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Herb-Induced Liver Injury: A Global Concern
1USC Research Center for Liver Disease, USC Keck School of Medicine, Los Angeles, CA, 90033, USA. kaplowit@usc.edu.
Chinese Journal of Integrative Medicine
|May 11, 2018
Summary
Traditional Chinese medicine and herbals can cause liver injury. While often mild and dose-related, rare idiosyncratic reactions, potentially immune-mediated, can lead to severe liver damage in susceptible individuals.
Area of Science:
- Hepatology
- Toxicology
- Immunology
Background:
- Herbal and traditional Chinese medicines are widely used for liver disease treatment.
- Phytochemicals in these remedies can cause liver injury, ranging from mild to severe.
- Liver injury from these agents can be dose-dependent or idiosyncratic.
Purpose of the Study:
- To investigate the mechanisms of liver injury induced by Chinese and herbal medicines.
- To understand the role of phytochemicals in drug-induced liver injury (DILI).
- To explore the immunological basis of severe idiosyncratic liver reactions.
Main Methods:
- Review of existing literature on herb-induced liver injury (HILI).
- Analysis of case reports detailing liver injury from traditional remedies.
- Discussion of proposed mechanisms, including dose-dependency and immune mediation.
Main Results:
- Phytochemicals possess hepatotoxic potential, manifesting in various patterns.
- Most injuries are mild and transient, but severe idiosyncratic reactions occur rarely.
- Adaptive immune responses are implicated in severe, idiosyncratic liver injury.
Conclusions:
- Herbal and traditional Chinese medicines, despite therapeutic use, are significant causes of liver injury.
- Understanding the dose-related and idiosyncratic nature of phytochemical toxicity is crucial.
- Immune-mediated pathways likely contribute to severe liver damage in susceptible patients.
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