Schisandra

BACKGROUND: Chronic stress is detrimental to the maintenance of the main response system - the hypothalamic-pituitary-adrenal (HPA) axis. The current study aimed to investigate the efficacy of two plant-based adaptogens, a formula containing Rhodiola, holy basil and Schisandra chinensis (VL-G-A57) and a full-spectrum ashwagandha (VL-G-E12), on stress and related symptoms in individuals with high stress. MATERIALS AND METHODS: The 60-day randomized, double-blind, placebo-controlled clinical study included individuals aged between 18 to 65 years with a body mass index (BMI) of 18 to 29.9 kg/m2. One hundred eighty-six participants were randomized to one of the adaptogens, VL-G-A57 or VL-G-E12, or to placebo. The primary outcome was a reduction in stress levels. Secondary outcomes were changes in sleep quality, fatigue, restorative sleep, mental alertness, mood dysregulation, and anxiety. A priori power analysis determined the required sample size. Efficacy was assessed by comparing mean changes in the primary endpoint at days 30 and 60 using ANCOVA, with baseline values as covariates. Dunnett's post hoc test identified significant differences versus placebo, and within-group changes were evaluated using paired t-tests. Normality was assessed visually and via Shapiro-Wilk/Kolmogorov-Smirnov tests as needed. Secondary outcomes were analyzed similarly. Analyses were conducted using R (v4.0.5) and XLSTAT (v2021.3.1). RESULTS: At day 60, both VL-G-A57 and VL-G-E12 significantly reduced Perceived Stress Scale (PSS) scores compared to placebo (p < 0.0001). Sleep quality, as measured by the Pittsburgh Sleep Quality Index (PSQI), improved significantly in both adaptogen groups (VL-G-A57: p = 0.0008, VL-G-E12: p < 0.0001). This corresponded well with the Restorative Sleep Questionnaire-Weekly (RSQ-W) results in the two IP arms when compared with placebo (p < 0.0001). Additionally, mood dysregulation (VL-G-A57: p = 0.0454), anxiety (VL-G-A57: p = 0.0004, VL-G-E12: p = 0.0015), and stress levels (VL-G-A57-VL-G-E12: p < 0.0001) showed significant improvements compared to placebo. No differences in mental alertness were observed. CONCLUSION: The study concluded that both VL-G-A5

BACKGROUND: Intense pulsed light (IPL) therapy is widely used for skin rejuvenation but frequently induces transient skin barrier impairment, erythema, and discomfort. Post-procedure skincare targeting barrier repair and symptom relief remains a clinical priority. OBJECTIVE: To evaluate the efficacy, safety, and satisfaction of a cream containing 4-tert-butylcyclohexanol, Tephrosia purpurea seed extract, and Schisandra sphenanthera extract (TTS cream) in facilitating skin recovery after IPL therapy. METHODS: In this randomized, double-blind, split-face study, 30 healthy female subjects received IPL therapy. One hemiface was randomly applied TTS cream, and the contralateral side was applied a control moisturizing toner after IPL. Objective instrument assessments were conducted at baseline (D0), post-IPL (D0'), 30 min post-application (D30min), and on days 3 (D3), 7 (D7), 14 (D14), and 28 (D28). Subjective assessments and satisfaction surveys were concurrently collected. RESULTS: IPL therapy significantly increased TEWL, erythema, and skin dehydration at D0' (p < 0.01). At D30min, compared to the control, TTS cream significantly improved skin hydration (∆ = 12.79 vs. 0.32 C.U., p < 0.01). At D28, TTS cream significantly reduced erythema index (∆ = -54.61, p < 0.01), erythema area (∆ = -7.02%, p < 0.01), and TEWL (∆ = -4.41 g/m2 h, p < 0.01). Subjective assessments confirmed TTS cream significantly alleviated stinging, burning, and redness (p < 0.01). Satisfaction rates reached 100% for gentleness and 96.67% for symptom relief. No adverse effects were reported throughout the study. CONCLUSIONS: These findings indicate that the TTS cream effectively enhances skin barrier recovery, reduces erythema, and relieves discomfort following IPL therapy, highlighting its potential application in the postoperative care of aesthetic medicine. © 2026 The Author(s). Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.

Saengmaeksan (SMS) is a traditional drink that consists of three natural herbs, Lirio platyphlla, Panax ginseng, and Schisandra chinensis, and improves fatigue, liver function, and immunity. Moderate-intensity exercise has a positive effect on fatigue, liver function, and immune function, whereas long-term high-intensity training has a negative effect on these aspects. We hypothesized that SMS intake will improve fatigue (ammonia, lactic acid), liver function (aspartate transaminidase (AST) and alanine aminotransferase (ALT)), and immunity (IgA, IgG, IgM) with high-intensity training. To investigate this hypothesis, 17 male college tennis players were randomly assigned to SMS and placebo groups with high-intensity training. SMS and placebo were consumed in 110 mL doses for a total of 770 mL. High-intensity training was performed at 70%-90% of heart rate reserve, conducted five times weekly for 4 weeks. A significant interaction effect was observed between the SMS and control (CON) groups regarding ammonia, ALT, and IgA levels. Ammonia levels significantly decreased in the SMS group, but there was no difference in the lactic acid levels. AST significantly decreased in the SMS group. IgA significantly increased in the SMS group, IgM significantly decreased in both groups, but there was no change in IgG. The correlation analysis revealed positive correlation in ΔAST vs. ΔALT, ΔALT vs. ΔIgG, and ΔIgA vs. ΔIgG in the SMS group. These findings demonstrate that SMS intake can reduce ammonia, AST, ALT, and IgM levels, while causing an increase in IgA, which has a positive effect on fatigue reduction, liver function, and immunoglobulins in a high-intensity training or related environment.

