The Integration of Traditional and Modern Medicine: Future Prospects for Pharmacognosy

Abstract

Pharmacognosy itself is an all embrasive subject linking traditional medicine (TM) to mainstream?allopathically oriented medicine. It highlights the investigation of bioactive polyphenols from?a variety of sources especially medicinal, found in plants with attention to structural features and the therapeutic applicability of these compounds. The development of TM within contemporary health?care systems as a response to global health threats is more and more recognized, particularly in contexts where traditional systems of medicine still dominate the health care arena. This kind of integration requires that it be supported by evidence-based studies that prove the effectiveness, safety, and standardization of herbal medicine. This review seeks to describe the contemporary context of endeavors to integrate traditional andodern approaches to health. It will evaluate systems in which traditional healers and biomedical workers have worked together to significant effect and challenges. The journal will also consider articles involving the scientific considerations about which herbal drugs may be developed based on ethnopharmacological considerations, as well as the discovery of natural product propereties and mechanisms of action and methods for enhancing the quality, efficacy, and safety of medicinal plants and phytomedicines. The paper will also identify and outline strategic areas that may provide direction for future policy development, clinical applications, and research to support its integration. The review intends to help further progress to a more inclusive, holistic, and sustainable healthcare system that builds on the strengths of traditional?and modern medical knowledge.

Keywords

Introduction

Traditional medicine (TM) and modern medicine (MM) are two separate health care systems; both have their own advantages to provide a lot of useful information if used skillfully. TM is based on native wisdom and cultural practices and utilizes natural resources (plants, animals, minerals) in disease prevention, diagnosis, and therapy.  Modern, i.e., allopathic medicine Modern system of medicine (allopathy) is science-based and employs drugs and surgery. Pharmacognosy, which is the scientific examination and study of plant-derived drugs, bridging the gap between TM and MM. (1) It uses the principles of chemistry, biochemistry and pharmacology with a view to the design of various products for promoting the sustainability of healthcare system.  TM has a long tradition and had been developed as a main healthcare system for several populations, whereas the development of MM has been accompanied by the technological advances of modern science. (2) Whilst MM is the best-evidence treatment for infectious and chronic illnesses it is frequently ineffective for multifactorial or idiopathic illnesses, resulting in iatrogenic events or treatment illness. There has been renewed interest in TM because of its availability, cultural relevance and its perception of safety. A combined model using both TM and MM may provide a more comprehensive patient-focused care model. (3)  Pharmacognosy studies facilitate identification of bioactive compounds in traditional medicines, help to standardize clinical effect, and contribute toward drug discovery and more safe herbal products. (4)  In particular integration has some problems due to absence of standardization and issue of quality control in TM, herb-drug interactions, inadequate scientific validation potential as well as biopiracy. Interdisciplinary efforts between researchers, clinicians, traditional healers, policy-makers, and regulatory agencies are needed to address the challenges. (5) (6) Measures, such as moralised attitudes and a strong regulatory environment, must also be put in place to safeguard traditional knowledge and sustainable exploitation of natural resources. (7) This works sheds light on the status of pharmacognosy and on the cases in which plants can provide success in health. It addresses issues, perspectives, and the use of advanced management tools to manage resources sustainably. (8) Finally, it provides a vision for the future and highlights the future of pharmacognosy as a means to contribute for a more just, sustainable, and efficacious global healthcare system. By 2025, pharmacognosy is projected to improve global health reality by integrating ancient wisdom and practice with cutting edge science. (9)

2.Background: Traditional and Modern Medicine

Traditional medicine (TM) refers to a broad set of health care practices, knowledge, and beliefs that use medicines and therapies derived from plants, animals, and minerals, as well as spiritual therapies, manual techniques, and exercises. These fibroins can be used alone or in combination to enhance health and also to diagnose, treat, and prevent disease. (10) Modern medicine (which is also called biomedicine or allopathic medicine) is true science based, with properly conducted and repeatable scientific studies and the principle of use of evidence-based medicine for scientific diagnosis and treatment of disease. (11) While these systems may look different, they are more and more regarded as complementary, with each having unique strengths in a synergy which can lead to more complete and efficient health services. (12)

3.Pharmacognosy: Bridging the Gap

Pharmacognosy -the science of medicine from natural sources- is of utmost importance in the link between traditional and modern medicine. (10)  The importance of which is increasing on a global scale by 2025, in parallel with the environmental issues and increasing interest in natural products and their potential medicinal applications. The future of this field is in integrating traditional wisdom and modern science, to ensure their efficacy and safety. (13)

4. Traditional Medicine: Concepts and Practices

Traditional medicine (TM) refers to the knowledge, skills, and practices using medicinal herbs, plants and animals, spiritual therapies, manual techniques and exercises, and applied to diagnose, improve or maintain body and mental well-being. (13) They can be used alone or in any combination for health promotion, and for the diagnosis, treatment or prevention of disease. This is rooted in the culture of many communities, and has been handed down through generations, often long predating ‘modern medicine’ based on evidence. TM is recognized by WHO as an important and often neglected component of health care across the globe. (14)

4.1. Core Concepts of Traditional Medicine

Whereas modern medicine tends to be pathogen/symptom/disease-oriented, TM sometimes employs a scenic approach, taking into account the patient with his physical, mental and spiritual conditions and environment. Central to these is the notion of balancing the energies or elements in the body, such as the TCM concept of qi or the notion of doshas in Ayurveda. (15)  Disease is considered to be an imbalance in these energies and any treatment is intended to create balance. In addition, TM frequently highlights preventive practices and lifestyle changes to sustain a healthy life style. (16) (17) The precise concepts differ greatly among individual TM systems and depend on cultural and geographic contexts.

