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Phytotherapy-Induced Hepatocytotoxicity: A Case Report.

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  • 1Department of Internal Medicine C, Kaplan Medical Center, Hebrew University, Rehovot 76100, Israel.

Current Issues in Molecular Biology
|July 26, 2024
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Summary

This case study details severe herbal-induced liver injury (HILI) from green tea and protein supplements. The findings suggest a hypersensitivity reaction involving mitochondrial toxicity and immune response, highlighting the need for adverse reaction reporting.

Keywords:
apoptosiscaspasedrug-induced liver injuryherbal-induced liver injurylymphocyte toxicity assaynecrosisproinflammatory cytokines

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Area of Science:

  • Hepatology
  • Toxicology
  • Immunology

Background:

  • Herbal and complementary medicines are frequently used alongside conventional treatments.
  • There is a growing need to understand potential adverse effects of these integrated therapies.

Observation:

  • A 39-year-old male developed severe hepatotoxicity after two months of consuming a green tea-containing powder and a branched-chain amino acid supplement.
  • Hepatotoxicity resolved upon discontinuation of the supplements, with no other causative factors identified.
  • Laboratory investigations, including lymphocyte toxicity assays and cytokine profiling, were performed to elucidate the mechanism of injury.

Findings:

  • The patient's lymphocytes exhibited increased susceptibility to necrosis when exposed to the supplements, indicating mitochondrial toxicity.
  • Elevated levels of pro-inflammatory cytokines and chemokines, including vascular endothelial growth factor (VEGF) and tumor necrosis factor-alpha (TNF-α), were observed.
  • The cellular markers suggested a mechanism of toxicity primarily involving necrosis rather than apoptosis.

Implications:

  • The combination of certain protein supplements and herbal teas can trigger a T-lymphocyte-1 mediated immune response leading to herbal-induced liver injury (HILI) in susceptible individuals.
  • This case underscores the importance of comprehensive adverse event reporting systems for herbal and complementary medicines.
  • Standardized definitions and assessment criteria are crucial for international reporting of adverse drug reactions.