Jinzhen oral liquid in pediatric respiratory diseases: Multi-Target mechanisms, quality control, and clinical translation

• Multi-Target Mechanisms : Jinzhen Oral Liquid (JZOL) exerts broad therapeutic effects in pediatric respiratory diseases via suppression of TLR4/NF-κB signaling, dual TRPV1/TRPA1 channel inhibition, and gut–lung axis modulation. • Clinical Benefits : JZOL effectively treats acute bronchitis, Mycoplasma pneumoniae pneumonia, hand-foot-and-mouth disease, and COVID-19, reducing antibiotic/glucocorticoid use, shortening fever duration, and improving outcomes. • Quality Standardization : HPLC, metabolomics, and network pharmacology identify robust quality markers (Q-markers), ensuring consistent production and standardization of JZOL. • Integrated Pharmacological Actions : JZOL exhibits anti-inflammatory (via TLR4/NF-κB and MAPK pathways), antitussive (TRPV1/TRPA1 blockade), broad-spectrum antiviral (including SARS-CoV-2), and gut microbiota-modulating effects, enriching beneficial bacteria (e.g., Akkermansia, Lactobacillus spp. ) and regulating glycerophospholipid metabolism. • Future Research Directions : Emphasizes the need for multi-omics integration, rigorous clinical trials, and exploration of synergistic mechanisms to further validate JZOL's efficacy and safety across diverse populations, promoting its global adoption and reducing antibiotic resistance. Jinzhen Oral Liquid (JZOL) , a traditional Chinese medicine prescription (TCMp) comprising eight herbal components, exhibits a multifaceted therapeutic profile through TLR4/NF-κB suppression, dual TRPV1/TRPA1 channel inhibition, and gut-lung axis modulation. Clinically, JZOL has demonstrated efficacy in managing pediatric respiratory diseases, including acute bronchitis, Mycoplasma pneumoniae pneumonia, hand-foot-and-mouth disease, and COVID-19. This review synthesizes recent advances in quality control strategies—such as the identification of quality markers (Q-markers) via high-performance liquid chromatography (HPLC) and metabolomics—and mechanistic studies elucidating its multi-target actions. Key mechanisms include inhibition of TLR4/NF-κB and MAPK signaling to reduce pro-inflammatory cytokines (e.g., TNF-α, IL-6), dual TRPV1/TRPA1 blockade to alleviate neurogenic cough, and gut microbiota modulation via the gut-lung axis. Clinical trials further support JZOL as a safe and effective adjuvant therapy, demonstrating reduced antibiotic and glucocorticoid dependence and shorter fever duration. While challenges persist in mineral characterization and trial design, this review underscores the integration of TCM with modern science to advance its global adoption. Future research should prioritize multi-omics integration, rigorous clinical validation, and exploration of synergistic mechanisms.