Top 10 academic advances in traditional Chinese medicine in 2024

1. New breakthroughs in cross-organ “brain-gut” strategies for the prevention and treatment of digestive diseases Refractory digestive diseases, represented by functional gastrointestinal disorders and inflammation-to-cancer transformation in the digestive tract, are associated with high incidence, complex pathogenesis, and considerable treatment challenges. These conditions are closely linked to acute and chronic stress-related injuries in the central nervous system. Single-modality therapies are insufficient to address the cross-organ nature of these disorders. Prof. Wei Wei (Wangjing Hospital, China Academy of Chinese Medical Sciences), Researcher Rong Peijing (Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences), and Prof. Liu Fengbin (The First Affiliated Hospital of Guangzhou University of Chinese Medicine) proposed a novel strategy of “brain-gut coordination.” A multicenter randomized controlled trial involving 1796 patients with functional gastrointestinal disorders demonstrated that this strategy significantly improved symptoms such as abdominal bloating, abdominal pain, and diarrhea, as well as anxiety and depression. It also reduced recurrence rates in conditions such as functional dyspepsia and irritable bowel syndrome and led to the establishment of a clinical efficacy evaluation system for brain-gut coordination. The study also used multiomics approaches to elucidate the scientific foundations of the strategy. The findings were published in the International Journal of Surgery and Gastric Cancer in 2024, and 3 invention patents were granted. This progress represents a new strategy for treating refractory digestive diseases based on the holistic principles of traditional Chinese medicine (TCM) and offers new insights into the management of major chronic conditions. In parallel, the increasing consumption of high-fat, high-calorie foods has led to a year-by-year rise in obesity rates. The small intestine, as the primary site for fat absorption, has long been believed to carry out this process autonomously. However, a team led by Profs. Wang Weiqing and Wang Jiqiu (Ruijin Hospital, Shanghai Jiao Tong University School of Medicine) discovered that intestinal fat absorption is directly regulated by the brain. Based on this discovery, they identified puerarin, a compound found in Puerariae Lobatae Radix, which inhibits specific neurons along the brain-gut axis. Puerarin was found to significantly shorten jejunal microvilli, reduce the absorptive surface area, and reduce fat absorption capacity. This redefined fat absorption from a previously considered self-regulated process to one regulated by the vagal nerve. The results were published in Nature in 2024. This advancement further clarifies the scientific basis of TCM’s holistic regulation of the brain-gut axis and provides new targets and perspectives for future antiobesity drug development and physiological research on the brain-gut axis. 2. High-level evidence supporting TCM in preventing and treating cardiovascular event chain The cardiovascular event chain refers to the process by which high-risk factors lead to atherosclerosis and the rupture of vulnerable plaques, resulting in myocardial infarction, followed by arrhythmia, heart failure, and eventually death. Supported by China’s National Key R&D Program, Prof. Jia Zhenhua (Hebei Yiling Hospital), together with Academician Tong Xiaolin and Profs. Yang Yuejin, Li Xinli, Huang He, and Bu Peili, conducted systematic research on the prevention and treatment of the cardiovascular event chain using TCM. A clinical study involving 889 patients with metabolic syndrome and impaired glucose tolerance showed that Jinlida Granules can regulate metabolic disorders, protect blood vessels, delay atherosclerosis, and significantly reduce the risk of developing diabetes. In another trial with 220 patients with coronary vulnerable plaques, Tongxinluo Capsules were found to increase fibrous cap thickness, stabilize plaques, alleviate angina, and reduce the risk of cardiovascular events. In a study involving 920 patients with atrial fibrillation, Shensong Yangxin Capsules reduced the recurrence risk within 1 year after catheter ablation, lowered the atrial fibrillation burden, and improved quality of life. A clinical trial involving 3119 patients with chronic heart failure demonstrated that Qili Qiangxin Capsules improved prognosis and reduced both cardiovascular mortality and the risk of rehospitalization due to worsening heart failure. Through basic research and network-based integrative analysis, the studies elucidated the mechanisms and scientific principles behind preventing upstream risk factors, treating current lesions, and controlling downstream progression. The findings were published in Nature Medicine, JAMA Internal Medicine, and the European Heart Journal in 2024. This progress highlights the unique advantages and efficacy of TCM in interrupting the cardiovascular event chain and provides a research paradigm for TCM-based strategies in managing major diseases. Heart failure represents