Phytotherapies

Iqbal Ramzan is the Dean of the Faculty of Pharmacy at the University of Sydney, Australia. He is a registered pharmacist and holds a Diploma of the Australian Institute of Company Directors. Dr. Ramzan also served two terms as a Fellow of The University. He is an author/co-author of over 140 publications in pharmacokinetics, pharmacodynamics, drug assays, and drug metabolism. Dr. Ramzan is a member of several professional committees and councils, including the Director of the Council of Pharmacy Schools (Australia and New Zealand). He also serves on the Australian Government's Pharmaceutical SubCommittee of the Advisory Committee on Prescription Medicines.

List of Contributors xvii

Preface xxi

1 Phytotherapies—Past, Present, and Future 1
Iqbal Ramzan and George Q. Li

1.1 Overview of Phytotherapy 1

1.2 Preclinical Research on Phytotherapies 3

1.3 Clinical Research on Phytotherapies 6

1.4 Safety of Phytotherapies 8

1.5 Profile of Research in Complementary Medicine 9

1.6 Summary and Future Directions 12

References 12

2 Quality Control and Quality Assurance of Phytomedicines: Key Considerations, Methods, and Analytical Challenges 18
Wai‐Ping Yau, Cheong Hian Goh, and Hwee‐Ling Koh

2.1 Introduction 18

2.2 Key Considerations in QC/QA of Phytomedicines 20

2.3 Methods for QC/QA of Phytomedicines 27

2.4 Challenges 37

2.5 Conclusions 40

References 40

3 Preclinical (In Vivo) and Laboratory (In Vitro) Evidence of Phytomedicine Efficacy 49
Mohi Iqbal Mohammed Abdul and Tom Hsun‐Wei Huang

3.1 Introduction to Development of Drugs from Nature 49

3.2 Use of In Vitro and in Vivo Models in Herb Drug Research: Learning Thus Far 50

3.3 Cardiovascular‐ and Stroke‐Related Diseases: In Vitro and In Vivo Focus 53

3.4 Conclusions 60

References 61

4 Clinical Efficacy Trials with Natural Products and Herbal Medicines 65
Christina L. Nance

4.1 Introduction 65

4.2 Trials in Various Disease States 66

4.3 Natural Product: Green Tea 73

4.4 EGCG Clinical Trials 75

4.5 Human Clinical Study: EGCG and HIV‐1 Infection 78

4.6 Conclusion 80

References 80

5 Novel Formulations and Drug Delivery Systems for Phytotherapies 89
Shengpeng Wang, Meiwan Chen, Qi (Tony) Zhou, and Hak‐Kim Chan

5.1 Limitations of Conventional Formulations for Herbal Medicines 89

5.2 Crucial Issues of Developing Novel Delivery Systems for Herbal Medicines 91

5.3 Novel Delivery Systems of Herbal Medicines 93

5.4 Summary 96

References 97

6 Phytotherapies Used by Indigenous Populations 101
Bradley S. Simpson and Susan J. Semple

6.1 Introduction 101

6.2 Phytotherapies of Indigenous Australians 103

6.3 Challenges of a Changing Environment 114

6.4 Conclusions 117

References 118

7 Phytotherapies from Traditional Chinese Medicine 122
Michael Rieder

7.1 Traditional Chinese Medicine 122

7.2 Key Concepts in Traditional Chinese Medicine 124

7.3 Herbal Medicine and Traditional Chinese Medicine 126

7.4 Issues in the Development of Phytotherapy from Traditional Chinese Medicine 130

7.5 Phytotherapies Developed from Traditional Chinese Medicine 131

7.6 Huang Qin Tang and the Development of PHY906 134

7.7 Ginseng 136

7.8 Moving Forward 138

References 138

8 Integrating Traditional Greco‐Arab and Islamic Diet and Herbal Medicines in Research and Clinical Practice 142
Bashar Saad

