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Herbal Hepatotoxicity

  • Chit Shing Jackson Woo
  • Hani El-Nezami
Chapter

Abstract

The liver is probably the most important organ responsible for protecting humans from exposure to foreign compounds. With its strategic location between the intestinal tract and the circulation system, and its unique metabolic capacity, the liver acts as the first defense barrier metabolizing and detoxifying foreign compounds. In contrast, these features have rendered it highly susceptible to adverse and toxic effects. The current herbalism all over the globe has led to the increasing consumption of herbal products with an associated incidence of herbal hepatotoxicity. Herbal hepatotoxicity has been a well-recognized issue for years, but so far systematic studies are lacking. This chapter presents the current situation of liver damage induced by herbal products, the classification of herb-induced liver injuries (HILI), and their potential risk factors. The hepatotoxicity of selected well-known herbal products as reported in the literature is reviewed, and causality assessment for HILI is discussed.

Keywords

Herbal hepatotoxicity Herb-induced liver injury Herbal medicine Herbs Herbal remedy 

Abbreviations

ADP

Adenosine diphosphate

ADR

Adverse drug reaction

AG

Atractylis gummifera

ATP

Adenosine triphosphate

ATR

Atractyloside

CAM

Complementary and alternative medicine

CAT

Causality assessment tool

CIOMS

Council for the International Organization of Medical Sciences

CMV

Cytomegalovirus

CYP

Cytochrome P

DILI

Drug-induced liver injury

DILIN

Drug-Induced Liver Injury Network

EBV

Epstein-Barr virus

EPH

Ephedrine

FDA

Food and Drug Administration

HAV

Hepatitis A virus

HBV

Hepatitis B virus

HCV

Hepatitis C virus

HDS

Herbal and dietary supplements

HILI

Herb-induced liver injury

HSV

Herpes simplex virus

MV Scale

Maria and Victorino Scale

NDGA

Nordihydroguaiaretic acid

PA

Pyrrolizidine alkaloids

PSE

Pseudoephedrine

RUCAM

Roussel Uclaf Causality Assessment Method

TNF

Tumor necrosis factor

VZV

Vesicular stomatitis virus

WHO

World Health Organization

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© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Consumer and RetailSGS Hong Kong LimitedFanlingHong Kong
  2. 2.School of Biological Sciences, Faculty of ScienceThe University of Hong KongPokfulamHong Kong

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