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Herbal hepatotoxicity: current status, examples, and challenges.

Carlemi Calitz1, Lissinda du Plessis1, Chrisna Gouws1

  • 1a 1 North-West University, Centre of Excellence for Pharmaceutical Sciences , Private Bag X6001, Potchefstroom, 2520, South Africa +27 18 299 4035 ; +27 87 231 5432 ; sias.hamman@nwu.ac.za.

Expert Opinion on Drug Metabolism & Toxicology
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Summary

Many herbal medicines, despite their natural origin, can cause liver injury (hepatotoxicity). This review examines phytochemicals linked to liver damage and challenges in diagnosing herb-induced liver injury.

Keywords:
complementary and alternative medicineherb induced liver injuryherbal medicinephytochemicaltraditional herbal medicine

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Area of Science:

  • Pharmacology
  • Toxicology
  • Herbal Medicine Research

Background:

  • Public perception often regards herbal medicines as safe due to natural origins and traditional use.
  • However, plants contain toxic secondary metabolites that can cause adverse effects, including liver injury (hepatotoxicity).
  • Some cases of herb-induced liver injury resolve upon discontinuing the herbal medicine.

Purpose of the Study:

  • To review herbal medicines associated with hepatotoxicity.
  • To identify phytochemicals implicated in liver injury.
  • To discuss challenges in assessing causality and diagnosing herb-induced liver injury.

Main Methods:

  • Review of selected herbal medicines linked to hepatotoxic effects.
  • Inclusion of case studies of patients with herb-induced liver injury.
  • Inclusion of in vitro and in vivo studies confirming liver injury.

Main Results:

  • Identified specific herbal medicines associated with liver injury.
  • Discussed phytochemicals contributing to hepatotoxicity where data is available.
  • Highlighted challenges in establishing a definitive link between herbal medicine use and liver injury.

Conclusions:

  • Growing evidence supports the occurrence of herb-induced liver injury.
  • Causality assessment for herb-induced liver injury is complex.
  • Pre-emptive testing and diagnosis of herb-induced liver injury face significant challenges.