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Advances in Natural Products: Basic, Therapeutic, and Computational Approaches in Chronic and Infectious Diseases

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A special issue of Pharmaceuticals (ISSN 1424-8247). This special issue belongs to the section "Natural Products".

Deadline for manuscript submissions: 26 May 2026 | Viewed by 24634

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Special Issue Editors

Dr. Maira Huerta-Reyes

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Unidad de Investigación Médica en Enfermedades Nefrológicas, Hospital de Especialidades “Dr. Bernardo Sepúlveda Gutiérrez”, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Cuauhtémoc, Ciudad de México 06720, Mexico
Interests: pharmacognosy; botany; medicinal chemistry; patents in plants; chronic diseases

Dr. Gil Alfonso Magos-Guerrero

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Department of Pharmacology, Faculty of Medicine, University National Autonomous of Mexico (UNAM), Mexico City 04510, Mexico
Interests: medicinal chemistry; cardiovascular diseases; pharmacology; cheminformatics

Dr. Oscar Barrera-Vázquez

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Department of Pharmacology, Faculty of Medicine, University National Autonomous of Mexico (UNAM), Mexico City 04510, Mexico
Interests: natural products; cheminformatics; network pharmacology; fingerprints

Prof. Dr. Michael Danilenko

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Department of Clinical Biochemistry and Pharmacology, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel
Interests: acute myeloid leukemia; cell differentiation; vitamin D and its analogs; retinoids; plant-derived bioactive compounds; redox signaling; calcium signaling; cell cycle regulation; apoptosis
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Special Issue Information

Dear Colleagues,

Natural products have long been a valuable source of active compounds with diverse structures and a wide range of biological activities. Approximately 50% of current pharmaceuticals are derived directly or indirectly from natural products, primarily from plants. This has created a vibrant research environment focused on potential medical treatments for some of the world’s most pressing diseases, including chronic and infectious illnesses. Given the complex impacts of these diseases on quality of life for the global population, along with the side effects associated with their treatments, there is an urgent need for effective management strategies. The development of natural products is a significant alternative, as modern technology and in silico research have enhanced the discovery, design, and evaluation of more targeted pharmaceutical compounds.

For this Special Issue, we invite submissions focused on basic and computational sciences that explore the pharmaceutical applications of natural products in improving human health in the context of chronic and infectious diseases. We welcome studies on drug extraction, identification, and purification in both preclinical and clinical research. We invite submissions on topics including, but not limited to, cardiovascular diseases, cancers, chronic respiratory and kidney diseases, and infectious diseases caused by microorganisms that affect the global population.

Dr. Maira Huerta-Reyes
Dr. Gil Alfonso Magos-Guerrero
Dr. Oscar Barrera-Vázquez
Prof. Dr. Michael Danilenko
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pharmaceuticals is an international peer-reviewed open access monthly journal published by MDPI.

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natural products
chronic diseases
infectious diseases
computational
in silico

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Published Papers (10 papers)

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19 pages, 337 KB

Open AccessArticle

The Role of an Herbal Preparation in Enhancing the Efficacy of Basic Therapy in Patients with Periodontitis: Evaluation of Clinical, Microbiological and Cytomorphometric Parameters

by Ivana Stanković, Radmila Obradović, Ana Pejčić, Dušanka Kitić, Milica Petrović, Boško Toljić, Marija Bradić-Vasić and Katarina Živadinović

Pharmaceuticals 2026, 19(4), 586; https://doi.org/10.3390/ph19040586 - 7 Apr 2026

