Systematic review of published data on herb induced liver injury

Herbal products have been widely used as a means of ethnomedicine worldwide. Recently, the potential hepatotoxicity of herbs has become a medical issue but comprehensive studies are limited. This study aims to determine the clinical features of herb induced liver injury (HILI) including its constitu...

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Published inJournal of ethnopharmacology Vol. 233; pp. 190 - 196
Main Authors Byeon, Jung-Hwan, Kil, Ji-Hye, Ahn, Yo-Chan, Son, Chang-Gue
Format Journal Article
LanguageEnglish
Published Ireland Elsevier B.V 06.04.2019
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Abstract Herbal products have been widely used as a means of ethnomedicine worldwide. Recently, the potential hepatotoxicity of herbs has become a medical issue but comprehensive studies are limited. This study aims to determine the clinical features of herb induced liver injury (HILI) including its constituent ratio among liver injury case cohorts that included both HILI and drug induced liver injury (DILI). A systematic review was conducted using a literature search for DILI/HILI in seven electric databases including PubMed, Cochrane and Embase. We analyzed the DILI/HILI cases and clinical characteristics in terms of herbs, conventional drugs, concomitant, or others. Thirty-one studies met the necessary criteria and included 9 prospective and 22 retrospective studies. Among total number of overall DILI/HILI cases (7511, male 2819, female 3669 and unknown 1023), 25.0% (1874 cases) were implicated in herbs. HILI was relatively higher in females (69.8% vs. 30.2% male), compared to conventional drugs (57.3% female vs. 42.7% male, p < 0.01), while it was prone to induce hepatocellular injury (hepatocellular 78.8%, cholestatic 8.9%, mixed type 12.3%), contrary to conventional drugs (hepatocellular 56.7% vs. cholestatic 22.1% vs. mixed 21.2%), respectively (p < 0.01). The main herbs causing HILI included Polygonum multiflorum, Psoralea corylifolia, Corydalis yanhusuo, and Rheum officinale. This review created the comparative and comprehensive feature of hepatotoxicity by herbal products, which provides reference data for the clinical applications and establishing pharmacovigilance system of herbs. [Display omitted]
AbstractList Herbal products have been widely used as a means of ethnomedicine worldwide. Recently, the potential hepatotoxicity of herbs has become a medical issue but comprehensive studies are limited. This study aims to determine the clinical features of herb induced liver injury (HILI) including its constituent ratio among liver injury case cohorts that included both HILI and drug induced liver injury (DILI). A systematic review was conducted using a literature search for DILI/HILI in seven electric databases including PubMed, Cochrane and Embase. We analyzed the DILI/HILI cases and clinical characteristics in terms of herbs, conventional drugs, concomitant, or others. Thirty-one studies met the necessary criteria and included 9 prospective and 22 retrospective studies. Among total number of overall DILI/HILI cases (7511, male 2819, female 3669 and unknown 1023), 25.0% (1874 cases) were implicated in herbs. HILI was relatively higher in females (69.8% vs. 30.2% male), compared to conventional drugs (57.3% female vs. 42.7% male, p < 0.01), while it was prone to induce hepatocellular injury (hepatocellular 78.8%, cholestatic 8.9%, mixed type 12.3%), contrary to conventional drugs (hepatocellular 56.7% vs. cholestatic 22.1% vs. mixed 21.2%), respectively (p < 0.01). The main herbs causing HILI included Polygonum multiflorum, Psoralea corylifolia, Corydalis yanhusuo, and Rheum officinale. This review created the comparative and comprehensive feature of hepatotoxicity by herbal products, which provides reference data for the clinical applications and establishing pharmacovigilance system of herbs. [Display omitted]
Herbal products have been widely used as a means of ethnomedicine worldwide. Recently, the potential hepatotoxicity of herbs has become a medical issue but comprehensive studies are limited. This study aims to determine the clinical features of herb induced liver injury (HILI) including its constituent ratio among liver injury case cohorts that included both HILI and drug induced liver injury (DILI). A systematic review was conducted using a literature search for DILI/HILI in seven electric databases including PubMed, Cochrane and Embase. We analyzed the DILI/HILI cases and clinical characteristics in terms of herbs, conventional drugs, concomitant, or others. Thirty-one studies met the necessary criteria and included 9 prospective and 22 retrospective studies. Among total number of overall DILI/HILI cases (7511, male 2819, female 3669 and unknown 1023), 25.0% (1874 cases) were implicated in herbs. HILI was relatively higher in females (69.8% vs. 30.2% male), compared to conventional drugs (57.3% female vs. 42.7% male, p < 0.01), while it was prone to induce hepatocellular injury (hepatocellular 78.8%, cholestatic 8.9%, mixed type 12.3%), contrary to conventional drugs (hepatocellular 56.7% vs. cholestatic 22.1% vs. mixed 21.2%), respectively (p < 0.01). The main herbs causing HILI included Polygonum multiflorum, Psoralea corylifolia, Corydalis yanhusuo, and Rheum officinale. This review created the comparative and comprehensive feature of hepatotoxicity by herbal products, which provides reference data for the clinical applications and establishing pharmacovigilance system of herbs.
Author Byeon, Jung-Hwan
Kil, Ji-Hye
Son, Chang-Gue
Ahn, Yo-Chan
Author_xml – sequence: 1
  givenname: Jung-Hwan
  surname: Byeon
  fullname: Byeon, Jung-Hwan
  email: michael4520@naver.com
  organization: Korean Medical College of Daejeon University, 62, Daehak-ro Dong-gu, Daejeon 301-716, Republic of Korea
– sequence: 2
  givenname: Ji-Hye
  surname: Kil
  fullname: Kil, Ji-Hye
  email: sophia4256@gmail.com
  organization: Korean Medical College of Daejeon University, 62, Daehak-ro Dong-gu, Daejeon 301-716, Republic of Korea
– sequence: 3
  givenname: Yo-Chan
  surname: Ahn
  fullname: Ahn, Yo-Chan
  email: ycahn@dju.kr
  organization: Department of Health Service Management, Daejeon University, 62, Daehak-ro Dong-gu, Daejeon 301-716, Republic of Korea
– sequence: 4
  givenname: Chang-Gue
  surname: Son
  fullname: Son, Chang-Gue
  email: ckson@dju.ac.kr
  organization: Liver and Immunology Research Center, Dunsan Oriental Hospital of Daejeon University, 75, Daedeok-daero 176, Seo-gu, Daejeon 35253, Republic of Korea
BackLink https://www.ncbi.nlm.nih.gov/pubmed/30639232$$D View this record in MEDLINE/PubMed
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Keywords DILI
PAs
Liver
RUCAM
Traditional Chinese medicine
TSG
MFDS
Hepatotoxic
Adverse effect
HSOS
ADR
TKM
Drug-induced liver injury
Herbal drug
HILI
TCM
Language English
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Snippet Herbal products have been widely used as a means of ethnomedicine worldwide. Recently, the potential hepatotoxicity of herbs has become a medical issue but...
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SubjectTerms Adverse effect
Drug-induced liver injury
Hepatotoxic
Herbal drug
Liver
Traditional Chinese medicine
Title Systematic review of published data on herb induced liver injury
URI https://dx.doi.org/10.1016/j.jep.2019.01.006
https://www.ncbi.nlm.nih.gov/pubmed/30639232
Volume 233
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