Available
online
at
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Integrative
Medicine
Research
jo u rn al h o m e p a g e :w w w . i m r - j o u r n a l . c o m
Review
Article
Pharmacognostic
outlooks
on
medical
herbs
of
Sasang
typology
Su
Hye
Lim
a,b,
Eun
Sang
Jeon
b,c,
Jeongyun
Lee
d,
Sang
Yun
Han
b,
Han
Chae
b,∗aDepartmentofPharmacognosy,FacultyofPharmacy,IstanbulUniversity,Istanbul,Turkey
bDivisionofLongevityandBiofunctionalMedicine,SchoolofKoreanMedicine,PusanNationalUniversity,Busan,
Korea
cDepartmentofComplementaryandAlternativeMedicine,MedipolUniversity,Istanbul,Turkey
dKoreaInstituteofOrientalMedicine,Daejeon,Korea
a
r
t
i
c
l
e
i
n
f
o
Articlehistory:
Received28March2017 Receivedinrevisedform 27June2017
Accepted28June2017 Availableonline8July2017
Keywords: medicalherb personalizedmedicine pharmacognosy Sasangtypology
a
b
s
t
r
a
c
t
Thepurposeofthisstudywastoreviewthepharmacognostic characteristicsofSasang type-specificmedicalherbsandsuggestbiologicalmechanismsthatmightberelatedtothe personalizedtreatmentoftheEast.
MajorcompoundsandtheirpharmacologicalactivitiesofmedicalherbsforeachSasang typesweresystematicallyreviewed.Thepharmacognosticcharacteristicsofitsmain com-poundsweresystematicallyanalyzedwithpreviousstudiesandthreeweb-baseddatabases. Sasangtype-specificmedicalherbswereselected,andbiologicaleffectsoftheir phy-tochemicals werereviewed fromthepathophysiological featuresofeachSasangtypes. PhenolicsweredominantinTae-Yangtype-specificherbs,iridoidsandtriterpeneswith antipyreticanddiureticeffectswereinSo-Yangtype-specific,saponins(triterpenesaponins andsteroidalsaponins)withantitussiveeffectswereinTae-Eumtype-specific,and monoter-peneandsesquiterpeneswithstomachiceffectwereinSo-Eumtype-specificherbs.
PharmacognosticunderstandingsonSasangtype-specificmedicalherbswith considera-tionoftype-specificpathophysiologicalfeatureswereprovidedforthefirsttime.Thisstudy wouldcontributetoin-depthunderstandingsonthepathophysiologyofSasangtypology andintegrationofEast-AsianandWesternpersonalizedmedicine.
©2017KoreaInstituteofOrientalMedicine.PublishedbyElsevier.Thisisanopenaccess articleundertheCCBY-NC-NDlicense (http://creativecommons.org/licenses/by-nc-nd/4.0/).
∗ Correspondingauthor.DivisionofLongevityandBiofunctionalMedicine,SchoolofKoreanMedicine,PusanNationalUniversity,30
Jangjeon-dong,Geumjeong-gu,Busan50610,Korea. E-mailaddress:han@chaelab.org(H.Chae). http://dx.doi.org/10.1016/j.imr.2017.06.005
2213-4220/©2017KoreaInstituteofOrientalMedicine.PublishedbyElsevier.ThisisanopenaccessarticleundertheCCBY-NC-NDlicense (http://creativecommons.org/licenses/by-nc-nd/4.0/).
1.
Introduction
Personalizedmedicineforimprovingefficacyandsafetyhas been a major topic of medicine for thousands of years1–3
sincefourhumoraltypesofHippocratesandGalen4andfive
phaseandYin-YangbasedtypologyoftraditionalEast-Asian medicine;2 however, those were just a coarse draft
with-outdetailsforpathophysiology,diagnostics,andtype-specific medicaltreatments.
The Sasang typology is a person-centered personalized medicinedividingpeopleintofourSasangtypesofTae-Yang (TY),So-Yang (SY),Tae-Eum(TE),and So-Eum(SE) byJema Leeinhisbook,Longevityand LifePreservation oftheEastern
Medicine(1894,1900);5thisbookprovidestype-specific
guide-line forsafe and effective medicalherbs and acupuncture treatment.1,6ItisareinterpretationoftraditionalEast-Asian
medicinebasedonbiopsychosocialtraitswiththesupportof thousandyearsofclinicalexperienceandConfucius person-alitystudiesinKorea.1,6,7
TherehavebeenextensiveSasangtypologystudieson psy-chological traits,8 physicalcharacteristics,9,10 genetic,3 and
clinical9,11 standpoints. As for the psychological
perspec-tives, Eysenck’sextraversion,12 Gray’s behavioral activation
and inhibition system (BAS and BIS),13 Cloninger’s novelty
seeking(NS)andharmavoidance(HA),14andChae’sSasang personalityquestionnaire(SPQ)7,8werereportedtobeuseful
fordescribingeachSasangtypes,andtheSYSasangtypehas highExtraversion,highBASandlowBIS,highNSandlowHA, andhighSPQ;however,theSESasangtypeisonthecontrary. Theobesity-relatedbodymassindex(BMI)andthyroid hor-monalactivity-relatedponderalindex (PI)were reportedbe valuableforphysicalcharacteristics,andtheTESasangtype hashighBMIandPI,whereastheSESasangtypehaslowBMI andPI.1,7,9,10.