Viewed by 377

Abstract

Objectives: Periodontitis represents an inflammatory condition affecting the supporting structures of teeth. Basic therapy relies on scaling and root planning, but often fails to eliminate subgingival pathogens. Phytotherapy has emerged as an adjunct due to its antimicrobial, anti-inflammatory, antioxidant, and tissue-protective properties. The aim of this study was to evaluate the effects of the phytotherapeutic product Propoherb G^® as an adjunct to mechanical periodontal therapy. Methods: This study included 90 systemically healthy participants divided into three groups: control, basic therapy, and basic therapy + Propoherb G^®. Periodontal clinical parameters were assessed, alongside the presence of periodontopathogens (A. actinomycetemcomitans, P. gingivalis, and T. denticola) using PCR and cytomorphometric analysis of gingival cells at baseline, first day, and eleven days after therapy. Results: Results showed significant improvements in periodontal clinical parameters in both treatment groups, with the most pronounced effect observed in the Propoherb G^® group (p < 0.001). A marked reduction in periodontopathogenic bacteria was achieved, with Propoherb G^® demonstrating sustained elimination of P. gingivalis and T. denticola, and a significant reduction of A. actinomycetemcomitans compared to standard therapy alone (p < 0.001). The control group showed no significant changes. Cytomorphometric analysis showed a significant decrease in all measured cell parameters after therapy (p < 0.001) in the group with Propoherb G^® preparation. Conclusions: The adjunctive use of Propoherb G^® enhances the clinical, microbiological and cytomorphometric outcomes of basic therapy. These findings support the potential of phytotherapy as a safe and effective supplement to basic treatment, although further studies with larger sample sizes and longer follow-up are necessary to standardize protocols and optimize clinical application. Full article

(This article belongs to the Special Issue Advances in Natural Products: Basic, Therapeutic, and Computational Approaches in Chronic and Infectious Diseases)

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22 pages, 836 KB

Open AccessArticle

Topical Polyherbal Phytopreparation Reduces Gingival Inflammation: Evidence from a Randomized Controlled Clinical Study Supported by In Silico Analysis

by Milica Petrović, Ljiljana Kesić, Jovana Veselinović, Jelena Popović, Nikola Živković, Bojana Miladinović, Miloš S. Jovanović, Branislava Stojković, Simona Stojanović and Dušanka Kitić

Pharmaceuticals 2026, 19(3), 398; https://doi.org/10.3390/ph19030398 - 28 Feb 2026

Viewed by 499

Abstract

Background: Numerous plant-derived products have shown notable potential in preclinical studies and traditional use for the management of periodontitis, although clinical studies validating their efficacy remain scarce. The present study investigated the efficacy of a polyherbal phytopreparation as an adjunctive therapy to scaling and root planing (SRP) in patients with periodontitis, and further examined its underlying mechanisms of action, pharmacokinetic behavior, and toxicological profile using in silico approaches. Methods: Eighty patients with moderate periodontitis (stage II, grade A) were randomly assigned to two groups: a control group (n = 40) treated with SRP alone, and an experimental group (n = 40) receiving SRP followed by topical phytotherapeutic treatment with the polyherbal Tinctura paradentoica^®. Efficacy was evaluated using the gingival index, periodontal pocket depth, and cytomorphometric analysis of gingival cells before treatment and one month after. The in silico analysis, guided by HPLC profiling, included MolDock-based docking to assess interactions of bioactive compounds with cyclooxygenase isoforms COX-1 and COX-2 as anti-inflammatory targets, and evaluation of their pharmacokinetic and toxicity properties (ADME/Tox) using SwissADME, ProTox-3.0, and pkCSM. Results: Compared with SRP treatment, the experimental treatment significantly reduced the gingival index and periodontal pocket depth (p < 0.05), as well as the assessed cytomorphometric parameters (nuclear area, perimeter, and Feret’s diameter values) (p < 0.001). Rerank analysis revealed van der Waals-driven isoform selectivity: compact phenolic acids and aglycones favored COX-1, whereas bulky glycosides (e.g., rutin, narcissoside) were optimized for COX-2, with luteolin-7-O-glucoside showing near-balanced engagement. The ADME/Tox analysis indicated generally favorable pharmacokinetic and safety characteristics of phenolic compounds from the phytopreparation, including low systemic absorption and no predicted mutagenicity or skin sensitization potential. Conclusions: The topical application of the polyherbal phytopreparation demonstrated significant potential to enhance the efficacy of conventional SRP therapy by promoting the regression of gingival inflammation in patients with moderate periodontitis, further supported by in silico findings. Full article

