Background/Objectives: Physical exercise has been a cornerstone of health and vitality across all age groups; however, while its importance remains undeniable, the complications associated with exercise such as fatigue, muscle damage, inflammation, and oxidative stress are not always effectively managed through conventional strategies. This review aims to highlight the current evidence on the potential role of natural products in alleviating these exercise-induced responses and supporting exercise performance and recovery. Methods: The available preclinical and clinical literature was comprehensively reviewed to evaluate the effects of natural products on exercise performance and recovery. Evidence was categorized according to five major mechanisms: attenuation of muscle fatigue, enhancement of muscular endurance, improvement of muscular strength and neuromuscular function, modulation of inflammation and other physiological benefits. Results: Approximately 164 natural products have been investigated for their potential to improve exercise performance and recovery by targeting fatigue-related markers, improving energy metabolism, and regulating oxidative stress. Conclusions: These findings underscore the potential of natural products as promising agents as complementary strategies for addressing exercise-induced fatigue and improving recovery. Although current findings indicate biological plausibility and therapeutic potential of natural products, further clinical evidence is required before definitive performance related recommendations can be established. Future well-designed clinical trials are essential to establish efficacy, safety and translational applicability.

Tumor‐associated macrophages (TAMs), particularly the M2‐like subtype, contribute to an immunosuppressive tumor microenvironment and promote tumor progression. Melittin, a natural bioactive peptide derived from bee venom, has been reported to exert anticancer and immunomodulatory effects; however, the cellular targets and molecular mechanisms underlying its selective action on TAMs remain incompletely defined. This study aimed to investigate the immunomodulatory effects of melittin on TAM subsets and to identify the molecular determinant responsible for its selectivity toward M2‐like macrophages. Macrophage subsets were analyzed following melittin treatment using flow cytometry, gene expression analysis, and immunofluorescence. Binding interactions were assessed by biochemical and biophysical approaches. Tumor growth and immune cell composition were examined in wild‐type and CD18‐deficient mice. Melittin treatment selectively reduced M2‐like TAM populations while increasing infiltration of CD8 ⁺ cytotoxic T cells in tumor tissues. Mechanistic analyses revealed that melittin preferentially binds to the integrin subunit CD18 (ITGB2), which is enriched in M2‐polarized macrophages, leading to disruption of M2‐associated phenotypes in vitro. Notably, genetic deletion of CD18 abolished the M2‐suppressive and antitumor effects of melittin in vivo. These findings demonstrate that CD18 is functionally required for the immunomodulatory and antitumor activities of native full‐length melittin. This study provides mechanistic insight into the selective action of a natural bioactive peptide and supports its potential as a lead compound for natural product‐based immunomodulatory strategies.

Adjuvant chemotherapy for breast cancer (BC) has improved survival rates but often causes adverse effects such as nausea, vomiting, myelosuppression, and peripheral neuropathy, which can greatly impact patient quality of life. Integrative medicine (IM) provides adjunctive therapies to alleviate these toxicities and support immune function, yet existing clinical practice guidelines and pathways offer broad recommendations that may not sufficiently address the specific needs of post-chemotherapy BC patients. To address this gap, we developed an IM Inpatient Care Program framework for BC patients within one week of chemotherapy administration, drawing on the Korean Medicine Clinical Practice Guideline (KMCPG) for BC supportive care, an established clinical pathway, and additional guidelines focused on chemotherapy-related toxicities. The proposed inpatient model prioritizes systematic monitoring, early detection, and management of common chemotherapy-induced side effects such as neutropenia, peripheral neuropathy, gastrointestinal issues, and psychological distress. Key components include vital sign surveillance, targeted diagnostic tests (e.g., hematology, imaging), dietary and lifestyle recommendations, tailored herbal medicine prescriptions, acupuncture, moxibustion, and referral protocols for serious complications. The IM Inpatient Care Program aims to standardize treatment processes, enhance patient and clinician satisfaction, and reduce potential emergency department visits. By aligning evidence-based guidelines with real-world clinical insights, this model provides a structured approach to optimize BC patient care post-chemotherapy. Future efforts should involve implementing and evaluating the program in diverse clinical settings to refine its utility, measure outcomes, and potentially lower healthcare costs while improving quality of life for BC patients.