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Zoology, chemical composition, pharmacology, quality control and future perspective of Musk (Moschus): a review


Musk, the dried secretion from the musk sac gland which is located between the navel and genitals of mature male musk deer, is utilized as oriental medicine in east Asia. It has been utilized to treat conditions such as stroke, coma, neurasthenia, convulsions, and heart diseases in China since ancient times. This paper aims to provide a comprehensive overview of musk in zoology, chemical composition, pharmacology, clinical applications, and quality control according to the up-to-date literature. Studies found that musk mainly contains macrocyclic ketones, pyridine, steroids, fatty acids, amino acids, peptides, and proteins, whilst the main active ingredient is muscone. Modern pharmacological studies have proven that musk possesses potent anti-inflammatory effects, neuroprotective effects, anti-cancer effects, antioxidant effects, etc. Moreover, muscone, the main active ingredient, possesses anti-inflammatory, neuroprotective, antioxidant, and other pharmacological effects. In the quality control of musk, muscone is usually the main detection indicator, and the common analytical method is GC, and researchers have established novel and convenient methods such as HPLC-RI, RP-UPLC-ELSD, and Single-Sweep Polarography. In addition, quality evaluation methods based on steroids and the bioactivity of musk have been established. As for the identification of musk, due to various objective factors such as the availability of synthetic Muscone, it is not sufficient to rely on muscone alone as an identification index. To date, some novel technologies have also been introduced into the identification of musk, such as the electronic nose and DNA barcoding technology. In future research, more in vivo experiments and clinical studies are encouraged to fully explain the pharmacological effects and toxicity of musk, and more comprehensive methods are needed to evaluate and control the quality of musk.


Natural musk is the dried secretion from the musk sac gland which located between the navel and genitals of mature male Moschus berezovskii Flerov (Forest musk deer), Moschus sifanicus Przewalski (Alpine musk deer), or Moschus moschiferus Linnaeus (Siberian musk deer) of the Cervidae family [1,2,3]. Natural musk is initially recorded in Shen Nong’s Classic of the Materia Medica (Shen Nong Ben Cao Jing). It possesses the efficacy of opening the orifices (resuscitating), invigorating blood and promoting menstruation, relieving swelling and pain. Meanwhile, it has been utilized as a kind of medicine to treat stroke, coma, neurasthenia, convulsions, heart diseases, ulcerous sores, and other conditions for 2000 years in China [2, 4, 5]. Because of its potential efficacy, musk is often used in combination with other traditional Chinese medicines to treat diseases. For example, Xihuang Wan, containing Bovis calculus, Olibanum, Myrrha, and Moschus, is a traditional prescription for clearing heat and detoxifying, reducing phlegm and resolving masses, promoting blood circulation and eliminating swelling, as well as removing stasis and relieving pain. It is mainly used to treat breast cancer, buboes, scrofula, subcutaneous nodule, deep multiple abscesses, pulmonary abscess, and small intestinal abscesses [1]. In addition to being used for medicinal purposes, natural musk has been used in the perfume industry for hundreds of years in Europe, due to the low output and wide application of natural musk, it cost five times as much as gold once in Europe, and now is prohibitively so [6, 7].

As the source of the natural musk, geographically, musk deer are mainly distributed across at least 13 countries in Asia (Fig. 1). To date, seven species have been discovered in the aggregate worldwide, while the specified sources of natural musk in Chinese Pharmacopoeia (2020 edition) are Moschus berezovskii Flerov, Moschus sifanicus Przewalski, and Moschus moschiferus Linnaeus [1, 8]. Traditionally, people had to kill musk deer to obtain musk in the past, which eventually led to a steep decline in the population of musk deer in the past 3–4 decades [9]. One study estimated that the musk deer population in China was no more than 0.1 million by the end of the last century, while that in the 1950s was 2.5 million [10]. According to data from the International Union for Conservation of Nature, six out of the seven species are endangered [8, 10, 11]. Moreover, the population of 7 species of musk deer is still decreasing [6, 12]. Accordingly, they are currently listed in Appendix I in the Convention on International Trade in Endangered Species of Wild Fauna and Flora and Category I of the State Key Protected Wildlife List of China [8, 13]. To ensure the sustainable use of natural musk, the Chinese Government stipulated that only 4 Chinese patent medicine are allowed to use natural musk during preparation, namely Angong Niuhuang Pill, Liushen Pill, Babao Dan, and Pien Tze Huang. Also, the group led by the Institute of Materia Medica Chinese Academy of Medical Science developed artificial musk, a musk-like mixture mainly containing synthetic muscone and other substitutes, in 1993 in China in response to the shortage of natural musk [14]. Moreover, the group won the first prize of the National Science and Technology Progress Award in 2015. However, the specific details are not known since the method of manufacturing artificial musk is a state secret. Modern pharmacological and biological experiments had shown that artificial musk has similar activities and indications as natural musk [2, 15]. Meanwhile, farming became a vital way to protect musk deer and the only legal way to obtain the natural musk. The farming of musk deer started in 1958 and preserving the wild populations at the same time in China, and expansion of musk deer farming has been made from then on [3, 16].

Fig. 1
figure 1

Countries where musk deer are distributed

In this paper, the zoology, chemical composition, pharmacological properties, toxicity, pharmacokinetics, and quality control of musk are reviewed. Relevant information about musk and musk deer was collected from the website about Big Data of Traditional Chinese Medicine, the Official website of an international organization. Relevant literature on musk was collected from scientific databases including PubMed, ScienceDirect, Web of Science, Springer, Wiley, and CNKI, spanning the years 1906–2020. The purpose of this review is to summarize the relevant information of musk with emphasis on its pharmacological activities and quality control, so as to provide more up-to-date information and inspiration for future research.


The musk deer is a kind of protected and economical animal in China (Fig. 2). Alpine musk deer body hair is sandy brown, the rear is brown. Its body hair is tan and the hair on the back end of the ear is brown. Of the three animals that are sources of musk, the forest musk is the smallest, they weigh 7 to 9 kg and are 70 to 80 cm long, followed by the Siberian musk deer (9–13 kg and 70–90 cm long) and then the Alpine musk deer (10–15 kg and 80–90 cm long). Male ones of the three species possess well-developed canines that expose outside the lips. The canines of the Alpine musk deer are wider than those of the Forest musk. Their snouts are not the same length, the snout of Forest musk deer is short, but the snout of Alpine musk deer is longer. Forest musk deer is similar in shape and hair color to Siberian musk deer. Its hair color is gray-brown or dark brown and darker than that of Siberian musk deer and Alpine musk deer, meanwhile, the hair color on its hip is much deeper and the stripes under its neck are obvious. The hair on the back end of the ear is brown and that on the base of the ear and within the auricle is white or yellowish-white. There is no spot on the back of the mature male Forest musk deer. Adult Alpine deer has 4–6 large brown patches on the back of the neck, with a few fuzzy spots on the rear. The hair on the jaw is white and stripes under the neck are light yellow or off-white. Adults of Siberian musk deer distributed in northeastern China and the Dabie Mountains in Anhui have cinnamon-colored spots. The hair color of deer distributed in the Qinling Mountains and west of Sichuan is darker and without spots. The stripes around the neck are obvious, and there are spots on that of cubs. The tails of all three species of musk deer are short and hidden in the fur [17, 18].

Fig. 2
figure 2

Musk deer and musk. A Moschus berezovskii Flerov, B Moschus sifanicus Przewalski, C. Moschus moschiferus Linnaeus, D. Musk, E. Musk sachets

Musk obtained from wild musk deer is soft, oily, and loose. The surfaces of irregular spherical or granular ones are mostly purple-black, oily, and shiny, with a few lines, and the section is dark brown or yellow–brown. The powdery ones are mostly tan or yellow–brown, and consist of a small amount of fine hair and shed inner membrane. Musk obtained from domestic musk deer is granules, short strips, or irregular clumps. The surface of these clumps is uneven, purple-black or dark brown, oily, slightly shiny, with a small amount of hair and shed inner membrane. Musk possesses an intense and peculiar aroma and tastes slightly spicy, slightly bitter, and salty [1].

Chemical composition

Forest musk deer is the most widely distributed and most farmed species in China. In addition, after a literature search, it was found that researchers have studied the chemical composition of forest musk the most, therefore, this section will discuss forest musk. The composition of natural musk is complex and variable [19]. It mainly contains macrocyclic ketones, pyridine, steroids, fatty acids, amino acids, peptides, and proteins [2, 19,20,21]. Moreover, the active ingredients in musk are mainly macrocyclic ketones, steroids, and some peptides. Some chemical structures of active components in musk are shown in Fig. 3.

Fig. 3
figure 3

Chemical structures of some cyclic ketones and steroids in musk

Macrocyclic ketones

Muscone (3-methylcyclopentadecan-1-one) (1), one of the macrocyclic ketones, was isolated by Walbaum in 1906 and characterized by Ruzicka et al. in 1926 [22,23,24]. After decades of research, it is considered as the major medicinal active and odor-contributing ingredient of natural musk [21, 22, 25,26,27]. Moreover, 4-methylcyclopentadecan-1-one (2), normuscone (cyclopentadecanone) (3), cyclotetradecanone (4), 3-methylcyclotridecan-1-one (5), cyclohexadec-8-en-1-one (6), cyclododecanone (7) have been isolated from musk [21].


Steroids in musk are variable and they are the second-largest lipid component in musk, and these compounds contain many androstane derivatives, with which the androgenic effects of musk are closely linked [19,20,21]. Some steroids have been isolated from musk thus far, such as Cholesterol (8), Cholestan-3-ol (9), Cholest-7-en-3β-ol (10), 3α-hydroxy-5β-androstan-17-one (11), 3-ethyl-3-hydroxy-5α-androstan-17-one (12), 5α-androstane-3α,17β-diol (13), 4α-methyl-5α-cholest-8(14)-en-3β-ol (14), 3,11-dihydroxy-(3α,5β,11α)-androstan-17-one (15), 3-acetate, (3β,17β)-androst-5-ene-3,17-diol (16), 3α-hydroxyandrost-4-en-17-one (17), 3α-ureido-androst-4-en-17-one (18), 4,6-cholestadien-3β-ol (19), 4α-methyl-5α-cholest-7-en-3β-ol (20), 5β-cholestan-3α-ol (21), 5β-androstan-3α,11α,17β-triol (22), 22,23-Dibromostigmasterol acetate (23), Androsterone, trifluoroacetate (24), Cholest-5-ene-3,16,22,26-tetrol (25), Cholesta-3,5-diene (26), lanosterol (27), and dehydroepiandrosterone sulfate (28) [21].