(This article belongs to the Special Issue Advances in Natural Products: Basic, Therapeutic, and Computational Approaches in Chronic and Infectious Diseases)

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12 pages, 1649 KB

Open AccessArticle

Antitumor-Directed Fractionation of Lophocereus marginatus Extracts Against Murine L5178Y-R Lymphoma Cells

by Ángel David Torres-Hernández, César Iván Romo-Sáenz, Ramiro Quintanilla-Licea, Diana Elia Caballero-Hernández, Jesica María Ramírez-Villalobos, Diana Laura Clark-Pérez, Celia María Quiñonez-Flores, Joel Horacio Elizondo-Luevano, Patricia Tamez-Guerra and Ricardo Gomez-Flores

Pharmaceuticals 2026, 19(3), 369; https://doi.org/10.3390/ph19030369 - 26 Feb 2026

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Abstract

Background/Objectives: Cancer has been associated with significant morbidity and mortality worldwide, particularly related to chemotherapy resistance. Therefore, it is essential to investigate alternative sources of non-toxic antitumor compounds. The cactus Lophocereus marginatus is native to Mexico and is commonly used to treat gastrointestinal infections and diabetes in traditional medicine. Methods: The in vitro antitumor activity of L. marginatus extract fractions against murine L5178Y-R lymphoma cells was evaluated. The crude extract and its solvent-derived fractions were evaluated for cytotoxicity, selectivity, and hemolytic activity. Results: The crude extract exhibited an IC₅₀ of 9.09 μg/mL, demonstrating a high selectivity index (SI: 330.03), with no hemolytic activity observed at 1000 μg/mL. The LM-HP, LM-CP, and LM-MP partitions showed varying IC₅₀ values (6.74, 7.93, and 45.38 μg/mL, respectively) and selectivity indices of 445.1, 378.31, and 66.1, respectively. Only LM-HP induced hemolysis at 200 μg/mL. The most promising fraction, CP-F8, exhibited an IC₅₀ of 11.2 μg/mL, high selectivity index (354.29), and antioxidant activity, without hemolytic effects. Phytochemical analysis of CP-F8 identified phenolic compounds, triterpenes, and sterols, which are known for their anti-cancer and anti-inflammatory properties. In vivo tests showed no significant liver damage or changes in body weight, indicating the safety of CP-F8. Conclusions: These results suggest that CP-F8 is a promising antitumor candidate with selective cytotoxicity and minimal toxicity to normal cells. Full article

(This article belongs to the Special Issue Advances in Natural Products: Basic, Therapeutic, and Computational Approaches in Chronic and Infectious Diseases)

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17 pages, 2793 KB

Open AccessArticle

Exploring the Anti-Inflammatory Effects of Aloe vera Flower (AVF) and Its Active Ingredients in a Skin Inflammation Model Induced by Glyoxal-Derived Advanced Glycation End Products (GO-AGEs)

by Eun Yoo Lee, Seong-Min Hong, Sun Yeou Kim and Razia Sultana

Pharmaceuticals 2026, 19(1), 121; https://doi.org/10.3390/ph19010121 - 9 Jan 2026