4.2. Common Practices in Traditional Medicine

Indigenous medical systems are very diverse and hallucinogens are only exploited by some traditions: (Traditional medical practices are very varied and correspond to very particular ideosyncrases and ecological conditions). Hourann is a central part of many TM systems that involve the application of natural plant extracts or the whole plant for treatment. (18) Acupuncture, which is an essential part of TCM, is based on the manipulation of existing points on the body with needles to be able to regulate the flow of qi. Ayurvedic treatment involves using a combination of herbal treatment, diet and lifestyle modification, and yoga meditation practices. Other practices are massotherapy, spiritism, and animal-based products. (19) The effectiveness and safety of these approaches vary and require rigorous scientific investigation before they can be responsibly integrated into conventional healthcare systems. (20)

5. Modern Medicine and Pharmacognosy

Modern medicine as it is now, evidence based, pharmaceutical and technically driven, has contributed immensely to better health outcomes across the world. (21) However, its limitations, such as high price, drug adverse effects, and emergence of antimicrobial resistance, have made traditional medicine to become the focus of attention, and its possible combination with modern medicine has become an alternative option again. (22)

5.1. The Role of Pharmacognosy in Drug Discovery

Pharmacognosy is the bridge covering the gap between traditional systems of medicine and modern drug development processes. (23) Using biological assay-techniques, e.g. phytochemical analysis, bioactivity screening and structure elucidation, pharmacognosists are able to identify and characterize bioactive compounds that are active in medicinal plants. (24) These lead compounds can subsequently be developed as pharmaceutical agents or lead compounds for chemical modifications. Only a few of these have entered the clinic, such as paclitaxel (Taxol) extracted from the Pacific yew tree and artemisinin from Artemisia annua, emphasizing the potential of pharmacognosy in finding new drugs against multiple diseases from natural sources with the origin from traditional medicine. (25) (26) 

5.2. Challenges and Opportunities in Integration

Challenges Although pharmacognosy offers potential, to integrate traditional and modern medicine there are many challenges. These are also the absence of standard quality control measures for herbal products, risks for herb-drug interactions and necessity of well conducted clinical trials to prove safety and efficacy of traditional medicine sense. In addition, IP rights and TK-based benefit sharing agreements are key considerations.(27)  But, such challenges are also opportunities for pharmacognosy to contribute to the development of analytical tools, perform safety evaluations, and develop ethical considerations for the sustainable utilization of medicinal plants.(28)  The emergence of personalized medicine and the development of genomics and proteomics have opened up excellent prospects for pharmacognosy to discover biomarkers that can predict responses to a specific herbal medicine in individual patients, and will be useful for more personalized and efficient treatments.(29) (30)

5.3. Future Directions

The horizon to redeem pharmacognosy is through cross-disciplinary input, in addition to utilization of modern-day methods, and interfacing players such as researchers, health practitioners, and the source healers. (1) Building up an extensive set of databases of natural products and their chemical and biological data will be critical in accelerating the pace of efforts in drug discovery. (31) (32) Finally, the use of artificial intelligence and machine leaning over big datasets of conventional wisdom and experimental data will contribute in identifying new drug candidates and knowledge of their efficacy and safety. (33) Pharmacognosy will become more and more essential in tapping the useful potential of natural resources, as we move towards holistic, and patient-centric medicinal practice. (27)

6. Current Applications of Traditional Medicine in modern Healthcare

6.1. Herbal medicines and Phytopharmaceuticals

Plants are the basis of phytotherapeutic medicines, which form part of the traditional medical systems and are increasingly included in the general health care. (34) Phytopharmaceuticals, defined to include pure or standardized extracts of medicinal plants, form a conceptual link between traditional herbal remedies and modern pharmaceutical practice. (35) Herbal remedies are attractive because the products are perceived as being ‘natural’ and part of a holistic manner of treatment, a perception that can be quite different from the more focused action of chemical medication. But there are still the issues of quality control, standardization and safety. (13)  The future of herbal drugs and herbopha rmaceuticals: towards c ultural based development The future of herbal drugs and herbopha rmaceuticals may be predicated on sc ientific evaluation and establishment of effective regulat ory mechanisms to safeguard ard the patients and medicine. (36)

6.2. Natural Products in Drug Discovery

Natural product (NP) compounds from plants, microorganisms, and marine organisms have long been an important reservoir of potential drug candidate. A great number of new drugs are natural products or have been modeled after natural products. (37)  Natural product structures are, from time to time, complicated and diverse, yet can serve up novel pharmacologies that are unavailable or impossible through synthesis. (38) Although combinatorial chemistry and high-throughput screening have become in favorite with some of the pharmaceutical industry, natural products-based drug discovery continues to be an important strategy, especially for more complex diseases requiring multi-target types of therapy. (39) Progress in genomics, metabolomics and analytical technologies has given a new lease of life to NP research, leading to the discovery of novel therapeutic bioactive compounds. (40)

6.3. Evidence Based Approaches to Herbal Medicine

The successful integration of traditional medicine into the mainstream healthcare requires an evidence-based investigational approach to support the efficacy and safety of herbal preparations. (41)  It will require hard work, including preclinical inquiry into modes of action and clinical trials to determine the benefits and possible harms of therapies. RCTs are regarded as the preferred method by which to test the efficacy of herbal interventions. Nevertheless, the implementation of RCT methodology is problematic for complex herbal mixtures and individualized treatment in TM. (42) There is a need to develop suitable research methodologies, which respect the wholeness of traditional medicine but also conform to the scientific framework which is vital for evidence-based medicine.

