Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), is a non-specific intestinal disease characterized by chronic inflammation (Olsen et al., 2009). The prevalence rates of UC and CD have risen to 294 and 213 per 100,000 respectively in Europe while the incidence rate of IBD in Hong Kong has tripled to 3.1 per 100,000, illustrating the scale of the disease as a public health issue (Burisch et al., 2013; Mak et al., 2020). Patients with IBD suffer from abdominal pain, diarrhea, hematochezia and weight loss related to pathological changes including ulcerative activation, mucosal damage, and autoimmune disturbance (Petryszyn and Paradowski, 2018). Multi-faceted extrinsic and intrinsic triggers (the latter including microorganisms, genetic susceptibility, and immunological overreaction) are thought to contribute to the initiation and aggravation of IBD. Dyshomeostasis in gut microflora may lead to bacterial invasion through the intestinal barrier and an abnormal immune response with overexpression of inflammatory factors, causing IBD-like symptoms (Lee, 2015). However, the precise etiology is not yet fully understood. Anti-inflammatory agents, such as sulfasalazine and mesalazine, with a long history of utilization, are conventional treatments while biological immunosuppressants, steroids, and even microbiome-inspired therapeutics are effective (Plichta et al., 2019). Although therapeutics of this kind can bring rapid alleviation of symptoms, a limited recovery, high recurrence rates, heavy economic burden, and severe adverse events are major drawbacks and have encouraged sufferers to seek alternative methods for better management of IBD.

Complementary and alternative approaches provide significant benefits for IBD treatment. As a critical part of global supplementary medicine, herbal medicine has attracted much attention due to the unique therapeutic effects of natural material. An abundant body of medical herbs, such as Coptis chinensis Franch (Huanglian), Zingiber officinale Rosc (Ganjiang), and Paeonia lactiflora Pall (Shaoyao), have shown the potentials in the management of colitis (Cao et al., 2019). Among these anti-IBD phytotherapies, Danshen exhibited multilevel efficacies and Danshen-containing products have been utilized in clinic as satisfying treatments. Danshen (Salvia miltiorrhiza Bge.) was first recorded in Shennong’s herbal classic of materia medica, Shennong Bencao Jing, a botanical monograph written in the Eastern Han dynasty (AD25-AD220) in China. Danshen is widely applied in the treatment of systemic, especially cardiovascular diseases (Wang L. et al., 2017). More recently, research has shown that natural compounds isolated from Danshen have anti-inflammatory, anti-oxidative and anti-bacterial properties, and are effective in immune regulation and intestinal epithelium protection (Ma et al., 2016; Gao et al., 2017). Danshen extract or molecule compounds could improve colitis symptoms, such as gastro-intestinal bleed, weight loss, and lethal rate in rodent colitis models. In addition, Danshen-based products have shown therapeutic efficacy in clinical trials with attenuation of symptoms and protection from disease recurrence (Deng et al., 2016; Zhu, 2018; Zhu, 2019). Danshen product has been approved by College ter Beoordeling van Geneesmiddelen-Medicines Evaluation Board (CBG-MEB) and used in Europe since 2016.

While these findings imply that Danshen can have a significant impact on IBD, the related molecular mechanisms have not been clearly identified due to methodological limitations related to the “multi-compounds-multi-targets” approach of modeling a sophisticated regulatory network of signal transduction (Luo et al., 2020). Interdisciplinary research has led to the development of identification tools, establishment of a holistic index-assessment system, crosstalk with decussate subjects, and improved statistical analysis methods (Liu et al., 2017; Bai et al., 2018).

This review is a systematic evaluation of the efficacy and safety of Danshen in the treatment of IBD evidenced by experimental studies and clinical trials. Bioactive compounds existing in Danshen were identified, relevant clinical trials were sourced and experimental reports were analyzed to unmask potential mechanisms of Danshen in IBD. To minimize the limitations of the “one-compound-single-target” approach, which does not include the multiple targets in disease, a network pharmacology approach was utilized to estimate and visualize potential actions of Danshen. The safety of Danshen and Danshen-containing products was also discussed. The review provides new ideas about novel applications of Danshen in IBD.