A previous animal study demonstrated that the administration of Omija extract and soybean mixture (OSM) improved glycemic control in the type 2 diabetes model. In this study, we conducted a 12-week, randomized, double-blinded, and placebo-controlled clinical trial to determine the effects of OSM in humans with hyperglycemia. Participants with fasting plasma concentrations of 100-140 mg/dL were enrolled (n = 80) and administered either OSM or placebo products for 12 weeks. The outcomes included measurements of efficacy (fasting plasma glucose (FPG), postprandial glucose (PPG), fasting plasma insulin (FPI), postprandial insulin (PPI), hemoglobin A1c (HbA1c), C-peptide, fructosamine, and lipid parameters) and safety at baseline and at 12 weeks. After the intervention, the OSM group showed significantly decreased levels of FPG, PPG (30, 60 min), PPI (60 min), insulin area under the curve (AUC), fructosamine, and low-density-lipoprotein (LDL) cholesterol compared to the placebo group. No clinically significant changes in any safety parameter were observed. Therefore, it is hypothesized that OSM supplementation is an effective and safe functional food supplement for humans with hyperglycemia.

BACKGROUND: Studies suggest that Schisandra chinensis Baillon (Sc) may enhance muscle strength and mass because of its anti-inflammatory and antioxidant properties. OBJECTIVES: We aimed to examine the effects and safety of consumption of Sc extract (SCe) for 12 wk on muscle strength and mass in older adults with relatively low muscle mass who do low-intensity exercise. METHODS: A randomized, double-blind, placebo-controlled trial was performed in adults >50 y of age. Fifty-four participants were randomly assigned into 2 groups and, for 12 wk, received either 1 g SCe/d or a placebo. All participants were required to walk for 30-60 min/d for >3 d/wk during the trial period. At baseline and at 4 and 12 wk after treatment, the participants were examined for knee extension strength using Biodex isokinetic dynamometers, handgrip strengths, and body composition, and blood tests were performed. The Euro-QoL-5D (EQ-5D) questionnaire and the FFQ were administered at baseline and at 12 wk after treatment. Physical activity was assessed using a self-recorded daily exercise log and an accelerometer during the study. RESULTS: SCe supplementation over 12 wk caused a higher increase in right knee extensor strength by 10.2 Nm (95% CI: 3.7, 16.8 Nm; P = 0.003) and left knee extensor strength by 6.7 Nm (95% CI: 0.3, 13.1 Nm; P = 0.041) than did the placebo. However, no differences were observed in the muscle mass, anti-inflammatory markers, antioxidative markers, and EQ-5D score between the groups. None of the participants experienced adverse events. CONCLUSIONS: SCe supplementation may enhance skeletal muscle strength but not mass in older adults who perform low-intensity exercise. This trial was registered at clinicaltrials.gov as NCT03402308. © The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.

BACKGROUND: Recurrent pneumonia in the elderly can repeatedly damage lung function and reduce quality of life, posing certain challenges to clinical treatment. OBJECTIVE: To analyze the synergistic immune regulatory effects of Cistanche deserticola, Schisandra chinensis and Cornus officinalis on elderly patients with recurrent pneumonia. METHODS: A total of 165 patients with recurrent pneumonia from Chengde Medical University from January 2024 to January 2025 were recruited, 158 were enrolled after exclusions, 8 lost to follow-up, and 150 finally analyzed. The 150 patients were divided into MC group (n=75) and MA group (n=75). Both groups were treated with Ma Xing Shi Gan Tang and Azithromycin, while the MC group was additionally treated with Cistanche deserticola, Schisandra chinensis and Cornus officinalis. The main evaluation includes the Traditional Chinese Medicine Syndrome Score (TCMSS), lung function indicators, inflammation indicators, immune indicator levels and clinical efficacy of two groups. Secondary outcomes include quality of life scores, incidence of complications and adverse reactions. RESULTS: After treatment, the lung function indicators, immune indicators and clinical efficacy in MC group were higher than in the CC group; the TCMSS and inflammatory indicators were lower in the CC group (P>0.05). No significant difference in quality of life score, incidence of complications and adverse reactions between the two groups (P<0.05). CONCLUSION: This method has a good immunomodulatory effect on elderly patients with recurrent pneumonia and is worthy of further promotion and application.

