementary alternative medicine among Malaysian adults

“…However, in this current work, we found that recommendations of friends and family were the main reasons of CAM use. It was also demonstrated that belief played a major role in its use, as respondents believed that CAM was natural and safer, similar to previous findings (Firenzuoli and Gori, 2007).Among the various CAM used, herbal medicine was most the common choice (Firenzuoli and Gori, 2007), which was representative of the current population. While they recognized its benefits, unfortunately not many were aware that CAM is not without its risks (Wong et al, 2012).…”

Analysis of Constituents from Guibi-Tang with Lactobacillus

“…Indeed, many herbal therapies have become increasingly popular among patients and physicians, and they are now used by approximately 20% of the population in the United States because herbal medicines generally have few side effects and they are very effective [2]. However, concerns have been raised over the lack of quality control and scientific evidence for the safety of herbal medicine [3]. Besides, few scientific studies have explored the safety and toxicity of herbal medicines, so severalwa-rnings have been issued regarding the potential adverse effects of herbal medicines [4], [5].…”

Current issues and perspectives in herbal hepatotoxicity: a hidden epidemic

“…Rigid controls of vegetal derivatives are of paramount importance because herbs may be corrupted by aflatoxins [5] (or other natural toxic substances), heavy metals (lead, chromium, cadmium, etc. ), or adulterated with undeclared herbs or even with synthetic drugs [6].…”

“…Since many herbal products on the market have not been thoroughly tested for their pharmacology and toxicology, pharmacovigilance is of paramount importance in detecting unwanted reactions [5,9], because clinical patterns and severity can be highly variable, even for the same product [1].…”

“…Changes in transcriptomics, proteomics or metabolite profiles may serve as early, sensitive indicators of a potential toxicity, and are thought to precede toxic outcomes; in particular, gene expression data (transcriptomics) are thought to be more sensitive than traditional toxicological endpoints [5,10]. Toxicogenomics can also help to bridge traditional in vitro and in vivo toxicity assessment, and might be a very effective tool in studying the safety of herbal medicines by expanding the predictivity of potential toxicity in earlier stages of product development [5,10].…”