Journal of Biomedical Sciences

Keywords

Encyclopedia; Herbal medicine; Traditional medicine; Research; Iran

Introduction

The use of medicinal plants in therapy has been known for centuries in every culture and civilization [1,2]. Traditional medicine is an important part of human health care and there is an increasing worldwide demand for botanicals in all countries [1,3]. In other words, patients desire to benefit from the use of complementary and alternative medicine (CAM) such as herbal medicine. However, sometimes they are not informed that herbal therapy, especially over a proven conventional therapy, may be toxic and dangerous [4]. In order to decrease this kind of risks, clinicians and pharmacists need to be informed about herbs and other CAM practices [5,6], especially with their own country endemic, traditional herbs [7].

On the other hand, the drug discovery process is becoming extremely expensive for the pharmaceutical industry. Natural drug discovery based on ethnopharmacology and traditional medicines is becoming an attractive area [8]. Medicinal herbs and related herbal products are important targets of patent claims since they have become of great interest to the international drug and cosmetic industry [1]. However, there are many problems associated with botanicals research, for instance limited data exist on the safety and efficacy of botanical products [7,9]. Therefore, reducing the time of research, economizing investments with better safety and conducting high-quality botanicals research are essential and indispensable. To do this, a quick access to valid information is requisite.

The aim of this article is to introduce a framework for a compendious and reciprocal encyclopedia of herb-disease based on Iranian herbal studies. Such an encyclopedia helps researchers and enthusiasts on herbal medicine to find out that the effects of an herb have been investigated on the treatment of which kind of disease or the management of a particular disease has been examined using which herbs, in a shortest possible time.

Materials and Methods

This review is based on Winslow et al. [4] and WHO [10] definition of herb. A search limited to Iran was conducted using 36 search terms listed in Table 1 in the data sources PubMed, Scopus, ScienceDirect, Wiley, and SpringerLink up to the end of 2012.

Table 1: Search terms used in combination with Iran to find Iranian studies investigating herbal medicines in the management of different aspects of health and disease.

Inclusion and exclusion criteria

All human, animal and in vitro studies were included. Review articles, letters to editor, unpublished data such as thesis and published studies from countries other than Iran were omitted. Two reviewers independently examined the title and abstract of each article to avoid duplications.

Data extraction and classification

Data including investigated disease(s), common and scientific names of investigated herbs were extracted from the titles and abstracts of articles. Investigated subjects and diseases have been categorized in 18 groups, including cancer, cardiovascular, cellular and molecular (Cell. Mol.) studies, embryology, endocrinology, genitourology, gastrointestinal (GI), gynecology, immunology, infectious, metabolism, mucocutaneous, musculoskeletal, neuroscience, ophthalmology, renal, reproductive, and respiratory systems (Table 2).

Table 2: A categorization of issues investigated in 18 subjects and diseases studied by Iranian herbal researchers.

Botanical scientific nomenclature

The appropriate scientific name and endemicity of all herbs introduced in the reviewed articles were validated taxonomically according to Ghahreman and Attar [11], Mozaffarian [12] and www.theplantlist.org [13]. Botanical scientific nomenclatures applied in the reviewed articles were evaluated according to Rivera et al. [14].