BACKGROUND: Temozolomide (TMZ) is a standard chemotherapeutic agent for glioma, but prolonged use frequently leads to drug resistance, reducing its therapeutic efficacy. Schisandrin B (Sch B), a lignan isolated from Schisandra chinensis, demonstrates promising anti-neoplastic activity. This study investigated the synergistic effects of Sch B and TMZ on U87 glioma cells to explore their combined influence on cell viability, apoptosis, and mitochondrial function. METHODS: U87 glioma cells were treated with Sch B, TMZ, or their combination. Cell viability was assessed using MTT assays. Apoptosis was evaluated by Hoechst staining and flow cytometry, while JC-1 staining and Western blotting were used to assess mitochondrial membrane potential, oxidative stress markers, and apoptosis-related proteins. Cell cycle analysis and pre-treatment with Z-VAD-FMK were performed to confirm pathway involvement. RESULTS: Combination treatment significantly reduced cell viability (54.14%) compared to TMZ (72.47%) or Sch B (70.4%) alone. Flow cytometry indicated elevated apoptosis (22.3%) in the combination group. JC-1 staining and protein expression analyses revealed mitochondrial depolarization, cytochrome c release, activation of caspase-3 and -9, and a decreased Bcl-2/Bax ratio. The combined treatment induced G2/M cell cycle arrest via p53/p21 activation and increased oxidative stress. Pre-treatment with Z-VAD-FMK partially reversed these effects, confirming caspase-dependent mitochondrial apoptosis. CONCLUSIONS: Sch B enhances TMZ-induced cytotoxicity in U87 glioma cells by promoting mitochondrial dysfunction, oxidative stress, and caspase-mediated apoptosis. These findings suggest that Sch B may serve as a promising adjuvant to improve the efficacy of TMZ-based glioma therapy, warranting further validation in resistant and in-vivo models. © 2025 The Author(s). Published by IMR Press.

The well-established calcineurin inhibitor, tacrolimus, as an immunosuppressive agent, is widely prescribed after organ transplantation. Cytochrome P450 (CYP 450) isoforms are responsible for the metabolism of many features associated with food parameters like phytochemicals, juices, and fruits. This review article summarizes the findings of previous studies to help predict the efficacy or side effects of tacrolimus in the presence of food variables. From the commencement of databases associated with the topic of interest to 26 October 2024, all relevant articles were searched through PubMed, Scopus, and Web of Science. The suggested therapeutic range for tacrolimus trough concentration (C0 ) was reported as 5-15 ng/ml blood. Tacrolimus interaction with food variables could significantly change C0 after organ transplantation. For example, grapefruit juice could increase tacrolimus C0 due to CYP enzyme inhibition. Toxicity such as nephrotoxicity could result from turmeric and other herbal or food products. By inhibiting tacrolimus-metabolizing enzymes and transporters, a high intake of vegetables could increase the risk of adverse effects. Secondary metabolites of vegetables could lead to toxicity in patients with tacrolimus. Furthermore, grapefruit juice, citrus fruits, turmeric, and pomegranate juice could change clinical pharmacokinetics parameters such as Tmax, Cmax, AUC, and C0 of tacrolimus after organ transplantation. Bioavailability of tacrolimus might be decreased by induction of the CYP450 system and P-gp efflux pump due to cranberry, rooibos tea, and boldo. Increased inhibitory effect on CYP450 system and/or P-gp efflux pump by grapefruit juice, schisandra, berberine, turmeric, pomegranate juice, pomelo, and ginger could increase bioavailability of tacrolimus. A vigilant immunosuppressive strategy accompanied by scheduled therapeutic drug monitoring is recommended before and after transplant surgery.

OBJECTIVES: Chinese herbal medicine (CHM) has been shown to be effective in autoimmune rheumatic diseases, but harmful herb-drug interactions might be inherent. We aim to review the evidence regarding herb-drug interactions between immunosuppressive drugs used in autoimmune rheumatic diseases and CHM. METHODS: We searched PubMed, EMBASE and CINAHL from inception till 30 April 2023 using keywords that encompassed 'herb-drug interactions', 'herbs' and 'immunosuppressants'. Articles were included if they contained reports about interactions between immunosuppressive drugs used in the treatment of rheumatic diseases with CHM. Level of evidence for each pair of interaction was graded using the algorithm developed by Colalto. RESULTS: A total of 65 articles and 44 unique pairs of interactions were identified. HDIs were reported for cyclophosphamide, cyclosporine, tacrolimus, methotrexate, mycophenolic acid, glucocorticoids, sulfasalazine, tofacitinib and biologic disease-modifying antirheumatic drugs. Among these, cyclosporine (n = 27, 41.5%) and tacrolimus (n = 19, 29.2%) had the highest number of documented interactions. Hypericum perforatum had the highest level of evidence of interaction with cyclosporine and tacrolimus. Consumption reduced the bioavailability and therapeutic effects of the drugs. Schisandra sphenanthera had the highest level of evidence of interaction with tacrolimus and increased the bioavailability of the drug. Majority of the articles were animal studies. CONCLUSION: Overall level of evidence for the included studies were low, though interactions between cyclosporine, tacrolimus, Hypericum perforatum and Schisandra sphenanthera were the most and well-documented. Healthcare professionals should actively enquire about the concurrent use of CHM in patients, especially when drugs with a narrow therapeutic index are consumed. Interactions between natural products and cancer treatments: underlying mechanisms and clinical importance. Chan WJ(1), Adiwidjaja J(1)(2), McLachlan AJ(1), Boddy AV(3), Harnett JE(4). Author information: (1)Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia. (2)Di

