The hunt for botanicals

Herbal medicine can be a double-edged sword and should be more rigorously investigated for both its beneficial and harmful effects, say researchers writing in a special supplement of Science. Co-written by King's College London experts, the article reviews botanicals that have shown promising results in treating fibrosis or tissue scarring, along with some other herbs that are associated with pro-fibrotic damage to the liver, the kidney and some other organs. Around 45% of deaths in the US can be attributed to fibrotic diseases such as systemic sclerosis, cardiovascular disease, liver cirrhosis, lung fibrosis and progressive kidney disease. In fibrosis, normal healthy tissue is replaced by scar tissue, which in turn often leads to chronic organ failure. For many of these chronic conditions no cure currently exists, despite progresses in understanding the mechanisms of fibrosis and pinpointing a number of possible drug targets and anti-fibrotic drug leads. The only anti-fibrotic drug currently registered in Europe and the US, pirfenidone, has shown some beneficial effects in patients with idiopathic pulmonary fibrosis and fibrotic kidney diseases, but its clinical efficacy on fibrosis remains equivocal. A number of herbal medicinal products such as those used in traditional Chinese medicine have been reported to have some effect on fibrosis, but robust scientific evidence of these botanicals as safe and effective anti-fibrotic therapeutics is lacking.