IBD is a chronic inflammatory disease induced by multi-faceted triggers including epigenetic factors and genetic susceptibility (Olsen et al., 2009). Smoking is a significant environmental risk factor for exacerbating IBD at any age, including infancy (Shouval and Rufo, 2017), but does not have the same impact in UC patients (Blackwell et al., 2019). Mental stress, health status, infectious diseases, vitamin D deficiency, unhealthy diets characterized by high fat (especially saturated acid), high sugar, high cholesterol, and low fiber, all contribute to the pathogenesis of IBD (Mouli and Ananthakrishnan, 2014; Lewis and Abreu, 2017; Khalili et al., 2018). Antigens and dietary nutrients have an important role in maintaining homeostasis between intestinal bacteria and commensal microflora. For instance, breast-feeding helps to decrease the risks of IBD by improving the homeostatic ecosystem in the infant gut (Andrew R. Barclay et al., 2009). Differences in intestinal microflora structure between patients with IBD and healthy volunteers demonstrated that gut microorganisms are an important factor in the disease, consistent with evidence that animal colitis could be induced in healthy mice by inoculating intestinal microflora from those with UC (Plichta et al., 2019). In addition to the type of gut bacteria, their distribution, abundance, and mobility are important factors in the initiation of IBD (Guo et al., 2020). Fungi, viruses, and parasites also influence gut homeostasis. Interestingly, certain parasites have a beneficial effect on the host immune response, and therefore on colitis (Harris, 2016; Pickard et al., 2017). However, this effect needs to be explored further to provide more compelling evidence on the roles of primary and secondary metabolites in the patho-physiological course of IBD (Segal et al., 2019).

It is well known that invasive pathological bacteria and toxins lead to dysfunction of intestinal epithelial cells and damage in intestinal integrity, which consequently disturbs the host immune response and aggravates inflammatory cascades in mucosal tissues (Katsanos and Papadakis, 2017). The intestinal barrier is a defensive structure composed of host cells, mucosal matrix, synergic bacteria, and immune triggers such as antibodies, antimicrobial peptides, cytokines, and chemokines (Lee, 2015). With the ability to regenerate rapidly in damaged tissues, intestinal epithelial and mesenchymal stem cells have important roles in maintaining mucosal structure and protective functions (Chami et al., 2018). Tight junctions (TJs) between epithelial cells are fundamental to intestinal barrier integrity, and their condition is indicative of the degree of inflammatory damage in IBD. Consequently, mucosal healing is a significant feature of remission in IBD.

IBD involves dysfunction of the innate and adaptive immune systems, with overexpression of inflammatory mediators followed by excessive immune responses inducing chronic or acute inflammatory damage to the colon (Soufli et al., 2016). Macrophages and monocytes play a part in this damage and a range of dysregulated immune cells have been found to disrupt cellular homeostasis (Park et al., 2017). Another notable feature is the abnormal presence of adaptive immune cells including Th1, Th2, Th17, and Treg lymphocytes, which are important to the hosts’ recognition and neutralization of gut antigens (Friedrich et al., 2019). Aberrant expression of pro-inflammatory cytokines such as tumor necrosis factor-α (TNF-α), IL-6, IL-1β, and Interferon-γ (IFN-γ), reflects a persistent disturbed immune response which initiates and aggravates intestinal inflammation (Katsanos and Papadakis, 2017). In patients with UC, the lamina propria and mucosa are infiltrated by Th1 and Th17-profile cells, and a similar process occurs in patients with CD via IL-23/IL-17 axis (Feagan et al., 2016; Friedrich et al., 2019). Therapeutic management of intractable IBD requires monoclonal antibodies with high intensity and specific targeting of representative cytokines, and research in this area has increased understanding of chronic inflammatory diseases and their etiologies.

Risk factors for IBD include economic status, lifestyle, diet, society stress, and genetic factors, the latter consistent with evidence of higher risk in certain ethnic or genetic groups (Ng et al., 2013; Eka et al., 2014). Genome-wide gene expression studies have unmasked the existence of a set of IBD-related genes, which participate in different locations and stages of IBD, in parallel with distinctions between UC and CD phenotypes (Noble et al., 2008; Olsen et al., 2009). Mutation of nucleotide binding oligomerization domain-containing protein 2 (NOD2), associated with toll-like receptors (TLRs) and NOD-like receptors (NLRs), is followed by dysfunction of autophagy and inflammatory responses while deletion of mucin 1 (MUC1) and MUC4 disturbs the mucosal homeostasis (Ramanan et al., 2014; Vancamelbeke et al., 2017). Genetic abnormality associated with the host’s immune response, intestinal barrier protection, or inflammatory signal transduction may contribute to the manifestation of IBD-associated symptoms (Eka et al., 2014). However, knowledge of candidate sites is not yet sufficient to evaluate the pathology and to form the basis of diagnostic tests for IBD. Further research is needed to investigate the mechanisms involved. Since holistic outcomes result from sophisticated triggers and interactions at a molecular level, a detailed understanding of molecular mechanisms is important to shed light on prognosis, protection, and amelioration of IBD.

