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Beware of the Potential Risks for Polygoni Multiflori Caulis-Induced Liver Injury
Wei-Song Kong1, Gui Zhou1, Li-Wei Xu1,2
1Department of Pharmacy, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Frontiers in Pharmacology
|April 18, 2022
Summary
Polygoni Multiflori Caulis (PMC) is widely used, but its liver injury risk is underestimated. Studies show PMC causes milder liver injury than its root forms due to lower toxin levels, yet awareness is crucial.
Area of Science:
- Pharmacology
- Natural Products Chemistry
- Toxicology
Background:
- *Reynoutria multiflora* (PM) is a key Traditional Chinese Medicine.
- Its root (RPM, PMP) hepatotoxicity is known, but the stem (PMC) risk is overlooked.
- PMC usage is significantly higher than RPM and PMP.
Purpose of the Study:
- Investigate potential PMC-induced liver injury risks.
- Compare clinical usage, chemical composition, and animal toxicity of PM, PMP, and PMC.
- Explore the mechanism of liver injury by key compounds in PMC.
Main Methods:
- Clinical usage analysis of RPM, PMP, and PMC over 12 months.
- Quantification of active compounds (e.g., SG, emodin) in water extracts.
- Hepatotoxicity assessment in mice and mechanistic studies.
Main Results:
- PMC usage exceeded RPM/PMP by nearly fivefold, with 68% of PMC doses at 30g.
- PMC extracts contained significantly lower levels of *cis*-SG, *trans*-SG, and emodin.
- PMC induced milder idiosyncratic liver injury compared to its root counterparts.
Conclusions:
- PMC poses a potential risk for liver injury that warrants attention.
- Lower levels of hepatotoxic compounds (*cis*-SG, *trans*-SG) contribute to PMC's milder toxicity.
- Clinical and toxicological data highlight the need for awareness regarding PMC safety.