Pharmacological effects

According to relevant literature, musk and its main active ingredient, muscone, possess various pharmacological effects such as anti-inflammatory activity, neuroprotective activity, and cardiovascular-protective activity. All the specific details are shown in Table 1 and some relevant molecular mechanisms are depicted in Figs. 4, 5, 6.

Table 1 Pharmacological activities of musk
Fig. 4
figure 4

The mechanisms of musk against inflammatory diseases

Fig. 5
figure 5

The neuroprotective effect of musk

Fig. 6
figure 6

The protective effect of musk against microglial cell inflammation

Anti-inflammatory effects

Inflammation is a kind of biological function triggered by the rupture of mechanical tissue or the reaction caused by physical, chemical, or biological agents in the body. The diseases associated with inflammation include cardiovascular disease, arthritis, cancer, diabetes, Alzheimer's disease, Parkinson's disease, etc. [30]. Studies have shown that the anti-inflammatory effect of traditional Chinese medicine (TCM) is achieved by inhibiting the expression of master transcription factors, pro-inflammatory cytokines, chemokines, intercellular adhesion molecules, and pro-inflammatory mediators [31]. Modern studies have proven that natural musk is an anti-inflammatory agent [32, 33] and some molecular mechanisms are depicted in Fig. 4.

Subcutaneous injection of musk Tween 80 emulsion could reduce croton oil-induced inflammatory response in male albino rats [32]. Taneja et al. [34] investigated the inhibitory effect and mechanism of musk on acute and chronic inflammation models, including the carrageenan-induced edema and formalin arthritis model. The mechanism study indicated that the anti-inflammatory effect of musk may be related to the reduction of histamine and 5-hydroxytryptamine (5-HT) content in inflammatory tissues. Another study also showed that musk has antihistamine and anti-5-HT effects [35]. Moreover, the aqueous extract of musk residues that have been extracted with diethyl ether and 95% ethyl alcohol and a polypeptide (musk-1) with a molecular weight less than 10,000 Da in this extract have also attracted great interest from researchers [36, 37]. In the early stage, Zhu et al. found that intravenous administration of the aqueous extract and musk-1 counteracted effectively croton oil-induced ear inflammation in mice, respectively [37]. Further studies demonstrated that this aqueous extract was effective in a variety of inflammatory models. In addition, the anti-inflammatory effect of intravenous musk-1 on croton oil-induced ear inflammation in mice was 36 times greater than that of hydrocortisone [38]. Moreover, it indicated that musk could modulate the immune function of the body and the presence of adrenal glands is necessary for the anti-inflammatory effect of musk [38, 39]. Mechanism studies indicated that the aqueous extract could inhibit platelet aggregation and arachidonic acid metabolism pathway, increase cyclic adenosine monophosphate levels [39, 40]. Subsequently, Wang et al. conducted a series of experiments to study the anti-inflammatory mechanism of musk-1 using rat neutrophils as subjects. The results showed that musk-1 could inhibit 5-lipoxygenase activity in neutrophils [41], the release of lysozyme [42,43,44,45], and platelet-activating factor production and acetyl-CoA-dependent acetyltransferase activity [46]. Meanwhile, musk-1 could significantly inhibit the chemotactic response of neutrophils [47]. These effects may be important mechanisms for their anti-inflammatory effects.

Moreover, muscone was proved to possesses anti-inflammatory effects and utilized to treat inflammatory disorders. Excessive inflammation can lead to slow wound healing [48]. He et al. [49] investigated the regulatory mechanism of muscone on chronic wound inflammation. Muscone was found to significantly inhibit the expression of ICAM-1, VCAM-1, and CD44 on the surface of human umbilical vein endothelial cells (HUVEC), thereby inhibiting the adhesion of polymorphonuclear leukocytes to HUVEC to suppress excessive inflammation and promote healing of chronic wounds. Interleukin (IL)-1 initiates and controls the inflammatory response [50]. Studies demonstrated that overproduction of IL-1β played an important role in the pathogenesis of human intervertebral disc degeneration [51]. Liang et al. [52] studied the protective effect of muscone on vertebral end-plate degeneration. In vitro, muscone inhibited the IL-1β-induced phosphorylation of extracellular signal-regulated kinases 1/2 and c-Jun N-terminal kinase in a dose-dependent manner. In vivo, muscone inhibited the expression of prostaglandin E2, 6-keto-prostaglandin F1a, IL-1β, and tumor necrosis factor α and recovered the structural distortion of the degenerative disc. Moreover, the therapeutic potential of muscone on cervical spondylotic myelopathy (CSM) was evaluated by Zhou et al. In the chronic cervical cord compression rat model, muscone promoted motor recovery in rats. Molecular studies revealed that muscone could inhibit activation of the NLRP3 inflammasome, NF-κB, and Drp1 in lesions to attenuate inflammatory responses and neuronal damage in model rats [53]. In LPS-stimulated BV2 and primary microglial cells, muscone could inhibit the NLRP3 inflammasome and NF-κB activation to suppress mRNA levels of IL-1β, IL-6, and TNF-α and iNOS and Cox-2 protein expression [53]. These results indicated that the potential of muscone to treat CSM is due in part to its anti-neuroinflammatory effects. In addition, intraperitoneal injection of muscone could reduce inflammatory pain by blocking the NOX4/JAK2-STAT3 pathway and NLRP3 inflammasome, which can cause an inflammatory response [54].

Neuroprotective effects

Natural musk has the action of inducing resuscitation and has been utilized as a TCM in treating stroke, coma, neurasthenia, convulsions for thousands of years [4]. Modern studies have demonstrated the neuroprotective effects of musk. Ayuob et al. found that in a depression model, inhaling musk could improve behavioral changes, elevated serum glucocorticoid levels, memory impairment, neurodegenerative changes, and changes in salivary gland structure induced by chronic unpredictable mild stress [55,56,57,58].

In addition, the neuroprotective effects of muscone were evaluated by researchers (Figs. 5 and 6). Wang et al. demonstrated that muscone could change the permeability of the blood–brain barrier (BBB) model in vitro. The mechanism is related to reducing the expression of permeability glycoprotein (P-gp) and matrix metallopeptidase 9 (MMP-9) [59]. This may be one of the reasons why Muscone could cross the BBB to reach the lesion sitePlease do not break the line before the next sentence. Muscone has a therapeutic effect on cerebral ischemia. In vitro studies showed that muscone could inhibit glutamate-induced PC12 cell apoptosis [60]. A further mechanistic study suggested that this effect was attributed to muscone reducing reactive oxygen species (ROS) production and Ca2+ influx through NR1 and camki-dependent ASK-1/JNK/p38 signaling pathway [61]. Liang et al. found that in the MCAO rat model, muscone could effectively down-regulate the expression of EAAC1 mRNA to achieve its neuroprotective effect [62]. Moreover, the mechanism may also be related to reducing NR1 protein expression [63]. In addition, Sun et al. [64] demonstrated that muscone had an obvious neuroprotective effect on mice with complete cerebral ischemia. This protective effect attributed to the fact that muscone can increase the superoxide dismutase (SOD) content of the brain tissue of rats, reduce the malondialdehyde (MDA) content, reduce the increase of excitatory amino acids (EAA) content caused by ischemia and hypoxia, and inhibit the excitatory neurotoxicity caused by EAA. Fas is a death receptor and is of paramount relevance in stroke pathogenesis [65]. It is suggested that neutralizing FasL would be a great choice for stroke treatment. In cerebral ischemia rats, muscone exerted a neuroprotective effect through inhibiting apoptosis by suppressing the expression of Fas [66]. Post-stroke recovery is also important for patients and neural stem cells (NSCs) are of importance in this process. Muscone can promote neural stem cell proliferation and differentiation to protect against cerebral ischemia. This effect is attributed to the activation of the PI3K/Akt signaling pathway [67]. Cerebral ischemia is accompanied by edema, and this symptom may lead to death [68]. Muscone can alleviate edema of brain tissue in the ischemic area and significantly reduce the brain water content to play a protective role. In addition, muscone can also change the permeability of the BBB, reduce albumin exposure and leakage, and reduce the degree of edema of brain cells [69]. Jiang et al. [70] found that in the early period after traumatic brain injury, muscone could exert neuroprotective effects by inhibiting the expression of MMP-9 and reducing cerebral edema.

Moreover, muscone exerts protective effects against traumatic brain injury (TBI). Intranasal administration of muscone can promote the secretion of brain-derived neurotrophic factor and nerve growth factor by olfactory ensheathing cells to exert a neuroprotective effect [71]. Another study demonstrated that muscone exerted neuroprotective effects after TBI by activating the PKA-CREB signal pathway [72]. Cheng et al. studied the mechanism of anti-epilepsy activity of muscone and found that muscone blocked the expression of c-Fos and c-Jun in the brain during seizures, and this effect had a dose–effect relationship [73, 74]. Recently, He et al. proved that muscone could improve depression-like behavior in rats by repressing lipopolysaccharide (LPS)-induced neuroinflammation. The underlying mechanism may be its suppression of microglia activation and production of IL-1β through acting on TLR4/MyD88 and TLR4/NLRP3 as well as its blockade on the expression of RANTES and MCP-1 (monocyte chemotactic protein 1) via antagonizing renin/Ang II axis [25].

Taken together, the above findings suggest that musk has good neuroprotective effects and has great potential for treating neurological diseases. Some related molecular mechanisms are depicted in Figs. 5 and 6, and the details are summarized in Table 1.