the terminal stage of cardiovascular disease and poses critical challenges due to high mortality and rehospitalization rates. Guided by TCM theories, Prof. Wang Wei (Guangzhou University of Chinese Medicine) and Prof. Wang Yong (Beijing University of Chinese Medicine) proposed a novel detoxification-based therapy rooted in the TCM principle of “invigorating Qi, warming Yang, and activating blood.” They developed Qishen Granules, which have received clinical trial approval and completed technology transfer. Using a pioneering 4-in-1 zebrafish embryo model for drug screening, they identified 16 small-molecule compounds with cardioprotective effects and discovered for the first time that astragaloside III acts as a homodimer-specific agonist of RXRα, thus optimizing cardiac energy metabolism and alleviating heart failure symptoms. The results were published in Science Bulletin in 2024 and formed the basis of the 2024 Expert Consensus on the Diagnosis of Heart Failure with Toxin Syndrome. This work exemplifies a model of new TCM development driven by TCM theory and offers valuable strategies and approaches for treating chronic heart failure. 3. Major breakthroughs in using TCMs for acute radiation injury Strengthening the development and application of emergency medications for nuclear incidents is of great significance to enhancing the national nuclear safety strategy. TCMs, characterized by the holistic regulatory effects, hold unique advantages in the prevention and treatment of acute radiation injuries and require further in-depth exploration. With support from multiple national-level research programs, the team led by Researcher Gao Yue (Institute of Military Medicine, Academy of Military Sciences) has achieved major breakthroughs in using TCMs for managing acute radiation injury. For the first time, they discovered that hemp seed oil and its active component cannabidiol can promote the restoration of hematopoietic stem cell stemness through the Atf2–Wnt/BMP signaling pathway, thus improving the survival rate of irradiated animals. They also demonstrated that the TCM formula Liangxue Guyuan Yishen Decoction increases the abundance of Akkermansia muciniphila in the gut, elevates intestinal isobutyric acid levels, promotes intestinal wall repair, and improves survival in irradiated animal models. In addition, the team developed a ferulic acid-based hydrogel with excellent biocompatibility, which effectively alleviates radiation-induced inflammatory responses, stimulates vascular regeneration and collagen deposition in damaged skin, and accelerates postradiation wound healing. The research findings were published in MedComm, Journal of Nanobiotechnology, and Phytomedicine in 2024. The team was awarded a special-use drug certificate and production approval by the military and received the 2024 Ho Leung Ho Lee Science and Technology Progress Award. This represents a major breakthrough in the field of nuclear emergency medicine, broadens the scope of TCM application, and further demonstrates the critical role of TCM in addressing national strategic needs. 4. Molecular mechanism underlying trait and quality changes in cultivated American ginseng explained To date, more than 100 major TCMs have undergone a transition from wild harvesting to artificial cultivation. However, domestication may lead to changes in morphological traits and chemical composition, potentially impacting the quality and efficacy of medicinal materials. Based on the TCM concept of “identifying form to determine quality,” Academician Huang Luqi and Researcher Yuan Yuan (China Academy of Chinese Medical Sciences) proposed that Dao-di herbs (geo-authentic medicinal materials) should exhibit “Three Excellence” characteristics. Their team conducted a genetic-level comparison between wild and cultivated American ginseng. They identified structural differences in the genetic makeup of wild and cultivated American ginseng and found that Expansin-like proteins regulate both root morphology and the accumulation of ginsenoside Rg1 by balancing cell development and metabolite synthesis. This dual regulation enables targeted improvement of shape and quality traits in cultivated ginseng. Their findings were published in 2024 in Plant Biotechnology Journal and Science Bulletin. The findings provide a model for elucidating trait and quality changes in domesticated TCMs at the molecular level, based on the concept of “optimal shape and optimal quality.” They also offer a methodological foundation for exploring the mechanisms underlying the formation of geo-authentic characteristics in TCMs. 5. Progress in biosynthesis of trace bioactive components in TCMs using integrated multidimensional data platforms Bioactive components in TCMs represent a rich source for natural drug discovery, yet many of them occur in trace amounts and are difficult to synthesize chemically. The rise of synthetic biology and related biotechnologies has created new opportunities for the heterologous production of these components. Led by Academician Huang Luqi and Researcher Guo Juan (China Academy of Chinese Medical Sciences), the molecular