Spotlight on the accumulation of heavy metals in Traditional Chinese medicines: A holistic view of pollution status, removal strategies and prospect

The accumulation of heavy metal in circulating TCMs has attracted widespread attention because the security and therapeutic efficacy are inevitably imperiled by the survival ecological environment and human production activities. How to reduce the pollution level and improve the toxicity damage becomes an urgent issue. This article provides a comprehensive overview of the current status of heavy metal contamination over a thousand types of single herbal (botanical, animal and mineral medicines) and TCM preparations published over nearly two decades. The survey revealed that growth ecosystems (soil, water sources), anthropogenic factors (harvesting, processing, storage), specific varieties and medicinal parts utilized as well as the inherent resistance capacity are the key factors that affect the accumulation of heavy metals in TCMs. And Pb, Cu and Cr are the major cumulative elements for botanicals, while mineral and animal medicines are dominated by As and Cu elements, respectively. Ongoing efforts aimed at mitigating the level and translocation rate of heavy metals by optimized cultivation processes, appropriate processing methodologies and advanced adsorption techniques are effective removal strategies. And the prospects of TCMs as a detoxifying agent for heavy metal toxicity damage posed development potential. Besides, the correlation between the speciation of arsenic (As) and chromium (Cr) and their toxicity should also be elaborated in order to provide effective references for standardizing drug dosage and cycle. And the imperative from the perspective of improving limitations standards of HMs for animal medicines, external preparations and folk medicines as well as exploring the interaction mechanisms between heavy metals and active ingredients of TCMs provides the direction for the follow-up study.