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      Ethnobotanical Survey on Bitter Tea in Taiwan

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          Abstract

          Ethnopharmacological evidence: In Taiwan, herbal tea is considered a traditional medicine and has been consumed for hundreds of years. In contrast to regular tea, herbal teas are prepared using plants other than the regular tea plant, Camellia sinensis (L.) Kuntze. Bitter tea (kǔ-chá), a series of herbal teas prepared in response to common diseases in Taiwan, is often made from local Taiwanese plants. However, the raw materials and formulations have been kept secret and verbally passed down by store owners across generations without a fixed recipe, and the constituent plant materials have not been disclosed.

          Aim of the study: The aim was to determine the herbal composition of bitter tea sold in Taiwan, which can facilitate further studies on pharmacological applications and conserve cultural resources.

          Materials and methods: Interviews were conducted through a semi-structured questionnaire. The surveyed respondents were traditional sellers of traditional herbal tea. The relevant literature was collated for a systematic analysis of the composition, characteristics, and traditional and modern applications of the plant materials used in bitter tea. We also conducted an association analysis of the composition of Taiwanese bitter tea with green herb tea (qing-cao-cha tea), another commonly consumed herbal tea in Taiwan, as well as herbal teas in neighboring areas outside Taiwan.

          Results: After visiting a total of 59 stores, we identified 32 bitter tea formulations and 73 plant materials. Asteraceae was the most commonly used family, and most stores used whole plants. According to a network analysis of nine plant materials used in high frequency as drug pairs, Tithonia diversifolia and Ajuga nipponensis were found to be the core plant materials used in Taiwanese bitter tea.

          Conclusion: Plant materials used in Taiwanese bitter tea were distinct, with multiple therapeutic functions. Further research is required to clarify their efficacy and mechanisms.

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          Synergistic Effects of Chinese Herbal Medicine: A Comprehensive Review of Methodology and Current Research

          Traditional Chinese medicine (TCM) is an important part of primary health care in Asian countries that has utilized complex herbal formulations (consisting 2 or more medicinal herbs) for treating diseases over thousands of years. There seems to be a general assumption that the synergistic therapeutic effects of Chinese herbal medicine (CHM) derive from the complex interactions between the multiple bioactive components within the herbs and/or herbal formulations. However, evidence to support these synergistic effects remains weak and controversial due to several reasons, including the very complex nature of CHM, misconceptions about synergy and methodological challenges to study design. In this review, we clarify the definition of synergy, identify common errors in synergy research and describe current methodological approaches to test for synergistic interaction. We discuss the strengths and weaknesses of these models in the context of CHM and summarize the current status of synergy research in CHM. Despite the availability of some scientific data to support the synergistic effects of multi-herbal and/or herb-drug combinations, the level of evidence remains low, and the clinical relevancy of most of these findings is undetermined. There remain significant challenges in the development of suitable methods for synergistic studies of complex herbal combinations.
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            The role of inflammation and liver cancer.

            Persistent inflammation is known to promote and exacerbate malignancy. Primary liver cancer, mostly hepatocellular carcinoma (HCC), is a clear example of inflammation-related cancer as more than 90 % of HCCs arise in the context of hepatic injury and inflammation. HCC represents the fifth most common malignancy and the third leading cause of cancer-related death worldwide with about one million new cases diagnosed every year with almost an equal number of deaths. Chronic unresolved inflammation is associated with persistent hepatic injury and concurrent regeneration, leading to sequential development of fibrosis, cirrhosis, and eventually HCC. Irrespective of the intrinsic differences among various etiological factors, a common denominator at the origin of HCC is the perpetuation of a wound-healing response activated by parenchymal cell death and the resulting inflammatory cascade. Hence, the identification of fundamental inflammatory signaling pathways causing transition from chronic liver injury to dysplasia and HCC could depict new predictive biomarkers and targets to identify and treat patients with chronic liver inflammation. This chapter critically discusses the roles of several major cytokines, chemokines, growth factors, transcription factors, and enzymes as well as a distinct network of inflammatory signaling pathways in the development and progression of HCC. It also highlights and analyzes preclinical animal studies showing innovative approaches of targeting inflammatory mediators and signaling by a variety of natural compounds and synthetic agents to achieve effective therapy as well as prevention of hepatic malignancy. Additionally, current limitations and potential challenges associated with the inhibition of inflammatory signaling as well as future directions of research to accelerate clinical development of anti-inflammatory agents to prevent and treat liver cancer are presented.
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              South African herbal teas: Aspalathus linearis, Cyclopia spp. and Athrixia phylicoides--a review.

