Cytochrome P450 (CYP) enzymes, predominantly expressed in the liver and intestine, are central to phase I drug metabolism. The CYP1, CYP2, and particularly CYP3 families account for most oxidative biotransformation and nearly half of all drug elimination. Their activities are modulated by genetic polymorphisms, environmental factors, and drug interactions, contributing to interindividual variability in drug efficacy, safety, and susceptibility to drug-induced liver injury. This study systematically evaluated the regulatory effects of commonly used Traditional Chinese Medicine (TCM) and Western herbal medicines on major CYP isoforms. PubMed and Google Scholar were searched for studies published between January 2000 and March 2025, with UpToDate used as a supplementary resource. Eligible evidence included in vitro assays, in vivo animal studies, human pharmacokinetic investigations, and well-documented case reports assessing herbal effects on CYP3A4, CYP2C9, CYP2D6, and CYP1A2. Evidence was graded by strength and integrated with mechanistic and pharmacokinetic data for interaction risk assessment. Herbal candidates included Astragalus membranaceus (Huangqi,), Salvia miltiorrhiza (Danshen,), Ginkgo biloba (Ginkgo,), Bupleurum chinense (Chaihu,), and Hypericum perforatum (St. John's wort,). Many herbs demonstrated clinically relevant induction or inhibition of CYP activity, particularly CYP3A4, with the potential to alter drug exposure, reduce therapeutic efficacy, or increase toxicity. Collectively, these findings underscore the imperative for systematic assessment of CYP-mediated herb-drug interactions in integrative medicine and support the development of safer, personalized therapeutic strategies grounded in a refined understanding of metabolic variability.

Ganoderma lucidum, a highly valued medicinal mushroom in Traditional Chinese Medicine (TCM), has a long history of clinical use. Although its immunomodulatory and anticancer properties have been extensively investigated, an integrated framework connecting traditional therapeutic principles with modern molecular pharmacology remains underdeveloped. This review proposes a novel meridian-based pharmacological framework that bridges classical TCM theory with contemporary precision oncology. Specifically, the direct tumor-suppressive effects of G. lucidum polysaccharides (GLPs) across organ-specific malignancies, including lung, liver, hematological, and genitourinary cancers, are systematically examined to explore potential associations between classical meridian tropism and tissue-specific anticancer activity. These organ-targeted effects are further linked to experimentally validated mechanisms, including cell-cycle arrest, apoptosis induction, DNA repair interference, autophagy modulation, inhibition of epithelial-mesenchymal transition, and sensitization to chemotherapy. Beyond their direct tumor-suppressive effects, GLPs also exhibit potent immunomodulatory activities that may enhance cancer immunotherapy. Their roles in regulating systemic immunity and remodeling the tumor microenvironment are highlighted through macrophage reprogramming, dendritic cell maturation, and cytotoxic T-cell activation, together with their potential synergistic interactions with immune checkpoint blockade therapies. By integrating direct tumor suppression with immune-mediated mechanisms within a meridian-based framework, this review provides a comprehensive perspective on the therapeutic potential of GLPs and offers insights to support their future clinical translation in oncology.

Respiratory syncytial virus (RSV) is an RNA virus transmitted via droplets and affects individuals across all age groups. Although RSV is increasingly being recognized as a key pathogen in adults, differentiating RSV infection from other acute viral infections solely on the basis of clinical features is challenging. Polymerase chain reaction is the gold standard for RSV detection. Notably, RSV accounts for 2% to 10% of all hospitalizations due to respiratory tract infections in adults. Among hospitalized adults with RSV infection, 18.9% require intensive care, experiencing a disease burden similar to that of influenza. Severe RSV infection disproportionately affects older adults with multiple comorbidities, such as chronic heart failure and chronic obstructive pulmonary disease. This review focused on the manifestations and outcomes of RSV infection and on advances in the development of RSV vaccines. We comprehensively searched PubMed for relevant studies published between 1991 and 2024. Evidence-based specific to RSV treatments remain limited, with supportive care being the mainstay of management. In 2023, 2 protein subunit vaccines were approved for individuals aged ≥60 years; in addition, an mRNA-based vaccine that exerts substantial protective effects against severe RSV disease received approval in the United States. The development of novel antiviral therapies and vaccines holds promise for mitigating the burden of RSV infection. However, further research is required to evaluate the real-world effectiveness of vaccines, particularly in high-risk hospitalized patients requiring intensive care or mechanical ventilation, to optimize implementation strategies.

Body composition (BC) is a key determinant of metabolic risk, treatment tolerance, and long-term outcomes. The distribution of skeletal muscle, visceral adipose tissue (VAT), and ectopic fat provides greater prognostic information than total body weight alone does. However, conventional anthropometric measures, such as body mass index, cannot distinguish skeletal muscle from VAT and ectopic fat, potentially obscuring clinically relevant phenotypes such as sarcopenia, myosteatosis, and sarcopenic obesity. This review addresses the "BMI paradox" by evaluating how different imaging modalities identify high-risk phenotypes, such as sarcopenic obesity, that are not detected by standard anthropometric measures. Radiological imaging enables high-precision quantification by using validated metrics. In Asian populations, clinical interpretation requires population-specific thresholds. For example, the Asian Working Group for Sarcopenia 2019 criteria define low muscle mass as an appendicular skeletal muscle index of <7.0 kg/m[2] for men and <5.4 kg/m[2] for women. Computed tomography is the reference standard for BC assessment, and Hounsfield units are used to identify myosteatosis, typically within a range of -29 to +150 HU for skeletal muscle. Magnetic resonance imaging enables scanner-independent quantification of ectopic fat by using proton density fat fraction and is used for longitudinal monitoring of metabolic interventions. Studies report a substantial reduction in VAT within 12 months after metabolic surgery. Artificial intelligence has changed the workflow of BC analysis by reducing manual segmentation time from 15-30 minutes per case to seconds while maintaining high concordance with manual methods. This improvement enables opportunistic screening using existing diagnostic scans without additional radiation exposure or cost. Integration of radiologic assessment with quantitative biomarkers supports the use of BC imaging as a structured "metabolic report," which can guide therapeutic decision-making and support proactive health risk management.