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The globalization of herbalism and its widespread use as a part of
integrative medicine in developed countries has stimulated the need to
understand the therapeutic value and safety parameters of medicinal plants
and dietary supplements. Generally, when traditional remedies are
compounded and prescribed appropriately, within the parameters of expected
value, their safety and efficacy far outweighs the risks, and most
untoward reactions are mild and are tolerated as a consequence of use.
Many medicinal plants have already provided the pharmaceutical industry
with valuable compounds, and others continue to be valued by those that
practice phytotherapy or that are available in "dietary supplements".
However it is important to realize that oversight of worldwide regulatory
mechanisms, including those in the U.S., are at present inadequate to
guard against untoward reactions that might arise. These negative events
can usually be traced to entrepreneurs or inexperienced practitioners
adulterating or changing well- known formulations or creating products,
which use botanicals in non-traditional ways. In this regard the dietary
supplement industry is particularly prone to creating a wide range of
novel and untested botanical remedies and promoting them to
self-medicating public. The clinical outcome can be particularly
problematical if these are used in combination with certain pharmaceutical
agents. It is for these reasons that research in this area is so
fascinating and challenging.
Understanding how traditional knowledge and empirical selection has served
to identify plants with potential therapeutic value continues to be a
major research focus. This is based on appreciation of how to optimize the
value of medical ethnobotanical data by using suitable bioreactivity
assays to specifically "targeted" disease entities, identifying favored
taxa by an epidemiological technique called "ethnomedical focusing", and
utilizing chemical as well as ethnobotanical and bioreactivity
dereplications to evaluate traditional pharmacopeias and new innovative
phytotherapies alike. Conceptual similarities in phytotherapies occur
worldwide, primarily because related plants are likely to possess common
bioreactive compounds. Similarly, allied infectious agents are also likely
to share sensitivities to related compounds. Called phylogenetic
amplification, these methods and that of targeting and ethnomedical
focusing have been invaluable in identifying new sources of compounds, and
new target diseases from medicinal plants used in Africa, India and the
Amazon. Examples of discoveries made in my laboratory and that of my
collaborator, Dr. Walter Lewis, have included studies on novel stimulating
beverages; the prevention of tooth decay; tooth removal; the promotion of
parturition; the treatment of skin infections, malaria, hepatitis B and
delta hepatitis; and the significant enhancement of wound healing.
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