pharmacognosy research team established an integrated multidimensional omics platform by consolidating genetic data from medicinal plants. They built a biosynthetic component library containing over 1000 biosynthetic gene modules for bioactive components in TCM and developed a gene function analysis system based on multiomics data and integration of multiple biological systems. This comprehensive platform has enabled the high-efficiency heterologous production of representative trace bioactive components such as terpenoids and alkaloids. The team’s findings were published in 2024 in Nature Communications, ACS Catalysis, Acta Pharmaceutica Sinica B, iMeta, and the Journal of Integrative Plant Biology. This work offers a new solution for the efficient, heterologous, and environmentally sustainable production of bioactive ingredients in TCMs. 6. Biosynthetic pathways and antiviral mechanisms of benzylisoquinoline alkaloids Benzylisoquinoline alkaloids are a class of components in TCM with notable antiviral activity. However, their complex stereochemical structures and low natural abundance in source plants make chemical synthesis difficult, which has significantly constrained drug discovery and the sustainable utilization of these medicinal resources. Academician Chen Shilin (Chengdu University of Traditional Chinese Medicine), Prof. Xu Anlong and Prof. Wang Yao (Beijing University of Chinese Medicine), and Prof. Xu Zhichao (Northeast Forestry University) carried out systematic research on benzylisoquinoline alkaloids derived from traditional medicinal herbs such as Stephania japonica (Thunb.) Miers and Menispermum dauricum DC. Using a herbal genomics-based research system, the team screened for antiviral active ingredients, elucidated their biosynthetic pathways, and clarified, through both in vivo and in vitro studies, the scientific mechanisms by which these components modulate antiviral immune metabolism at the cellular level and enhance the body’s antiviral immune responses. Their research identified novel antiviral drug candidates such as cepharanthine and tetrandrine, which exhibit broad-spectrum efficacy, clear pharmacological activity, and favorable safety profiles. The findings were published in 2024 in Science Advances, Nature Communications, and Advanced Science. This progress provides new ideas and a solid scientific foundation for the development of novel antiviral drugs and the improvement of current antiviral therapies. 7. New Progress in the demonstrative application of artificial intelligence in TCM Applying artificial intelligence (AI) to uncover the scientific principles of TCM and enhance its clinical efficacy presents both a significant opportunity and a major challenge for the inheritance and innovation of TCM. Led by Prof. Li Shao (Tsinghua University; European Academy of Sciences and Arts), the research team developed and launched the UNIQ system, a core research and development platform that integrates TCM with AI. The system establishes a multilevel network encompassing phenotypes, cells, molecules, and medicinal compounds, enabling a panoramic analysis of TCM mechanisms. Based on this platform and big data, the team developed a multimodal, multiomics AI algorithm (AI-TWM), which uncovered diagnostic and therapeutic patterns related to the progression from gastritis to gastric cancer. They also constructed an intelligent recognition system for the extremely early stage of gastric cancer, providing crucial support for early risk warning, prevention, and treatment. The results were published in Cancer Discovery in 2024 and received the Grand Prix and Double Gold Medal at the International Exhibition of Inventions of Geneva. This advancement demonstrates the feasibility of AI-assisted integrative TCM and Western medical therapies and serves as a model for AI-driven disease prevention and drug discovery in TCM. As research technologies evolve rapidly, a key challenge remains in identifying the molecular targets and responsive cell populations underlying the pharmacological effects of TCM compounds. Addressing this, Profs. Cheng Yiyu, Fan Xiaohui, and Wang Yi (College of Pharmaceutical Sciences, Zhejiang University) integrated AI algorithms such as pedestrian reidentification and random walk analysis to build a large-scale dataset of mitochondrial dynamic phenotypes in cardiomyocytes under drug intervention. They independently developed new tools including MitoReID, scRank, and scCube, successfully identifying the responsive cell types and molecular targets of TCM bioactive components such as tanshinone IIA and epicatechin. These tools overcame the limitations of conventional omics approaches in resolution and throughput, enabling intelligent target identification using phenotypic and single-cell transcriptomic data. The research was published in Nature Computational Science, Nature Communications, and Cell Reports Medicine in 2024, and led to 2 invention patents and 1 software copyright. This progress provides new tools for large-scale omics research and new methodologies for interpreting the scientific basis of TCM. 8. Preliminary development