Conclusion and future directions
The success rate of the synthetic route for developing new medicinal agents may be 1/10,000; however, the success rate with the search for new therapeutic moieties based on medicinal plants used in the traditional medicinal system can be as high as 1/4 or more.183 However, drug discovery based on natural compounds also has limitations. When herbal medicines such as LBPs are used as therapeutic agents, the clinical evidence supporting their use in humans is often weak or lacking. A better understanding of their safety, disposition pathways, and therapeutic targets will help with the optimal use. Standardization in the planting, harvesting, processing, and manufacturing is also important for the quality control of herbal products.
Although there are no reports on the severe toxicity of LBPs in humans, two cases of possible interactions between warfarin and LBPs have been reported, indicating a potential risk of LBP–drug and Goji–drug interaction.184–186 Clinicians should question patients about their use of herbal therapies like LBPs and document such use in their medical records before prescribing drugs such as warfarin.
LBPs as a mixture of active polysaccharides from Goji berries have shown multiple pharmacological activities, including anti-aging, antioxidative, anti-fatigue, anticancer, anti-diabetic, anti-viral, hepatoprotective, cardioprotective, neuroprotective, hypolipidemic, radioprotective, anti-osteoporosis, anti-inflammatory, and immunomodulating effects. The mechanisms for these beneficial effects are multifaceted, involving a number of signaling molecules and pathways. A better understanding of how LBPs act on these signaling pathways and molecules can improve our knowledge on glycobiology. Further studies using systems pharmacology approaches such as proteomic and metabolomic analysis are needed to uncover the molecular target networks of LBPs.
Despite the importance of Goji in the traditional Chinese medicine and increased popularity in Western countries, clinical safety data on LBPs are sparse. A safe and optimal use of herbal medicines like LBPs requires a full understanding of their pharmacokinetics, side effects, and mechanisms of action.187 The dose–response and dose–toxicity relationships of LBPs should be established in animal and human studies. It is essential to develop new formulations to ensure the maximum efficacy and effectiveness and minimum side effects of LBP-related health products.