As for the biological mechanism for Sasang typol-ogy,autonomicreactivity11includinghypothalamus–pituitary
gland–adrenal axisreactivity10 wassuggested. The
sympa-theticreactivityincreaseswiththeorderofTE,SY,SE,andTY, andtheparasympatheticreactivitydecreaseswiththesame order.Alongwiththese,the TESasangtypereportedly has ahigher prevalenceofhypertension,diabetes, obesity, and metabolicdiseases,andtheSESasangtypeisassociatedwith diseasesfromanxietyandemotionalinstability.9,12,15
Additionally,thepathophysiologicalsymptomsarepivotal pattern identification system for Sasang typology, and the SasangDigestiveFunctionInventory(SDFI)was reportedto beclinicallyusefulfordiscriminatingtheTEandSESasang types.15TheSDFImeasuresthesturdinessofdigestive
sys-temanditsfunctionandnegativelycorrelateswithfunctional dyspepsia.15
However,studies onmechanism ofSasang type-specific treatments were not sufficient even with proven clinical usefulness16–20becausethestudyonpathophysiological
pre-dispositionsofeachSasang types11 and clinicalstudy with
complexherbalcompoundrequiresophisticatedandtedious step-by-stepapproach.
Therefore,thisstudywouldreviewpharmacognostic char-acteristicsofSasangtype-specificmedicalherbswhichwould providephysical,chemical,biochemical,andbiological
prop-ertiesofherbalmedicinewithnaturalorigin;21,22thiswould
providerobusttheoreticalbackgroundforstudyingthe mech-anismofSasangtype-specifictreatments.
The term pharmacognosy is derived from two Greek
words“pharmakon” and“gnosis” whichmean drug andto acknowledge,andit approachesmedicinalherbswiththeir major constituents of phenolics, alkaloids, and terpenoids as secondary metabolites or phytochemicals.23 With the
developmentofmoderntechnologyofextraction,isolation, purification,anddiagnosticmethods,leadcompoundsfrom plantscontributedtothedevelopmentofmoderndrugs24such asaspirinfromsalicylicacid.25 Wewouldevaluateprevious
studies7,14,26–30regardingSasangtype-specificmedicalherbs
andsystematicallyreviewtheirmajorcompoundsand phyto-chemicalsanditspharmacognosticactivitieswiththehelpof previousstudiesandweb-baseddatabases.31–33.
This study would provide an understanding on Sasang type-specificmedicationfrompharmacologicalperspectives and foundation forthe integrationofEasternand Western personalizedmedicineinthenearfuture.
2.
Methods
2.1. SelectionofSasangtype-specificmedicalherbs
Frequentlyusedtype-specificmedicalherbsofSasang typol-ogy were selected with Longevity and Life Preservation in Eastern MedicineandDong-Mu-Yoo-Go Yak-Sung-Ga. Their pharmacognostic features were reviewed with textbooks of herbal medicine, three web-based databases, and pre-vious studies.26,34. Three databases included Up-to-dateof
Pharmacognosy,31 Pharmacological function of traditional
medicalherbs,32andSearchforPharmacognosticInformation
Database.33
2.2. PharmacognosticpropertyofSasangtype-specific medicalherbs
Wesystematicallyreviewedthepharmacologicalproperties of Sasang type-specific medical herbs in perspectives of phytochemicalsorsecondary metabolitesofnaturalplants, animals,andminerals.35Type-specificmedicalherbsofeach
Sasang types were classified into three groups of phyto-chemicals of terpenoids, phenolics, and alkaloids, and the pharmacologicalpropertiesofeachSasangtype-specific med-ical herbs were investigated with previous studies on its dominantchemicals.
