In recent years, the growing misuse of antibiotics worldwide has spurred the emergence of drug-resistant bacterial strains, posing a grave threat to public health. Traditional Chinese medicine (TCM), a practice with thousands of years of history, offers natural and unique advantages in the treatment of infectious diseases. This article delves into the imperative need to further explore and utilize TCM for managing clinical infections triggered by drug-resistant bacteria.
Materials and Methods
A thorough literature search encompassing PubMed, Web of Science, Google Scholar, and the China National Knowledge Infrastructure databases was conducted. This research sought to extract information concerning the antimicrobial effects of Chinese herbal medicines, compounded Chinese medicines, monomeric compounds of herbal origin, and the combined use of Chinese medicine and antimicrobial drugs. Furthermore, the study aimed to understand the synergistic effects of these combinations and their potential to restore antibiotic sensitivity in drug-resistant strains.
Antibacterial Effect of TCM
The antibacterial properties of Chinese herbal medicines, including popular herbs like Coptis chinensis (Huang Lian), Scutellaria baicalensis (Huang Qin), and honeysuckle (Jin Yin Hua), were investigated. These herbs showcased remarkable antibacterial activity against various pathogenic bacteria, including E. coli (E. coli), Shigella (Kui Bie), Salmonella (Jiu Cai Shen), and more. Their extracts demonstrated strong inhibitory effects against harmful bacteria such as Staphylococcus aureus (Jin Yin Hua).
Antibacterial Effect of Compounded Chinese Medicines
The combination of different TCM treatments, known as compounded Chinese medicines, was explored. For instance, combining Scutellaria baicalensis (Huang Qin), dandelion (Pu Gong Ying), and Artemisia argyi leaves (Ai Ye) enhanced antibacterial activity. This combination not only effectively suppressed Pseudomonas aeruginosa and multidrug-resistant E. coli (E. coli) but also regulated inflammatory responses and improved immunity.
Antibacterial Effect of Monomeric Compounds of Herbal Origin
Various monomeric compounds derived from herbal sources were examined. Berberine, for instance, exhibited inhibitory effects on diverse microorganisms, including E. coli (E. coli), P. aeruginosa (Chang Chun Fu), S. aureus (Jin Yin Hua), and B. subtilis (Fu Rong). Naringin (Zhi Ke) demonstrated potential as a food preservative, inhibiting biofilm formation by food-borne pathogens like Pseudomonas spp.
Antibacterial Effect of Chinese Medicine Combined with Antibacterial Drugs
Combining TCM or TCM compounds with antibiotics resulted in synergistic antibacterial activity. Eugenol and colistin, when used together, displayed enhanced antibacterial effects against drug-resistant E. coli (E. coli). This synergy holds significant promise for controlling colistin-resistant strains. Additionally, various TCM monomers combined with antibiotics restored the sensitivity of drug-resistant bacteria to these drugs, offering potential solutions for clinical antibiotic use.
Mechanisms of TCM’s Antimicrobial Action
TCM exerts its antibacterial effects through multiple mechanisms, including the modification of bacterial cell membrane permeability, inhibition of protein and nucleic acid synthesis, disruption of enzyme activity, control of bacterial pathogenicity, and the interference with the formation of bacterial biofilms. These diverse mechanisms help TCM combat infections and bacterial resistance.
Bacterial Resistance and Current Status
Bacterial resistance to antibiotics, both inherent and acquired, has reached critical levels. Multidrug-resistant bacteria, including “superbacteria,” are on the rise, undermining the effectiveness of antibiotic treatments and posing a severe threat to human and animal health.
Mechanisms Through which Chinese Medicine Reverses Drug Resistance
TCM exhibits the potential to reverse bacterial drug resistance by various mechanisms:
Elimination of Resistance Plasmids: Some TCM compounds can eliminate drug-resistant plasmids in bacterial strains, reducing resistance.
Inhibition of Extended-Spectrum β-lactamases (ESBLs): TCM compounds have been shown to inhibit ESBLs, potentially restoring the sensitivity of bacteria to β-lactam antibiotics.
Inhibition of Bacterial Biofilm Formation: TCM can interfere with the formation of bacterial biofilms, improving antibiotic effectiveness and reversing resistance.
Bacterial Inhibition Via Active Efflux Pump: TCM compounds have demonstrated the ability to inhibit bacterial efflux pump genes, enhancing antibiotic efficacy and combating resistance.
Conclusions and Future Prospects of Chinese Medicine
As antibiotic resistance becomes increasingly severe, TCM presents an avenue for addressing this global health crisis. Leveraging TCM’s inherent antibacterial properties, synergy with antibiotics, and potential to reverse drug resistance mechanisms offers hope for the development of new antimicrobial agents. Further research is required to unlock the full potential of traditional Chinese medicine in the fight against drug-resistant bacterial infections.
*European Review for Medical and Pharmacological Sciences 2022; 26: 5553-5561*
[Link to full article](https://www.europeanreview.org/wp/wp-content/uploads/5553-5561.pdf)