Phytochemical profiling of Danshen began in the 1930s (Zhou et al., 2005) and enhances understanding of Danshen’s role in disease treatment. With novel extraction, separation, and identification techniques applied in plant research, ingredients have been retrieved from Danshen and their structure are described (Guo et al., 2014). The principal bioactive compounds of Danshen are divided into two parts according to structural characteristics (Zhang XZ. et al., 2016). One is the hydrophilic phenolic acids. The core phenolic structure, in a C₆C₃ cluster, exists in both polyphenolic salvianolic compounds like Salvianolic acid B (SAB) and non-polyphenolic compounds such as Salvianic acid A (SA), Caffeic acid (CA), and Protocatechuic aldehyde (PA). The second group, most termed tanshinones, consist of lipophilic phenanthraquinones and their derivatives, is classified into diterpenoids, tricyclic diterpenoids and royleanone tanshinones (Wang L. et al., 2017). Diterpenoid tanshinone, which is represented by Tanshinone IIA (TIIA), Tanshinone IIB (TIIB), and Cryptotanshinone, is constructed according to the basic phenanthraquinone cluster with 1,2-o-quinones core and furan-like units (Hatfield et al., 2013). In addition, the furan or dihydrofuran ring is displaced by isopropyl cluster in tricyclic diterpenoids while royleanone tanshinones are characterized by 1,4-p-quinones, with Miltirone and Isotanshinone respectively.

Despite differences in structure, compounds of Danshen display common therapeutic effects on IBD, including anti-inflammatory properties of tanshinones and anti-oxidative properties of salvianolic acids (Wang L. et al., 2017; Gao et al., 2017). Other compounds were reported such as triterpenoids and flavones, and including physiological constituents (amino acids and metallic elements) (Guo et al., 2014). In addition, many species of essential oils were discovered in the flower of Danshen rather than the root and rhizome, indicating that novel applications may be found by exploiting all parts of the plant (Liang et al., 2009). However, few reports about non-tanshinone or non-salvianolic acid compounds of Danshen have focused on the management of colitis. For more details on the structure of compounds of Danshen, supplementary reviews are available (Zhou et al., 2005; Zhang XZ. et al., 2016; Wang L. et al., 2017). The compounds outlined above are included in the present review and are depicted in Figure 1.

Danshen is traditionally used for menstrual disorder, traumatic injury, anxiety, depression, and cardiovascular diseases. Recent investigations have reported that Danshen and its constituents may have potential for protection against cancer, inflammation, allergy, oxidation and harmful microorganisms, and may have a role in immune regulation (Gao et al., 2017; Gu et al., 2017; Li et al., 2018). Evidence-based therapeutic effects on diabetes, autoimmune disease, alcohol dependence, and nervous system disorders such as Parkinson’s disease and Alzheimer’s disease suggest the scope for a range of clinical applications, which sustain the Danshen-based pharmaceutic industry (Yin et al., 2009; Su et al., 2015).

Two or more participant herbs with different therapeutic functions are combined to create a formula with the potential to treat complex clinical disorders. In Chinese herbal medicine, a core characteristic herb within this combination determines the therapeutic direction of the formula. Danshen is introduced in Chinese herbal medicine theory as a medicine to treat blood-associated diseases (Liao et al., 2019), and reports of its effectiveness as a treatment for IBD and related syndromes are rare. However, medicinal formulae in which Danshen is the main constituent are increasingly applied to the management of IBD. In addition, many clinical trials using Chinese patent drugs mostly consisting of Danshen such as Danshen Injection have been reported.