Plantmetabolitesareproduced bytheirmetabolismand classified into primary andsecondary metabolites. Primary metabolites,suchascarbohydrates,lipids,aminoacids,and nucleic acids are crucialforthe growth ofplants, whereas secondary metabolites, such as alkaloids, terpenoids, and phenolics,playadefensiveroleagainstherbivoresand harm-fulecologicalenvironment36,37 and exhibitpharmacological
activities as main compounds of medicinal herbs.38 The
phytochemicals have been usedfor various pharmacologic activities, such as antioxidant, antimicrobial, immunos-timulant, anti-inflammatory, and anticancer,36 and can be
Table1–ListofSasangtype-specificmedicalherbs. Sasangtype Type-specificmedicalherbs
Tae-Yang Acanthopanaxsessiliflorum,Actinidiaarguta,Chaenomelessinensis,Phragmitescommunis,Pinusdensiflora,Prunus japonica,Vitisvinifera
So-Yang Akebiaquinatavar.polyphylla,AlismaorientalisAnemarrhenaasphodeloides,Araliacontinentalis,Coptisjaponica,Cornus officinalis,Euphorbiakansui,Gardeniajasminoidesvar.grandiflora,Lyciumchinense,Ostericumkoreanum,Paeoniasuffruticosa, Phellodendronamurense,Plantagoasiatica,Polyporusumbellatus,Poriacocos,Rehmanniaglutinosa,Saposhnikoviadivaricata, Schizonepetatenuifolia,TrichosantheskirilowiiTussilagofarfaraGypsumfibrosum(inorganicdrug)
Tae-Eum Acorusgramineus,Angelicadahurica,Angelicatenuissima,Asparaguscochinchinensis,Castaneacrenata,Chrysanthemum indicum,Cimicifugaheracleifolia,Coixlacryma-jobi,Dimocarpuslongan,Dioscoreatenuipes,Ephedrasinica,Gingkobiloba,Liriope platyphylla,Morusalba,Nelumbonucifera,Platycodongrandiflorum,Polygalatenuifolia,Prunusarmeniaca,Puerarialobata, Raphanussativus,Rheumpalmatum,Schizandrachinensis,ScutellariabaicalensisUlmuspumila,Zizyphusjujuba
So-Eum Aconitumcarmichaeli,Alliumfistulosum,Amomumvillosum,Angelicagigas,Astragalusmembranaceus,Atractylodesjaponica, Aucklandialappa,Cinnamomumcassia,Citrusunshiu,Cnidiumofficinale,Crotontiglium,Cyperusrotundus,Glycyrrhiza uralensis,Paeonialactiflora,Panaxginseng,Perillafrutescens,Pinelliaternate,Pogostemoncablin,Polygonummultiflorum, Zingiberofficinale,Zizyphusjujube
dividedintothreemajorgroupsofterpenoids,phenolics,and alkaloids.38
Terpenoids have diverse groups with more than 23,000 structures, they are the biggest group in the secondary metabolites,38 and include volatile compounds to attract
or expel other animals with their aroma like citronellal, thymol.36Terpenoidsuseisopreneasabuildingblockandare
subdivided into monoterpenes,sesquiterpenes, diterpenes, triterpenes,tetraterpenes,polyterpenes,steroidderivedfrom triterpenes and saponins derived from triterpenes, and steroids.Iridoidsareasubclassofmonoterpenes.37
Phenoliccompounds,whicharefamousfortheir antioxi-dantproperty,areeasilyfoundintea,coffee,berries,fruits, and vegetables,such asrutin,quercetin, and hesperidin.35
Their antioxidant property has been regarded to protect human beings from oxidative stress and free radical-mediateddiseases.38 Phenolicshavehydroxylated aromatic
rings in common and could be divided into
phenyl-propenes, coumarins, flavones, flavanones, flavonols, fla-vanes,isoflavones,anthocyanins,anthraquinones,stilbenes, lignans,andtannins.
Alkaloids,derivedfrom the wordofalkaline,are oneof themostactivesecondarymetabolitesdescribedasorganic basic nitrogen-containing structures,36 and some of them
are neutral and weakly acid.38 Most alkaloids are toxic
with bitter taste. They have a long history in medication; someofthem like morphineand ephedrine exhibitstrong pharmacologicalactivities.Alkaloidscontainoneorseveral nitrogenatomsintheirstructuresandaredividedintothree majorgroupsoftruealkaloids,protoalkaloids,and pseudo alkaloids.37,39
3.
Results
Weselectedandanalyzed7medicalherbsforTYtype,22for SYtype,26forTEtype,and21forSEtype(Table1).OneSY type-specificdrugofGypsumfibrosumisinorganic, notfrom plants,and twoherbs(Lycium chinense and Rehmannia
gluti-nosa)areusedastwodifferentdrugs(Lyciicortex,Lyciifructus,
Rehmanniae radix, and Rehmanniae radix preparat) in SY type.
