title: A Comprehensive Review of Recent Studies on Herb-Drug Interaction: A Focus on Pharmacodynamic Interaction.
abstract: OBJECTIVE
  The concomitant use of herbal and conventional drugs accelerates the possibility of clinically significant herb-drug interactions (HDIs). This paper aims to analyze the current status of HDI studies worldwide and to review studies on HDI-induced pharmacodynamic (PD) interactions.
  
  
  METHODS
  HDI studies published from 2000 to 2014 and indexed in PubMed were categorized according to publication year, area/country, study methods and objectives, and disease categories. The reviewed studies focused on HDI-induced PD; each PD interaction with concurrent use of approximately 100 herbal drugs and 70 conventional drugs was summarized. All PD-related articles were categorized according to four characteristics: herbal drugs, conventional drugs, types of PD interaction, and type of study. Among them, 17 well-designed clinical studies were evaluated by using the Jadad Quality Assessment Scale.
  
  
  RESULTS
  The number of HDI reports has gradually increased since 2000, with a primary focus on neoplasms and diseases of the circulatory system. Most of these investigated pharmacokinetic reactions, such as cytochrome P450 enzyme metabolism, with fewer reports investigating PD. Most PD interaction studies investigated warfarin, ginkgo leaves, and St. John's wort. An evaluation of 17 studies revealed a generally positive view of PD effects involving synergism or reduced toxicity and a high average quality score (>3 points on a 0-5 scale).
  
  
  CONCLUSIONS
  These results demonstrate that most HDI studies so far have examined PK interactions and have been limited to very few conventional drugs and herbal drugs. This suggests that more studies focusing on PD are necessary to understand interactions between commonly used herbal and conventional drugs.
authors.affiliation: 1 Department of Life and Nanopharmaceutical Sciences, Graduate School, Kyung Hee University , Seoul, Korea.
authors.forename: Jin Gyu
authors.initials: JG
authors.lastname: Choi
authors.affiliation: 2 Department of Pharmacy, College of Pharmacy, Kyung Hee University , Seoul, Korea.
authors.forename: Sang Min
authors.initials: SM
authors.lastname: Eom
authors.affiliation: 2 Department of Pharmacy, College of Pharmacy, Kyung Hee University , Seoul, Korea.
authors.forename: Jaeyoung
authors.initials: J
authors.lastname: Kim
authors.affiliation: 2 Department of Pharmacy, College of Pharmacy, Kyung Hee University , Seoul, Korea.
authors.forename: Soon Han
authors.initials: SH
authors.lastname: Kim
authors.affiliation: 3 Department of Herbal Pharmacology, College of Korean Medicine, Kyung Hee University , Seoul, Korea.
authors.forename: Eugene
authors.initials: E
authors.lastname: Huh
authors.affiliation: 3 Department of Herbal Pharmacology, College of Korean Medicine, Kyung Hee University , Seoul, Korea.
authors.forename: Hocheol
authors.initials: H
authors.lastname: Kim
authors.affiliation: 4 College of Medicine, Hallym University , Chuncheon, Korea.
authors.forename: Yunwoo
authors.initials: Y
authors.lastname: Lee
authors.affiliation: 5 Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University , Seoul, Korea.
authors.forename: Hyangsook
authors.initials: H
authors.lastname: Lee
authors.affiliation: 1 Department of Life and Nanopharmaceutical Sciences, Graduate School, Kyung Hee University , Seoul, Korea.|6 Department of Oriental Pharmaceutical Science, College of Pharmacy and Kyung Hee East-West Pharmaceutical Research Institute, Kyung Hee University , Seoul, Korea.
authors.forename: Myung Sook
authors.initials: MS
authors.lastname: Oh
mesh_terms: D000818:Animals; D035843:Biomedical Research; D000068456:Clinical Studies as Topic; D041743:Herb-Drug Interactions; D006801:Humans; D051379:Mice; D028321:Plant Preparations; D051381:Rats
chemical_list: D028321:Plant Preparations