Abstract
Herbal medicine is widely used in Asia as well as the west. Hepatotoxicity is one of the most severe side effects of herbal medicine which is an increasing concern around the world. Reynoutria multiflora (Thunb.) Moldenke (Polygonum multiflorum Thunb., PM) is the most common herb that can cause herb-induced liver injury (HILI). The recent scientific and technological advancements in clinical and basic research are paving the way for a better understanding of the molecular aspects of PM-related HILI (PM-HILI). This review provides an updated overview of the clinical characteristics, predisposing factors, hepatotoxic components, and molecular mechanisms of PM-HILI. It can also aid in a better understanding of HILI and help in further research on the same.
Highlights
Herbal medicine, as a complementary and alternative medicine, is widely used in Asia as well as the west
The serum levels of tumor necrosis factor (TNF)-α, IL-1β, and IL-6 were significantly increased in patients susceptible to Reynoutria multiflora Moldenke (PM)-herb-induced liver injury (HILI) compared with those tolerant to PM-related HILI (PM-HILI), with a threefold increase in TNFα, and its levels significantly correlated with multiple differential metabolites
A targeted metabolomics study by Dong et al (Dong et al, 2015) showed that bile glycodeoxycholic acid levels and serum hyodeoxycholic acid (HDCA) levels are significantly decreased in PM-HILI rats, which may serve as potential biomarkers for PM-HILI
Summary
As a complementary and alternative medicine, is widely used in Asia as well as the west. The hepatotoxicity of drugs can be intrinsic or idiosyncratic (European Association for the Study of the Liver, 2019). The former refers to a liver injury that is closely related to drug dosage and timing, can be predicted, and has insignificant individual differences; the latter refers to a liver injury that is not correlated with the drug dosage and timing, is unpredictable, seen in a few people, and has a significant individual difference. Herbal medicine is a common cause of drug-induced liver injury (DILI). A recent study carried out in Asian countries focusing on the causes of DILI reported that herbal medicine accounts for about 25% of all DILI (Byeon et al, 2019; Shen et al, 2019). PMrelated HILI (PM-HILI) is seen only in a few of the patients consuming this herb
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