PURPOSE: This article aimed 1) to review herbal medicine containing pyrrolizidine alkaloids (PA)-induced toxicities of the liver; 2) to encourage the recognition and prevention of common problems encountered when using complementary and alternative medicine and 3) to review the toxic effects of herbal remedies containing PAs. DESIGN AND METHODS: We performed a systematic literature search using the PubMed and Google Scholar engines. The search was not restricted to languages. We also provide an interpretation of the data. CONCLUSIONS: Herbal remedies containing PAs can induce liver damage, including hepato- sinusoidal obstruction syndrome or veno-occlusive disease. Preventing overdose and monitoring long-term use of such remedies may avoid glutathione depletion leading to mitochondrial injury, and therefore avoid liver cell damage. Moreover, immediately stopping the herbal medication prevents further harm to the liver. Chronic consumption of hepatotoxicants can lead to cancer formation and promotion. The role of active metabolites in PA-induced liver toxicity and their mechanism of action require further investigation. This article is open to POST-PUBLICATION REVIEW. Registered readers (see "For Readers") may comment by clicking on ABSTRACT on the issue's contents page.
PURPOSE: This article aimed 1) to review herbal medicine containing pyrrolizidine alkaloids (PA)-induced toxicities of the liver; 2) to encourage the recognition and prevention of common problems encountered when using complementary and alternative medicine and 3) to review the toxic effects of herbal remedies containing PAs. DESIGN AND METHODS: We performed a systematic literature search using the PubMed and Google Scholar engines. The search was not restricted to languages. We also provide an interpretation of the data. CONCLUSIONS: Herbal remedies containing PAs can induce liver damage, including hepato- sinusoidal obstruction syndrome or veno-occlusive disease. Preventing overdose and monitoring long-term use of such remedies may avoid glutathione depletion leading to mitochondrial injury, and therefore avoid liver cell damage. Moreover, immediately stopping the herbal medication prevents further harm to the liver. Chronic consumption of hepatotoxicants can lead to cancer formation and promotion. The role of active metabolites in PA-induced liver toxicity and their mechanism of action require further investigation. This article is open to POST-PUBLICATION REVIEW. Registered readers (see "For Readers") may comment by clicking on ABSTRACT on the issue's contents page.
Authors: Kelly A Shipkowski; Joseph M Betz; Linda S Birnbaum; John R Bucher; Paul M Coates; D Craig Hopp; Duffy MacKay; Hellen Oketch-Rabah; Nigel J Walker; Cara Welch; Cynthia V Rider Journal: Food Chem Toxicol Date: 2018-04-04 Impact factor: 6.023
Authors: Jean-François Picron; Mélanie Herman; Els Van Hoeck; Séverine Goscinny Journal: Environ Sci Pollut Res Int Date: 2019-02-18 Impact factor: 4.223
Authors: Oana Cristina Seremet; Octavian Tudorel Olaru; Claudia Maria Gutu; George Mihai Nitulescu; Mihaela Ilie; Simona Negres; Cristina Elena Zbarcea; Carmen Nicoleta Purdel; Demetrios A Spandidos; Aristides M Tsatsakis; Michael D Coleman; Denisa Marilena Margina Journal: Mol Med Rep Date: 2018-03-26 Impact factor: 2.952
Authors: Monika A Jarzabek; William R Proctor; Jennifer Vogt; Rupal Desai; Patrick Dicker; Gary Cain; Rajiv Raja; Jens Brodbeck; Dale Stevens; Eric P van der Stok; John W M Martens; Cornelis Verhoef; Priti S Hegde; Annette T Byrne; Jacqueline M Tarrant Journal: PLoS One Date: 2018-06-07 Impact factor: 3.240
Authors: Hellen A Oketch-Rabah; Amy L Roe; Cynthia V Rider; Herbert L Bonkovsky; Gabriel I Giancaspro; Victor Navarro; Mary F Paine; Joseph M Betz; Robin J Marles; Steven Casper; Bill Gurley; Scott A Jordan; Kan He; Mahendra P Kapoor; Theertham P Rao; Averell H Sherker; Robert J Fontana; Simona Rossi; Raj Vuppalanchi; Leonard B Seeff; Andrew Stolz; Jawad Ahmad; Christopher Koh; Jose Serrano; Tieraona Low Dog; Richard Ko Journal: Toxicol Rep Date: 2020-02-15