              Rooibos (Aspalathus linearis (Brum.f) Dahlg.) and honeybush (Cyclopia Vent. species) are popular indigenous South African herbal teas enjoyed for their taste and aroma. Traditional medicinal uses of rooibos in South Africa include alleviation of infantile colic, allergies, asthma and dermatological problems, while a decoction of honeybush was used as a restorative and as an expectorant in chronic catarrh and pulmonary tuberculosis. Traditional medicinal uses of Athrixia phylicoides DC., or bush tea, another indigenous South African plant with very limited localised use as herbal tea, include treatment of boils, acne, infected wounds and infected throats. Currently rooibos and honeybush are produced for the herbal tea market, while bush tea has potential for commercialisation. A summary of the historical and modern uses, botany, distribution, industry and chemical composition of these herbal teas is presented. A comprehensive discussion of in vitro, ex vivo and in vivo biological properties, required to expand their applications as nutraceutical and cosmeceutical products, is included, with the main emphasis on rooibos. Future research needs include more comprehensive chemical characterisation of extracts, identification of marker compounds for extract standardisation and quality control, bioavailability and identification of bio-markers of dietary exposure, investigation of possible herb-drug interactions and plant improvement with regards to composition and bioactivity.
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                Author and article information

                Contributors
                Journal
                Front Pharmacol
                Front Pharmacol
                Front. Pharmacol.
                Frontiers in Pharmacology
                Frontiers Media S.A.
                1663-9812
                18 February 2022
                2022
                : 13
                : 816029
                Affiliations
                [1] 1 Chinese Medicine Research Center , Department of Chinese Pharmaceutical Sciences and Chinese Medicine Resources , Master Program for Food and Drug Safety , China Medical University , Taichung, Taiwan
                [2] 2 Chinese Medicine Research Center , Department of Chinese Pharmaceutical Sciences and Chinese Medicine Resources , China Medical University , Taichung, Taiwan
                [3] 3 Graduate Institute of Health Industry Technology , Research Center for Food and Cosmetic Safety , and Research Center for Chinese Herbal Medicine , College of Human Ecology , Chang Gung University of Science and Technology , Taoyuan, Taiwan
                [4] 4 Department of Gastroenterology and Hepatology , Chang Gung Memorial Hospital , Taoyuan, Taiwan
                [5] 5 Department of Food Nutrition and Health Biotechnology , Asia University , Taichung, Taiwan
                [6] 6 Department of Pharmacology , Yale University School of Medicine , New Haven, CT, United States
                [7] 7 Department of Chinese Medicine , China Medical University Hospital , School of Post-Baccalaureate Chinese Medicine , College of Chinese Medicine , China Medical University , Taichung, Taiwan
                [8] 8 School of Pharmacy , China Medical University , Taichung, Taiwan
                Author notes

                Edited by: Michael Heinrich, University College London, United Kingdom

                Reviewed by: Manuel Pardo de Santayana, Autonomous University of Madrid, Spain

                Diego Rivera, University of Murcia, Spain

                Lukasz Luczaj, University of Rzeszow, Poland

                *Correspondence: Shan-Yu Su, shanyusu@ 123456gmail.com ; Shyh-Shyun Huang, sshuang@ 123456mail.cmu.edu.tw
                [ † ]

                These authors have contributed equally to this work

                This article was submitted to Ethnopharmacology, a section of the journal Frontiers in Pharmacology

                Article
                816029
                10.3389/fphar.2022.816029
                8894760
                35250565
                f405606f-4e71-4fcd-a62e-3b2667221002
                Copyright © 2022 Chao, Chen, Pao, Deng, Cheng, Su and Huang.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 16 November 2021
                : 13 January 2022
                Categories
                Pharmacology
                Original Research

                Pharmacology & Pharmaceutical medicine
                taiwanese bitter tea,field survey,taiwanese traditional medicine,ethnobotany,health geography

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