Cardiovascular-protective effects

Cardiovascular disease is the deadliest disease worldwide, and its morbidity and mortality rates continue to rise. Studies have shown that some herbs or active ingredients in them have the potential to treat cardiovascular diseases, such as curcumin [75], baicalin [76], and berberine [77]. There is evidence that musk is also effective against cardiovascular disease. Quan et al. found that musk can play a protective role against H2O2-induced H9C2 cardiomyocytes injury by eliminating ROS and improving intracellular antioxidant enzyme activity [78]. Moreover, musk can play a protective role in H2O2-induced HUVEC injury by improving intracellular antioxidant enzyme activity and reducing oxidative stress [79]. Also, researchers investigated the effect of muscone on cardiovascular disease in vitro and in vivo. Hong et al. demonstrated that muscone can stabilize mitochondrial ΔΨm, reduce cell permeability and reduce Ca2+ influx, thereby inhibiting HUVEC cell apoptosis induced by H2O2 [80]. Zhou et al. [81] studied the application of muscone in random skin flap transplantation. Muscone can promote skin flap angiogenesis, activate VEGF expression, reduce apoptosis, increase SOD levels and decrease MDA levels. Therefore, muscone can improve the survival rate of skin flaps by anti-oxidation, anti-apoptosis, and promoting angiogenesis. Moreover, myocardial infarction (MI) is the leading cause of death and disability in developed countries, and a number of challenges remain in preventing and treating MI. Wang et al. found that muscone could improve cardiac remodeling and dysfunction caused by MI. The mechanistic study revealed that muscone could reduce the expression of transforming growth factor-β1 (TGF-β1), tumor necrosis factor-α (TNF-α), IL-1β, and nuclear factor-κB (NF-κB) to reduce the inflammatory response. Moreover, muscone could reduce myocardial apoptosis by upregulating the Bcl-2/Bax ratio. What’s more, the intervention of muscone significantly induced the phosphorylation of Akt and eNOS, which is related to vascular endothelial function [82]. Further, Du et al. demonstrated that muscone improved cardiac function in mice with MI by enhancing angiogenesis. The underlying mechanism of this effect was up-regulating hypoxia-inducible factor 1α (HIF-1α) and vascular endothelial growth factor A (VEGFA) expression levels [83]. Similarly, by reducing macrophage-mediated chronic inflammation, muscone can improve cardiac function in mice with MI. The mechanism was to inhibit the activation of NF-κB and NLRP3 inflammasome, thereby blocking the production of inflammatory cytokines (IL-1β, TNF-α, and IL-6) [84]. When cardiomyocytes were pretreated with muscone before I/R injury, the increase of LDH release, MDA production, creatine kinase activity, caspase-3 activity, [Ca2+]i, apoptosis rate and expression of Bax protein, and reduction of SOD activity, MMP, and expression of Bcl-2 protein can be alleviated. This suggested that muscone can protect I/R injury by inhibiting cellular oxidative stress and apoptosis [85].

Anti-cancer effects

Musk is widely used to treat cancer. It is included in many traditional Chinese medicine formulae for treating cancer, such as the Xihuang pill [86]. Xu et al. [87] studied the effects of musk and muscone on 22 types of tumor cells. It was found that musk and muscone could widely induce cancer cell growth inhibition and apoptosis. In a nude mouse model of blood stasis syndrome, muscone can significantly inhibit the growth of breast cancer. The mechanism may be related to the reduction of VEGF expression [88]. Qi et al. [89] found that muscone had a certain anti-cancer effect in hepatocellular carcinoma and this effect attributed to the induction of apoptosis and autophagy of liver cancer cells. The mechanistic study showed that apoptosis was a consequence of endoplasmic reticulum stress through the PERK/ATF4/DDIT3 signaling pathway, and autophagy was closely related to the AMP kinase/mTOR complex 1 signaling pathway. P-gp is a product of the multidrug resistance (MDR) gene, and the high expression of P-gp on the tumor cell membrane is the main mechanism of MDR formation [90]. Wang et al. used human colon carcinoma cell line Caco-2 as a target and proved that muscone can effectively inhibit the function of P-gp [91].

Promoting effect on stem cell therapy

Nowadays, mesenchymal stem cells (MSCs) are widely used in stem cell therapy [92]. Related reports have demonstrated that musk has the effect of promoting mesenchymal stem cell therapy and the details are summarized in Table 1. In vitro, muscone (3, 6, 9 mg/L) can enhance the proliferation of human gingival mesenchymal stem cells (GMSCs), and 6 mg/L of muscone had the best effect. In vivo, muscone can effectively inhibit osteoblast differentiation and promote GMSC proliferation, migration, and adipogenesis, which is attributed to the inhibition of the Wnt/β-catenin signaling pathway [93]. In a skull defect rat model, muscone (4.2, 8.4, 16.8 μL/100 g) could promote the migration of exogenous stem cells in vivo, and the effect was better at concentrations of 4.2 and 8.4 μL/100 g [94], and the mechanism was related to the promotion of BMSCs proliferation and osteogenic differentiation and the promotion of exogenous BMSCs migration in vivo [95, 96]. Studies have shown that the mechanism by which musk promoted the migration of exogenous bone marrow mesenchymal stem cells to the injury site may be related to its promotion of MCP-1 expression and SDF-1 (stromal cell-derived factor-1) expression in bone defects [97, 98]. Li et al. investigated the mechanism by which musk promotes the healing of bone defects in the skull of rats. The mechanism of musk promoted healing may be related to the increase of serum SDF-1 and hepatocyte growth factor (HGF) levels, the up-regulation of mRNA expression of stem cell factor (SCF), MCP-1, fibroblast growth factor 2 (FGF-2), TGF-β, and VEGF, as well as the down-regulation of mRNA expression of epidermal growth factor (EGF) [99,100,101,102]. Guo et al. found that muscone had a protective effect on femoral head necrosis caused by alcohol. In vitro, muscone had the potential to promote alkaline phosphatase (ALP) activity and mRNA expression of collagen 1 (COL1) and osteocalcin (OCN) in ethanol-treated hBMSCs. In vivo, muscone could restore BV/TV ratio and bone density of necrotic femoral heads [103]. In addition, in an acute kidney injury (AKI) model, muscone enhanced the therapeutic effect of bone marrow mesenchymal stem cells by promoting cell proliferation, secretion, and migration. The mechanism may be related to the expression of C-X-C chemokine receptor (CXCR) 4 and 7 up-regulation [104].

Other effects

In addition to the pharmacological effects mentioned above, other pharmacological effects of musk and muscone have also been reported, including inducing liver drug metabolism enzymes, antibacterial, etc. Muscone can induce certain P-450 isoenzymes, which in turn can alter the metabolism and endogenous substrates of drugs. Pretreatment with muscone (75 mg/kg) for 1 day can increase 2.8 times of benzophenantamine demethylase activity in rat microsomes [105]. Tanaka et al. studied the effect of muscone on rat liver microsomal drug metabolism enzyme system and other enzyme activity parameters in vitro and in vivo and found that muscone could induce liver metabolism enzymes [106]. Muscone mainly induced P450 IIB1 and P450 IIB2 with a slightly weaker effect than phenobarbital [107]. Recently, Phung et al. studied the preventive effect of muscone against cisplatin nephrotoxicity. In LLC-PK1 cells, muscone was proved to prevent cisplatin-induced oxidative stress, inflammation, and apoptosis. The mechanistic studies revealed that muscone could inhibit ROS accumulation and induce HO-1 expression to exert an antioxidant effect in cisplatin-treated LC-PK1 cells. Meanwhile, muscone could suppress the phosphorylation of p38, which may mediate production of TNF-α. Moreover, in cisplatin-treated LC-PK1 cells, muscone played an anti-apoptotic role by inhibiting p53, caspase-3, 7, and 8, and restoring the Bcl-2/Bax ratio [108]. In addition, the protective role of muscone in postmenopausal osteoporosis was evaluated by Zhai et al. [109] employing bone marrow monocytes, RAW264.7, and female C57BL/6 ovariectomized mice. In vitro, muscone inhibited osteoclastogenesis in BMMs and RAW264.7 cells. In vivo, the bone loss was prevented by muscone by suppressing osteoclastogenesis. The over-activated RANKL signaling pathways will promote the reproduction of osteoclasts. The molecular study demonstrated that muscone could reduce the levels of RANK and TRAF6, leading to the suppression of downstream NF-kB and MAPK signaling pathways.

Musk extract had inhibitory and bactericidal effects on the growth of pathogenic bacteria such as Staphylococcus aureus and Penicillium [110]. Saddiq studied the inhibitory effects of musk on five opportunistic pathogenic fungi, namely Aspergillus flavus, Aspergillus fumigates, Rhizopus stolonifer, Fusarium solani, and Candida albicans. Musk extract (25%) had an inhibitory effect on the above fungi, the inhibition rates were 74.61%, 68.76, 56.92%, 71.57%, and 67.80%, respectively. Subsequent animal experiments showed that musk extract can reduce lung toxicity caused by A. flavus [111]. AL-Jobori et al. studied the antifungal activity of musk in vitro. Five kinds of fungi were used, including Aspergillus fumigates, Aspergillus niger, Alternaria Spp., Trichomphyton mentagrophytes, and Fusarium Spp. All concentrations (25, 50, 75, or 100%) and amounts (1, 2, 4 mL) inhibited fungal growth and completely eliminated the fungi [112]. Meanwhile, musk also inhibited the activity of hydatid cyst [113]. Dong et al. demonstrated that muscone (0.1, 1, 10, 50 mol/L) could reduce high glucose-induced autophagy and apoptosis in RSC 96 cells, and its mechanism was to activate the AKT/mTOR signaling pathway [26].