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Abstract

Objective: Advanced glycation end-products (AGEs) contribute to oxidative stress and inflammation, leading to various disorders, including skin inflammation. Here, we investigated the anti-inflammatory effects of Aloe vera flower (AVF) extract and its active constituents, vitexin (V) and isovitexin (IV), in a glyoxal-derived AGE (GO-AGE)-induced skin inflammaging model. Methods: We evaluated the effects of AVF, V, and IV in epidermal keratinocytes (HaCaT cells) using enzyme-linked immunosorbent assay, Western blotting, quantitative real-time polymerase chain reaction, and in silico molecular docking. Results: Treatment of HaCaT cells with AVF, V, or IV significantly suppressed the secretion and expression of interleukins (IL-6 and IL-8) at both the mRNA and protein level, and reduced the expression of key inflammatory proteins, including kappa-light-chain-enhancer of activated B cells (NF-κB) and cyclooxygenase-2 (COX-2), and phosphorylation of mitogen-activated protein kinase (MAPK) pathway proteins. Notably, the inhibitory effects of V and IV on COX-2 expression were more comparable to or exceeded those of the positive control (Epigallocatechin gallate), even at a lower concentration. Conversely, the expression of sirtuin 1 (SIRT1) was upregulated by AVF, V, and IV, with IV showing 1.5-fold upregulation. Molecular docking analyses supported these findings, with IV displaying a particularly high binding affinity for COX-2 (−11.0 kcal/mol). Conclusions: These findings highlight the potential of AVF, V, and IV as novel therapeutic agents for managing skin inflammaging by modulating inflammatory pathways. Full article

(This article belongs to the Special Issue Advances in Natural Products: Basic, Therapeutic, and Computational Approaches in Chronic and Infectious Diseases)

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35 pages, 3818 KB

Open AccessArticle

Machine Learning-Based QSAR Screening of Colombian Medicinal Flora for Potential Antiviral Compounds Against Dengue Virus: An In Silico Drug Discovery Approach

by Sergio Andrés Montenegro-Herrera, Anibal Sosa, Isabella Echeverri-Jiménez, Rafael Santiago Castaño-Valencia and Alejandra María Jerez-Valderrama

Pharmaceuticals 2025, 18(12), 1906; https://doi.org/10.3390/ph18121906 - 18 Dec 2025

Viewed by 1031

Abstract

Background/Objectives: Colombia harbors exceptional plant diversity, comprising over 31,000 formally identified species, of which approximately 6000 are classified as useful plants. Among these, 2567 species possess documented food and medicinal applications, with several traditionally utilized for managing febrile illnesses. Despite the global burden of dengue virus infection affecting millions annually, no specific antiviral therapy has been established. This study aimed to identify potential anti-dengue compounds from Colombian medicinal flora through machine learning-based quantitative structure–activity relationship (QSAR) modeling. Methods: An optimized XGBoost algorithm was developed through Bayesian hyperparameter optimization (Optuna, 50 trials) and trained on 2034 ChEMBL-derived activity records with experimentally validated anti-dengue activity (IC₅₀/EC₅₀). The model incorporated 887 molecular features comprising 43 physicochemical descriptors and 844 ECFP4 fingerprint bits selected via variance-based filtering. IC₅₀ and EC₅₀ endpoints were modeled independently based on their pharmacological distinction and negligible correlation (r = −0.04, p = 0.77). Through a systematic literature review, 2567 Colombian plant species from the Humboldt Institute’s official checklist were evaluated (2501 after removing duplicates and infraspecific taxa), identifying 358 with documented antiviral properties. Phytochemical analysis of 184 characterized species yielded 3267 unique compounds for virtual screening. A dual-endpoint classification strategy categorized compounds into nine activity classes based on combined potency thresholds (Low: pActivity ≤ 5.0, Medium: 5.0 < pActivity ≤ 6.0, High: pActivity > 6.0). Results: The optimized model achieved robust performance (Matthews correlation coefficient: 0.583; ROC-AUC: 0.896), validated through hold-out testing (MCC: 0.576) and Y-randomization (p < 0.01). Virtual screening identified 276 compounds (8.4%) with high predicted potency for both endpoints (“High-High”). Structural novelty analysis revealed that all 276 compounds exhibited Tanimoto similarity < 0.5 to the training set (median: 0.214), representing 145 unique Murcko scaffolds of which 144 (99.3%) were absent from the training data. Application of drug-likeness filtering (QED ≥ 0.5) and applicability domain assessment identified 15 priority candidates. In silico ADMET profiling revealed favorable pharmaceutical properties, with Incartine (pIC₅₀: 6.84, pEC₅₀: 6.13, QED: 0.83), Bilobalide (pIC₅₀: 6.78, pEC₅₀: 6.07, QED: 0.56), and Indican (pIC₅₀: 6.73, pEC₅₀: 6.11, QED: 0.51) exhibiting the highest predicted potencies. Conclusions: This systematic computational screening of Colombian medicinal flora demonstrates the untapped potential of regional biodiversity for anti-dengue drug discovery. The identified candidates, representing structurally novel chemotypes, are prioritized for experimental validation. Full article