In this review, papers describing clinical trials on the effectiveness of Danshen for the treatment of UC, the most frequently occurring phenotype of IBD, were sought from the following databases: China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical database (VIP), Wanfang, Chinese biomedical literature service system (SinoMed), and other resources in Chinese or in English based on Pubmed, MEDLINE, embase, and the Cochrane Central Register of Controlled Trials. To build a complete figure, “Danshen”, “Salvia miltiorrhiza Bge.“, and “ulcerative colitis” were regarded as search terms without limitations. Then, only randomized controlled trials (RCTs) till Dec. 2020 without significant bias assessed by Cochrane criteria and in which patients were diagnosed with UC were included in the review.

Overall, 19 clinical trials with a total of 1,440 patients were included in Figure 3. Although diagnostic criteria varied between these trials, patients who were eligible generally exhibited typical symptoms of UC characterized by hematochezia, abdominal pain, and consistent diarrhea. Only two trials used the Mayo Score to assess the disease course (Deng et al., 2016; Liu et al., 2019) while 5 trials recorded the precise location of ulcers, such as descending colon, sigmoid colon and rectum (Dong, 2004; Zhu, 2018; Zhu, 2019) and at least eight trials described the pathological course of UC including severity and remission phases (Han et al., 2005; Yang and Zhang, 2005). No significant heterogeneity in age, treatment course, disease course, gender, or ethnicity was found among the trials. Danshen-based interventions consisted of Compound Danshen injection (Li and Luo, 2011; Zheng et al., 2013), Danshen injection (Zheng et al., 2013), Danshen powder for injection (Li, 2019), Tanshinone capsule (Xiong and Wang, 2016; He, 2018), Danshen Chuanxiong injection (Sheng et al., 2014; Xu, 2015). Characteristics of these products including pharmaceutical forms, dose, frequency, and mode of administration were shown in Tables 3, 4, 5. All interventions in experimental groups were combinations of Danshen products and conventional treatments for UC including sulfasalazine, mesalazine, probiotics, antibiotics, or dexamethasone and these were compared with only the conventional treatments in the control groups.

The rate of clinical efficacy attributed to Danshen plus conventional treatment of UC ranged from 83.3 to 96.9%, suggesting that either aqueous or lipophilic constituents of Danshen exhibited therapeutic effects. Although 11 trials reported adverse events including rash, headache, diarrhea, nausea, abdominal pain, and dizziness (Han et al., 2005; Sheng et al., 2014; Liu et al., 2019), these side effects were ameliorated after cessation of treatment. Similar rates of adverse events between experimental groups and control groups suggested that Danshen is a safe treatment.

In the patients taking Danshen products, both duration and severity of clinical symptoms including abdominal pain, blood stool, diarrhea, and tenesmus were ameliorated. Endoscopic evaluation of mucosal condition showed improvement with less erosion, better healing in ulcers, and improvement in microenvironment ecosystem, and the recurrence of UC was decreased. The following biomarkers representing inflammation and microcirculation were also at healthy levels: IL-6, IL-8, IL-10, TNF-α (Zhu, 2018; Li, 2019), C-reactive protein (CRP), d-Lactate (DL), D-dimer (D-D), blood sedimentation, serum levels of platelet (PLT), plasma fibrinogen (FIB), and mean platelet volume (MPV) (Xiong and Wang, 2016; He, 2018). Based on the collective clinical evidence, Danshen was considered as a potential auxiliary treatment for UC.

The clinical evidence summarized above suggests that Danshen may be considered as a potential auxiliary treatment for UC. However, while the included studies were randomized and controlled, they were found to be of low quality due to methodological flaws including small samples, and potentially biased selection processes. Hence, more standardized clinical trials of randomized, double-blind, and multi-centered design are needed to further test the safety and efficacy of Danshen products.

In contrast to conventional medicine, the holistic nature of Chinese herbal medicine is characterized by multi-compounds, multi-targets, multi-functions, and multi-systems, acting co-operatively toward a desired outcome. This network model challenges researchers to explain its precise mechanisms of action. Network pharmacology, rooted in systems biology, is a flexible approach combining the disciplines of bioinformatics, computational analysis, and polypharmacology, which can be used to investigate the complex interactions inherent in Chinese herbal medicine (Zhang et al., 2019). Network pharmacology therefore offers the possibility of a solution to multiple element profile complexity, in which intersections and interactions of physiological proteins and other biological factors are important (Hu et al., 2019). The paradigm of network pharmacology also accelerates drug discoveries featuring as combinatorial rules and compound-gene associations (Shao Li and Zhang., 2013). In recent years, network pharmacology has been wildly employed in Chinese medicine research, including pharmacology, phytochemistry, and pharmacokinetics, providing a holistic view on the complex relationships between herbal medicine and the host (Zhao et al., 2019a; Yuan et al., 2020).