8.1 Introduction 142

8.2 Food Therapy in Greco‐Arab and Islamic Medicine 147

8.3 Medicinal Plants 157

References 177

9 Evolution of Herbal Medicines in Europe and its Relationship with Modern Medicine 183
Elizabeth M. Williamson and Kelvin Chan

9.1 Background 183

9.2 Historical Perspective 184

9.3 European Herbal Medicine: Relationship with Modern Medicine 194

9.4 Summary 194

References 196

10 Chemical Classification and Chemistry of Phytotherapeutics Constituents 199
Pei H. Cui and Colin C. Duke

10.1 Introduction 199

10.2 Phytochemicals 201

10.3 Other Phytochemicals 215

10.4 Medicinal Effects Relating to Dietary Intake 217

10.5 Natural Products as Leads for Drug Development 223

10.6 Summary 230

References 230

11 Therapeutic Potential of Ginsenosides in Management of Atherosclerosis 236
Xiao‐Jing Zhang, Huanxing Su, Yi-Tao Wang, and Jian-Bo Wan

11.1 Introduction 236

11.2 Chemical Diversity of Ginsenosides and Distribution 238

11.3 Anti‐Atherosclerotic Effects of Ginsenosides 240

11.4 Underlying Mechanisms of Ginsenosides Against Atherosclerosis 244

11.5 Conclusions and Future Perspectives 258

Acknowledgments 258

References 258

12 Phytotherapy Pharmacophores for Major Cellular Drug Targets 268
Jennifer A. Ong, Paul W. Groundwater, and David E. Hibbs

12.1 Introduction 268

12.2 What is a Pharmacophore? 269

12.3 Pharmacophore Models of Cardiovascular Drugs 270

12.4 Pharmacophore Models for Anticancer Drugs 285

12.5 Pharmacophore Models for Anti‐Inflammatory Drugs 290

12.6 Pharmacophore Models for Anti‐Infective Drugs 297

12.7 Pharmacophore Models for Neurological Drugs 299

12.8 Pharmacophore Models for Miscellaneous Drugs 305

12.9 Conclusions 309

References 309

13 Use of Kava as a Phytotherapeutic Agent and Kava‐Related Hepatotoxicity 312
Dong Fu and Iqbal Ramzan

13.1 Introduction 312

13.2 Active Components in Kava 313

13.3 Therapeutic Applications of Kava 314

13.4 Pharmacology of Kava 314

13.5 Side Effects of Kava 317

13.6 Hepatotoxicity of Kava 318

13.7 Summary and Future Challenges 322

References 323

14 Phytotherapies as New Drug Sources: Gossypol and Curcumin 330
Vivian Wan Yu Liao, Rajeshwar Narlawar, David E. Hibbs, and Paul W. Groundwater

14.1 Botanical Sources of Gossypol and Curcumin 330

14.2 Stereoisomerism, Tautomerism, and Reactivity 332

14.3 Biological Activity of Gossypol and its Analogues 337

14.4 Biological Activity of Curcumin and its Analogues 346

References 360

15 Phytotherapies for the Management of Obesity and Diabetes 370
Michel Rapinski and Alain Cuerrier

15.1 Introduction 370

15.2 Plants from the North American Pharmacopoeia 372

15.3 Pharmacological Screening: Providing Empirical Evidence for Phytotherapies 379

15.4 Community‐Based Participation: Developing Phytotherapies from Traditional Knowledge 385

15.5 Conclusions 387

References 387

16 Phytotherapeutics for Cancer Therapy 394
Daniel M.‐Y. Sze, Hao Liu, Maureen V. Boost, Raimond Wong, and Stephen Sagar

16.1 Introduction 394

16.2 Anticancer Phytotherapeutics With NK Enhancement 395

16.3 Conclusions 423

References 425

17 Phytomedicines for Fatty Liver Disease and Functional Gastrointestinal Conditions 429
George Q. Li, Moon‐Sun Kim, Fangming Jin, and Jun‐Lae Cho