7. Integration of Traditional and Modern Medicine

7.1 Global Trends in Integrative Healthcare

Integrative Medicine (IM) -practicing conventional, Western healthcare providers in conjunction with traditional medicine (TM) providers - is becoming increasingly popular worldwide. The trend mirrors increasing patient appetite for holistic, personalized health care, which considers well-being in body, mind, and spirit. (43) (44) There are a number of possible reasons behind this increase: for instance, increasing evidence of effect of some TM therapies for specific conditions; a desire to cut back on pharmaceutical interventions; increased recognition of the limitations of conventional medicine in addressing chronic conditions. (45) The WHO has supported the integration of TM into national health systems in an effort to improve access to care, especially among vulnerable communities. This worldwide effort is complemented by growing investigation into TM practices and products with efforts to make their use standardized and evidence-based. (46)

7.2. Benefits and Challenges of Integration

There are few potential advantages of TM integrated with allopathic medicine. Patients benefit from better symptom control, quality of life, and satisfaction with care. Integrated care may also be cost-effective in some cases, especially among patients with long-term conditions. (47) But there are still large obstacles. These challenges include insufficient sound scientific evidence of many of TM therapies, problems with stability and standardization of the quality of TM products, and potential safety issues associated with drug herb interactions between TM and conventional medicines. (48) (49) In addition, philosophical and diagnostic discrepancies between TM and modern medicine can form barriers to communication and cooperation among practitioners. Meanwhile, legal and regulatory foundation is also required to guarantee the safety and ethics of integrated medicine.

7.3. Models of Integrative Medicine (China, India, Africa, Etc.)

Various approaches for the integration of TM have been developed in different areas. TCM is well integrated into health care in China, alongside modern medicine. (50) TCM therapies such as acupuncture and herbal medicine are frequently included in treatment regimens for diverse health concerns. Unnaturopathy The AYUSH system (Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy) is India's healthcare approach supported by government initiatives for research, education and standardization. (51) (52) Traditional healers are an important part of primary health care, especially in the rural areas where access to modern treatment and treatment is limited in most African countries. Initiatives are being developed to collaborate with traditional health practitioners, train them, and include their practices in national health programs, responding to concerns around safety and regulation. (52)  These variations underscore the need for culturally-informed integration, acknowledging the strengths and limitations of specific systems.

8. Modern Tools and Techniques in Pharmacognosy

Pharmacognosy has been changing considerably by application of modern methods, or by revision of traditional recourses. These advances are changing the way we can search, screening and apply plant-derived compounds for medicinal use. (27)

8.1. Phytochemical screening and Standardization

Modern phytochemical screening is more than just a mere qualitative procedure. High-Performance Liquid Chromatography (HPLC) coupled to a Mass Spectrometry (MS) detector provides a fast screening and quantification method for many compounds in plant extracts. (53)  Standardization, an essential process used to maintain batch to batch consistency of herbal drugs/medicines, is greatly aided by these techniques. For example, HPLC quantitative analysis can determine the content of particular marker compounds to maintain each batch within-established quality criteria. (54) Moreover, methods such as nuclear magnetic resonance (NMR) spectroscopy facilitate the determination of the structure of new compounds, thereby accelerating the drug-discovery process.

8.2. Ethnopharmacology and Bioassay Guided Research

Ethnopharmacology (or ethnopharmacy) is the science of traditional use of medicines and an excellent source of natural product for drug discovery. Bioassay-directed fractionation, a fundamental methodology in pharmacognosy is now supplemented with hitherto unavailable technology with high-throughput screening (HTS) and automated bioassays. (55)  Both of these technologies have allowed the quick high-throughput screening of large collections of plant extracts for bioactivity against specific targets. (56) Through the integration of modern bioassay approaches with ethnomedical knowledge, new structures with therapeutic potential can be efficiently recognized.

8.3. Chromatography and Spectroscopic Techniques

Chromatography and spectroscopy as indispensable methods in contemporary pharmacognosy. Volatile compounds are commonly analyzed by gas chromatography-mass spectrometry (GC-MS), while non-volatile compounds are generally analyzed by liquid chromatography-mass spectrometry (LC-MS). (57) These methods provide complete data on the chemical composition of plant extracts. Additionally, spectroscopic techniques such as UV-Vis spectroscopy, infrared (IR) spectroscopy and NMR spectroscopy may be used for characterization and structure determination of a compound. (58)  Progress in these techniques (including the evolution of hyphenated methods like LC-MS/MS, GC-MS/MS) has tremendously improved the sensitivity and selectivity of analysis. (59)

8.4. Molecular Pharmacognosy and Genomics

In the arduous struggle to develop new drugs to treat several cancers, pharmacognosy through the molecular routes, with the aid of the genomics, proteomics and transcriptomics tools, that is, molecular pharmacognosy, is helping to unravel the biosynthesis and mode of action (MoA) of plant secondary metabolites for specific target diseases.(60) Isolation of genes and regulation of genes Int: Genomics allows us to know which genes are implicated in the synthesis of medicinally useful molecules, and transcriptomics provides information about regulation of genes in different environmental conditions or developmental stages.(61)  Proteomics method enables to detect and measure proteins of metabolic pathways. These strategies could also be applicable for increasing the production of target compounds by metabolic engineering or plant breeding.  In addition, dissecting the molecular mechanisms that mediate the effects of plant bioactive compounds could result in the generation of more targeted and efficient therapeutics (62) (28)