(This article belongs to the Special Issue Advances in Natural Products: Basic, Therapeutic, and Computational Approaches in Chronic and Infectious Diseases)

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24 pages, 2802 KB

Open AccessArticle

Evaluation of the Activity of Amino Chalcone Against Staphylococcus Strains Harboring Efflux Pumps

by Isydório Alves Donato, Cristina Rodrigues dos Santos Barbosa, Antonio Henrique Bezerra, Suieny Rodrigues Bezerra, Ray Silva Almeida, Cícera Datiane de Morais Oliveira-Tintino, Isaac Moura Araújo, Ewerton Yago de Sousa Rodrigues, Maria Yasmin Cândido de Oliveira, Francisco Ferdinando Cajazeiras, Jayza Maria Lima Dias, Jesyka Macedo Guedes, Jéssica Híade Silva Cristino, Emmanuel Silva Marinho, Márcia Machado Marinho, Hélcio Silva dos Santos, Henrique Douglas Melo Coutinho, Saulo Relison Tintino, Irwin Rose Alencar de Menezes and Francisco Assis Bezerra da Cunha

Pharmaceuticals 2025, 18(11), 1629; https://doi.org/10.3390/ph18111629 - 28 Oct 2025

Viewed by 809

Abstract

Background/Objectives: The increasing prevalence of multidrug-resistant Staphylococcus aureus represents a major clinical challenge, primarily driven by the acquisition of multiple resistance mechanisms. Among these, efflux pumps such as NorA play a pivotal role in quinolone resistance by promoting active drug extrusion and reducing intracellular antibiotic levels. This study evaluated the synthetic chalcone CMA4DMA as a potential NorA efflux pump inhibitor and modulator of bacterial resistance. Methods: Antimicrobial susceptibility assays were conducted against S. aureus SA1199 (wild-type) and SA1199B (NorA-overexpressing) strains. The minimum inhibitory concentration (MIC) of CMA4DMA and its modulatory effects on norfloxacin and ethidium bromide were determined. Efflux inhibition was assessed by ethidium bromide accumulation and SYTOX Green assays. Molecular docking and in silico ADMET analyses were performed to predict binding affinity and pharmacokinetic parameters. Results: CMA4DMA exhibited no intrinsic antibacterial activity (MIC ≥ 1024 µg/mL) but reduced the MIC of norfloxacin from 32 to 8 µg/mL and that of ethidium bromide from 32 to 8 µg/mL in SA1199. In SA1199B, reductions from 64 to 16 µg/mL and from 64 to 32 µg/mL were observed, respectively. Fluorescence increased by 15% without affecting membrane integrity. Docking revealed a binding affinity of −7.504 kcal/mol, stronger than norfloxacin (−7.242 kcal/mol), involving key residues Leu218, Ile309, Arg310, and Ile313. ADMET data indicated high intestinal absorption (88.76%) and permeability (Papp = 1.38 × 10⁻⁵ cm/s). Conclusions: CMA4DMA effectively restored norfloxacin susceptibility in resistant S. aureus strains, highlighting its potential as a promising scaffold for developing novel efflux pump inhibitors and antibiotic adjuvants. Full article

(This article belongs to the Special Issue Advances in Natural Products: Basic, Therapeutic, and Computational Approaches in Chronic and Infectious Diseases)

