National TCM Key Lab of Serum Pharmacochemistry, Key Lab of Chinmedomics, Key Pharmacometabolomics Platform of Chinese Medicines, Heilongjiang University of Chinese Medicine, Heping Road 24, Harbin, 150040, China.
Phytother Res. 2014 Apr;28(4):526-33. doi: 10.1002/ptr.5032. Epub 2013 Aug 1.
Shifting current drug discovery tide from 'finding new drugs' to 'screening natural products' may be helpful for overcoming the 'more investment, fewer drugs' challenge. Traditional Chinese medicine (TCM), relying on natural products, has been playing a very important role in health protection and disease control for thousands of years in Asia, whose therapeutic efficacy is based on the 'synergism', that is, the combinational effects to be greater than that of the individual drug. Based on syndromes and patient characteristics and guided by the theories of TCM, formulae are designed to contain a combination of various kinds of crude drugs that, when combined, generally assume that a synergism of all ingredients will bring about the maximum of therapeutic efficacy. The increasing evidence has shown that multiple active component combinations of TCM could amplify the therapeutic efficacy of each agent, representing a new trend for modern medicine. However, the precise mechanism of synergistic action remains poorly understood. The present review highlights the concept of synergy and gives some examples of synergistic effects of TCM, and provides an overview of the recent and potential developments of advancing drug discovery towards more agile development of targeted combination therapies from TCM.
将当前的药物发现潮流从“寻找新药”转向“筛选天然产物”,可能有助于克服“投入更多、药物更少”的挑战。中药(TCM)依靠天然产物,在亚洲已经有几千年的健康保护和疾病控制方面发挥了非常重要的作用,其治疗效果基于“协同作用”,即组合效应大于单个药物的效应。基于症状和患者特征,并以中医理论为指导,设计配方包含各种粗药的组合,当组合在一起时,通常假设所有成分的协同作用将带来最大的治疗效果。越来越多的证据表明,中药的多种活性成分组合可以放大每种药物的治疗效果,代表了现代医学的新趋势。然而,协同作用的确切机制仍知之甚少。本综述强调了协同作用的概念,并给出了一些中药协同作用的例子,概述了从中药中发现更灵活的靶向组合疗法的最新和潜在进展,为药物发现提供了一个新的视角。