9. Challenges in Integrating Traditional and Modern Medicine

The theory of traditional and modern medicine combination is still a chaos problem that needs to be solved to achieve the transformation and realization of the value of pharmacognosy. (63) These obstacles are at the levels of regulation, quality control, intellectual property, ethics and the acknowledgement of the practice by doctors and scientists. Clearing these obstacles is essential if traditional remedies are to be usefully integrated with modern systems of medical care. (64)

9.1. Regulatory and Standardization issues

Much of this can be attributed to the absence of standardized regulatory policies of traditional medicines. Traditional medicines are not subjected to the thorough clinical trials and quality control of modern pharmaceuticals. (34)  This inconsistency makes it challenging to validate the safety and effectiveness of traditional remedies and to integrate them into allopathic health care systems. It is necessary to establish detailed mechanisms of the manufacture, labeling, and sales of herbal drugs. (65) There should be harmonization of regulatory requirements in various regions to allow for international cooperation and transfer of TM information and material. Pharmacopoeia and formulary development, involving well-studied traditional medicines can also contribute to standardization. (66)

9.2. Quality control and safety concerns

Quality assurance and safety are major considerations in the collaboration between modern medicine and TSFs. Herbs themselves are mixed and complex drugs, and their components are complex and diverse, which are caused by the plants species, origin, harvest time, and processing technology3-4. (67) (68) This variability may result in differences in the quality of the product and on the therapeutic effect. Poisoning and adulteration with toxic materials and substitution by the wrong plant are other risks. Strict quality control, like authentication of herbal materials, standardization of extraction procedure, and determination of contents of active compounds, is essential for the safety and efficacy of herbal remedies. (69) Additionally, a full safety profile, which includes toxicology and drug interaction studies, is essential to characterize and minimize risks of traditional medicine use.

9.3. Intellectual Property Rights and Ethical Issues

Documentation and utilization of indigenous knowledge raises significant issues of IPR and ethical concerns. Just as with many other ethnicities, indigenous peoples tend to possess traditional knowledge about the plants’ medicinal values, transmitted from generation to generation. (70)  It is important to preserve the knowledge from this theft and to secure the benefits of commercial production for these communities. The unilateral application of patents to traditional medical knowledge and existence of indigenous communities raises concerns about biopiracy and sense of exploitation. (71)  Creating fair and equitable benefit-sharing arrangements, advocating for prior informed consent and respecting the sovereignty of indigenous peoples to determine the use of their traditional knowledge, are necessary components to encourage ethical and sustainable practice within pharmacognosy.

9.4. Acceptance by the Medical and Scientific Community

It is necessary to win the recognition of traditional medicine and modern medicine from the medical community and scientific community. A great deal of health professionals still have doubts about the efficiency and safety of folk lore remedies, in view of the absence of scientific data and standard quality control. Results Based on this case, the importance of well-designed clinical trials that utilize appropriate methodologies and endpoints is essential for the assessment of the traditional medicine effectiveness. Disseminating research results in well-respected scientific journals and educational programs may also contribute to greater knowledge and better acceptance by healthcare providers. In addition, encouraging cross-fertilizations between scientists, clinicians and traditional healers would allow the sharing of knowledge and the development of a more integrative practice of health care. (72)

10. Future Prospects for Integration of Traditional and Modern Medicine in Pharmacognosy

10.1 Innovations in Herbal Drug Development and Standardization

The perspectives of pharmacognosy in the next century will depend on the novel strategies of herbal drug development including strict standardization. Nanotechnology may provide exciting opportunities to improve drug delivery and bioavailability of plant extracts. For instance, tailored nano solutions can enhance the targeted delivery of active substances to certain tissues or cells, thereby enhancing therapeutic performance and minimizing side-effects. (73) In addition, modern analytical procedures like high performance thin layer chromatography (HPTLC) and mass spectrometry are being increasingly employed for quality control and authentication of herbal materials. These techniques allow for the accurate identification and quantification of bioactive constituents in herbal products, thereby standardizing plant-based remedies to guarantee uniform quality and safety. Establishing validated biomarkers of phytotherapeutic efficacy is a critical area to further the objective evaluation of clinical therapeutic responses also in clinical trials. (74)

10.2 Integration of Pharmacogenomics and Personalized Herbal Medicine

The application of pharmacogenomics in herbal medicine is an important advance in the field of personalized medicine. Pharmacogenomics concerns the influence of an individual's genetic makeup on their response to drugs, including herbal products. By understanding the genetic exogenous factors involved in the metabolism, effectiveness and toxicities of herbs, treatments can be better suited to individual patients.  This is exemplified by polymorphisms in drug-metabolizing enzymes that metabolize drugs and herbs such as cytochrome P450s that can modulate the bioavailability and bioactivity of herbal components. PM based on pharmacogenomics has the potential to maximize therapeutic efficacy and minimize adverse effects. (75)

10.3 Digital Pharmacognosy and AI-Based Ethnobotanical Databases

Utilising AI and huge ethnobotanical databases, digital pharmacognosy is evolving how we find and use herbal remedies. AI algorithms scrutinize large data sets of traditional knowledge, chemical structures, and biological activities to pick out promising drug candidates. Ethnobotanical databases recording the traditional uses of plants from indigenous communities are potential source for drug discovery. The pharmacological activities of plant compounds as a result can be predicted by machine learning models, based on chemical structures of the plant compounds and known bioactivity data.(76)   Medicinal plants as a pool of curative agents are well known and recognized; however, their use should have been impeded to a considerable extent by the advent of synthetic drugs beginning from the early part of 20 th century; the discovery and development of the latter being facilitated by the development of advanced digital techniques during the last 4-5 decades owing to the explosive development and advent of digital technologies. Such digital tools help rescale the drug discovery process, optimize and reduce dependence on conventional screens as well as offers opportunities to protect traditional knowledge. (77) (78)

