Recently, the research team led by Professor Chen Zhong and Researcher Xu Cenglin from Zhejiang Chinese Medical University (ZCMU) made significant progress in the treatment of drug-resistant epilepsy with traditional Chinese medicine (TCM). Their latest study, titled “Gardeniae Fructus extract terminates refractory status epilepticus with a wide time window through inhibiting neuroinflammation,” was published in the prestigious journal Phytomedicine.

The research demonstrated that Gardeniae Fructus, a TCM herb known for its “clearing heat fire” effect, can effectively terminate refractory status epilepticus (SE)—a severe and often fatal form of epilepsy—by inhibiting neuroinflammation mediated by high mobility group box-1 (HMGB1). The treatment also showed a relatively wide therapeutic window. This is the first study to scientifically confirm the therapeutic potential of Gardeniae Fructus in treating drug-resistant SE and to provide a modern pharmacological interpretation of its traditional “clearing heat fire” properties.

Status epilepticus (SE) is a medical emergency characterized by prolonged or repeated epileptic seizures, often resulting in high mortality and morbidity. The standard first-line treatment is intravenous administration of benzodiazepines diazepam (DZP). However, DZP must be administered within a very narrow time window to be effective and is often associated with rapid development of drug resistance. Hence, there is an urgent need to develop new drugs and therapeutic strategies to terminate drug-resistant SE.

Gardeniae Fructus was first recorded in the ancient Chinese pharmacopoeia Shennong Bencao Jing (Shennong’s Classic of Materia Medica). Bitter in taste and cold in nature, it is believed in TCM to act on the heart, lung, and sanjiao meridians. It is traditionally used for purging fire and relieving irritability, clearing heat and promoting diuresis, cooling blood and detoxication.

In this study, researchers prepared a Gardenia extract (GE) using a distillation method. They found that GE alone significantly reduced the severity of seizures in a drug-resistant SE model. Further investigation revealed that GE terminates seizures by inhibiting HMGB1-mediated excitatory synaptic transmission, thus providing new insight into the modern mechanism of its traditional “clearing heat fire” effect.

The first author of the paper is Sun Minjuan, a Ph.D. student from the School of Pharmaceutical Sciences of ZCMU; Yuan Zhijian, a master’s student from the School of Pharmaceutical Sciences, and Li Menghan, a technician at the Academy of Chinese Medical Sciences of ZCMU, are co-first authors. Professor Chen Zhong and Researcher Xu Cenglin are corresponding authors. Researcher Cao Gang from the School of Pharmaceutical Sciences and Professor Ji Xuming from the School of Basic Medical Sciences also contributed significantly to the study. The project was supported by grants from the National Natural Science Foundation of China and Zhejiang Provincial Natural Science Foundation.