3.1. TYtype-specificmedicalherbsandtheir pharmacognosticproperties
SevenTY type-specificmedical herbsare divided into four phenolic drugs, one terpenoid drug, and two other drugs. AlthoughtherewerefewnumbersofTYtype-specificmedical herbsforanalyzinganddrawingconclusion,30their
pharma-cological activitiesmightbecategorized asprotectingliver, boosting immune system, and reducing oxidative stresses (Table2).
ThebiggestgroupinTYtype-specificdrugsisphenolics consisting of phenylpropene, flavone, lignan, and stilbene. Phenoliccompoundsarecharacterizedbytheirantioxidant, anti-inflammatory, and other biological activities.37 Under
the category ofphenolics, some ofthe lignan compounds havehepatoprotectiveproperty(silymarinfromSilybum
mar-ianum), which is used to treat chronic hepatitis and live
cirrhosis.35Stilbenesactsasphytoalexin,whichisapartof
defense systems protecting plants against diseases,40 and
resveratrol from Vitis vinifera is one of the stilbene com-poundsactingasastrongantioxidantagent.39Inphenolics,
hepatoprotectiveandimmunostimulant,41,42antioxidantand
anti-inflammatory,43 antioxidant and anti-inflammatory,37
andanti-inflammatory44effectswereexhibited.
TheterpenedrugofTYtype-specific herbsalsoexhibits itshepatoprotectiveproperty.Interpenoids,ursolicacidand euscaphic acid from Chaenomelisfructus have hepatopro-tective and anti-inflammatory effects.45 In other groups,
amygdalinandprunasinfromPrunisemenshowed antitus-siveeffect,37andasparaginefromPhragmitisrhizomashowed
diureticandantipyreticactivities.39
3.2. SYtype-specificmedicalherbsandtheir pharmacognosticproperties
Twenty-twoSYtype-specificmedicalherbswouldbeclassified into13terpenoiddrugs,3phenolicdrugs,3alkaloiddrugs,and 3otherdrugs.SecondarymetabolitesofSYtype-specificherbs showedantipyretic,anti-inflammatory,and diuretic proper-tiesasshowninTable3.
ThemajorgroupinSYtype-specificherbsisterpenoids, and iridoids and triterpenes are dominant in this group. Triterpenes have a wide spectrum of biological
activi-Table2–PharmacognosticpropertiesofTae-Yangtype-specificmedicalherbs.
Class Namesofcompoundsandmedicalherbs Pharmacologicalactivities
Terpenes
Triterpenes Ursolicacid,euscaphicacid(Chaenomelisfructus) Hepatoprotectiveandanti-inflammatory1 Phenolics
Phenylpropenes, EleutherosideB(Acanthopanaciscortex) Hepatoprotectiveandimmunostimulant2,3 Flavones Quercetin(Actinidiaefructus) Antioxidantandanti-inflammatory4 Lignans EleutherosideE(Acanthopanaciscortex) Immunostimulant2,3
Stilbenes Resveratrol(Vitisradix) Antioxidantandanti-inflammatory5 Pinosylvin(Pinilignum) Anti-inflammatory6
Others
Cyanogenicglycosides Amygdalin,prunasin(Prunisemen) Antitussive5
Aminoacids Asparagine(Phragmitisrhizoma) Diureticandantipyretic7
Table3–PharmacognosticpropertiesofSo-Yangtype-specificmedicalherbs.