17.1 Introduction 429

17.2 Phytomedicines for FLD 430

17.3 Phytomedicines for IBS 439

17.4 Phytomedicines for Constipation 444

17.5 Summary and Future Perspectives 448

References 448

18 Phytomedicines for Inflammatory Conditions 464
Sigrun Chrubasik‐Hausmann

18.1 Traditional Medicines for Inflammatory Conditions in Europe 464

18.2 Twenty‐First‐Century Update on Paids 465

18.3 Oral Extracts from Salix Species 465

18.4 Oral Extracts from Harpagophytum procumbens 468

18.5 Oral Avocado–Soybean Unsaponifiables 469

18.6 Oral Extracts From Tripterygium wilfordii 473

18.7 Oral Paids Containing Unsaturated Fatty Acids 475

18.8 Other Oral Paids 476

18.9 Topical Paids 477

References 478

19 Phytotherapies for Infectious Diseases: Are These Really Useful? 483
Gail B. Mahady, Gabrielle Escalante, Pooja Mikkilineni, Laura J. Mahady, Temitope O. Lawal, and Bolanle A. Adeniyi

The History of Medicine 483

19.1 Introduction 484

19.2 Historical Precedent for Natural Products as Antimicrobial Drugs 486

19.3 Are Phytotherapies Useful for the Treatment of Infectious Diseases? 487

19.4 Naturally Occurring Compounds that may Reduce Zoonosis 495

19.5 Synergistic and Additive Effects with Antibiotics 496

19.6 New Emerging Infectious Diseases and those with no Known Treatments 496

19.7 SARS 497

19.8 Reducing MRSA Carriage 498

19.9 Conclusions 499

References 500

20 Phytomedicines for CNS Disorders: Safety Issues for use with Antiepileptic Drugs 504
Sophia Yui Kau Fong, Rosina Yau Mok, Qiong Gao, Yin Cheong Wong, and Zhong Zuo

20.1 Introduction 504

20.2 Methodology of Systematic Literature Search 506

20.3 Pharmacokinetic Interactions 506

20.4 Pharmacodynamic Interactions 512

20.5 Conclusions 524

References 524

21 Phytotherapies: Drug Interactions in Cancer 536
Andrew J. McLachlan and Stephen J. Clarke

21.1 Introduction 536

21.2 Use of Herbal and Complementary Medicines by People Living with Cancer 537

21.3 Mechanisms of Phytotherapy–Drug Interactions 538

21.4 Selected Examples of Phytotherapy Medicines that have the Potential to Cause Drug Interactions in Cancer 540

21.5 Future Perspectives: Need for Evidence and Advice to Cancer Patients and Physicians 546

21.6 Conclusions 547

Acknowledgments 547

Conflict of Interest 547

References 547

22 Quality Use of Medicines: Considerations in Phytotherapy 554
Lynn Weekes

22.1 Introduction 554

22.2 Relevance of Qum for Herbal Medicines 556

22.3 Use of Phytotherapies by Consumers 558

22.4 Consumer Attitudes and Beliefs about Herbal Medicines 559

22.5 Applying the Qum Framework to Phytotherapies 561

22.6 Building Blocks for Quality Use of Herbal Medicines 566

22.7 Conclusion 570

References 570

23 Intellectual Property and Patent Issues with Phytotherapy Products 573
Gint Silins, Jennifer Tan, and Kelvin Chan

23.1 Introduction 573

23.2 IP Rights—Phyto‐Industry 575

23.3 Brief Overview of Patents and the Patenting Process 578

23.4 Other Types of IP Rights 585

23.5 Patenting Trends for Phytotherapeutics 587

23.6 Traditional Knowledge and IP Rights 587

Disclaimer 589

References 590

24 International Regulatory Status of Phytotherapies 593
Ernest V. Linek

24.1 Introduction 593

24.2 Specific Country Regulations 596

24.3 Future of Phytotherapies: World Health Organization (WHO) 631

Further Reading 634

Index 635