Clinical application

Musk possesses a wide range of pharmacological effects. In modern clinical applications, musk and muscone are utilized to treat diseases and they are mostly used in combination with other Chinese herbal medicines. To date, many clinical trials have been listed in the global clinical trial registry ( and the Chinese Clinical Trial Registry (

Internationally, a total of 8 clinical trials related to musk have been registered, among which four are related to musk Shexiang Baoxin Pill (NCT01897805, NCT03072121, NCT04026724, NCT04022031), one is related to Mayinglong musk hemorrhoid ointment (NCT01881282), one is related to Gongjin-dan (NCT03219515), one is related to Qishe Pill (NCT01274936), and one is related to Angong Niuhuang Pill (NCT00817609). For example, the therapeutic effect and safety of compound carraghenates cream with Mayinglong musk hemorrhoid ointment in the treatment of hemorrhoids, especially regarding the relief of pain. The curative effect of Shexiang Baoxin Pill on coronary artery disease not amenable to revascularization based on western medicine therapy was evaluated. Of these, one trial has been completed (NCT01881282), five trials are of unknown status, and two observational trials related to Shexiang Baoxin Pill have not yet enrolled patients. But unfortunately, none of these clinical trials have published results.

In China, 15 clinical trials of Chinese patent medicines containing musk have been registered since 2012. These tests are mostly related to Shexiang Tongxin Dropping Pill (ChiCTR2000035167, ChiCTR2000032429, ChiCTR1900025810, ChiCTR-IPC-17010823, ChiCTR-IPR-16009785, ChiCTR-IPR-16008950, ChiCTR-IPR-15006020,) and Shexiang Baoxin Pill (ChiCTR2000041451, ChiCTR2000034817, ChiCTR1900027946, ChiCTR-TRC-10001237, ChiCTR-TRC-12003513). Moreover, all of these clinical trials are related to cardiovascular disease. For example, the Second Affiliated Hospital of the Second Military Medical University studied the therapeutic effect of Shexiang Tongxin Dropping Pill on myocardial perfusion among acute myocardial infarct patients (Shexiang Tongxin Dropping Pill). Recently, a clinical trial of Shexiang Baoxin Pill in the treatment of coronary microvascular dysfunction has been prospectively registered (ChiCTR2000034817). Furthermore, a trail of musk used to treat acute ST-elevation myocardial infarction has also been in preparation (ChiCTR2000037470).

Overall, clinical trials related to musk or Chinese patent containing musk are gradually increasing, especially in China, which is of great significance for more scientific and full utilization of musk.

Toxicity and safety

The related report indicated that muscone had toxic effects on zebrafish (AB = type) embryo development. Muscone (5, 10, 20, 40, 80, 100 μmol/L) had a lethal effect on zebrafish embryos. When the concentration of muscone reached 80 and 100 μmol/L, the embryo death rate reached 100% at 96 h after fertilization. High-dose muscone had a significant effect on zebrafish embryo development in a time- and dose-dependent manner, which mainly manifested as abnormal development of muscle tissue and heart tissue [114]. Muscone (0.005, 0.01, 0.03, 0.1, 0.2 mM) was toxic to zebrafish embryos by increasing Myh6 and Myh7 mRNA expression and reducing thyroid genes (Trh, Thrβ, and Dio3) expression [115]. Muscone could induce CYP1A2 and CYP3A4 expression in liver cells in vitro and in vivo. In addition, when the dose exceeded 50 mg/kg, muscone had significant liver toxicity in Kunming mice [116]. Further, pharmacodynamic drug-drug interactions (DDIs) occur when the pharmacological effect of one drug is altered by that of another drug in a combination regimen [117]. Liu et al. [118] demonstrated that muscone would reduce the hypnotic and analgesic effects of ketamine, a widely used general anesthetics, in a dose-independent manner, which may be related to changes in NR1 and delta-opioid receptors. Hence, when a patient is given muscone preoperatively, it is important to monitor the depth of anesthesia during the surgery.


The pharmacological activity of a drug in the body is closely related to its absorption, distribution, metabolism, and excretion process in the body. In view of the extensive usage of musk in TCM, an in-depth study of the pharmacokinetics of it is necessary. Unfortunately, the pharmacokinetics of musk are poorly studied globally. On the other hand, there are some pharmacokinetics studies on the muscone, the main active component. At the early stage, Zhu et al. established a method employing gas chromatography and applied it to the determination of blood concentration after oral administration of muscone. After oral administration of 80 mg/kg muscone, the parameters indicated that the whole blood concentration–time curve of muscone in rats was best fitted to a two-compartment open model. The T1/2Ka (min), Tmax (min), Cmax (mg/L) and T1/2β (min) were 22, 74.4, 1.44 and 196.1, respectively. These results indicated that muscone was absorbed quickly and eliminated quickly in rats, [119]. After that, Zhu et al. utilized the same method to determine the pharmacokinetic parameters of intravenously administered muscone in rats, rabbits, and dogs. After intravenous administration of muscone (12, 18 and 24 mg/kg) to rats, the T1/2α, T1/2β, Vss and Vc were 9.4–9.6 min, 118.1–131.2 min, 22.5–23.5 L/kg and 2.3–2.9 L/kg, respectively. The whole blood concentration–time curve was best fitted to a two-compartment open model. Whilst AUC (μg·min−1/mL) were 153.0, 207.7 and 258.2, respectively, which were dose-proportional. After intravenous administration of muscone to rabbits and dogs at a dose of 24 and 18 mg/kg respectively, the whole blood concentration–time curves were both fitted to a three-compartment open model. In rabbits, the T1/2α (min), T1/2β (min), T1/2γ (min), Vss (L/kg) and Vc (L/kg) were 4.82 ± 2.60, 24.87 ± 13.62, 331.92 ± 61.32, 51.65 ± 25.61, 2.13 ± 0.84. In dogs, the T1/2α (min), T1/2β (min), T1/2γ (min), Vss (L/kg) and Vc (L/kg) were 2.78 ± 3.8, 29.98 ± 22.11, 366.39 ± 185.44, 7.25 ± 2.23, 0.38 ± 0.30 [120]. Moreover, Li et al. also demonstrated that muscone can be quickly absorbed in the gastrointestinal tract, and the highest concentration of plasma and brain tissue was reached 1.5 h after intragastric administration, indicating that muscone quickly entered the brain tissue through the BBB. The elimination rate constants of muscone in brain tissue and plasma were 0.56 h−1 and 0.45 h−1, respectively, indicating that muscone was eliminated rapidly in the brain and plasma (the concentration in the brain decreases slightly faster than that in the plasma). Therefore, there was no accumulation of muscone in the brain [121].

Quality control

As we all know, the quality difference of traditional Chinese medicine is universal. Taking musk as an example, its quality depends on the physique of the musk deer, harvest time, drying method, etc. In addition, there were reports in the early years that there was counterfeit musk on the market. Therefore, it is indispensable to establish a potentially reliable, sensitive, accurate and repeatable analysis method to ensure the quality of musk. The methods mentioned in this section are listed in Table 2.

Table 2 Quality control and identification methods for musk

Quantitative quality control of musk

According to Chinese Pharmacopoeia (2020 edition), in addition to morphological and microscopic identification, as well as loss on drying and ash check, the concentration of muscone should exceed 2.0% as determined by GC [1] to control the quality of natural musk. Moreover, other methods have been established to detect muscone, such as GC–MS [122], HPLC-RI [123], RP-UPLC-ELSD [124], Single-Sweep Polarography [125]. However, the chemical composition of traditional Chinese medicine is complex, and with the advent of synthetic muscone, it is not appropriate to rely solely on muscone as an indicator of biological activity. In view of the fact that steroids are another feature in musk, some methods for the determination of steroid content in musk have been established [126,127,128]. Moreover, Luo et al. developed a biological evaluation method to evaluate the clinical efficacy of musk based on the biological potency of its anti-thrombin activity [129].

Qualitative quality control of musk

Natural musk has been a precious Chinese herbal medicine since ancient times, and it has been expensive and in short supply for a long time, and hence, this situation stimulated the musk forgery. As synthetic muscone becomes available, new methods of counterfeiting may emerge. Meanwhile, the composition of natural musk is complex. Hence, it is of vital importance to seek reasonable and effective ways to identify and comprehensively evaluate natural musk. Some researchers have established methods for authenticating and evaluating natural musk. Traditionally, microscopic authentication can be used as a fast on-site method [130]. Zhang et al. used GC–MS spectrometry and searched the NIST standard library to quickly determine most of the chemical components in the musk samples, making it easier to screen the fake musk. They found that the types and content of low-content steroids were quite different and had strong characteristics. Therefore, this study focused on the analysis of the steroidal component in the samples collected. Their data showed that the steroids contained in musk were very complex and variable. However, the analysis from multiple samples can capture its characteristic components as the basis for identification. The components included in androgen hormones had strong characteristics and regularity. The establishment of fingerprints of steroid hormones can simplify data processing [128]. In addition, Zhou et al. utilized Fourier transform infrared spectroscopy (FTIR) which was fast, sensitive, intuitive, and non-destructive, to identify the authenticity of musk [131]. Ahn et al. established a direct enzyme-linked immunosorbent assay (ELISA) to identify and evaluate different sources of musk for the first time. Firstly, they purified musk protein 1 (MP-1), a unique protein, from musk and made polyclonal antibodies in rabbits. And then a direct ELISA for quantitative analysis was developed using anti-MP-1 polyclonal antibodies. Lastly, the ELISA was validated by the determination of the quantity of MP-1. MP-1was detected in four out of nine musk samples, and the concentrations that can be detected ranged from a few nanograms in 1 g of protein. The results demonstrated that this method is useful for evaluating the authenticity of natural musk [132]. The odor is an important property of natural musk and with the development of electronic nose (E-Nose), identification methods of TCM based on E-Nose are emerging. Ye et al. employed an E-Nose (αFOX-4000) to analyze the aroma of several musk samples, namely 1 artificial musk sample, 5 natural musk samples, and 3 fake musk samples. The data showed that the chemical information between different samples was severely damaged, leading to complex and fuzzy results of musk quality evaluation. Then the original data obtained from the response values of 18 sensors were analyzed by principal component analysis. The adulterates were not only easily discriminated from authentic musk samples based on the above analysis but also showed a clear separation of different quality proportions of adulterated musk [133]. Importantly, DNA barcoding has become a new direction for biological species identification and has attracted the attention of many experts. Zhao et al. designed a pair of musk mini-DNA barcode identification primers of about 180 bp and successfully identified the fake products [134].