Class Namesofcompoundsandmedicalherbs Pharmacologicalactivities
Terpenes
Monoterpenes Menthone,pulegone(Schizonepetaespica) Diaphoreticandanti-inflammatory7 Diterpenes Kaurenoicacid(Araliaecontinentalisradix) Antirheumatic,analgesic,anddiuretic8,9 Triterpenes AlisolA(Alismatisrhizoma) Hypolipidemicanddiuretic10
Pachymicacid(Poria) Diureticandstomachic7,11 3,29-Dibenzoylkarounitriol(Trichosanthissemen) Expectorant12,13
Triterpenesaponins Akeboside(Akebiaecaulis) Diureticandantimicrobial14,15
SteroidalSaponins Timosaponin(Anemarrhenaerhizoma) Antipyretic,anti-inflammatory,andantimicrobial8,16 Triterpenesteroid Euphorbone(Euphorbiaekansuiradix) Purgative17
Steroid Ergosterol(Polyporus) Diuretic12
Iridoids Aucubin(Plantaginissemen) Diuretic,antitussive,andexpectorant18 Gardenoside,geniposide(Gardeniaefructus) Anti-inflammatoryandantipyretic12
Catalpol(Rehmanniaeradix) Hypoglycemic,sedative,andimmunostimulant12,19. Morroniside,loganin(Cornifructus) Antioxidantimmunostimulant20
Phenolics
Phenylpropenes, Paeonol(Moutanradiciscortex) Antipyreticandantioxidant12
Coumarins Imperatorin,isoimperatorin(Ostericiradix) Analgesic,anti-inflammatory,anddiuretic7,9 Imperatorin,bergapten(Saposhnikoviaeradix) Antipyreticandanalgesic12,21
Alkaloids
Berberin(Phellodendricortex) Antimicrobialandantipyretic7,8,12,16,21 Berberine(Coptidisrhizoma) Antimicrobialandantipyretic8,12,21 Kukoamine(Lyciicortex) Antipyreticandhypotensive8,12,21 Others
Inorganics CaSO4·2H2O(Gypsum) Antipyretic8,22
Furancompound 5-hydroxymethyl-2-furaldehyde(Rehmanniaeradix preparat)
Hemopoietic16,23 Non-proteinaminoacids. Betaine(Lyciifructus) Hepatoprotective12,21
ties and exhibit cytotoxic and diuretic properties with bitter tastes.35 Triterpenoid group of SY type-specific
herbs are used for inflammations and arthritis for their anti-inflammatory,diuretic,andanalgesicproperties.In ter-penoids,diaphoreticandanti-inflammatory,39antirheumatic,
analgesic, and diuretic,46,47 hypolipidemic and diuretic,48
diuretic and stomachic,39,49 expectorant,50,51 diuretic and
antimicrobial,33,35 antipyretic, anti-inflammatory, and
antimicrobial,32,46 purgative,52 diuretic,50 diuretic,
antitus-sive,andexpectorant,53anti-inflammatoryandantipyretic,50
hypoglycemic, sedative, and immunostimulant,50,54 and
antioxidantandimmunostimulant55activitieswerereported.
In phenolics, antipyretic and antioxidant,50 analgesic, anti-inflammatory, and diuretic,39,47 and antipyretic and
analgesic31,50 propertieswere reported. Coumarinsare
aro-maticandusedforanti-inflammatory,diuretic,and antimicro-bialproperties,37andsomeofthemexhibitananticoagulant
property as warfarin.35 Among secondary metabolites,
iri-doids, alkaloids, and coumarins exhibit strong therapeutic activities.56,57Iridoidcompoundsofharpagosidein
Harpago-phytumprocumbensareusedforinfections,inflammations,and
rheumatism,andsomeiridoidshaveanextremelybittertaste andusedfordyspepsiaandlackofappetite.37
In alkaloids, antimicrobial and antipyretic31,32,39,46,50
as well as antipyretic and hypotensive31,46,50
prop-erties were found. In other groups, hemopoietic,32,58
hepatoprotective,31,50andantipyretic46,49effectswerefound.
3.3. TEtype-specificmedicalherbsandtheir pharmacognosticproperties
Twenty-sixTEtype-specificmedicalherbsaredividedinto11 terpenoiddrugs,8phenolicdrugs,4alkaloiddrugs,and3other drugs. Saponin groups (triterpene saponins and steroidal saponins)holdadominantpositionandTEtype-specific
med-Table4–PharmacognosticpropertiesofTae-Eumtype-specificmedicalherbs.
Class Namesofcompoundsandmedicalherbs Pharmacologicalactivities
Terpenes
Sesquiterpenes Bilobalide(Ginkgonissemen) Antitussive7,12
Handelin,chrysanthelide(Chrysanthemiflos) Anti-inflammatoryandantimicrobial7,8 Tussilagone(Farfaraeflos) Antitussive8,24
Triterpenes Cycloartane-typetriterpene(Cimicifugaerhizoma) Anti-inflammatoryandosteoprotective16,25 Triterpenesaponins Platycodin(Platycodonisradix) Anti-inflammatoryandantitussive12,21
JujubosideA(Zizyphisemen) Sedative7,16
Polygalasaponin(Polygalaeradix) Expectorantandantitussive21,24 SteroidalSaponins Dioscin(Dioscoreaerhizoma) Antidiabeticandimmunomodulatory26