10.4. Education and Training in Integrative Pharmacognosy

Training programs in integrative pharmacognosy are essential to implement these new approaches in research and practice. Such courses should discuss both traditional and contemporary concepts of herbalism. Skills like plant identification, phytochemistry, pharmacology, clinical research and development and regulatory aspects need to be developed in students. An interdisciplinary curriculum and the information from various fields such as botany, medicine, chemistry, and public health are required. In addition, education and training needs to focus on ethical concerns, cultural competency and evidence-based integrative medicine practice. (79) (80)

10.5. Policy Development and Global Collaboration in Integrative Medicine

Policy Making and International Cooperation for Integration of Traditional and Modern Medicine are critical. Regulations play a very important role in ensuring the safety, quality and efficacy of herbal medicines. It is against this backdrop that these frameworks must consider issues relating to standardisation, quality control and the need for any mandatory labelling. Integrative medicine requires international collaborations to circulate the knowledge, resources, and experience in a best practices process. (81)  It is significant that the World Health Organization (WHO) is contributing to safe and effective use of traditional medicine worldwide. Aligning Rules Governance and generating cross-research-installation-academic-discipline-enterprise collaboration can promote integration of traditional and western medicine in global health systems. (82)

CONCLUSION

The acceptance of TM and MM provides the possibility for a technical advance of the medical approach in the 21st century. Pharmacognosy: the medicine of the past, present and future? By 2025, pharmacognosy will have fully exploited the surging technologies to reinforce drug discovery and therapeutic inventions.  TM is highly experiential and involves empirical evidence that consists knowledge of plant-based treatments, while that same form of knowledge often does not meet up with the standards of scientific and empirical validations that MM calls for. Pharmacognosy makes possible the isolation, identification, and testing of bioactive substances from natural sources, to confirm and extend traditional uses. Genomics, proteomics, metabolomics, and high-throughput screening methods continue to facilitate the discovery of bioactive agents. The advance of computational methods, including molecular docking, moreover expedite the early discovery of new compounds of clinical application. Despite these breakthroughs, many challenges have yet to be overcome, such as standardization, quality control, and intellectual property protection. Sustainable development of new drugs—both in terms of safety and efficacy—of herbal drugs and ethical concerns on the protection of rights of indigenous knowledge (IK) holders are also critical. The future of pharmacognosy is to encourage interdisciplinary approaches, support the legal aspects, and ensure equitable accessibility. An integrated system of health care that includes TM as one part and MM as another part may provide safer, effective, and personalized therapeutic options for various populations.

