Editorial: Clinical phytopharmacology

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Editorial on the Research Topic Clinical phytopharmacologyIt is now outdated to state, as many medical doctors still do, that "there is no evidence for herbal medicines".Since the new millennium, there has been a great increase in the number of clinical trials of medicinal plant preparations, and systematic reviews, some of which show promising results (Davidson et al., 2013;Timmer et al., 2013;Hu et al., 2017;Anheyer et al., 2018; Willcox et al., 2021b;Chattopadhyay et al., 2022).The Research Topic of papers in this Research Topic bears testimony to the many studies assessing medicinal plant preparations in a clinical context.While only five are formally included in the Research Topic, Frontiers in Pharmacology has published a large number of clinical studies and systematic reviews and meta-analyses.However, progress has slowed down since the COVID-19 pandemic, as many trials were postponed.The increased use of remote consultations also made recruitment more difficult for trials which require face-to-face clinical assessment (Willcox et al., 2023).This might explain why this special Research Topic had relatively few submissions.We hope that this downturn has been temporary and that clinical trials of promising herbal medicines will again be prioritised.High-quality randomised controlled clinical trials (RCTs) are essential for determining the effectiveness and safety of any treatment.They form the basis for systematic reviews and meta-analyses which inform evidence-based clinical guidelines for health workers (Chattopadhyay et al., 2023).Many studies on herbal medicine assess activity using invitro effects or animal models, but their results do not correlate very well with results from clinical trials (Willcox et al., 2011).In vitro studies may produce "false positive" results if the substances active in vitro are poorly bioavailable or are converted to inactive metabolites in humans.Conversely, they can produce "false negative" results if the active substances in humans are metabolites, and their parent compounds are inactive.Many animal models also produce misleading results as their metabolism and diseases differ significantly from those of humans.For example, penicillin is toxic to guinea pigs and may never have been deemed safe to use in humans, if it had first been tested in guinea pigs rather than mice (Stuart and Slavin, 1951).Many natural products which are very safe for human