10. Cancer Chemother Pharmacol. 2023 Feb;91(2):103-119. doi: 10.1007/s00280-023-04504-z. Epub 2023 Jan 27. Interactions between natural products and cancer treatments: underlying mechanisms and clinical importance. Chan WJ(1), Adiwidjaja J(1)(2), McLachlan AJ(1), Boddy AV(3), Harnett JE(4). Aut

The calcineurin inhibitor tacrolimus (TAC) shows inter-and intra-individual variability in blood levels and has a narrow therapeutic index. To reduce the chance of fluctuations in immunosuppressive activity and potential drug interactions, it is critical to keep track of drug concentrations. Cytochrome-P450 (CYP) isoenzymes CYP3A4 and CYP3A5, as well P-glycoprotein (P-gp) are involved in TAC bioavailability. TAC's interactions with herbal extracts are reviewed here, because with more people using TAC, it is becoming crucial to know which extracts, which are often part of self-medication, can alter TAC blood concentrations. TAC bioavailability was decreased when co-administered with St John's wort (SJW), cranberry, rooibos tea, and boldo in human models by induction of the CYP450 system and/or P-gp efflux pump, meanwhile, the TAC bioavailability was increased when co-administered with grapefruit juice (GFJ), schisandra, berberine, turmeric, pomegranate juice, pomelo, and ginger in human and or animal models by inhibition effect on CYP450 system and/or P-gp efflux pump. Thus, physicians and pharmacists should thoroughly educate their patients regarding the use of supplemental herbs before administering TAC. Furthermore, patients who are already undergoing TAC treatment should be informed about the possibility of dangerous interactions between herbal remedies and TAC.

Adrenergic β-blockers are used to treat many conditions, including hypertension, cardiac arrhythmias, heart failure, angina pectoris, migraine, and tremors. The majority of the β-blockers including Propranolol, Metoprolol, Acebutolol, Alprenolol, Betaxolol, Carvedilol, Nebivolol and Oxprenolol are metabolised majorly by CYP2D6, and Bisoprolol is primarily metabolised by CYP3A4 enzymes. The drugs inhibiting or inducing them may alter the pharmacokinetics of those β-blockers. The plasma concentrations of Propranolol might be elevated by the concomitant use of drugs, such as SSRIs (Fluoxetine, Paroxetine), SNRIs (Duloxetine) and Cimetidine, while the plasma concentrations of Metoprolol increased by the concurrent use of SSRIs (Fluoxetine, Paroxetine), Amiodarone, Celecoxib, Cimetidine, Terbinafine, and Diphenhydramine. β-blockers can also interact pharmacodynamically with drugs, including fluoroquinolones, antidiabetic agents and NSAIDs. In addition, β-blockers may interact with herbs, such as curcumin, Ginkgo biloba, Schisandra chinensis, green tea, guggul, hawthorn, St. John's wort and Yohimbine. This article focuses on clinically relevant drug interactions of β-blockers with commonly prescribed medications. In addition to Pharmacokinetics and Pharmacodynamics of the drug interactions, recommendations for clinical practice are highlighted. The prescribers and the pharmacists are needed to be aware of the drugs interacting with β-blockers to prevent possible adverse drug interactions.

The co-administration of voriconazole (VCZ) and Wuzhi tablet (WZ) is frequently prescribed for solid organ transplantation patients in China. However, the pharmacokinetic interactions between VCZ and WZ as well as its bioactive constituents, such as schisandrin A and schisandrol B, remain unknown. Therefore, the effects of WZ and the two lignans on the metabolism of VCZ and the potential role of cytochromeP450 (CYP450), especially cytochrome P450 2C19 (CYP2C19), were investigated. The results showed that WZ extensively inhibited the activities of CYP1A2, 2A6, 2B6, 2C8, 2C9, 2C19, 2D6, 2E1, and 3A4. Noteworthy, 2.5 mg/mL WZ almost completely inhibited the activity of 2C19, and the inhibition ratio reached 78.6±3% and 63.5±4.6% for schisandrin A and schisandrol B at concentrations 100 μM, respectively. In addition, rats were treated with a single or consecutive 14 day oral dose of WZ (250 mg/kg), schisandrol B (10 mg/kg) and schisandrin A (10 mg/ kg). In rats treated with WZ, the AUC0-∞ value for intravenous VCZ dosing was increased by 80.2% (single dose, p < 0.05) and 66.4% (dosage for 14 day, p < 0.05) and the Cmax was increased by 10.5% (p < 0.05) and (20.6%, p < 0.05), respectively, much greater than that when VCZ (28 mg/kg) was given alone. Unexpectedly, the AUC and Cmax values after schisandrol B and schisandrin A treatment were significantly increased. However, the mRNA expression of liver CYP2C19 and the protein expression of liver CYP2C19 were surprisingly increased after treatment with WZ, schisandrol B and schisandrin A in rats. Therefore, attention should be paid to when WZ and VCZ are administered concomitantly, as dosage adjustment might become necessary. Further clinical study is warranted to validate the interaction between WZ and VCZ.