REFERENCES

1. 1. 1. 1. Song Z, Chen G, Chen CYC. AI empowering traditional Chinese medicine? Chemical science. 2024 Jan 1;15(41):16844-86.
         2. Mukherjee PK, Harwansh RK, Banerjee S, Bahadur S, Biswas S. Paradigm shift in natural product research: traditional medicine inspired approaches. Phytochemistry Reviews. 2017 Jan 21;16(5):803–26.
         3. Stefan SM, Rafehi M. Medicinal polypharmacology: Exploration and exploitation of the polypharmacolome in modern drug development. Drug Development Research. 2023 Nov 3;85(1)
         4. Ara I, Hajam T, Maqbool M, Ara N, Bukhari B. Present status, Standardization and safety issues with herbal drugs. International Journal of Research in Pharmaceutical Sciences and Technology. 2020 May 18;1(3):95–101.
         5. Green B, Colucci E. Traditional healers’ and biomedical practitioners’ perceptions of collaborative mental healthcare in low- and middle-income countries: A systematic review. Transcultural Psychiatry. 2020 Jan 14;57(1):94–107.
         6. Awoke A, Cosendey BN. Investigate the Ethnomedical Practices of Different Indigenous Communities: A literature Review. International Journal of Ethnoscience and Technology in Education. 2025 Mar 1;2(1):64.
         7. Hamilton AC. Medicinal plants, conservation and livelihoods. Biodiversity and Conservation. 2004 Jul 1;13(8):1477–517.
         8. Theodoridis S, Drakou EG, Hickler T, Thines M, Nogues-Bravo D. Evaluating natural medicinal resources and their exposure to global change. The Lancet Planetary Health. 2023 Feb 1;7(2):e155–63.
         9. Saggar S, Mir PA, Shilpa S, Kaur A, Uppal J, Kumar N, et al. Traditional and Herbal Medicines: Opportunities and Challenges. Pharmacognosy Research. 2022 Apr 24;14(2):107–14.
         10. Mukherjee P, Harwansh R, Kar A, Bahadur S, Banerjee S. Evidence based validation of Indian traditional medicine Way forward. World Journal of Traditional Chinese Medicine. 2016 Jan 1;2(1):48.
         11. Muharremi G, Meçani R, Muka T. The Buzz Surrounding Precision Medicine: The Imperative of Incorporating It into Evidence-Based Medical Practice. Journal of personalized medicine. 2023 Dec 29;14(1):53.
         12. Fung FY, Linn YC. Developing traditional chinese medicine in the era of evidence-based medicine: current evidences and challenges. Evidence-Based Complementary and Alternative Medicine. 2015 Jan 1;2015(7023):1–9.
         13. Liu SH, Lam W, Cheng YC, Jiang Z, Chuang WC. Safety surveillance of traditional Chinese medicine: current and future. Drug Safety. 2015 Feb 1;38(2):117–28.
         14. Morandi A, Roberti Di Sarsina P, Dalla Libera D, Tosto C. Salutogenesis and Ayurveda: indications for public health management. EPMA Journal. 2011 Dec 1;2(4):459–65.
         15. Wang X, Zhang A, Wang P, Sun H. Systems Biology Technologies Enable Personalized Traditional Chinese Medicine: A Systematic Review. The American Journal of Chinese Medicine. 2012 Jan 1;40(06):1109–22.
         16. Zhang Z, Zhu M. Holistic View of TCM on Cancer Integrative Therapy. Future Integrative Medicine. 2023 Sep 26;2(3):159–67.
         17. Alrashedy NA, Molina J. The ethnobotany of psychoactive plant use: a phylogenetic perspective. PeerJ. 2016 Oct 5;4(4):e2546.
         18. Mamtani R, Mamtani R. Ayurveda and Yoga in Cardiovascular Diseases. Cardiology in Review. 2005 May 1;13(3):155–62.
         19. Dham S, Shah V, Hirsch S, Banerji MA. The role of complementary and alternative medicine in diabetes. Current Diabetes Reports. 2006 May 1;6(3):251–8.
         20. Addis G, Urga K, Genebo T, Abebe D. Perceptions and practices of modern and traditional health practitioners about traditional medicine in Shirka district, Arsi zone, Ethiopia. Ethiopian Journal of Health Development. 2002 Jan 1;16(1).
         21. Zhang Z, Xu Z, Fitzgerald M, Luo L, Luo L, Huang N, et al. Integration of traditional, complementary, and alternative medicine with modern biomedicine: the scientization, evidence, and challenges for integration of traditional Chinese medicine. Acupuncture and Herbal Medicine. 2024 Jan 17;4(1):68–78.
         22. Gertsch J. Botanical Drugs, Synergy, and Network Pharmacology: Forth and Back to Intelligent Mixtures. Planta Medica. 2011 Mar 16;77(11):1086–98
         23. Itokawa H, Lee KH, Morris-Natschke SL, Akiyama T. Plant-derived natural product research aimed at new drug discovery. Journal of Natural Medicines. 2008 Apr 22;62(3):263–80.
         24. Gaire BP. Herbal Medicine in Ischemic Stroke: Challenges and Prospective. Chinese Journal of Integrative Medicine. 2018 Apr 1;24(4):243–6.
         25. Kinghorn AD, Balandrin MF. Human Medicinal Agents from Plants. american chemical society; 1993 May.
         26. Kinghorn AD. Pharmacognosy in the 21st century. Journal of Pharmacy and Pharmacology. 2001 Feb 1;53(2):135–48.
         27. Wang M, Zhang S, Li R, Zhao Q. Unraveling the specialized metabolic pathways in medicinal plant genomes: a review. Frontiers in plant science. 2024 Dec 24;15.
         28. Del Boccio P, Pieragostino D, Di Ioia M, Rossi C, Sacchetta P, Cicalini I. Integration of metabolomics and proteomics in multiple sclerosis: From biomarkers discovery to personalized medicine. PROTEOMICS – Clinical Applications. 2016 Mar 11;10(4):470–84.
         29. Verma AK, Singh K, Gupta JK, Kumar S, Jain D. Pharmacological Approaches and Innovative Strategies for Individualized Patient Care. Recent patents on biotechnology. 2025 Jan 20;19.
         30. Olivon F, Neyts J, Allard PM, Koval A, Wolfender JL, Apel C, et al. Bioactive Natural Products Prioritization Using Massive Multi-Informational Molecular Networks. ACS Chemical Biology. 2017 Sep 15;12(10):2644–51.