and application of an integrated evidence chain approach for evaluating the efficacy of TCM The conventional efficacy evaluation model for TCM, which relies primarily on randomized controlled trials, does not fully address the systematic evidence needs of TCM clinical practice. There is an urgent need to develop new research models and methodologies that align more closely with the principles and clinical characteristics of TCM. To address this, a team led by Prof. Xiao Xiaohe (PLA General Hospital), in collaboration with Academician Chen Xiangmei, Prof. Wang Jiabo (Capital Medical University), and Prof. Dai Aiguo (Hunan University of Chinese Medicine), proposed and established a new evaluation strategy known as the Integrated Evidence Chain Approach. This approach integrates evidence from multiple levels and sources, including clinical experience (preliminary evidence), experimental studies (supporting evidence), and clinical trials (confirmatory evidence). The methodology was validated through clinical case studies, and the results were published in 2024 as the cover article of China Journal of Chinese Materia Medica and in Acta Pharmaceutica Sinica B. In parallel, the team led by Prof. Zhang Junhua (Tianjin University of Traditional Chinese Medicine) developed a technical framework for the construction and evaluation of TCM evidence chains. By using a core set of indicators, the framework links research evidence across clinical, animal, cellular, and molecular levels, thus linking clinical evidence with basic scientific mechanisms. Using the “Three Drugs and Three Formulas” as a demonstration case, the team completed practical verification of the framework. Together, these efforts mark the initial establishment of a strategy, methodology, and standard system for efficacy evaluation that is well-suited to the characteristics of TCM. 9. Breakthrough in revealing hidden components and active substances in TCM using innovative technologies Due to longstanding technical limitations, many unrecognized components remain in TCM, and the pharmacologically active material basis of these medicines has yet to be fully clarified. Prof. Gao Hao (Jinan University) and his team developed several innovative technologies, including a method for distinguishing apparently equivalent diastereomers and a theoretical chemical space mapping strategy guided by biosynthetic rules. These technologies were successfully applied to commonly used TCM such as Lycii Fructus and Angelicae Sinensis Radix. The team discovered and named new structural classes of compounds, including phthalide-based oligomers represented by falcarinphthalide and phenylpropionyl fatty amines represented by lycibarbarspermidine. They completed the biomimetic synthesis of falcarinphthalide, elucidated the biosynthetic pathway of lycibarbarspermidine, and achieved its heterologous expression, thereby providing a robust chemical foundation for innovative drug development. The research findings were published in 2024 in ACS Central Science, Nature Communications, and other journals. The principle and methodology for distinguishing apparent-equivalent nonenantiomeric isomers proposed by the team were also included in the third edition of the textbook Natural Medicinal Chemistry (Science Press). This achievement offers a new methodological approach and a practical example for elucidating the bioactive substances in TCM. 10. Targeted release of antitumor TCM active components via novel drug delivery systems The therapeutic potential of TCM in treating malignant tumors, including improving clinical efficacy and reducing adverse effects, has been limited by the poor solubility, low bioavailability, and insufficient targeting ability of many active ingredients. To address these challenges, the team led by Prof. Zhang Tong (Shanghai University of Traditional Chinese Medicine) developed efficient tumor-targeting nanodrug delivery systems, including saponin-based liposomes that integrate both medicinal and delivery functions, and biomimetic delivery systems based on cell membranes. Guided by the TCM principle of “strengthening body resistance to eliminate pathogenic factors,” the team achieved targeted delivery of representative active ingredients. These included ginsenoside Rg3, a tonifying agent that reinforces the body’s vital energy, as well as gambogic acid and bufalin, which embody the TCM concept of “fighting toxin with toxin.” These delivery systems enabled precise transport of the compounds to tumor tissues and metastatic sites, thus enhancing antitumor immunity, alleviating tumor hypoxia, and promoting vascular normalization. As a result, they helped overcome challenges such as resistance to small-molecule targeted therapies and poor responses to immunotherapy. The research was published in 2024 in Advanced and Advanced This progress highlights novel drug delivery systems can enhance the efficacy of antitumor TCM components and offers new strategies for the development of innovative antitumor of of source This work was by from the of of and in the of Traditional Chinese Medicine not to this article as were the current