ETHNOPHARMACOLOGY RELEVANCE: Tacrolimus is a well-known potent but expensive immunosuppressant. We previously clarified the herb-drug interaction between tacrolimus and Wuzhi tablet (WZ), a prescribed drug of ethanol extract of Schisandra sphenanthera, and showed the ideal effect of WZ on maintaining therapeutic level of tacrolimus and reducing the total drug expense. However, WZ possesses a biphasic effect on regulating CYP3A (the major metabolizing enzyme of tacrolimus), which could induce the mRNA and protein expression after long-term treatment while transiently inhibit the activity of CYP3A. In clinic, clinicians are confused about the relationship between the blood concentration of tacrolimus and the dose and the duration of pretreatment of WZ. Therefore, the effects of the pretreatment time and the dose of WZ on the pharmacokinetics of tacrolimus is urgently needed to be clarified to better combine the use of WZ and tacrolimus in clinic. AIM OF THE STUDY AND METHOD: This study aimed to investigate the effects of the pretreatment time and the dose of WZ on the pharmacokinetics of tacrolimus in rats. RESULTS AND CONCLUSIONS: After pretreated rats with WZ for 0, 0.5, 2, 6, 12 or 24 h, the area under the curve (AUC) of tacrolimus was 2.27 ± 0.59, 1.87 ± 1.14, 2.86 ± 0.64, 1.62 ± 0.70, 1.54 ± 1.06 and 1.12 ± 0.69-fold of that of the tacrolimus alone group, respectively. The ratio of AUC of tacrolimus to that of the co-administration group with 0, 62.5, 125, 250, 500 or 750 mg/kg of WZ was 1.00: 1.07: 1.44: 2.60: 2.32: 2.42, respectively. These findings suggested that WZ increased tacrolimus AUC in a pretreatment time- and dose-dependent manner. In line with the in vivo findings, WZ extract inhibited CYP3A activity in a pre-treatment time- and concentration-dependent manner in human liver microsomes. In conclusion, the pharmacokinetics of tacrolimus was significantly affected by the pretreatment time and the dose of WZ. Oral pretreatment with WZ for 0-2 h or co-dosing of 250 mg/kg of WZ most significantly increased the blood concentration of tacrolimus. These findings would be helpful for guiding the reasonable use of WZ and tacrolimus in clinic.

Abstract: Currently, Angiostrongylus cantonensis infections are predominantly treated with albendazole. However, the use of albendazole can provoke certain neurological symptoms as a result of the immune response triggered by the dead worms. Therefore, treatment usually involves co-administration of corticosteroids to limit the inflammatory reaction. Corticosteroids play a useful role in suppressing inflammation in the brain; however, long-term usage or high dosage may make it problematic.Schisandrin B, an active ingredient from Schisandra chinensis, has been shown to have anti-inflammatory effects on the brain. This study aimed to investigate the effects and potential of schisandrin B in combination with albendazole to treat Angiostrongylus-induced meningoencephalitis. Here, we show that albendazole-schisandrin B co-treatment suppressed neuroinflammation in Angiostrongylus-infected mice and increased the survival of the mice. Accordingly, albendazole-schisandrin B co-treatment significantly inhibited inflammasome activation, pyroptosis, and apoptosis. The sensorimotor functions of the mice were also repaired after albendazole-schisandrin B treatment. Immune response was shown to shift from Th2 to Th1, which reduces inflammation and enhances immunity against A. cantonensis. Collectively, our study showed that albendazole-schisandrin B co-therapy may be used as an encouraging treatment for Angiostrongylus-induced meningoencephalitis.

The fruit of Schisandra chinensis (SC) is a well-known traditional herb used for pharmacological purposes in Asian countries (e.g., Korea, China, and Japan). In animal studies, SC extract supplementation had beneficial effects on muscle strength and lactate level. However, the effect of SC extract supplementation on skeletal muscle strength and lactate at rest in humans remains unclear. The purpose of this study was to evaluate the effect of SC extract supplementation on quadriceps muscle strength (QMS) and lactate at rest in adult women. Forty five healthy post-menopausal middle-aged women (61.9 ± 8.4 years) were randomly divided into the SC (n = 24) or the placebo group (n = 21). The SC group consumed 1000 mg of SC extract per day, whereas the placebo group consumed 1000 mg of starch per day for 12 weeks. The difference in muscle mass, physical function, and biomarkers and the relative changes between baseline and 12 weeks were evaluated. We used two-factor repeated measures analysis of variance (ANOVA) to determine interaction (group × time) effects for variables. Statistical significance was accepted at p < 0.05. In ANOVA results, QMS (p = 0.001) and lactate level (p = 0.038) showed significant interactions. With paired t-tests, QMS was significantly increased (p < 0.001) and lactate level at rest was significantly decreased (p < 0.05) after 12 weeks in the SC group. However, no interactions were found between the other variables. Supplementation of SC extract may help to improve QMS as well as decrease lactate level at rest in adult women. We believe that SC extract is a health supplement that can support healthy life in this population.

