ABSTRACT Aconiti Radix, the dried root of Aconitum carmichaelii Debeaux, is a cornerstone of traditional Chinese medicine. Aconiti Radix embodies a dual “poison‐medicine” nature, primarily attributed to its diterpenoid alkaloids (DAs). Structurally, these compounds are categorized as C18, C19, and C20 types based on their carbon skeletons. In this review, we propose a novel “mechanism‐to‐application” framework to organize the current knowledge on Aconiti Radix Ads., bioactive constituents. We decipher how the structural features of DAs dictate their interactions with fundamental biological targets, such as ion channels and inflammatory pathways, thereby underlying their analgesic, anti‐inflammatory, and cardiotoxic effects. Crucially, we reframe these mechanisms within a translational context: the neurotoxicity that underlies analgesia is repurposed as a potential basis for insecticidal activity, while the membrane‐disruptive properties linked to cytotoxicity are harnessed for their antimicrobial potential against plant pathogens. Finally, we address strategies for detoxification and the hurdles in translating these potent compounds into safe therapeutics or sustainable agrochemicals. We argue that overcoming these challenges requires a deep mechanistic understanding, which is a prerequisite for unlocking the full therapeutic and agricultural potential of Aconiti Radix.
Shen et al. (Thu,) studied this question.
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