Hence, we applied this approach in an attempt to explain the mechanisms by which Danshen acts as a treatment for IBD. Compounds with oral bioavailability (OB) ≥ 30% and drug-likeness (DL) ≥ 0.18 were selected based on the Traditional Chinese Medicine System Pharmacology database and Analysis Platform (TCMSP) evaluation criteria (Jiang et al., 2019). Other supplementary compounds with potentiality, bioactivity, and experimental manipulation of which was described in “Pharmacological actions and mechanisms of Danshen for IBD treatment”, were included to construct and enrich the compound library of Danshen (Supplementary Material S1). The Traditional Chinese Medicine Integrated database (TCMID) (Huang et al., 2018) and PubChem were consulted to find and remove duplications and mismatched compounds and then all eligible compounds were validated to exist in Danshen. MOL2, SMILES, and SDF formats of each compound were captured and then uploaded to Swiss Target Prediction (Gfeller et al., 2014), STITCH (Kuhn et al., 2008), and TCMSP to retrieve predictive targets. The following databases were also searched to construct a disease library: Online Mendelian Inheritance in Man (OMIM), Therapeutic Target database (TTD), National Center for Biotechnology Information (NCBI), the Pharmacogenomics Knowledge base (PharmGKB), Malacards, and Drugbank. The entry identifiers of all targets were manually converted into Uniprot symbols for uniformity. An herb-compound-target-disease network, which was formed by intersected targets between the compound library and the disease library (Supplementary Material S2), was created using Cytoscape 3.5.1 to explore the multi-level Danshen treatment. The intrinsic protein-protein interactions (PPIs) of IBD and Danshen were visualized using STRING (Szklarczyk et al., 2019). In addition, all eligible targets were input to DAVID Bioinformatics Resources for Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways and ClueGO plugin for Gene Ontology (GO) (Bindea et al., 2009).

In total, 64 compounds were identified for 66 IBD-Danshen overlapping targets, reflecting a range of possible functions of Danshen in the treatment of IBD. The resulting “herb-compound-target-disease” network, which included 130 hub nodes and 124 literature-supported lines of 346 intersectional ones, represented potential targets for botanical compounds in the treatment of IBD. Each objective compound could have more than one target, which in turn could interact with various compounds (Figure 4). Overlapping targets were uploaded to yield PPIs featuring 66 hubs and 404 interactions (Supplementary Figure S1).

Meanwhile, evidence-supported functions including positive regulation of cytokine production, inflammatory response, and positive regulation of programmed cell death appeared to be affected by Danshen in Supplementary Figure S2. In addition, other processes of cell component and cell activity cooperated to exhibit pleiotropic effects, reflecting the holistic principles of Danshen treatment.

As putative targets of compounds of Danshen were included in the integrated network of multiple regulatory systems responding to extrinsic and endogenous irritants, KEGG was used to imply direct and indirect signaling transduction of Danshen’s potential action (Supplementary Material S3). The results were concentrated on TNF signaling pathway, JAK/STAT signaling pathway, TLR/NLR signaling pathway, NF-κB signaling pathway, HIF signaling pathway, PI3K/AKT/PTEN signaling pathway, and MAPK signaling pathway, all playing irreplaceable roles in the process of IBD multiply regulated by Danshen. When comparing positions of Tanshinones with Salvianolic acids in the network, some common targets, such as NF-κB, IL-6, and TNF, which were enriched in inflammatory-associated signaling pathways, were correlated with these two clusters of Danshen compounds. Meanwhile, certain specific targets, such as PPAR-γ to Salvianolic acid B, and estrogen receptors to Tanshinones, achieving in dynamic regulated functions, improved multilevel management of Danshen’s therapies of IBD.