BACKGROUND: Gastroesophageal reflux disease (GERD) is a major cause of chronic cough. GERD-induced chronic cough is difficult to diagnose because some patients do not complain of any gastrointestinal (GI) reflux symptoms. Although chronic cough due to GERD is highly prevalent, no effective treatment is currently available, especially for GERD-related cough without GI symptoms. Because the herbal medicines Ojeok-san and Saengmaek-san can effectively treat GERD and cough, we aim to evaluate the efficacy and safety of a combination of these components for relieving chronic cough due to GERD. METHODS/DESIGN: This is a study protocol of a randomized, double-blind, placebo-controlled, single-center pilot trial. After a 1-week run-in period, a total of 30 patients with GERD-induced chronic cough will be randomly allocated to an intervention group (n = 15) or a placebo group (n = 15). Participants will receive 5.76 g of Ojeok-san plus Saengmaek-san or a placebo three times per day for 6 weeks. The primary outcome measures, which are the frequency and severity of cough, will be recorded using a cough diary. The secondary outcome measures will include a cough visual analogue scale, the Leicester Cough Questionnaire (Korean version), the Gastrointestinal Symptom Rating Scale, the Hull Airway Reflux (hypersensitivity) Questionnaire, the Pattern Identification for Chronic Cough Questionnaire, the Pattern Identification for Gastroesophageal Reflux Disease, and safety testing. Adverse events will also be reported. DISCUSSION: This will be the first clinical trial to explore the use of herbal medicines for GERD-related chronic cough, including patients without GI reflux symptoms. This study will provide useful evidence regarding the efficacy and safety of Ojeok-san plus Saengmaek-san treatment. In addition, this trial will offer a scientific basis for the combination of herbal medicines. This study will also provide important data for conducting a larger-scale clinical trial on GERD-induced chronic cough. TRIAL REGISTRATION: This trial has been registered with Clinical Research Information Service (CRIS) of South Korea (http://cris.nih.go.kr; registration number KCT0003115). Re

Schisandra chinensis fruit (SCF) is known to have beneficial effects on metabolic diseases, including obesity, and to affect gut microbiota in in vivo studies. However, in human research, there have been a few studies in terms of its clinical roles in lipid metabolism and modulation of gut microbiota. A double-blind, placebo-controlled study with 28 obese women with SCF or placebo was conducted for 12 weeks. Anthropometry and blood and fecal sampling were performed before and after treatment. Analysis of the gut microbiota in feces was performed using denaturing gradient gel electrophoresis and quantitative polymerase chain reaction. Although the values did not differ significantly between the 2 groups, the SCF group tended to show a greater decrease in waist circumference, fat mass, fasting blood glucose, triglycerides, aspartate aminotransferase, and alanine aminotransferase than the placebo group. Clustering of the denaturing gradient gel electrophoresis fingerprints for total bacteria before and after treatment indicated more separate clustering in SCF group than placebo. In correlation analysis, Bacteroides and Bacteroidetes (both increased by SCF) showed significant negative correlation with fat mass, aspartate aminotransferase, and/or alanine aminotransferase, respectively. Ruminococcus (decreased by SCF) showed negative correlation with high-density lipoprotein cholesterol and fasting blood glucose. In conclusion, administration of SCF for 12 weeks resulted in modulation of the gut microbiota composition in Korean obese women, and significant correlations with some bacterial genera and metabolic parameters were noted. However, in general, SCF was not sufficient to induce significant changes in obesity-related parameters compared with placebo.

Complementary remedies represent a potential alternative treatment for chronic diseases, including HIV/AIDS cases not meeting criteria for using highly active antiretroviral therapy (HAART). This study evaluated the safety and efficacy of CKBM-A01, a Chinese herbal medicine, and patient quality of life (QoL). Asymptomatic HIV patients with CD4 counts of 250-350 cells/microl were recruited into this open-labeled trial. Liquid CKBM-A01 was prescribed for a 36-week period. Study participants recorded all symptoms themselves on diary cards. Study parameters, including CD4 cell counts, HIV viral loads, and blood chemistry, were periodically monitored and questionnaires were used to assess QoL and to help with risk reduction. Eighteen volunteers, mean age (+/- SD) 32.07 (+/- 6.88) years, had a median (interquartile range, IQR) baseline CD4 count of 292 (268.50-338.25) cells/microl. No serious drug-related adVerse events due to CKBM-A01 were detected during the study. Intermittent diarrhea was reported in 55.6%, weakness or skin rash/itching in 50%, and increased bowel movement in 33.7%. No significant changes in log viral load or CD4 cell counts were observed at the end of the study. Most of the volunteers (72.2%) expressed satisfaction with CKBM-A01 and had a positive perception. Common colds and nasal symptoms were significantly lower during treatment (p = 0.019). CKBM-A01 appeared to be safe but gave no significant improvement in QoL in asymptomatic HIV patients, and gave no significant improvement in the treatment of HIV based on CD4 cell counts and viral loads.