         31. Pradhan T, Gupta O, Chawla G. The Future of ChatGPT in Medicinal Chemistry: Harnessing AI for Accelerated Drug Discovery. Chemistry Select. 2024 Mar 27;9(13).
         32. Serrano DR, Kara A, Ruiz HK, Simon JA, Sanchez-Guirales SA, Tomietto G, et al. Artificial Intelligence (AI) Applications in Drug Discovery and Drug Delivery: Revolutionizing Personalized Medicine. Pharmaceutics. 2024 Oct 14;16(10):1328.
         33. Calixto JB. Efficacy, safety, quality control, marketing and regulatory guidelines for herbal medicines (phytotherapeutic agents). Brazilian Journal of Medical and Biological Research. 2000 Feb 1;33(2):179–89.
         34. Balkrishna A, Kukreti A, Sharma N, Srivastava D, Srivastava S, Arya V. Exploring the Safety, Efficacy, and Bioactivity of Herbal Medicines: Bridging Traditional Wisdom and Modern Science in Healthcare. Future Integrative Medicine. 2024 Mar 25;3(1):35–49.
         35. Grace Pratiwi Rumahorbo C, Hutahaean S, Fatimah Zuhra C, Ilyas S, Ambarita H, Fachrudin HT, et al. Advancing Sustainable Herbal Medicine: Synthesizing Nanoparticles from Medicinal Plants. E3S Web of Conferences. 2024 Jan 1; 519:03038.
         36. Romano JD, Tatonetti NP. Informatics and Computational Methods in Natural Product Drug Discovery: A Review and Perspectives. Frontiers in Genetics. 2019 Apr 30;10(Suppl._1).
         37. Conrado GG, Da Rosa R, Reis RD, Pessa LR. Building Natural Product–Based Libraries for Drug Discovery: Challenges and Opportunities from a Brazilian Pharmaceutical Industry Perspective. Revista Brasileira de Farmacognosia. 2024 Apr 5;34(4):706–21.
         38. Proschak E, Stark H, Merk D. Polypharmacology by Design: A Medicinal Chemist’s Perspective on Multitargeting Compounds. Journal of Medicinal Chemistry. 2018 Jul 23;62(2):420–44.
         39. Cuperlovic-Culf M, Culf AS. Applied metabolomics in drug discovery. Expert Opinion on Drug Discovery. 2016 Jul 1;11(8):759–70.
         40. Mosihuzzaman M, Choudhary MI. Protocols on safety, efficacy, standardization, and documentation of herbal medicine (IUPAC Technical Report). Pure and Applied Chemistry. 2008 Jan 1;80(10):2195–230.
         41. Firenzuoli F, Gori L. Herbal Medicine Today: Clinical and Research Issues. Evidence-Based Complementary and Alternative Medicine. 2007 Jan 1;4(S1):37–40.
         42. Mind-Body Therapies in Children and Youth. Pediatrics. 2016 Sep 1;138(3).
         43. Baer HA, Coulter I. Taking stock of integrative medicine: Broadening biomedicine or co-option of complementary and alternative medicine? Health Sociology Review. 2008 Dec 1;17(4):331–41.
         44. Chung VCH, Leung TH, Wong CHL, Ho LTF. Designing delivery models of traditional and complementary medicine services: a review of international experiences. British Medical Bulletin. 2021 Mar 3;137(1):70–81.
         45. Yu SWY, Oriol NE, Hill C, Ricks ML, Bennet J. The scope and impact of mobile health clinics in the United States: a literature review. International Journal for Equity in Health. 2017 Oct 5;16(1).
         46. Kern J, Bielory L. Complementary and alternative therapy (CAM) in the treatment of allergic rhinitis. Current Allergy and Asthma Reports. 2014 Oct 1;14(12).
         47. Rosenthal DS, Dean-Clower E. Integrative Medicine in Hematology/Oncology: Benefits, Ethical Considerations, and Controversies. Hematology. 2005 Jan 1;2005(1):491–7.
         48. Matos LC, Greten HJ, Monteiro FJ, Machado JP. Understanding Traditional Chinese Medicine Therapeutics: An Overview of the Basics and Clinical Applications. Healthcare. 2021 Mar 1;9(3):257.
         49. Chaturvedi S, Tillu G, Kumar N, Deshpande S, Patwardhan B. AYUSH, modern medicine and the Covid-19 pandemic. Indian Journal of Medical Ethics. 2020 Jul 30;191–5.
         50. Subedi B. Perspective Chapter: Integrating Traditional Healers into the National Health Care System – A Review and Reflection. In intechopen; 2023.
         51. Wolfender J, Maillard M, Hostettmann K. Thermospray liquid chromatography?mass spectrometry in phytochemical analysis. Phytochemical Analysis. 1994 Jul 1;5(4):153–82.
         52. Govindarajan R, Pushpangadan P, Tejas V. High-Performance Liquid Chromatography (HPLC) as a Tool for Standardization of Complex Herbal Drugs. Journal of AOAC INTERNATIONAL. 2019 Jul 1;102(4):986–92.
         53. Kapur R, Giuliano KA, Mrksich M, Taylor DL, Vasudevan C, Campana M, et al. Streamlining the Drug Discovery Process by Integrating Miniaturization, High Throughput Screening, High Content Screening, and Automation on the CellChipTM System. Biomedical Microdevices. 1999 Jan 1;2(2):99–109.
         54. Deshmukh SK, Mishra PD, Balakrishnan A, Kulkarni?Almeida A, Khanna A, Periyasamy G, et al. Anti?Inflammatory and Anticancer Activity of Ergoflavin Isolated from an Endophytic Fungus. Chemistry & Biodiversity. 2009 May 1;6(5):784–9.
         55. Aziza N, Ahmad M, Ochilov U, Alkahtani J, Khaydarov K, Beilerli A, et al. Chromatographic authentication of botanical origin: Herbaceous pollen profiling with HPLC, HPTLC and GC-MS analysis. Biomedical Chromatography. 2024 Feb 21;38(6).
         56. Halket JM, Przyborowska AM, Bramley PM, Waterman D, Fraser PD, Patel RKP. Chemical derivatization and mass spectral libraries in metabolic profiling by GC/MS and LC/MS/MS. Journal of Experimental Botany. 2004 Dec 20;56(410):219–43
         57. Singh S, Roy R. The application of absolute quantitative 1H NMR spectroscopy in drug discovery and development. Expert Opinion on Drug Discovery. 2016 Jun 3;11(7):695–706.