SpicatosideA(Liriopistuber) Anti-asthmaticandanti-inflammatory16,27 Asparasaponin(Asparagituber) Antitussiveandanti-inflammatory7 Steroids -sitosterol,stigmasterol(Ulmicortex) Anti-inflammatoryandantimicrobial8,24 Phenolics
Phenylpropenes, Beta−asarone,alpha-asarone(Acorigramineirhizoma) Sedativeandspasmolytic7,15
Coumarins Oxypeucedanin,imperatorin(Angelicaedahuricaeradix) Anti-inflammatoryandanti-nociceptive12,21 Flavones Mulberrin,morusin(Moriradiciscortex) Diureticandhypotensive7,28
Baicalin,wogonin(Scutellariaeradix) Anti-inflammatoryandanti-allergic21,29 Isoflavones, Puerarin(Puerariaeradix) Anti-diarrheaandcardioprotective21,30 Anthraquinones, Sennoside,rhein(Rheiradixetrhizoma) Purgative21,31
Lignans Schizandrin,gomisin(Schizandraefructus) Anti-asthmaticandantioxidant8,12 Tannin Corilagin,ellagicacid(Longanaearillus) Sedative32
Alkaloids Ephedrine,pseudoephedrine(Ephedraeherba) Anti-asthmaticandsympathomimetic8,24,33 Coixol(Coicissemen) Anti-obesity34,35
Sinapine(Raphanisemen) Antihypertensiveandantitussive36,37 Armepavine,nuciferine(Nelumbinissemen) Hepatoprotectiveandanti-obesity21 Others
Cyanogenicglycosides Amygdalin(Armeniacaesemen) Anti-inflammatoryandanti-asthmatic8,38 Non-proteinaminoacids. Betaine(Castaneaesemen) Prophylactic39
Phthalide Ligustilide,buthylphthalide(Angelicaetenuisimaeradix) Anti-inflammatoryandanalgesic12,40
ical herbs showed anti-inflammatory, anti-asthmatic, and antitussivepropertiesasshowninTable4.
Interpenoids,saponins(triterpenesaponinsandsteroidal saponins)hold adominant position,and sesquiterpenes is the next. Medical herbs containing saponins are generally used for expectorant and antitussive and immunostim-ulant agents as platycodin in Platycodon grandiflorum.35,59
Saponin drugs and sesquiterpene drugs in TE
type-specific herbs are used as antitussive and expectorant agents. There were antitussive,39,50 anti-inflammatory and
antimicrobial,39,46 antitussive,46,60 anti-inflammatory and
osteoprotective,32,61 anti-inflammatory and antitussive,31,50
sedative,32,39 expectorant and antitussive,31,60 antidiabetic
and immunomodulatory,62 anti-asthmatic and
anti-inflammatory,32,63 antitussive and anti-inflammatory,39
and inflammatory and antimicrobial46,60 properties in this
group.
Phenolic drugs ofTE type-specific herbsexhibited anti-tussive,sedative, anti-inflammatory,hypotensive, and anti-allergiceffects. Inphenolics, sedativeand spasmolytic,33,39
anti-inflammatory and anti-nociceptive,31,50 diuretic and
hypotensive,39,64 anti-inflammatory and anti-allergic,31,65
anti-diarrhea and cardioprotective,31,66 purgative,31,67
anti-asthmaticandantioxidant,46,50andsedative68propertieswere
found.
Alkaloidcompounds inTE type-specific herbsexhibited
metabolism regulating properties against
hyperten-sion and obesity. In alkaloids, anti-asthmatic and
sympathomimetic,46,60,69 anti-obesity,70,71
antihyper-tensive and antitussive,71,72 and hepatoprotective and
anti-obesic31 propertieswere shown. Inother groups,
anti-inflammatory and anti-asthmatic,46,73 prophylactic,74 and
anti-inflammatoryandanalgesic50,75effectswerereported.
3.4. SEtype-specificmedicalherbsandtheir pharmacognosticproperties
Twenty-oneSEtype-specificmedicalherbsareclassifiedinto 13terpenoiddrugs,5phenolicdrugs,1alkaloiddrug,and2 otherdrugs.Asawhole,SEtype-specificmedicalherbstendto havestomachic,sedative,spasmolytic,andanti-inflammatory propertiesasprovidedinTable5.
Monoterpenesandsesquiterpenes(essentialoils)arethe biggestpartofSEtype-specific medicalherbs; furthermore, they are the mainconstituents of essential oils exhibiting gastro-protective, sedative, spasmolytic, and antimicrobial activities37,76 and are dominant in this group. Triterpene saponins exhibitimmunostimulantand tonicpropertiesas ginsenosidesandastragalosides.
In terpenoids, sedative and spasmolytic,31,39 antipyretic
andstomachic,46,50stomachicandantiulcer,46,50diureticand
stomachic,46,50 stomachic,anti-emetic,andspasmolytic,39,46
sedative and anti-inflammatory,39,77 stomachic and
secretory,78 stomachic and antitumor,39,46 purgative,32,39
tonic and adaptogenic,31,79 immunostimulant,31,39,50
anti-inflammatory and antiulcer,39 and sedative and
neuroprotective80propertieswerereported.