In traditional Chinese medicine, acupuncture is considered free of harmful side effects when properly performed. Pharmacokinetics provides a valuable approach to explore how acupuncture influences drug disposition. Stimulation at specific acupoints, such as Zusanli (ST36), may modulate drug absorption and action. While most studies highlight beneficial outcomes, potential risks also deserve consideration. A systematic review was conducted to evaluate how acupuncture or electroacupuncture at ST36 affects the pharmacokinetics of various drugs. Data on changes in absorption, distribution, metabolism, and excretion, along with pharmacokinetic parameters (e.g., average plasma concentration-time curve [AUC], Cmax, Tmax), were extracted and analyzed. Acupuncture at ST36 significantly influenced the pharmacokinetics of several compounds. For instance, it enhanced the absorption and plasma levels of Schisandra chinensis lignans and acetaminophen (APAP), increasing AUC and Cmax while shortening Tmax. Tissue distribution also shifted, with elevated concentrations observed in certain organs such as the lungs. While aspirin metabolism remained unaffected, ST36 stimulation delayed APAP clearance at higher doses, resulting in prolonged systemic exposure. In the case of triptolide, a bioactive diterpenoid, acupuncture increased its plasma levels and AUC. Some studies reported changes in biomarkers associated with liver function under elevated compound exposure, though no acute adverse effects were noted for commonly used agents. ST36 acupuncture can alter drug pharmacokinetics, potentially impacting drug exposure and clinical response. Awareness of such interactions is important when combining acupuncture with medication. Further studies are warranted to ensure the safe and effective integration of acupuncture into pharmacological treatment strategies.

OBJECTIVE: Insomnia represents a significant public health issue, with a notable impact on the global burden of disease. Traditional pharmacological interventions, while effective, often entail limitations and adverse effects, necessitating the exploration of alternative therapeutic modalities. Chinese herbal medicines, with their extensive historical use and presumed multifaceted pharmacological actions, emerge as potential candidates for insomnia management. METHODS: In strict adherence to the PRISMA-NMA guidelines, we systematically reviewed randomized controlled trials (RCTs) that investigated the therapeutic effects of Chinese herbal medicines on insomnia. The primary outcomes assessed were improvements in sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI), clinical effectiveness rates, and the incidence of adverse reactions. Comprehensive searches were conducted across several databases including MEDLINE, Cochrane Library, EMBASE, Wanfang Data, CNKI, and gray literature. Both direct and indirect evidence was synthesized using Bayesian network meta-analysis techniques to ascertain the relative performance of various herbal interventions. RESULTS: The analysis included 186 RCTs involving 13 different herbal interventions. Overall, the included studies exhibited a low-to-moderate risk-of-bias. Key findings from our study suggest that for PSQI scores, the top 5 treatments were guipi decoction, shenqi schisandra tablet, chaihu longgu muli decoction (CLMD), suanzaoren, and wuling capsule. Notably, the highest rankings for effective rate were achieved by longdan xiegan decoction, CLMD, guipi decoction, Huanglian Wendan decoction, and chaihu shugan powder. In terms of safety, jieyu pill, trazodone, and CLMD were the top 3, indicating superior safety profiles among all treatments. Crucially, both the PSQI scores and the effective rate, alongside the safety profile of most Chinese herbal medicines, were generally superior to conventional pharmaceutical treatments. CONCLUSION: The study provides robust evidence that certain herbal medicines may offer effective and safe alternatives for managing insomnia, potentially reducing the reliance on conven

BACKGROUND: Traditional Chinese medicine (TCM) is often used to treat chronic urticarial (CU), so its efficacy and safety on CU were studied according to systematic review and meta-analysis. METHODS: By searching PubMed, Wanfang, CNKI, and other databases for the literature on the treatment of CU with TCM in the past 10 years (2013-2023), the PICOS principle was used as the criterion for inclusion and exclusion of literature, and the quality of the included literature studies was systematically reviewed according to the Cochrane systematic review method and software RevMan5.3. RESULTS: A total of 14 articles were included, including 1192 patients. According to the analysis results, the total effective rate of TCM in the treatment of CU was (RR = 1.23, 95% confidence interval (CI) [1.16-1.29], P < .00001), the incidence of adverse reactions and recurrence rates were (RR = 0.23, 95% CI [0.13-0.39], P < .00001) and (RR = 0.24, 95% CI [0.13-0.43], P < .00001), and the symptom score was (MD = -0.38, 95% CI [-0.81-0.05], P = .08). The most frequently used Chinese herbs were Windbreak, Licorice, Angelica sinensis, Schizonepeta, Cicada slough, Cassia twig, Astragalus membranaceus, schisandra chinensis, Cortex dictamni and Dark plum. CONCLUSION: TCM has great advantages in the treatment of CU, can effectively improve the symptoms, the curative effect is stable and safe, but there are still some deficiencies in the standardization of curative effect evaluation.