         58. Timmermans ML, Paudel YP, Ross AC. Investigating the Biosynthesis of Natural Products from Marine Proteobacteria: A Survey of Molecules and Strategies. Marine Drugs. 2017 Aug 1;15(8):235.
         59. Kliebenstein DJ. Plant Defense Compounds: Systems Approaches to Metabolic Analysis. Annual Review of Phytopathology. 2012 Jun 15;50(1):155–73.
         60. Park SJ, Park JH, Lee JW, Han MJ, Kim TY, Cho J, et al. Global physiological understanding and metabolic engineering of microorganisms based on omics studies. Applied Microbiology and Biotechnology. 2005 Jul 23;68(5):567–79.
         61. Efferth T, Wink M, Zu YG, Schwarz G, Fu YJ, Konkimalla V. Molecular Target-Guided Tumor Therapy with Natural Products Derived from Traditional Chinese Medicine. Current Medicinal Chemistry. 2007 Aug 1;14(19):2024–32.
         62. Daryanani AE, Maduekwe UN, Baird P, Ehrenfeld JM. Ensuring Medical Device Safety: The Role of Standards Organizations and Regulatory Bodies. Journal of medical systems. 2025 Jan 25;49(1).
         63. Wang H, Chen Y, Wang L, Wang C, Liu Q, Yang S. Advancing herbal medicine: enhancing product quality and safety through robust quality control practices. Frontiers in Pharmacology. 2023 Sep 25;14.
         64. Schuh JCL, Funk KA. Compilation of International Standards and Regulatory Guidance Documents for Evaluation of Biomaterials, Medical Devices, and 3-D Printed and Regenerative Medicine Products. Toxicologic Pathology. 2018 Nov 5;47(3):344–57.
         65. Critchley JAJH, Chan TYK, Tomlinson B, Suthisisang CC, Zhang Y. Alternative Therapies and Medical Science: Designing Clinical Trials of Alternative/Complementary Medicines—Is Evidence?Based Traditional Chinese Medicine Attainable? The Journal of Clinical Pharmacology. 2000 May 1;40(5):462–7.
         66. Fong HHS. Integration of herbal medicine into modern medical practices: issues and prospects. Integrative Cancer Therapies. 2002 Sep 1;1(3):287–93.
         67. Mohammed Abubakar B, Wagiran A, Shamsir Omar MS, Mohd Salleh F. Review: DNA Barcoding and Chromatography Fingerprints for the Authentication of Botanicals in Herbal Medicinal Products. Evidence-Based Complementary and Alternative Medicine. 2017 Jan 1;2017(1):1–28.
         68. Hossain K, Ballardini RM. Protecting Indigenous Traditional Knowledge Through a Holistic Principle-Based Approach. Nordic Journal of Human Rights. 2021 Jan 2;39(1):51–72.
         69. Wynberg R. Making sense of access and benefit sharing in the rooibos industry: Towards a holistic, just and sustainable framing. South African Journal of Botany. 2016 Oct 4; 110:39–51.
         70. Sullivan R, Rowan NJ, Smith JE. Medicinal Mushrooms and Cancer Therapy: translating a traditional practice into Western medicine. Perspectives in Biology and Medicine. 2006 Mar 1;49(2):159–70.
         71. Basu S, Biswas P, Anto M, Singh N, Mukherjee K. Nanomaterial-enabled drug transport systems: a comprehensive exploration of current developments and future avenues in therapeutic delivery. 3 Biotech. 2024 Nov 4;14(12).
         72. Galarce?Bustos O, Henríquez?Aedo K, Aranda M, Pavón J. Detection and identification of acetylcholinesterase inhibitors in Annona cherimola Mill. by effect-directed analysis using thin-layer chromatography-bioassay-mass spectrometry. Phytochemical Analysis. 2019 Jun 11;30(6):679–86.
         73. La Russa R, Scopetti M, Martini G, Santurro A, Gatto V, Frati P, et al. Personalized Medicine and Adverse Drug Reactions: The Experience of An Italian Teaching Hospital. Current Pharmaceutical Biotechnology. 2017 Apr 16;18(3):274–81.
         74. Uprety Y, Yadav S, Shrestha KK, Boon EK, Asselin H. Indigenous use and bio-efficacy of medicinal plants in the Rasuwa District, Central Nepal. Journal of Ethnobiology and Ethnomedicine. 2010 Jan 26;6(1).
         75. Sharma SB, Gupta R. Drug development from natural resource: a systematic approach. Mini-Reviews in Medicinal Chemistry. 2015 Feb 24;15(1):52–7.
         76. Wu P, Yu H, Han J, Chen X, Zhang S, Liu C, et al. Therapeutic potential and pharmacological significance of extracellular vesicles derived from traditional medicinal plants. Frontiers in Pharmacology. 2023 Dec 1;14.
         77. Urrutia J, Anderson BT, Belouin SJ, Berger A, Griffiths RR, Grob CS, et al. Psychedelic Science, Contemplative Practices, and Indigenous and Other Traditional Knowledge Systems: Towards Integrative Community-Based Approaches in Global Health. Journal of Psychoactive Drugs. 2023 Sep 27;55(5):523–38.
         78. Sindhu RK, Kumar P, Gupta R, Wadhera G. Modern Herbal Nanogels: Formulation, Delivery Methods, and Applications. Gels. 2022 Feb 7;8(2):97.
         79. Scott AM, Paez D, Estrada Lobato E, Giammarile F, Kunikowska J, Abdel-Wahab M, et al. Guardians of precision: advancing radiation protection, safety, and quality systems in nuclear medicine. European Journal of Nuclear Medicine and Molecular Imaging. 2024 Feb 6;51(6):1498–505.
         80. Raja M, Cramer H, Wieland LS, Lee MS, Ng JY. Addressing the Challenges of Traditional, Complementary, and Integrative Medicine Research: An International Perspective and Proposed Strategies Moving Forward. Perspectives on Integrative Medicine. 2024 Jun 30;3(2):86–97.
         81. Gatt AR, Zammit R, Vella Bonanno P. Ethical considerations in the regulation and use of herbal medicines in the European Union. Frontiers in medical technology. 2024 Jun 14;6.
         82. Chatterjee B, Pancholi J. Prakriti -based medicine: A step towards personalized medicine. AYU (An international quarterly journal of research in Ayurveda). 2011 Jan 1;32(2):141.