Herbs have been a vital renewable source of medicine throughout human history as a large proportion of the global population still depends on them for their health benefits. The increasing popularity of herbal supplements has raised an obvious concern about the overall safety and potential interaction with other drugs in situ. The intent was to spur future research on herb-drug interactions as well as the mechanisms of interaction to understand the consequences of such interactions. The review was conducted by a systematic search of relevant literature using the databases of Google Scholar, Science Direct, Mendeley, Scopus, and PubMed. Publications written in English were used. Many herbal products are reported to exhibit herb-drug interaction with known orthodox medicines. The inhibition-induction mechanism triggers chain reactions which often result in reduced drug bioavailability, toxicities, or undesirable side effects. Some herbal phytoconstituents reportedly bind CYP2C9, CYP2C19, CYP2E1, and CYP3A1 among numerous others temporarily or irreversibly. The study was concluded by reiterating the imperativeness to routinely and regularly inform both physicians and patients of the inherent dangers such as reduced efficacy and increased toxicities associated with herb-drug interactions (HDI). Herb users should be regularly advised on the appropriate use of herbal supplements to avoid the risk of adverse drug interactions during co-administrations or in combination therapies. As both synergistic and antagonistic effects could be observed in HDI, further preclinical and clinical empirical studies are required to underscore the mechanism and extent of HDI.

Chronic apical periodontitis represents dynamic continuation of the presence of endodontic infection in the root canal system of the tooth, when the innate and acquired immune responses are activated and various cells and inflammatory mediators are recruited, which cause the consequent destruction of periapical tissues and the development of periapical lesions. The aim of the study was to analyze the concentration of IL-8 in tissue homogenates of periapical lesions and to compare the obtained results with the symptomatology of the patients and the size of the lesion. A total of 93 tissue samples of chronic periapical lesions were analyzed in this study. In relation to the clinical symptoms, the samples were divided into symptomatic and asymptomatic, and according to the size, into large and small lesions. The concentration of IL-8 was examined using an ELISA test. The results showed a significantly higher concentration of IL-8 in symptomatic periapical lesions compared to asymptomatic ones (p < 0.001). The concentrations of this chemokine was also significantly higher in the large lesions when compared to the small ones (p < 0.001). The elevated concentration of IL-8 in periapical lesions with pronounced clinical symptomatology as well as in large lesions specify that IL-8 is a dominant chemokine that contributes to the development of periapical inflammation and clinical progression of periapical lesions.