Schisandra chinensis (SC), a plant of the Magnoliaceae family, commonly known as "North Schisandra chinensis", has been listed as a top-grade Chinese medicine in the Shennong Materia Medica Classic for its high medicinal value since ancient times. Polysaccharides from S. chinensis fruits (SCPs) are an active component in SC, which have various biological activity, including immune regulation, anti-tumor, antioxidant, liver protective, anti-inflammatory and hypoglycemic activity. Research has shown that the extraction methods of SCPs include hot water extraction, water extraction and alcohol precipitation, ultrasonic-assisted, microwave-assisted and so on. Different extraction methods can affect the yield and purity of polysaccharides, and to improve the extraction yield of SCPs, two or more extraction methods can be combined. SCPs are mainly composed of glucose, mannose, rhamnose, galactose, galacturonic acid and arabinose. This article aims to provide a systematic review of the research progress in the extraction and separation methods, structural characterization, and biological activity of SCPs both domestically and internationally in recent years. This deeply explores the pharmacological activity and action mechanism of SCPs, and provides a certain point of reference for the research and clinical application of SC.

BACKGROUND: Herbal medicine is a low-cost treatment and has been increasingly applied in obesity treatment. Gut microbiota (GM) is strongly associated with obesity pathogenesis. METHODS: We conducted a systematic review guided by the question: "Does the use of herbal medicine change the GM composition in obese individuals?" Randomized clinical trials with obese individuals assessing the effects of herbal medicine intervention in GM were retrieved from the Medline, Embase, Scopus, Web of Science, and Cochrane Library databases, including the Cochrane Controlled Trials Register. Two reviewers independently extracted data using standardized piloted data extraction forms and assessed the study-level risk of bias using an Excel template of the Cochrane "Risk of bias" tool 2-RoB 2. RESULTS: We identified 1094 articles in the databases. After removing duplicates and reading the title and abstract, 14 publications were fully evaluated, of which seven publications from six studies were considered eligible. The herbs analyzed were Moringa oleifera, Punica granatum, Scutellaria baicalensis, Schisandra chinensis, W-LHIT and WCBE. The analysis showed that Schisandra chinensis and Scutellaria baicalensis had significant effects on weight loss herbal intervention therapy composed by five Chinese herbal medicines Ganoderma lucidum, Coptis chinensis, Astragalus membranaceus, Nelumbo nucifera gaertn, and Fructus aurantii (W-LHIT) and white common bean extract (WCBE) on GM, but no significant changes in anthropometry and laboratory biomarkers. CONCLUSIONS: Herbal medicine modulates GM and is associated with increased genera in obese individuals.

BACKGROUND: Various neurocognitive and mental health-related conditions have been associated with the gut microbiome, implicating a microbiome-gut-brain axis (MGBA). The aim of this systematic review was to identify, categorize, and review clinical evidence supporting medicinal plants for the treatment of mental disorders and studies on their interactions with the gut microbiota. METHODS: This review included medicinal plants for which clinical studies on depression, sleeping disorders, anxiety, or cognitive dysfunction as well as scientific evidence of interaction with the gut microbiome were available. The studies were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. RESULTS: Eighty-five studies met the inclusion criteria and covered thirty mental health-related medicinal plants with data on interaction with the gut microbiome. CONCLUSION: Only a few studies have been specifically designed to assess how herbal preparations affect MGBA-related targets or pathways. However, many studies provide hints of a possible interaction with the MGBA, such as an increased abundance of health-beneficial microorganisms, anti-inflammatory effects, or MGBA-related pathway effects by gut microbial metabolites. Data for Panax ginseng, Schisandra chinensis, and Salvia rosmarinus indicate that the interaction of their constituents with the gut microbiota could mediate mental health benefits. Studies specifically assessing the effects on MGBA-related pathways are still required for most medicinal plants.

Adaptogens are synthetic compounds (bromantane, levamisole, aphobazole, bemethyl, etc.) or plant extracts that have the ability to enhance the body's stability against physical loads without increasing oxygen consumption. Extracts from Panax ginseng, Eleutherococcus senticosus, Rhaponticum carthamoides, Rhodiola rosea, and Schisandra chinensis are considered to be naturally occurring adaptogens and, in particular, plant adaptogens. The aim of this study is to evaluate the use of plant adaptogens in the past and now, as well as to outline the prospects of their future applications. The use of natural adaptogens by humans has a rich history-they are used in recovery from illness, physical weakness, memory impairment, and other conditions. About 50 years ago, plant adaptogens were first used in professional sports due to their high potential to increase the body's resistance to stress and to improve physical endurance. Although now many people take plant adaptogens, the clinical trials on human are limited. The data from the meta-analysis showed that plant adaptogens could provide a number of benefits in the treatment of chronic fatigue, cognitive impairment, and immune protection. In the future, there is great potential to register medicinal products that contain plant adaptogens for therapeutic purposes.