Findings

Studied herbs and the aims of the treatments were extracted from the titles and abstracts of 1319 articles written by Iranian scientists and researchers from 1969 up to the end of 2012. Information on the studied herbs including their division, family, scientific names and names used in the reviewed articles, Persian names, and the aims of the studies are shown in appendix 1. Totally, the efficacy of 560 herbs belonging to 100 families was studied. Of them, 511 herbs belonging to 77 families were Angiosperm-dicotyledon and 49 herbs belonged to Angiosperm- monocotyledon, Gymnosperm, rhodophyta (red algae), phaeophyta (brown algae), basidiomycota (fungi), and chlorophyta (green algae) in a descending order (Table 3). Lamiaceae (Labiatae), Apiaceae (Umbelliferae), Asteraceae (Compositae) and Fabaceae (Leguminosae) were the most studied families with 412, 211, 179 and 75 studies in each, respectively. Most of the studied herbs belonged to Lamiaceae (Labiatae), Asteraceae (Compositae), Apiaceae (Umbelliferae), Fabaceae (Leguminosae) with 118, 72, 60 and 38 studied herbs in each, respectively. Among 100 studied herbal families, only one species was studied in 45 families, of them 41 were studied less than 10 times. The herbs including Crocus sativus L. (Iridaceae), Camellia sinensis (L.) Kuntze (Theaceae), Urtica dioica L. (Urticaceae) and Peganum harmala L. (Nitrariaceae) were the most frequently studied species within 66, 16, 13 and 11studies, respectively. Of 560 studied herbs, the species of 31 studied herbs (5.5%) were not specified in the titles and abstracts of 55 articles. Only 69 of 560 studied herbs (12.3%) were endemic (Table 4) and the remained 491 studied herbs (87.6%) were not endemic to Iran. Five herbs (0.9%) including C. sativus, Allium sativum L. (Amaryllidaceae), Zataria multiflora Boiss. (Lamiaceae) and Nigella sativa L. (Ranunculaceae) and Teucrium polium L. (Lamiaceae) were the most studied herbs with 66, 51, 41, 35 and 27 studies, respectively. The efficacy of C. sativus and A. sativum was studied on cardiovascular, Cell. Mol., immune, infectious, metabolism, mucocutaneous, neuroscience and renal systems. C. sativus was also examined in embryology, genitourinary, gynecology, musculoskeletal and respiratory systems. Cancer, GI and ocular system were additional aims for research on A. sativum. The effects of Z. multiflora, N. sativa and T. polium were also studied on the same items. The herbs were studied one time in 295 (52.7%) herbs, 2 to 9 times in 236 (42.1%) herbs and 10 to 21 times in 24 (4.3%) (Appendix 1).

Table 3: Division, number of families, total studies, number of studied herbs, number of endemic and unknown species per division of studied herbs in Iranian herbal research.

Appendix 2 shows the herbs studied for the management of the investigated subjects and diseases in each category. The efficacy of most herbs was investigated in infectious system, metabolism, neuroscience, Cell. Mol. and immunology with 289, 218, 122, 115 and 92 studied herbs in each, respectively (Table 2).

Features and Limitations of our Study

Our study is focused on Iranian research on herbal medicine up to the end of 2012. Data were extracted from titles and abstracts without any evaluation according to available scoring systems [15] and were not checked with the information in the full text of the reviewed articles. Accordingly, the beneficial or side effects of the studied herbs were not reviewed. However, we think our categorization gives a good point of view to researchers and scientists to have a concurrent glance to diseases and recommended herbs for them in traditional medicines. Thus, the benefits and importance of a reciprocal encyclopedia of herbdiseases can be seen.

From an Herb-disease Encyclopedia to an Herb-disease Database

An herb- disease encyclopedia comes to the help of herbal researchers and enthusiasts to find that a desired herb is useful or recommended for which kind(s) of health problems, and/or the management, pretreatment or treatment of a specific disease or disorders has been examine using which herb(s) or herbal product(s). Information on the history of traditional uses of herbs or traditional management of known health problems can be included as well. As mentioned earlier, due to the vast amount of information available for herbs and diseases, it is worth to emphasize that a comprehensive database in which the valid and assessed results of herbal research on various aspects of diseases are updated in detail is an ideal tool to increase the efficiency of research and to shorten the way of the herbal management and control of diseases [7]. The authors are currently working on the schema of an ideal herbal database, which will be published in future.