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Review

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40 pages, 1326 KB

Open AccessReview

Synergistic Effects of Plant Polysaccharides and Probiotics: A Novel Dietary Approach for Parkinson’s Disease Intervention

by Ye Jin, Lu Wang, Ruiting Lin, Jing He, Da Liu, Yang Liu and Yongzhi Deng

Pharmaceuticals 2026, 19(1), 157; https://doi.org/10.3390/ph19010157 - 15 Jan 2026

Cited by 1 | Viewed by 1147

Abstract

Parkinson’s disease (PD), the second most common neurodegenerative disorder globally, relies primarily on dopamine replacement therapy for conventional treatment. This approach fails to reverse core pathological processes and is associated with long-term side effects. Recent research on the microbiota-gut-brain axis (MGBA) has revealed that PD pathology may originate in the gut, forming a vicious cycle from the gut to brain through α-synuclein propagation, gut dysbiosis, intestinal barrier disruption, and neuroinflammation. This offers a novel perspective for managing PD through dietary interventions that modulate the gut microbiome. However, single probiotic or prebiotic interventions show limited efficacy. This review systematically introduces the novel concept of “synbiotics combining medicinal plant polysaccharides with probiotics,” aiming to integrate traditional “medicinal food” wisdom with modern microbiome science. The article systematically elucidates the pathological mechanisms of MGBA dysfunction in PD and the intervention mechanisms of probiotics and emphasizes the structural and functional advantages of medicinal plant polysaccharide as superior prebiotics. The core section delves into the multifaceted synergistic mechanisms between these two components: enhancing probiotic colonization and vitality, optimizing microbial metabolic output, synergistically reinforcing the intestinal and blood-brain barriers, and jointly regulating immune and neuroinflammation. This approach targets the MGBA to achieve multi-level intervention for PD. Full article

(This article belongs to the Special Issue Advances in Natural Products: Basic, Therapeutic, and Computational Approaches in Chronic and Infectious Diseases)

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25 pages, 1646 KB

Open AccessReview

Berberine: A Rising Star in the Management of Type 2 Diabetes—Novel Insights into Its Anti-Inflammatory, Metabolic, and Epigenetic Mechanisms

by Da Liu, Liting Zhao, Ying Wang, Lei Wang, Donglu Wu and Yangyang Liu

Pharmaceuticals 2025, 18(12), 1890; https://doi.org/10.3390/ph18121890 - 14 Dec 2025

Cited by 1 | Viewed by 13411

Abstract

Type 2 diabetes mellitus (T2DM) is a widespread metabolic disorder characterized by insulin resistance and pancreatic β-cell dysfunction, posing a substantial global health challenge. This review systematically summarizes the therapeutic potential of berberine, a natural isoquinoline alkaloid, in the management of T2DM. Berberine’s pharmacological activities are discussed from multiple perspectives, including enhancing insulin sensitivity and regulating glucose metabolism—encompassing glycogen synthesis, gluconeogenesis, and glucose transport. The review also highlights berberine’s anti-inflammatory, antioxidant, and epigenetic enzyme-targeting actions and its involvement in key T2DM-related signaling pathways such as AKT, AMPK, and GLUTs. These findings collectively elucidate the multi-targeted and multi-pathway molecular mechanisms underlying berberine’s efficacy against T2DM. Additionally, the review covers the pharmacological activities and molecular mechanisms of berberine in treating T2DM complications—including diabetic nephropathy, retinopathy, cardiomyopathy, neuropathy, and diabetic foot ulcers—as well as its clinical and preclinical applications and the synergistic benefits of combination therapy with agents such as metformin, ginsenoside Rb1, and probiotics. By systematically reviewing the literature retrieved from PubMed and Web of Science up to 2025, this article provides a comprehensive summary of current research, offering a theoretical foundation for the clinical use of berberine in T2DM therapy. Full article

(This article belongs to the Special Issue Advances in Natural Products: Basic, Therapeutic, and Computational Approaches in Chronic and Infectious Diseases)