Discussions and future perspectives

The present review summarizes the zoology, chemical composition, pharmacological effects, toxicity, pharmacokinetics, and quality control of musk by referring to published reports. Musk is a kind of animal secretion and so far, researchers have identified macrocyclic ketones, pyridine, steroids, fatty acids, amino acids, peptides, and proteins from musk. Pharmacological studies have shown that musk has various pharmacological activities, including anti-inflammatory effects, neuroprotective effects, cardiovascular protective effects, anti-cancer effects, promoting effects on stem cell therapy, etc. Although the progress in recent decades strongly proves the medicinal value of musk, there are still some notable scientific gaps in the subsequent research.

First, the chemical composition of musk is complex. Many studies now focus only on the biological activity of muscone, ignoring the biological activity of other chemical components. However, studies have shown that muscone is not the only active ingredient in musk. For instance, the androgenic effects of musk are closely related to the androgen derivatives it contained, and decades ago scholars isolated a peptide whose anti-inflammatory activity was 20 times that of hydrocortisone [36]. As a TCM, the pharmacological effects of musk are the result of all the components working together. Therefore, it is necessary for future research to focus more on the biological activities of other components. Moreover, in pharmacological research, one problem is that many mechanisms of action have not been studied. In addition, there are many traditional uses of musk that have not been proven by modern pharmacological experiments. Furthermore, most of the current pharmacological studies have only conducted animal or in vitro studies, resulting in a lack of clinical trial data, therefore, researchers should try to convert experimental research into clinical research.

Second, there is insufficient research on the toxicity and safety of the active substances contained in musk, although it has been utilized for treating diseases for thousands of years in China. Toxicity evaluation is indispensable before conducting clinical trials and developing new drugs. Therefore, research in this area should attract sufficient attention because there are few relevant reports. Moreover, DDIs may occur when two (or more) drugs are administered together. This effect may be synergistic (enhanced potency), antagonistic (reduced potency), or the appearance of a completely new effect that does not occur when taken alone. A study suggested that muscone may affect the anesthetic effect of ketamine [118]. Meanwhile, musk is usually used in combination with other traditional Chinese medicines in practical use. Therefore, more DDIs about musk or its active substances with other drugs need to be studied.

Third, the pharmacokinetic behavior of musk needs further study. Pharmacokinetics explains how a drug is absorbed and diffused by the body after administration, the chemical changes that occur in the body, and the way the drug works and is excreted. According to the literature, there is a lack of data on the metabolism and excretion of musk in vivo. Therefore, more studies on the pharmacokinetics of musk in vivo should be conducted.

Fourth, quality evaluation of natural musk is the basis for ensuring the quality and safety of it, so it is of utmost importance to establish more complete quality control methods and standards. It is not only difficult to fully reflect the pharmacological activity and quality of natural musk by prescribing the content of muscone as the only index but also does not meet the overall viewpoint of clinical medicine for TCM. Therefore, it is necessary to improve the existing statutory quality standards. In addition, it is necessary to explore other more holistic quality control methods. There have been studies using DNA-barcoding for the quality evaluation of musk [134, 135]. The results demonstrate that this method is a promising one for the quality control method of natural musk, but more relative studies need to be done to develop this approach more comprehensively. In addition, hyperspectral imaging is also emerging in the quality control of TCM [136]. Moreover, there are seven species of musk deer, and the Chinese Pharmacopoeia (2020 edition) stipulates that three of them are natural sources of musk. Since the source of musk used in clinical practice is not uniform, and therefore its biological activity may vary, more research should be conducted on the effects of the three musks identified in the regulations.


In the present review, we covered zoology, chemical composition, pharmacological effects, toxicity, pharmacokinetics, and quality control of musk as well as the zoology of musk deer. Currently, plenty of pharmacological effects of musk and its main active ingredient, muscone, have been proved by modern pharmacological research, such as anti-inflammatory effects and neuroprotection, but many other pharmacological effects related to traditional applications have yet to be proven. Simultaneously, other active substances in musk remain to be discovered and studied. Besides, there may be counterfeiting of musk in China due to the imbalance between supply and demand as well as substantial profits, yet the quantitative standards prescribed by the Chinese Pharmacopoeia (2020 edition) may not be able to fully reflect the comprehensive quality of musk. Therefore, it is of urgency to establish novel, comprehensive, and convenient musk quality evaluation methods.

Availability of data and materials

Not applicable.



Gas chromatography


High-performance liquid chromatography


Ultra-performance liquid chromatography


Traditional Chinese medicine


Coenzyme A




Intercellular adhesion molecule 1


Vascular cell adhesion protein 1


Human umbilical vein endothelial cells


Interleukin 1 beta


NOD-, LRR- and pyrin domain-containing protein 3


Lactic acid dehydrogenase


Reactive oxygen species


Middle cerebral artery occlusion


Permeability glycoprotein


Matrix metallopeptidase 9


Superoxide dismutase




Excitatory amino acids




Regulated upon Activation, Normal T Cell Expressed and Presumably Secreted


Monocyte chemotactic protein 1


Transforming growth factor-β1


Tumor necrosis factor-α


Nuclear factor-κB


Hypoxia-inducible factor 1 alpha


Vascular endothelial growth factor A




Bcl-2-associated X


Multidrug resistance


Mesenchymal stem cells


Gingival mesenchymal stem cells


Bone marrow stromal cells


Stromal cell-derived factor-1


Hepatocyte growth factor


Stem cell factor


Fibroblast growth factor 2


Epidermal growth factor


Alkaline phosphatase


Collagen 1




Trabecular bone volume fraction


Acute kidney injury


C-X-C chemokine receptor


Enzyme-linked immunosorbent assay


Musk protein 1


Electronic nose


  1. Pharmacopoeia of the People's Republic of China, (2020).

  2. Tang ZS, Liu YR, Lv Y, Duan JA, Chen SZ, Sun J, et al. Quality markers of animal medicinal materials: correlative analysis of musk reveals distinct metabolic changes induced by multiple factors. Phytomedicine. 2018;44:258–69.

    Article  CAS  PubMed  Google Scholar 

  3. Yang Q, Meng X, Xia L, Feng Z. Conservation status and causes of decline of musk deer (Moschus spp.) in China. Biol Conserv. 2003;109(3):333–42.

    Article  Google Scholar 

  4. Khan IA, Abourashed EA. Leung’s encyclopedia of common natural ingredients: used in food, drugs and cosmetics. Hoboken: Wiley; 2011.

    Google Scholar 

  5. Gong Y. Essentials of Chinese Materia Medica and Medical Formulas: new century traditional Chinese Medicine. Amsterdam: Elsevier Science; 2017.

    Google Scholar 

  6. Homes V. On the scent: conserving musk deer: the uses of musk and europe's role in its trade: Traffic Europe Brussels; 1999.

  7. Williams AS. The synthesis of macrocyclic musks. Synthesis. 1999;1999(10):1707–23.

    Article  Google Scholar 

  8. Shukla M, Joshi BD, Kumar VP, Thakur M, Mehta AK, Sathyakumar S, et al. Species dilemma of musk deer (Moschus spp) in India: molecular data on cytochrome c oxidase I suggests distinct genetic lineage in Uttarakhand compared to other Moschus species. Anim Biotechnol. 2019;30(3):193–201.

    Article  PubMed  Google Scholar 

  9. Mooki-Ierjee BD, Wilson RA. The chemistry and fragrance of natural musk compounds. In: T. Theimer E, editor. Fragrance chemistry: the science of the sense of smell; 2012. p. 433.

  10. Li X, Jiang X. Implication of musk deer (Moschus spp) depletion from hunter reports and dung transect data in northwest Yunnan, China. J Nat Conserv. 2014;22(5):474–8.

    Article  Google Scholar 

  11. IUCN2019. The IUCN red list of threatened species. Version 2019-2. 2019.

  12. Hawkins TH. Musk and the musk deer. Nature. 1950;166(4215):262.

    Article  CAS  PubMed  Google Scholar 

  13. Fan Z, Li W, Jin J, Cui K, Yan C, Peng C, et al. The draft genome sequence of forest musk deer (Moschus berezovskii). Gigascience. 2018;7(4):giy038.

    Article  PubMed Central  CAS  Google Scholar 

  14. Zhu X, Gao Y, Li S. Development of artificial musk. Chin Tradit Pat Med. 1996;18(7):38–41.

    Google Scholar 

  15. Shen F, Bai J-Y, Meng Y, Xiao X, Zhang S, Zhu X-Y, et al. Establishment of indirect enzyme-linked immunosorbent assay for artificial musk. J Asian Nat Prod Res. 2014;16(12):1171–4.

    Article  CAS  PubMed  Google Scholar 

  16. He L, Li L-h, Wang W-x, Liu G, Liu S-q, Liu W-h, et al. Welfare of farmed musk deer: changes in the biological characteristics of musk deer in farming environments. Appl Anim Behav Sci 2014;156:1–5.

  17. Animal husbandry volume editorial board of China agricultural encyclopedia general editorial board. China Agricultural Encyclopedia • Animal Husbandry Volume. Beijing: China Agriculture Press; 1996.

  18. Institute of Zoology of Chinese Academy of Sciences, Kunming Institute of Zoology of Chinese Academy of Sciences, Chengdu Institute of Zoology of Chinese Academy of Sciences, Shanghai Institute of Plant Physiology and Ecology of Chinese Academy of Sciences, Institute of Hydrobiology of Chinese Academy of Sciences. China Animal Scientific Database 2020.

  19. Sokolov VE, Kagan MZ, Vasilieva VS, Prihodko VI, Zinkevich EP. Musk deer (Moschus moschiferus): reinvestigation of main lipid components from preputial gland secretion. J Chem Ecol. 1987;13(1):71–83.

    Article  CAS  PubMed  Google Scholar 

  20. Jaechul DO, Kitatsuji E, Yoshii E. Study on the components of musk. I. Ether soluble components. Chem Pharm Bull. 1975;23(3):629–35.

    Article  Google Scholar 

  21. Li D, Chen B, Zhang L, Gaur U, Ma T, Jie H, et al. The musk chemical composition and microbiota of Chinese forest musk deer males. Sci Rep. 2016;6(1):18975.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Sommer C. The role of musk and musk compounds in the fragrance industry. Series Anthropogenic Compounds. Berlin: Springer; 2004. p. 1–16.

