REVIEW article
Front. Pharmacol.
Sec. Ethnopharmacology
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1667059
Integrated Toxicology of Aconitum carmichaelii Debx.: Bridging Traditional Toxicity-Efficacy Understanding and Modern Toxicology
Provisionally accepted
Xinyu 李心雨 Li1
Li 周丽 Zhou1
Zhenhong Jiang2Yong Liang1Yaguo Fan3
Zhaohui Ding3Hao Chen3Wenjun Liu1Xiang Zhou1
Huan-Hua Xu1*- 1Jiangxi University of Traditional Chinese Medicine, Nanchang, China
- 2Nanchang University Second Affiliated Hospital Jiangxi Key Laboratory of Molecular Medicine, Nanchang, China
- 3The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
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Toxicity has different meanings in traditional Chinese medicine (TCM) and modern toxicology. Integrative toxicology, a novel discipline proposed by our team, offers a robust solution for the scientific elucidation of toxicity in traditional Chinese medicines. Aconitum carmichaelii Debx. (aconite), a classic herbal medicine with a long-standing TCM clinical application history, demonstrates prominent effects in rescuing yang to reverse critical conditions, warming meridians to dispel cold, and tonifying yang to invigorate qi. It is widely used to treat yang deficiency, cold syndromes, and related disorders. However, the dual toxicity-efficacy attribute of aconite has substantially constrained the safety and breadth of its clinical application, leading to its classification as a "high-risk herb." Thus, this review introduces the concept of integrative toxicology to comprehensively summarize the chemical composition, pharmacological activity, and toxicity mechanisms of aconite. Particular emphasis is placed on various strategies and mechanisms for toxicity attenuation and efficacy enhancement within TCM formulae, including traditional approaches, such as processing and compatibility, as well as potential detoxification pathways identified in modern pharmacological studies. By systematically integrating the framework of integrative toxicology, this work aims to provide a more scientific and secure theoretical basis for the clinical application of aconite, promoting its transformation from a "high-risk herb" to a "controllable therapeutic agent" and thereby maximizing its potential value in modern medicine.
Keywords: Aconite, Integrative toxicology, detoxification, Compatibility, Pharmacologic effects, Toxicology
Received: 16 Jul 2025; Accepted: 15 Oct 2025.
Copyright: © 2025 Li, Zhou, Jiang, Liang, Fan, Ding, Chen, Liu, Zhou and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Huan-Hua Xu, huanhua323@jxutcm.edu.cn
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.