{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T01:08:03Z","timestamp":1788743283820,"version":"build-2803163510"},"reference-count":290,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T00:00:00Z","timestamp":1788652800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T00:00:00Z","timestamp":1788652800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Phytotherapy Research"],"abstract":"ABSTRACT<\/jats:title>\n \n Asthma affects 260\u2013300 million people worldwide. About 20%\u201335% of patients use medicinal plants with their asthma medication, often without telling their clinicians. Disclosure rates are low; up to 42% of asthma outpatients use herbal products, with no records in their charts. Previous reviews discussed herb\u2013drug interactions and asthma phytotherapy separately. There is no combined pharmacokinetic, pharmacodynamic, and toxicological evidence for all modern anti\u2010asthma agents. This review closes that gap. It draws from mechanistic, preclinical, and clinical data. It looks at eight common botanicals:\n \n Glycyrrhiza glabra<\/jats:italic>\n <\/jats:styled-content>\n ,\n \n Curcuma longa<\/jats:italic>\n <\/jats:styled-content>\n ,\n \n Nigella sativa<\/jats:italic>\n <\/jats:styled-content>\n ,\n \n Boswellia serrata<\/jats:italic>\n <\/jats:styled-content>\n ,\n Tylophora indica<\/jats:italic>\n ,\n \n Adhatoda vasica<\/jats:italic>\n <\/jats:styled-content>\n ,\n Astragalus membranaceus<\/jats:italic>\n , and\n \n Piper nigrum<\/jats:styled-content>\n . The review explains how these botanicals affect\n <\/jats:italic>\n cytochrome P450 isoenzymes, Phase II conjugative enzymes, and membrane transporters, including P\u2010glycoprotein. It also considers shared adrenergic, glucocorticoid\u2010receptor, and inflammatory targets of inhaled corticosteroids, \u03b2\n 2<\/jats:sub>\n \u2010agonists, leukotriene receptor antagonists, theophylline, and biologic agents. These interactions create clinical hazards. For example,\n \n Hypericum perforatum<\/jats:italic>\n <\/jats:styled-content>\n increases CYP3A4 activity by up to 11\u2010fold and can destabilize theophylline and corticosteroid levels.\n \n Ephedra sinica<\/jats:italic>\n <\/jats:styled-content>\n causes dose\u2010dependent sympathomimetic toxicity, which worsens \u03b2\n 2<\/jats:sub>\n \u2010agonist cardiovascular risk.\n \n Glycyrrhiza glabra<\/jats:italic>\n <\/jats:styled-content>\n may trigger pseudoaldosteronism and hypokalaemia by inhibiting 11\u03b2\u2010hydroxysteroid dehydrogenase type 2.\n \n Ginkgo biloba<\/jats:italic>\n <\/jats:styled-content>\n has been tied to bleeding events. Turmeric, previously seen as safe, now appears in drug\u2010induced liver injury registries. Compositional variability adds to the risk; for example, hyperforin content can range from 0.01% to 1.89%, and ephedrine content varies by more than 12\u2010fold across products. This review places its findings in the context of the WHO Global Traditional Medicine Strategy 2025\u20132034. It identifies important herb\u2013anti\u2010asthma drug pairs, defines monitoring endpoints, and proposes a pharmacogenetically informed framework for safely integrating medicinal plants into asthma care.\n <\/jats:p>","DOI":"10.1002\/ptr.70436","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:35:11Z","timestamp":1788741311000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pharmacokinetic and Pharmacodynamic Interactions Between Anti\u2010Asthma Drugs and Medicinal Plants: A Comprehensive Review"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9459-9557","authenticated-orcid":false,"given":"Emine","family":"Kocyigit","sequence":"first","affiliation":[{"name":"Department of Nutrition and Dietetics Ordu University Ordu T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4754-0149","authenticated-orcid":false,"given":"Aylin","family":"B\u00fclb\u00fcl","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics Ordu University Ordu T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9058-4630","authenticated-orcid":false,"given":"Betul","family":"Kocaadam\u2010Bozkurt","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics Erzurum Technical University Erzurum T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5829-7543","authenticated-orcid":false,"given":"Osman","family":"Bozkurt","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics Kulu Faculty of Health Sciences Konya T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0010-0012","authenticated-orcid":false,"given":"Duygu","family":"A\u011fag\u00fcnd\u00fcz","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics Gazi University Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3335-1822","authenticated-orcid":false,"given":"Raffaele","family":"Capasso","sequence":"additional","affiliation":[{"name":"Department of Agricultural Sciences University of Naples Federico II Portici Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,6]]},"reference":[{"issue":"6","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"349","DOI":"10.2165\/11586800-000000000-00000","article-title":"Boswellia serrata\n : An Overall Assessment of In\u00a0Vitro, Preclinical, Pharmacokinetic and Clinical Data","volume":"50","author":"Abdel\u2010Tawab M.","year":"2011","journal-title":"Clinical Pharmacokinetics"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/molecules23102696"},{"issue":"8","key":"e_1_2_13_4_1","first-page":"HC19","article-title":"Evaluation of Efficacy of Curcumin as an Add\u2010On Therapy in Patients of Bronchial Asthma","volume":"8","author":"Abidi A.","year":"2014","journal-title":"Journal of Clinical and Diagnostic Research: JCDR"},{"key":"e_1_2_13_5_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.hermed.2020.100404","article-title":"An Updated Knowledge of Black Seed (\n Nigella sativa\n Linn.): Review of Phytochemical Constituents and Pharmacological Properties","volume":"25","author":"Ahmad M. 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