Impact of Drug Metabolism/Pharmacokinetics and their Relevance Upon Traditional Medicine-based anti-COVID-19 Drug Research

Unlocking the Therapeutic Potential of Patchouli Leaves: A Comprehensive Review of Phytochemical and Pharmacological Insights

Plant-based products play an increasingly vital role in the pharmaceutical industry, including Pogostemon cablin (Blanco) Benth. (patchouli), which is notable for its rich history and extensive use in traditional medicine. Patchouli has a longstanding historical use as a remedy for a wide range of health conditions, including colds, fevers, headaches, inflammation, digestive disorders, and insect and snake bites. Comprehensive phytochemical studies have revealed that patchouli leaves contain diverse valuable bioactive compounds, notably patchouli alcohol, β-patchoulene, pogostone, α-bulnesene, and β-caryophyllene. Recent studies have demonstrated that patchouli leaves exhibit various pharmacological properties, including anti-oxidant, anti-inflammatory, antimicrobial, antidepressant, and anticancer effects. Despite robust traditional knowledge, specific therapeutic applications of patchouli leaves require scientific validation and standardization of their bioactive compounds. This review provides a comprehensive overview of the existing literature on the phytochemical composition, pharmacological properties, and underlying mechanisms of action of patchouli essential oil (PEO) and plant extracts obtained from patchouli leaves. It offers detailed insights into potential therapeutic applications, aiming to inform and guide future research across multiple medical disciplines. Ultimately, this review underscores the need for further research to validate and develop the medicinal applications of patchouli leaves, providing a foundation for future healthcare advancements.

Potential herb‒drug interactions between anti-COVID-19 drugs and traditional Chinese medicine

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread worldwide. Effective treatments against COVID-19 remain urgently in need although vaccination significantly reduces the incidence, hospitalization, and mortality. At present, antiviral drugs including Nirmatrelvir/Ritonavir (PaxlovidTM), Remdesivir, and Molnupiravir have been authorized to treat COVID-19 and become more globally available. On the other hand, traditional Chinese medicine (TCM) has been used for the treatment of epidemic diseases for a long history. Currently, various TCM formulae against COVID-19 such as Qingfei Paidu decoction, Xuanfei Baidu granule, Huashi Baidu granule, Jinhua Qinggan granule, Lianhua Qingwen capsule, and Xuebijing injection have been widely used in clinical practice in China, which may cause potential herb-drug interactions (HDIs) in patients under treatment with antiviral drugs and affect the efficacy and safety of medicines. However, information on potential HDIs between the above anti-COVID-19 drugs and TCM formulae is lacking, and thus this work seeks to summarize and highlight potential HDIs between antiviral drugs and TCM formulae against COVID-19, and especially pharmacokinetic HDIs mediated by metabolizing enzymes and/or transporters. These well-characterized HDIs could provide useful information on clinical concomitant medicine use to maximize clinical outcomes and minimize adverse and toxic effects.

High-quality trials and pharmacological studies needed as translational evidence for the application of traditional Chinese medicine Lianhua Qingwen against COVID-19

Traditional Chinese medicine (TCM) has been employed as complementary medication against COVID-19 in China since 2020. Two years since then, TCM, with Lianhua Qingwen (LHQW) as an example, has been included in every version of official clinical protocol guidelines. Recently, LHQW is even distributed to general public at risk but not yet infected. Such common application and widely claimed positive outcome among mild to moderate patients were accompanied by a number of published studies on antiviral, antiinflammatory, and immune modulatory potential using either in vitro or animal models. However, aside from retrospective understanding and open-labeled clinical trials with relatively small subject size, major gap in conclusive proof for efficacy and safety remains due to the lack of double-blind placebo-controlled studies and comprehensive pharmacodynamic and kinetic investigations. This is also supported by a recent WHO expert meeting on this subject, which acknowledged the potential benefits of TCM in mild-moderate cases, while recommended more rigorous studies to further understand effect size, application implications, and outcome determinants. Therefore, there is an urgent need to address the exact role TCM like LHQW could play in COVID-19 management from translational evidence-based perspective. High-quality clinical trials, pharmacological studies, and real-world data from recent outbreak are recommended.