    Google Scholar 

  23. Ruzicka L. Zur Kenntnis des Kohlenstoffringes VII. Über die Konstitution des Muscons. Helv Chim Acta. 1926;9(1):715–29.

    Article  CAS  Google Scholar 

  24. Walbaum H. Das natürliche Moschusaroma. J Prakt Chem. 1906;73(1):488–93.

    Article  Google Scholar 

  25. He M-C, Shi Z, Qin M, Sha N-N, Li Y, Liao D-F, et al. Muscone ameliorates LPS-induced depressive-like behaviors and inhibits neuroinflammation in prefrontal cortex of mice. Am J Chin Med. 2020;48:559–77.

    Article  PubMed  Google Scholar 

  26. Dong J, Li H, Bai Y, Wu C. Muscone ameliorates diabetic peripheral neuropathy through activating AKT/mTOR signalling pathway. J Pharm Pharmacol. 2019;71(11):1706–13.

    Article  CAS  PubMed  Google Scholar 

  27. Wang J, Xing H, Qin X, Ren Q, Yang J, Li L. Pharmacological effects and mechanisms of muscone. J Ethnopharmacol. 2020;262:113120.

    Article  CAS  PubMed  Google Scholar 

  28. Schinz H, Ruzicka L, Geyer U, Prelog V. 198. Muscopyridin, eine Base C16H25N aus natürlichem Moschus. Helv Chim Acta. 1946;29(6):1524–8.

    Article  CAS  Google Scholar 

  29. Biemann K, Büchi G, Walker B. The structure and synthesis of muscopyridine. J Am Chem Soc. 1957;79(20):5558–64.

    Article  CAS  Google Scholar 

  30. Kishore N, Kumar P, Shanker K, Verma AK. Human disorders associated with inflammation and the evolving role of natural products to overcome. Eur J Med Chem. 2019;179:272–309.

    Article  CAS  PubMed  Google Scholar 

  31. Pan M, Chiou YS, Tsai M, Ho C. Anti-inflammatory activity of traditional Chinese medicinal herbs. J Tradit Complem Med. 2011;1(1):8–24.

    Article  Google Scholar 

  32. Mishra RK, Arora RB, Seth S. Anti-inflammatory activity of musk. J Pharm Pharmacol. 1962;14(1):830–1.

    Article  CAS  Google Scholar 

  33. Morishita S, Mishima Y, Shoji M. Pharmacological properties of musk. Gen Pharm. 1987;18(3):253–61.

    Article  CAS  Google Scholar 

  34. Taneja V, Siddiqui HH, Arora RB. Studies on the anti-inflammatory activity of Moschus moschiferus (musk) and its possible mode of action. Indian J Physiol Pharm. 1973;17(3):241–7.

    CAS  Google Scholar 

  35. Seth SD, Mukhopadhyay AB, Bagchi N, Prbhakar MC, Arora RB. Antihistaminic and spasmolytic effects of musk. JPN J Pharm. 1973;23(5):673–9.

    Article  CAS  Google Scholar 

  36. Yu D, Liu X, Gao S. Studies on the antiinflammatory principle of musk. Acta Pharm Sin. 1980;15(5):306–7.

    CAS  Google Scholar 

  37. Zhu X, Xu G, Zhang Z. The pharmacological effects of musk. 1. The anti-inflammatory effect of musk on croton oil-induced ear inflammation in mice. Acta Pharm Sin. 1979;14(11):685–7.

    CAS  Google Scholar 

  38. Zhu X, Wang W, Xu G, Yang Y, Sun S, Xue L. The pharmacological activities of musk. II. The anti-inflammatory activity of the active components of musk. Acta Pharm Sin. 1988;23(6):406–10.

    CAS  Google Scholar 

  39. Zhu XY, Xu GF, Cheng YS, Sun SM, Yang YL. The pharmacological activities of musk. III. On the mechanisms of its anti-inflammatory activities. Acta Academiae Medicinae Sinicae. 1989;11(1):52–6.

    CAS  PubMed  Google Scholar 

  40. Cheng G. Pharmacological activities of musk. IV. Effects of musk on arachidonic acid metabolism in leukocytes from rat inflammatory exudate. Acta Academiae Medicinae Sinicae. 1992;14(5):346–50.

    CAS  PubMed  Google Scholar 

  41. Wang W, Bai J, Cheng G, Zhu X. The effect of glucoprotein component of musk on arachidonic acid metabolizing enzymes in rat polymorphonuclear leukocytes. Chin J Chin Mater Med. 1997;22(5):301.

    CAS  Google Scholar 

  42. Wang W, Bai J, Cheng G, Zhu X. Effects of the glucoprotein component of musk on the functions of rat polymorphonuclear leukocytes activated by fMLP in vitro. Acta Academiae Medicinae Sinicae. 1997;19(3):222–6.

    CAS  PubMed  Google Scholar 

  43. Wang W, Bai J, Cheng G, Zhu X. Effects of the glucoprotein component of musk on functions of rat polymorphonuclear leukocytes activated by LTB4 in vitro. Chin J Chin Mater Med. 1998;23(4):238.

    CAS  Google Scholar 

  44. Wang WJ, Bai JY, Cheng GF, Zhu XY. Effects of musk glucoprotein on the function of rat polymorphonuclear leukocytes activated by IL-8 in vitro. Chin J Chin Mater Med. 2001;26(1):50–3.

    CAS  Google Scholar 

  45. Wang W, Bai J, Zhou L, Cheng G, Zhu X. Effect of musk glucoprotein on certain functions of rat neutrophil activity by PAF in vitro. Chin Tradit Herbal Drugs. 1998;5:322–4.

    Google Scholar 

  46. Wang WJ, Zhou LE, Bai JY, Cheng GF, Zhu XY. Effects of musk glucoprotein on PAF production and cytosolic Ca2+ level in rat polymorphonuclear leukocytes in vitro. Chin J Chin Mater Med. 2000;25(12):733–6.

    CAS  Google Scholar 

  47. Wang W-j, Zhong M, Guo Y, Zhou L-e, Cheng G-f, Zhu X-y. Effects of musk glucoprotein on chemotaxis of polymorphonuclear leukocytes in vivo and in vitro. Chin J Chin Mater Med. 2003;28(1):59–62.

    Google Scholar 

  48. Rodrigues M, Kosaric N, Bonham CA, Gurtner GC. Wound healing: a cellular perspective. Physiol Rev. 2019;99(1):665–706.

    Article  CAS  PubMed  Google Scholar 

  49. He X, Li P, Qiu Q. Inhibitory effects of muscone on PMNS adhenrence to HUVEC and and the expression of ICAM-1, VCAM-1 and CD44 of HUVEC. Chin J Immunol. 2006;22(2):148.

    CAS  Google Scholar 

  50. Dinarello CA. Interleukin-1 in the pathogenesis and treatment of inflammatory diseases. Blood. 2011;117(14):3720–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Le Maitre CL, Freemont AJ, Hoyland JA. The role of interleukin-1 in the pathogenesis of human intervertebral disc degeneration. Arthritis Res Ther. 2005;7(4):R732–45.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  52. Liang QQ, Zhang M, Zhou Q, Shi Q, Wang YJ. Muscone protects vertebral end-plate degeneration by antiinflammatory property. Clin Orthop Relat Res. 2010;468(6):1600–10.

    Article  PubMed  Google Scholar 

  53. Zhou LY, Yao M, Tian ZR, Liu SF, Song YJ, Ye J, et al. Muscone suppresses inflammatory responses and neuronal damage in a rat model of cervical spondylotic myelopathy by regulating Drp1-dependent mitochondrial fission. J Neurochem. 2020;155(2):154–76.

    Article  CAS  PubMed  Google Scholar 

  54. Yu S, Zhao G, Han F, Liang W, Jiao Y, Li Z, et al. Muscone relieves inflammatory pain by inhibiting microglial activation-mediated inflammatory response via abrogation of the NOX4/JAK2-STAT3 pathway and NLRP3 inflammasome. Int Immunopharmacol. 2020;82:106355.

    Article  CAS  PubMed  Google Scholar 

  55. Ayuob NN, Ali SS, Suliaman M, El Wahab MGA, Ahmed SM. The antidepressant effect of musk in an animal model of depression: a histopathological study. Cell Tissue Res. 2016;366(2):271–84.

    Article  PubMed  Google Scholar 

  56. Ayuob NN, Ali SS, Suliaman M, El Wahab MGA, Ahmed SM. Correction to: The antidepressant effect of musk in an animal model of depression: a histopathological study. Cell Tissue Res. 2018;371(2):377–8.

    Article  PubMed  Google Scholar 

  57. Abd-El-Wahab MG, Ali SS, Ayuob NN. The role of musk in relieving the neurodegenerative changes induced after exposure to chronic stress. Am J Alzheimers Dis Other Demen. 2018;33(4):221–31.

    Article  PubMed  Google Scholar 

  58. Ayuob NN, Abdel-Tawab HS, El-Mansy AA, Ali SS. The protective role of musk on salivary glands of mice exposed to chronic unpredictable mild stress. J Oral Sci. 2019;61(1):95–102.

    Article  CAS  PubMed  Google Scholar 

  59. Wang G, Wang N, Liao H. Effects of muscone on the expression of P-gp, MMP-9 on blood–brain barrier model in vitro. Cell Mol Neurobiol. 2015;35(8):1105–15.

    Article  CAS  PubMed  Google Scholar 

  60. Sun R, Zhang Z, Huang W, Lv L, Yin J. Protective effects and machanism of muskone on pheochromocytoma cell injure induced by glutamate. Chin J Chin Mater Med. 2009;34(13):1701.

    CAS  Google Scholar 

  61. Yu L, Wang N, Zhang Y, Wang Y, Li J, Wu Q, et al. Neuroprotective effect of muscone on glutamate-induced apoptosis in PC12 cells via antioxidant and Ca(2+) antagonism. Neurochem Int. 2014;70:10–21.