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16 pages, 487 KB

Open AccessReview

Antidiabetic Properties of the Tropical Tree Schinus molle L. (pirul): A Comprehensive Review

by Rosa María Fonseca and Maira Huerta-Reyes

Pharmaceuticals 2025, 18(11), 1661; https://doi.org/10.3390/ph18111661 - 2 Nov 2025

Viewed by 1294

Abstract

The need for new medications to treat diabetes mellitus (DM) is a global health concern due to the cost and impact on patients and their families, health systems, and society. Recent approaches in drug development have focused on multitarget therapy for DM, considering its multifactorial and complex pathophysiology. The present work contributes to the review of the plant species Schinus molle L. (pirul), a tropical tree native to South America but now widespread worldwide, which has demonstrated anticancer, analgesic, antibacterial, and insecticidal properties. According to traditional uses, pirul has been employed as a food condiment, in the preparation of beverages and chewing gums, and in the treatment of DM. The antidiabetic effects of pirul appear to act through several mechanisms involved in DM. The methanolic extract of S. molle fruits collected in Tunisia exhibited a dose-dependent inhibition on both α-amylase and α-glucosidase enzymes (77.49% and 86.45%, respectively). A dose-dependent anti-inflammatory effect was also observed at 1, 2, 3, 4, and 5 h, in the carrageenan-induced rats’ paw edema model. Furthermore, in both the H₂O₂ and the superoxide radical assays, the pirul extract demonstrated moderate antioxidant activity (IC₅₀ = 0.22 mg/mL). Isomasticadienonic acid and Masazino-flavanone, the major components of active fractions and extracts of S. molle represent promising antidiabetic agents. Although pirul appears to be safe in in vivo acute and subchronic administrations, toxicological studies and clinical trials in individuals with DM are still pending. Full article

(This article belongs to the Special Issue Advances in Natural Products: Basic, Therapeutic, and Computational Approaches in Chronic and Infectious Diseases)

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20 pages, 2911 KB

Open AccessSystematic Review

Herbal Inhalation Therapy for Allergic Rhinitis: A Systematic Review and Meta-Analysis

by Sang-Song Shim, Jung-Eun Kil, Jiwon Park, Taehun Kim, Jungtae Leem, Beom-Joon Lee, Hee-Jae Jung and Kwan-Il Kim

Pharmaceuticals 2025, 18(12), 1877; https://doi.org/10.3390/ph18121877 - 11 Dec 2025

Viewed by 3085

Abstract

Background: Allergic rhinitis (AR) is a common immunological disorder characterized by nasal symptoms and impaired quality of life. Despite advances in pharmacotherapy, symptom control often remains inadequate. Herbal medicine atomized inhalation (HMAI), a modern adaptation of traditional East Asian fumigation, may offer an effective adjunct or alternative therapy. This systematic review and meta-analysis evaluated the clinical efficacy and safety of HMAI, emphasizing its role as a localized drug delivery system. Methods: Six databases were searched through 28 April 2025, for randomized controlled trials (RCTs) assessing HMAI for AR. Outcomes were pooled with random-effects meta-analysis; risk of bias and certainty of evidence were evaluated using Cochrane Risk of Bias 2.0 and GRADE. Results: Fourteen RCTs (n = 1606) met the inclusion criteria. HMAI significantly improved total effective rate compared with Western medicine (risk ratio = 1.20, 95% CI 1.09–1.32) and enhanced symptom relief when combined with Western or herbal treatments. However, the overall certainty of evidence ranged from moderate to very low due to methodological limitations across trials. Conclusions: HMAI may offer symptomatic benefits for patients with AR, particularly when used as an adjunct to existing therapies. Given the substantial variability and high risk of bias among included studies, these findings should be interpreted cautiously. Rigorous, placebo-controlled trials with standardized protocols are required to clarify the therapeutic role of HMAI in AR management. Full article

(This article belongs to the Special Issue Advances in Natural Products: Basic, Therapeutic, and Computational Approaches in Chronic and Infectious Diseases)

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