Research Progress on Traditional Chinese Medicines for Reversing Bacterial Resistance and Their Mechanisms of Action

DOI: 10.12201/bmr.202503.00056

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  Abstract: The escalating challenge of bacterial drug resistance has emerged as a critical global public health concern. Traditional Chinese Medicine (TCM), characterized by its multi-target mechanisms of action and low toxicity profile, has progressively become a pivotal research direction for reversing antibiotic resistance. This paper systematically reviews recent advances in molecular mechanisms underlying TCM-mediated regulation of drug-resistant bacteria, with emphasis on six key pathways: 1) suppression of resistance gene mutations through regulation of RecA protein activity; 2) inhibition of horizontal transfer of resistance genes via interference with plasmid conjugation and transformation; 3) enhancement of bacterial outer membrane permeability; 4) functional inhibition of efflux pumps exemplified by the AcrAB-TolC system; 5) elimination of resistance plasmids via activation of the Hok/Sok system; and 6) inhibition of extended-spectrum β-lactamase activity, particularly targeting CTX-M-15 enzymes. Clinical evidence supporting the synergistic effects of TCM-antibiotic combination therapies is critically analyzed, along with discussion of their clinical potential and limitations. Current research gaps are identified, including standardization deficiencies in TCM components, insufficient elucidation of multi-target mechanisms, and potential hepatotoxicity risks. Future directions are proposed, encompassing nanotechnology-enhanced drug delivery systems, multi-omics analysis to elucidate interaction networks, and international standardization initiatives. This study provides both theoretical foundations and practical references for advancing TCM development and clinical translation in antimicrobial resistance management.

  Key words: traditional Chinese medicine; active ingredients; antibiotic-resistant bacteria; molecular mechanisms; synergistic effects

  Submit time: 19 March 2025

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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