Frailty and Herbal Medicines- From Molecular Mechanisms to Clinical Efficacy

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Background

Throughout the history of herbal medicines such as Japanese Kampo medicine, the basic theories and the methods of diagnosis and treatment have differed considerably from those of Western medicine. Western medicine uses disease-based diagnosis, while traditional herbal medicines emphasize patient-based diagnosis. More than 200 Kampo recipes composed of mixtures of 2 to 15 components have been reported. Approximately 350 different components are used for these recipes. Most of them are medicinal herbs, but fungi, animal components, and minerals are also used. Approximately 120 of these crude drugs are listed in the Japanese Pharmacopeia, and one-third of them are also listed in WHO monographs.

Herbal medicines continue to evolve in the daily lifestyle and treatment regimens of patients, with illnesses such as cancer. Herbal medicines have a significant effect on reducing fatigue and pain, improving respiratory tract infections and gastrointestinal problems including diarrhea, nausea, and vomiting, protecting liver function, and even ameliorating the symptoms of cachexia. Although herbal medicines have not been fully accepted by mainstream medicine because of the complex nature of the formulae, the stringent quality control of herbal medicines, such as that in Japan, and reproducibility of preclinical findings, together with few adverse events, have made herbal medicines more and more attractive for the management of intractable diseases and health problems.

Older individuals show a spectrum of features categorized as frailty, defined by unintentional weight loss, self-reported exhaustion, muscle weakness, slow walking speed, and low physical activity. The functional and behavioral aspects of frailty are associated with loss of lean mass in the form of sarcopenia. While middle-age is often associated with increased body weight in many developed countries, later life is frequently characterized by loss of body mass, loss of muscle mass and bone loss. Frailty is thus a big problem in aged societies which shorten the healthy life-span.

This review series summarize the current state and future direction of herbal medicines and frailty from translational points of view. The multi-component herbal medicines capable of targeting multiple sites could be useful for reducing polypharmacy in frailty. Mechanistic studies and identification of active compounds could lead to new discoveries in aging sciences and facilitate clinical application of herbal medicines in the world.

Welcomed content:
A. Herbal medicines- Introduction and Kampo recipes for frailty
B. Frailty- From molecular mechanisms to clinical diagnosis and complications
C. Herbal medicines and frailty- Experimental studies
D. Herbal medicines and frailty- Clinical studies

If submitting to Frontiers in Pharmacology (section Ethnopharmacology) , please note-
This specialty section focuses on biological and pharmacological activities of plants, fungi and other organisms used locally or traditionally as a medicine or to improve health. Studies with the specific aim to either improve local healthcare by developing products based on such knowledge or studies in the context of drug discovery / development from natural sources will be considered if they are based on biological resources with a clear and well-defined local or traditional use. Purely biodiversity-based screening studies and studies of established natural products and their mechanism of action are outside the scope of this section. Studies reporting such local and traditional uses will only be accepted if the comply with the ConSEFS standards (Heinrich et al. 2017 ) . Toxicological research and clinical studies on medicinal plants are welcome.

Manuscripts which are highly specific, lack breadth and often are very similar to previous papers (often by the same group) are not acceptable and this will be assessed.

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- Antioxidant activity: here in vivo or in vitro studies using generally accepted pharmacological models are essential. Simple in silico and pharmacologically irrelevant assays for antioxidant activity (e.g. the DPPH assay, FRAP (Ferric Reducing Ability of Plasma), ABTS (2,2'-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid)) are not acceptable as a main tool for assessing an extract or a compound for activity. Such assays are commonly used in food chemistry and other fields, but are not of pharmacological relevance.
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Chemical
- The composition of the study material must be described in sufficient detail
- If ‘pure’ compounds are used information on the level of purity must be included

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