Thephenolicsarereportedtohavecardiovascular regulat-ingproperties.Inphenolics,anti-emeticandantitussive,39,81
anti-inflammatory and cardiovascular-disease-lowering,82
blood circulation-promoting and spasmolytic,46,83 and
Table5–PharmacognosticpropertiesofSo-Eumtype-specificmedicalherbs.
Class Namesofcompoundsandmedicalherbs Pharmacologicalactivities
Terpenes
Monoterpenes Albiflorin,paeoniflorin(Paeoniaeradix) Sedativeandspasmolytic7,21 Perillaldehyde,perillaalcohol(Perillaherba) Antipyreticandstomachic8,12 Bornylacetate(Amomifructus) Stomachicandantiulcer8,12 Sesquiterpenes Atractylon,atractylodine(Atractylodisalbaerhizoma) Diureticandstomachic8,12
Zingiberene,-bisabolene(Zingiberisrhizoma) Stomachicandanti-emetic,spasmolytic7,8 Cyperene,cyperol(Cyperirhizoma) Sedativeandanti-inflammatory7,41 Patchoulialcohol(Pogostemonisherba) Stomachicandsecretory42 Costunolide(Aucklandiaeradix) Stomachicandantitumor7,8 Diterpenes Cocacinogen(Crotonissemen) Purgative7,16
Triterpenesaponins Ginsenoside(Ginsengradix) Tonicandadaptogenic21,43 Astragalosides(Astragaliradix) Immunostimulant12,21
Glycyrrhizin(Glycyrrhizaeradix) Anti-inflammatoryandantiulcer7 Zizyphussaponin(Zizyphifructus) Sedativeandneuroprotective44 Phenolics
Phenylpropenes Homogentisicacid,3,4-Dihydroxybenzaldehyde (Pinelliaetuber)
Antiemeticandantitussive7,45 Cinnamicacid,cinnamaldehyde(Cinnamomiramulus) Anti-inflammatoryand
cardiovascular-disease-lowering46
Coumarins Decursin,decursinol(Angelicaeradix), Promotingbloodcirculationandspasmolytic8,47 Flavanones Hesperidin(Citriunshiipericarpium) Stomachicandantioxidant7,48
Alkaloids Aconitine(Aconitiradix) Cardiotonicandanalgesic43 Others
Phthalide Ligustilide,cnidilide(Cnidiirhizoma) Anti-inflammatoryandanalgesic12,40 Non-proteinaminoacids. Allicin,diallyl-disulfide.(Alliiradix) Antioxidantandantimicrobial49
In alkaloids, aconitine from Aconiti radix showed cardiotonicandanalgesiceffects.79Inothergroups,
antiox-idant and anti-inflammatory85,86 and antioxidant and
antimicrobial87propertieswerereported.
4.
Discussion
The Sasang typology is a unique personalized medicine ofKorea and suggests type-specific guideline for safe and effectiveuseofmedicalherbs;1,27however,outlooksof
phar-macognosy based on the phytochemicals have not been applied to understand the characteristics of Sasang type-specificmedicalherbs.28WesummarizedSasangtype-specific
medical herbs (Table 1) and systematically reviewed their pharmacognosticeffects(Tables2–5)inthisstudy.
Phenolics were dominantin the TYtype-specific herbs, whereas terpenoids were prevailing in other Sasang type-specificherbs.Iridoidsandtriterpeneswithantipyreticand diureticeffectsweretheforemostinSYtype-specificherbs, saponins(triterpene saponins and steroidalsaponins) with antitussiveeffectswerefrequentinTEtype-specificherbs,and monoterpenesandsesquiterpeneswithstomachiceffectwere frequentinSEtype-specificherbs.
ThepathophysiologyofSasangtypologyhavebeen exten-sivelyexamined,andseveralhypothesesmightbeexplained withpharmacognosticoutlookhere.8–11TheTYSasangtype
wasreportedtohavethehighestsympatheticreactivityand lowthresholdforBAS.11Inthisstudy,withalimitednumberof
medicalherbs,TYtype-specificmedicalherbshavebiological activitiesofprotectingliverfunction,boostingimmune sys-tem,andreducingoxidativestressthatmightbecausedby theactivatedresponsetostimulifromenvironment(Table2).
These characteristics ofTYtype-specific herbscome along withtheirdominantcompounds,suchaslignans,stilbenes, andterpenes.
