Advances in Pharmacological Actions and Mechanisms of Flavonoids from Traditional Chinese Medicine in Treating Chronic Obstructive Pulmonary Disease

Abstract

Chronic obstructive pulmonary disease (COPD) is a common respiratory disease with high morbidity and mortality. The conventional therapies remain palliative and have various undesired effects. Flavonoids from traditional Chinese medicine (TCM) have been proved to exert protective effects on COPD. This review aims to illuminate the poly-pharmacological properties of flavonoids in treating COPD based on laboratory evidences and clinical data and points out possible molecular mechanisms. Animal/laboratory studies and randomised clinical trials about administration of flavonoids from TCM for treating COPD from January 2010 to October 2020 were identified and collected, with the following terms: chronic obstructive pulmonary disease or chronic respiratory disease or inflammatory lung disease, and flavonoid or nature product or traditional Chinese medicine. Pharmacokinetic studies and external application treatment were excluded. A total of 15 flavonoid compounds were listed. Flavonoids could inhibit inflammation, oxidative stress, and cellular senescence, restore corticosteroid sensitivity, improve pulmonary histology, and boost pulmonary function through regulating multiple targets and signaling pathways, which manifest that flavonoids are a group of promising natural products for COPD. Nevertheless, most studies remain in the research phase of animal testing, and further clinical applications should be carried out.

Herbal Medicine Compared to Placebo for Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

“…Moreover, although not our outcome of interest, some RCTs included provided biological outcomes suggesting the anti-inflammatory effects of HM in COPD patients. This is consistent with recent findings suggesting the underlying mechanism of HM in COPD ( Santana et al, 2016 ; Kim et al, 2017 ; Yang et al, 2020 ). In addition, flavonoids, alkaloids, and terpenoids, which are major components of several HMs, have the potential to positively affect COPD through various mechanisms, such as lessening of inflammation and oxidative stress, inhibition of cellular senescence, restoration of corticosteroid sensitivity, and improvement of pulmonary histology as well as pulmonary function ( Santana et al, 2016 ; Yang et al, 2020 ).…”

“…This is consistent with recent findings suggesting the underlying mechanism of HM in COPD ( Santana et al, 2016 ; Kim et al, 2017 ; Yang et al, 2020 ). In addition, flavonoids, alkaloids, and terpenoids, which are major components of several HMs, have the potential to positively affect COPD through various mechanisms, such as lessening of inflammation and oxidative stress, inhibition of cellular senescence, restoration of corticosteroid sensitivity, and improvement of pulmonary histology as well as pulmonary function ( Santana et al, 2016 ; Yang et al, 2020 ). The possible underlying therapeutic mechanisms of HM shared with conventional medicine for COPD may raise expectations for a positive synergistic effect in treating COPD, but, conversely, may raise concerns about herb-drug interactions ( Pao et al, 2012 ).…”

Therapeutic Effects and Molecular Mechanisms of Bioactive Compounds Against Respiratory Diseases: Traditional Chinese Medicine Theory and High-Frequency Use

“…The proinflammatory cytokines and chemokines (TNF-α, IL-1, IL-6, and IL-8), the signaling pathways (NF-κB and MAPK pathways), and various stress-related molecules (SOD, MDA, GSH) participate in the different pathological stages of COPD (Yang et al, 2020). IL-8 recruits neutrophils and secretes several neutrophil elastases and metalloproteases, e.g., MMP-9, which results in alveolar destruction.…”

Accumulation Pattern of Flavonoids during Fruit Development of Lonicera maackii Determined by Metabolomics

“…Flavonoids are widely used in food, medicine and health care owing to their broad spectrum of pharmacological activities [39,40]. They also function in plant disease resistance and immunity [41].…”