    Article  CAS  PubMed  Google Scholar 

  62. Hui L, Hu C, Yin G, Ding-fang C. Effect of muscone on neuronal glutamate transporter EAAC1 expression in rats with acute cerebral ischemia. Chin J Integr Med. 2003;9(4):285–8.

    Article  Google Scholar 

  63. Hui L, Benyan L. The study of muscone on attenuating excitotoxity during acute cerebral ischemia. Pharmacol Clin Chin Mater Med. 2005;21(3):12.

    Google Scholar 

  64. Sun R, Zhang Z, Huang W, Lv L, Ren H. Protective effects of muskone on rats with complete cerebral ischemia. Tradit Chin Drug Res Clin Pharm. 2009;20(3):197–200.

    CAS  Google Scholar 

  65. Rosenbaum DM, Gupta G, D’Amore J, Singh M, Weidenheim K, Zhang H, et al. Fas (CD95/APO-1) plays a role in the pathophysiology of focal cerebral ischemia. J Neurosci Res. 2000;61(6):686–92.

    Article  CAS  PubMed  Google Scholar 

  66. Wei G, Chen DF, Lai XP, Liu DH, Deng RD, Zhou JH, et al. Muscone exerts neuroprotection in an experimental model of stroke via inhibition of the fas pathway. Nat Prod Commun. 2012;7(8):1069–74.

    CAS  PubMed  Google Scholar 

  67. Zhou Z, Dun L, Wei B, Gan Y, Liao Z, Lin X, et al. Musk ketone induces neural stem cell proliferation and differentiation in cerebral ischemia via activation of the PI3K/Akt signaling pathway. Neuroscience. 2020;435:1–9.

    Article  CAS  PubMed  Google Scholar 

  68. Katzman R, Clasen R, Klatzo I, Meyer JS, Pappius HM, Waltz AG. Report of joint committee for stroke resources. IV. Brain edema in stroke. Stroke. 1977;8(4):512–40.

    Article  CAS  PubMed  Google Scholar 

  69. Lv L, Zhang Z, Huang W, Ren H, Sun R. The protective effects and influence of blood brain barrier transfering function on CMAO model in rats caused by muskone. Pharmacol Clin Chin Mater Med. 2009;2:31–5.

    Google Scholar 

  70. Jiang G, Luo C, Peng X, Xiao G, Teng Z. Effects of muscone on the expression of MMP9 protein after traumatic brain injury in rats. J Emerg Tradit Chin Med. 2018;27(1):90–3.

    Google Scholar 

  71. Jiang T, Huang LF, Zhou SJ, Cui JJ, Ye Q. Brain protection of muscone in rats with brain injury. Chin J Integr Tradit West Med. 2016;36(6):724–8.

    Google Scholar 

  72. Jiang T, Huang L, Zhang X, Liang X. Nasal administration of muscone promotes cAMP-PKA-CREB signaling in rats with traumatic brain injury. Int J Clin Exp Med. 2019;12(5):5902–8.

    CAS  Google Scholar 

  73. Cheng J, Bai Y, Zhang X, Zhang L, Zhao Q. Influence of muscone on c-Fos expression in brains of rat kindling model of epilepsy chronically induced by pentylenetetrazol. Chin Tradit Pat Med. 2016;38(7):1443–9.

    Google Scholar 

  74. Cheng J, Bai Y, Zhang X, Zhang L, Zhao Q. Influence of muscone on c-jun expression in brain of epilepsy chronically induced by pentylenetetrazol. Chin Arch Tradit Chin Med. 2016;34(12):2962–5.

    CAS  Google Scholar 

  75. Li H, Sureda A, Devkota HP, Pittala V, Barreca D, Silva AS, et al. Curcumin, the golden spice in treating cardiovascular diseases. Biotechnol Adv. 2020;38:107343.

    Article  CAS  PubMed  Google Scholar 

  76. Shen M, Wang L, Yang G, Gao L, Wang B, Guo X, et al. Baicalin protects the cardiomyocytes from ER stress-induced apoptosis: inhibition of CHOP through induction of endothelial nitric oxide synthase. PLoS ONE. 2014;9(2):e88389.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  77. Chen K, Li G, Geng F, Zhang Z, Li J, Yang M, et al. Berberine reduces ischemia/reperfusion-induced myocardial apoptosis via activating AMPK and PI3K-Akt signaling in diabetic rats. Apoptosis. 2014;19(6):946–57.

    Article  CAS  PubMed  Google Scholar 

  78. Quan H, Yang X, Jin P, Li L, Jin D, Luo Y. Protective effect of Moschus and the alternative artificial moschus on H9c2 cardiomyocytes impaired by H2O2. J Chin Med Mater. 2018;41(4):961–5.

    Google Scholar 

  79. Quan H, Jin P, Li L, Han Y, Tan T, Luo Y. Protective effect of musk and its alternative artificial musk on HUVECs impaired by H2O2. Chin J Hosp Pharm. 2018;38(17):1783–7.

    Google Scholar 

  80. Hong Y, Jiang F. Effects of muscone on human vascular endothelial cells apoptosis induced by oxidative stress. Chin J Tradit Chin Med Pharm. 2011;26(9):2178–80.

    CAS  Google Scholar 

  81. Zhou K, Zhang Y, Lin D, Tao X. Effects of muscone on random skin flap survival in rats. J Reconstr Microsurg. 2016;32(3):200–7.

    Google Scholar 

  82. Wang X, Meng H, Chen P, Yang N, Lu X, Wang ZM, et al. Beneficial effects of muscone on cardiac remodeling in a mouse model of myocardial infarction. Int J Mol Med. 2014;34(1):103–11.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  83. Du Y, Ge Y, Xu Z, Aa N, Gu X, Meng H, et al. Hypoxia-inducible factor 1 alpha (HIF-1alpha)/vascular endothelial growth factor (VEGF) pathway participates in angiogenesis of myocardial infarction in muscone-treated mice: preliminary study. Med Sci Monit. 2018;24:8870–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  84. Du Y, Gu X, Meng H, Aa N, Liu S, Peng C, et al. Muscone improves cardiac function in mice after myocardial infarction by alleviating cardiac macrophage-mediated chronic inflammation through inhibition of NF-κB and NLRP3 inflammasome. Am J Transl Res. 2018;10(12):4235–46.

    CAS  PubMed  PubMed Central  Google Scholar 

  85. Wu Q, Li H, Wu Y, Shen W, Zeng L, Cheng H, et al. Protective effects of muscone on ischemia-reperfusion injury in cardiac myocytes. J Ethnopharmacol. 2011;138(1):34–9.

    Article  CAS  PubMed  Google Scholar 

  86. Su L, Jiang Y, Xu Y, Li X, Gao W, Xu C, et al. Xihuang pill promotes apoptosis of Treg cells in the tumor microenvironment in 4T1 mouse breast cancer by upregulating MEKK1/SEK1/JNK1/AP-1 pathway. Biomed Pharmacother. 2018;102:1111–9.

    Article  PubMed  Google Scholar 

  87. Xu L, Cao Y. Native musk and synthetic musk ketone strongly induced the growth repression and the apoptosis of cancer cells. BMC Complement Altern Med. 2016;16(1):511.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  88. Yong-hui L, Chang J, Lu-jun X, Shao-xian G, Rui W, Ye S, et al. Effects of musk ketone on the growth of blood stasis breast cancer model and expression of VEGF. J Xi’an Jiaotong Univ. 2014;4:547–50.

    Google Scholar 

  89. Qi W, Li Z, Yang C, Jiangshan Dai J, Zhang Q, Wang D, et al. Inhibitory mechanism of muscone in liver cancer involves the induction of apoptosis and autophagy. Oncol Rep. 2020;43(3):839–50.

    CAS  PubMed  PubMed Central  Google Scholar 

  90. Dong J, Qin Z, Zhang W-D, Cheng G, Yehuda AG, Ashby CR, et al. Medicinal chemistry strategies to discover P-glycoprotein inhibitors: an update. Drug Resist Update. 2020;49:100681.

    Article  Google Scholar 

  91. Wang S, Tan N, Ma C, Wang J, Jia P, Liu J, et al. Inhibitory effects of benzaldehyde, vanillin, muscone and borneol on P-Glycoprotein in Caco-2 cells and everted gut sac. Pharmacology. 2018;101(5–6):269–77.

    Article  CAS  PubMed  Google Scholar 

  92. Guadix JA, Zugaza JL, Gálvez-Martín P. Characteristics, applications and prospects of mesenchymal stem cells in cell therapy. Medicina Clínica (English Edition). 2017;148(9):408–14.

    Article  Google Scholar 

  93. Yuan WX, Wang XX, Zheng DH, Ma D, Cui Q, Yang F, et al. Muscone promotes the adipogenic differentiation of human gingival mesenchymal stem cells by inhibiting the Wnt/β-Catenin signaling pthway. Drug Des Devel Ther. 2019;13:3291–306.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  94. Xie XW, Hou FW, Li N. Effects of musk ketone at different concentrations on in vivo migration of exogenous rat bone marrow mesenchymal stem cells. Chin J Integr Tradit West Med. 2012;32(7):980–5.

    CAS  Google Scholar 

  95. Hou F-y, Xie X-w, Xi F-q, Xu S-h, Li S-h, Song M. Effects of muscone-containing serum on proliferation and differentiation of rat mesenchymal stem cells. J Xi’an Jiaotong Univ. 2013;34(1):110–4.

    CAS  Google Scholar 

  96. Hou F, Xie X, Shensong L, Shao H, Zhang L. Effect of musk ketone on in vivo migration of exogenous bone marrow mesenchymal stem cells in skull defect rats. Chin J Tissue Eng Res. 2017;21(13):2043–8.

    Google Scholar 

  97. Xie X-w, Zhao Y-l, Li N, Xu S-h, Wang Y-s, Jiang H, et al. Effects of musk on MCP-1 expression of skull bone defect model rats. Chin J Inform Tradit Chin Med. 2013;5:49–51.

    Google Scholar 

  98. Zhao Y, Xie X, Li N, Xu S, Jiang W, Li S, et al. Effect of musk on SDF-1 expression in rat skull bone defect model. Chin J Osteoporos. 2013;19(4):386–90.