TheSYSasangtypeisanextroverted,Yang-temperament, and active person with activated BAS and strong mus-culoskeletal body.7,8. In this study, secondary metabolites
of SY Sasang type-specific medical herbs have strong
therapeutic effects from the antipyretic, diuretic, anti-inflammatory, and anti-rheumatic properties that support elevated musculoskeletal activities of the SY type and sustain Yin functions of the body for balancing with stimulated Yang functions.11 The anti-inflammatory and
diuretic activitieswere reportedtobefrequentinSY type-specificmedicalherbsinpreviousstudies(Table3).88 These
features of SY type-specific herbs would be explained from their prevailing constituents of iridoids and triter-penes.
TheTESasangtypewasreportedtohaveahigher preva-lenceofhypertension,diabetes,obesity,andmetabolicdisease and a lower sympathetic activity than others.9,12,15
Alka-loid compounds of TE type-specific medical herbs exhibit metabolism-regulatingpropertiesagainstobesityand hyper-tension. Saponins and other terpenoids ofTE type-specific medical herbs were used as antitussive and expectorant agents. Anti-inflammatory, anti-asthmatic, and antitussive propertieswerecommoninTEtype-specificmedicalherbsas showninTable4.Theseresultsareinaccordancewith pre-viousstudies89thattheTEtype-specificmedicalherbshave
antitussive,expectorant,anddiaphoreticeffectsandmightbe relatedwithloweredsympatheticreactivityandimpairedor lessactivatedlungfunction,asdescribedbyJemaLee.10,11
TheSESasangtypeisanintrovertedandYin-temperament personwithleanbodyshapefromactivatedBIS.Furthermore,
they are reported to have prolonged and elevated sympa-theticreactivitythatmight leadtofrequentproblems with dyspepsia,lowdigestive function,andanxiety.9,12,15 TheSE
type-specificmedicalherbshavestomachic,sedative, spas-molytic,andanti-inflammatorypropertiesforthedominance of monoterpene and sesquiterpene compounds (Table 5). Monoterpeneandsesquiterpenecompoundsareconstituents of essential oils, and one of the previous studies showed thattheSEtype-specificmedicalherbsareusuallyaromatics helpingdigestivedysfunctionandsuppressingstress-related responses.11,15,90
TheSasangtypologyisasuccessfullysystematized tradi-tionalperson-centeredpersonalizedmedicinedividingpeople intofourSasangtypesandsuggestingsafeandeffectiveuse of medical herbs, and homeopathy might be the medical theoryofEuropeancountrieswithsameidea. Homeopathy considersa patientas awholeperson withhis/her typical physical,emotional,mental,constitutional,biographical,and environmentalaspects91,92andprovidestype-specific
descrip-tionwith bettersafetyand efficacy astheSasang typology does.93 Forexample,theaconitinefromAconitiradixisaSE
Sasangtype-specificmedicalherbforheatingupthebodyand boostingdigestivefunction,andinhomeopathy,aconitineis usedfortreatinganxietyofaconitetypepatients.94
However,asforthesubstantialdifferencestobe acknowl-edged,theSasang typologydivideshumansintofour types depending on their psychological and pathophysiological characteristicsandusestype-specificmedicalherbsin com-binationtostrengthentheirclinicaleffects.Onthecontrary, homeopathy labels patients withclinical responses to one specific medical drug, which resulted in tens of homeo-pathictypesandprescribesonespecificmedicineonlyforone patient.DetailedcomparisonbetweenSasangtypology and homeopathy from pharmacognosticperspectives isneeded forthedevelopmentofintegrativepersonalizedmedicinewith medicalherbs.
This study might have limitations for generalization of the resultssince wecould not fully cover the pharmacog-nosticeffectsofall the Sasang type-specificmedical herbs inhere forthe lackofreportedstudies.The pharmacolog-icaleffectsofminorcompoundsofeach medicalherband thatoftype-specificdecoctionsareguaranteedtobe exam-ined.Thesystemsbiologywouldbeneededfortheelucidation ofpharmacologicaleffectsinSasangtypologythatprescribes decoctionsmadewithseveraltype-specificherbsin combina-tion.And,althoughthecold-hotsubgroupdifferentiationof Sasangtypologyispivotalfortheclinicalpractice,itwasnot reflectedinthisreview.
In this study, the pharmacognostic characteristics of Sasang type-specific medical herbs were systematically reviewedaccording to their chemical compounds and bio-logical properties, and those were discussed with Sasang type-specific pathophysiological mechanisms for the first time.Thoughpharmacognosticstudiesonclinicaleffectsof type-specific herbal mixtureor formulais guaranteed,this studywouldprovidefoundationsforpharmacologyofSasang typology and help in understanding the characteristics of Sasangtype-specificherbsfromtheWestern pharmacognos-ticview.
Conflicts
of
interest
Theauthorshavenoconflictsofinteresttodeclare.
Acknowledgments
Thisworkwassupportedbya2-yearResearchGrantofPusan NationalUniversity.
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