Recounting Some of the Salient Points of Herbal Research

Knowing the gaps in studies and research, including research on medicinal herbs is of value to find out suitable guideline and policy for defining an efficient research. In our pervious review, the efficacy of medicinal herbs on the management of different aspects of diabetes mellitus (DM), including parameters in DM, pharmacological mechanisms, and the effects on the functions of organs were collected and compared (Table 4) [7] here, we showed that some important aspects of DM other than the blood glucose and HbA1C levels were not considered in both Iranian and non-Iranian herbal research. We think that providing and improving such a standard framework for diseases and health problems help herbal researchers to design their studies according to unexamined items which are also appropriate to their fund. It is clear that being familiar with the traditional uses of medicinal herbs is a prerequisite for experimental designing. Furthermore, as others and we have raised [7] journals need to define unanimous guidelines with emphasis on criteria such as botanical scientific nomenclature, the quality and safety of herbs, phytochemical, pharmacological and toxicological information to improve the validity and quality of the final publications.

Table 4: Division, family, scientific name and Persian name of studied herbs endemic to Iran extracted from Iranian herbal research.

Discussion and Conclusion

The most obvious finding is the little attention to endemic herbs to Iran in Iranian research, whereas Iran is a country with a known ancient history in traditional medicine, as well as diverse and rich vegetation. Endemic plants are unique genetic resources which worth further investigation. As we found, most herbs (52.7%) were studied once and the research on them was discontinued. Infectious system was the most investigated area (23.3% of reviewed studies) of Iranian herbal research. Despite the worldwide importance of infectious diseases, we believe that most common health problem of a society should be a priority. As well as, due to the widespread and popular use of herbal medicines, medical staffs should be familiar with traditionally used herbs, including endemic ones. Accordingly, it is expected that herbal researchers prioritize ethnopharmacological research on medicinal herbs, especially endemic ones which are traditionally used in their own country [7]. However, considering the time and expenditure that are spent to such studies, it is crucial to find reasons and motivations of designing such herbal research.

The finding 560 herbs were studied and that most of them possibly have beneficial effects is very promising. None of the five most studied herbs, including C. sativus, A. sativum, Z. multiflora, N. sativa and T. polium were endemic to Iran. C. sativus and A. sativum are among most known medicinal herbs with available phytochemical information [7]. Information collected in Appendix 1 makes it easy to define a research study; however, it is recommended that general considerations for herbal research, as well as specific issues for studies on a specific disease [7] in addition to the history of traditional usages of desired herb(s) are carefully examined from the beginning of an experiment to the end. Botanical scientific nomenclature is another critical case that should never be overlooked [14].

It was interesting for us that most reviewed herbs (95.7%) belonged to angiosperms, possibly due to their vast diversity and geographical distribution. Biogeographers and evolutionary biologists are also surprised with the dramatic rise in the abundance of angiosperms around the world. Various parameters have been hypothesized that play important roles during the early and later stages of angiosperm expansion, as well as the slowdown in the diversification of gymnosperms [16-19]. Perhaps, phytochemical and metabolome comparison between herbs from different plant kingdoms provides more evolutionary clues other than geographical distribution and diversification for more medicinal utilization of angiosperms. It has been reported that chemometric analyses such as reversed-phase high-performance liquid chromatography and biochemical markers can be used for analyzing and classifying intra-specific genetic relationship of plant populations [20,21]. Nowadays, scientists are encouraged to bioinformatics technics and the omics-based approaches in traditional medicine and ethnomedicine studies [22-25] which can be of help to manage the herbal research as large-scale datarich studies.

Clearly, there is still much to be done to discover the appropriate herbal medicine for the treatment and management of diseases due to the exhausting labor of the investigation on items such as the quality, safety, side effects, toxicity, and pharmacological mechanism for each herb. However, appropriate mechanisms, including standard frameworks for different aspects of diseases and pharmacological mechanisms of medicinal herbs, as well as a specialized database for herbal medicine can be defined to make easier overcoming such obstacles.

Finally, to compensate some features such as industrialization that seems unlikely to be omitted from new human modern life, the human kind restored to use traditional medicine for maintaining his/her health. However, every day more than over, it is needed to admit seriously that the lifestyle is the most effective and appropriate way for maintaining health by the prevention and management of diseases. According to an Iranian proverb, prevention is better than treatment.

Acknowledgement

We wish to thank our little children whom we spent much of our times belonging to them for our research and studies.yond their traditional use: a critical review. Nat Prod Rep 31:1585-1611.

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