    Google Scholar 

  99. Li Y, Li N, Xie X, Song M, Xu S, Li D. Study of the effect of musk on the relationship between stromal cell-derived factor 1 and hepatocyte growth factor in the rat model of skull bone defect. Chin J Osteoporos. 2016;22(11):1477–80.

    Google Scholar 

  100. Li Y, Li N, Xie X, Song M, Xu S, Jiang G. Effect and significance of musk on the expression of SCF and MCP-1 mRNA in the skull bone defect rat model. Chin J Osteoporos. 2017;23(3):286–356.

    Google Scholar 

  101. Li N, Li Y, Xie X, Zhao Y, Song M. Effects of musk on mRNA expressions of FGF-2 and EGF in the rat model of skull bone defect. J Xi’an Jiaotong University (Med Sci). 2017;38(3):453–6.

    Google Scholar 

  102. Li N, Yingfu L, Xie X, Li J, Xu W, Huang J. The effect of musk on mRNA expression of transforming growth factor β and vascular endothelial growth factor in bone tissues of cranial bone defect model rats. J Tradit Chin Med. 2017;58(14):1229–31.

    Google Scholar 

  103. Guo YJ, Luo SH, Tang MJ, Zhou ZB, Yin JH, Gao YS, et al. Muscone exerts protective roles on alcohol-induced osteonecrosis of the femoral head. Biomed Pharmacother. 2018;97:825–32.

    Article  PubMed  CAS  Google Scholar 

  104. Liu PF, Feng YT, Dong C, Yang DD, Li B, Chen X, et al. Administration of BMSCs with muscone in rats with gentamicin-induced AKI improves their therapeutic efficacy. PLoS ONE. 2014;9(5):e97123.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  105. Peng R, Zhu XY, Yang CS. Induction of rat liver microsomal cytochrome P-450 by muscone (3-methylcyclopentadecanone). Biochem Pharmacol. 1986;35(8):1391–4.

    Article  CAS  PubMed  Google Scholar 

  106. Tanaka E, Kurata N, Kohno M, Yoshida T, Kuroiwa Y. Induction of cytochrome P-450 and related drug-oxidizing activities in muscone (3-methylcyclopentadecanone)-treated rats. Biochem Pharmacol. 1987;36(24):4263–7.

    Article  CAS  PubMed  Google Scholar 

  107. Tanaka E, Funae Y, Imaoka S, Misawa S. Characterization of liver microsomal cytochrome P450 from rats treated with muscone (3-methylcyclopentadecanone). Biochem Pharmacol. 1991;41(3):472–3.

    Article  CAS  PubMed  Google Scholar 

  108. Phung HM, Lee S, Hwang JH, Kang KS. Preventive effect of muscone against cisplatin nephrotoxicity in LLC-PK1 cells. Biomolecules. 2020;10(10):1444.

    Article  CAS  PubMed Central  Google Scholar 

  109. Zhai X, Yan Z, Zhao J, Chen K, Yang Y, Cai M, et al. Muscone ameliorates ovariectomy-induced bone loss and receptor activator of nuclear factor-kappab ligand-induced osteoclastogenesis by suppressing TNF receptor-associated factor 6-mediated signaling pathways. Front Pharmacol. 2020;11:348.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  110. Saddiq AA. Potential effect of natural musk and probiotic on some pathogens strain. Int Res J Microbiol. 2011;2(5):146–52.

    Google Scholar 

  111. Saddiq AAN. Antiagnostic effect of musk and sidr leaves on some of the opportunistic fungi that cause Lung toxicity. Life Sci J. 2014;11(2s):99–108.

    Google Scholar 

  112. Al-Jobori KM, Al-Ameed AI, Witwit NM. In vitro antifungal activity of musk. Bull Environ Pharmacol Life Sci. 2015;4:38–44.

    CAS  Google Scholar 

  113. Al-Jobori KMM, Faraj AA, Witwit NM. Inhibitory effectiveness of musk on viability of protoscolices of hydatid cysts. Int J Curr Microbiol Appl Sci. 2016;5(4):998–1006.

    Article  CAS  Google Scholar 

  114. Chen Y, Zhong Y, Dong W, Chunjie L, Wang L, Yunzhu P, et al. Developmental toxicity of muscone on zebrafish embryos. Chin J Pharmacol Toxicol. 2014;28(2):267–73.

    CAS  Google Scholar 

  115. Li M, Yao L, Chen H, Ni X, Xu Y, Dong W, et al. Chiral toxicity of muscone to embryonic zebrafish heart. Aquat Toxicol. 2020;222:105451.

    Article  CAS  PubMed  Google Scholar 

  116. Liu S, Cheng Y, Rao M, Tang M, Dong Z. Muscone induces CYP1A2 and CYP3A4 enzyme expression in L02 human liver cells and CYP1A2 and CYP3A11 enzyme expression in Kunming mice. Pharmacology. 2017;99(5–6):205–15.

    Article  CAS  PubMed  Google Scholar 

  117. Niu J, Straubinger RM, Mager DE. Pharmacodynamic Drug-Drug Interactions. Clin Pharmacol Ther. 2019;105(6):1395–406.

    Article  PubMed  Google Scholar 

  118. Liu C, Huang Z, Li Z, Li J, Li Y. Muscone reduced the hypnotic and analgesic effect of ketamine in mice. J Chin Med Assoc. 2020;83(2):148–55.

    Article  CAS  PubMed  Google Scholar 

  119. Zhu Y, Cheng G, Zhu X. Study on quantitative in determination of muscone in plasma by gas chromatogrphy. Chin J Clin Pharmacol. 1992;3(8):167–72.

    Google Scholar 

  120. Zhu YW, Cheng GF, Zhu XY. Pharmacokinetics of muscone in rats, rabbits and dogs. Acta Pharm Sin. 1993;28(3):177–80.

    CAS  Google Scholar 

  121. Li J, Wang N, Lu H, Huang T. Pharmacokinetic study of muscone in rats. Tradit Chin Drug Res Clin Pharm. 2000;11(4):208–10.

    Google Scholar 

  122. Chen Q, Li P, Zhang Z, Zhen F, He J. Determination of muscone in musk by GC-MS. Herald Med. 2009;28(5):647–8.

    Google Scholar 

  123. Mino Y, Ota N. Rapid analysis of muscone in musk by high-performance liquid chromatography. Chem Pharm Bull. 1986;34(2):906–8.

    Article  CAS  Google Scholar 

  124. Jin C, Yan C, Luo Y, Li B, He J, Xiao X. Fast and direct quantification of underivatized muscone by ultra performance liquid chromatography coupled with evaporative light scattering detection. J Sep Sci. 2013;36(11):1762–7.

    Article  CAS  PubMed  Google Scholar 

  125. He Y, Tang X, Xiang S, Xu J. Determination of muscone in musk by sigle-sweep polarography. West China J Pharma Sci. 2002;17(1):53–4.

    CAS  Google Scholar 

  126. Yu B, Guo X, Tu G. Study on composition of musk steroids by HPLC. Chin Tradit Herbal Drugs. 1989;20(11):11–4.

    Google Scholar 

  127. Su G, Wu A, Gan X, Yue B, Li J. Quantitative analysis of musk components by GC/MS. Sichuan J Zool. 2009;28(4):509–16.

    Google Scholar 

  128. Zhang H, Tao Y, Hong X, Wang Z. Steriods in musk by gas chromatography/mass spectrometry. Chin Tradit Pat Med. 2005;27(1):79–83.

    Google Scholar 

  129. Luo Y, Tan T, Liang X, Zhao H, Liao Z, Yang M. Quality evaluation of musk based on the biological potency of its anti-thrombin activity. Chin J Chin Mater Med. 2018;43(10):2112–7.

    Google Scholar 

  130. Fu Y, Yang H, Ye YQ. Rapid identification of Moschus by microscopy. Chin J Pharma Anal. 2012;32(4):706–8.

    Google Scholar 

  131. Zhou J, Jin C, Luo Y, Wu Y, Li J, Luo Y, et al. Identification of musk by fourier transform infrared spectroscopy. Spectrosc Spect Anal. 2010;30(9):2368–71.

    CAS  Google Scholar 

  132. Ahn KS, Hahn B-S, Lee JP, Chang SY, Lee HK, Jeong CS, et al. Evaluation of musk by enzyme-linked immunosorbent assay. Biol Pharm Bull. 2002;25(4):418–21.

    Article  CAS  PubMed  Google Scholar 

  133. Ye T, Jin C, Zhou J, Li X, Wang H, Deng P, et al. Can odors of TCM be captured by electronic nose? The novel quality control method for musk by electronic nose coupled with chemometrics. J Pharm Biomed Anal. 2011;55(5):1239–44.

    Article  CAS  PubMed  Google Scholar 

  134. Zhao Y, Zhou J, Yuan Y, Huang L, Jin Y, Jiang C. Mini-DNA barcoding molecular identification of traditional Chinese medicinal Moschus. Mod Chin Med. 2019;21(9):1186–91.

    Google Scholar 

  135. Nakanishi H, Yoneyama K, Hayashizaki Y, Hara M, Takada A, Saito K. Establishment of widely applicable DNA extraction methods to identify the origins of crude drugs derived from animals using molecular techniques. J Nat Med. 2019;73(1):173–8.

    Article  CAS  PubMed  Google Scholar 

  136. Vermaak I, Viljoen A, Lindström SW. Hyperspectral imaging in the quality control of herbal medicines—the case of neurotoxic Japanese star anise. J Pharm Biomed Anal. 2013;75:207–13.

    Article  CAS  PubMed  Google Scholar 

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This study was supported by the Sichuan Provincial Administration of Traditional Chinese Medicine (2020JC0038).

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JL and XL organized, conceived, and supervised the study. KL and LX drafted the manuscript. MD and XZ collected and analyzed the data. JL revised the manuscript. All authors read and approved the final manuscript.

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Liu, K., Xie, L., Deng, M. et al. Zoology, chemical composition, pharmacology, quality control and future perspective of Musk (Moschus): a review. Chin Med 16, 46 (2021).

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