Network Pharmacology Evaluation Method Guidance-Draft, the recent guidance for network pharmacology research, provided a systematic evaluation method (Li, 2021). Therefore, we employed this criterion to assess the network object of Danshen-IBD, especially from aspects of data retrieving, network analysis, and outcome evaluation. We performed our work to meet fundamental requirements of the Network Pharmacology Evaluation Method Guidance-Draft but need validated data, such as existing compounds, functional proteins, and further experimental verification.

Danshen and its phytochemical constituents possess multiple therapeutic efficacies and have the potential in transformation of novel drugs. During the development of pharmaceutical industry, drug safety is necessary for further research. Danshen and Danshen-containing products can be tolerated for clinical usage (Jia et al., 2019). With safety tested by a set of toxicity research on various mammals including Sprague-Dawley rats, Beagle dogs, and mice, Danshen and Danshen-containing products, offer an optional treatment of IBD with acceptable tolerance (Gao et al., 2009; Li et al., 2009; Wang et al., 2012). In 2017, a real world study, employing data of 30180 consecutive inpatients from 36 hospitals, stated that a Danshen-containing product called Salvia Miltiorrhiza Depside Salt for Infusion was of good tolerance by the general population (Yan et al., 2017). In the included trials in “CLINICAL TRIALS OF DANSHEN AS A TREATMENT OF UC”, side events, which best reflect safety of Danshen products on human being, had no significant difference between control groups and Danshen-intervention groups. Meanwhile, the treatment course ranged from 4 to 8 weeks, covering the general treatment course in clinic. Although Tanshione IIA exhibited potential cardiotoxicity and other severe toxicity in zebrafish embryos at high concentrations, as Danshen-containing products are mostly made by hydrophilic constituents of Danshen, there remains the declaration of safety of Danshen-containing products for IBD treatments (Wang T. et al., 2017).

IBD is a chronic inflammatory disease, which induces heavy burden and lacks satisfying treatments. Although innovative drugs like monoclonal antibodies and specific agents achieve in better management and less side events, the high cost asks for economical and practical agents that are specific to IBD. Danshen is a classical herbal material frequently prescribed in Chinese medicine with a long history of over 2000 years. This herb possesses multiple therapeutic effects with low toxicity and is attracting more attention as a potential IBD treatment.

Clinical trials in which Danshen products were used supplementarily with conventional treatments indicated the efficacy of Danshen on symptoms and disease biomarkers. The Danshen products of hydrophilic cluster is used more often in clinical trials and these products like Danshen injection have shown ensured efficacy. However, as quality control of Chinese medicine injection is in challenge because of the sophistication of compounds directly entering blood, the side events can not be neglected, which asks for further evaluation on the safety of Danshen products used for IBD. Meanwhile, methodological issues including small sample sizes and flawed outcome measurements limit believability of the conclusion on Danshen’s capacity.

The compounds of Danshen are fundamentally classified by their solubility as phenolic acids and tanshinone derivatives. The development of instruments of high resolution, accuracy, and sensitivity, makes it possible to discover novel compounds of Danshen, which might have the potential to manage colitis. For instance, Savianolic acid C, one of the derivates of Savianolic acid B, has significant anti-inflammatory and anti-oxidative effects but has not been tested for colitis (Song et al., 2018). The individual compounds of Danshen with different structural features are reported to possess multiple pharmacological functions in colitis model. With deeper understand in the pathology of IBD, the anti-colitis capacity of compounds of Danshen can be explained clearly in another way. For instance, ferroptosis, which could be controlled by Tanshinone IIA, is recently reported to play an important role in IBD and will be the future field in which Danshen possesses anti-colitis capacity (Guan et al., 2020; Xu et al., 2020). Meanwhile, as a mixture of numerous compounds, Danshen exhibits its effects through multiple reactions among various compounds, different targets, and alternative biosystems. To give concise descriptions, system pharmacology approaches like network pharmacology are applied to visualize molecular mechanisms of Danshen. Although it has been developed for about 10 years, network pharmacology in Chinese medicine is still in infant to mimic the actual bio-reactions. Hence, more methods like omics are encouraged to use together to make a systematic figure of Danshen as a treatment of IBD.

With the case of Danshen in the management of IBD, the usage of medicinal herbs for complex disease shines a light on drug discovery, in which multipotent responses and uniqueness of the individuals are considered. Discovery of innovative compounds and exploring their applications are pivotal aims in the field of herbal medicine, and will contribute to the development of marketable botanical products such as Danshen injection in the future.