Abstract
The potential toxicity of herbal drugs, particularly drug-induced liver injury (DILI), has received extensive attention as the use of Chinese herbal medicine has rapidly increased globally. As a classic Chinese patent medicine, Zhuang Gu Guan Jie Wan (ZGGJW) has been brought into focus recently because of its satisfactory therapeutic effects on osteoarthritis (OA) as well as its unanticipated side effects. This study aimed to decipher the puzzling phenomenon of liver injury developing in response to ZGGJW that varies by the subtype of OA. Normal, anterior cruciate ligament transaction (ACLT) and partial medial meniscectomy (MMx) induced OA and ovariectomy combined with ACLT and partial MMx induced rat models were used and treated orally with ZGGJW or distilled water for 30 days. The results from histopathology, biochemistry, and immunohistochemistry showed that ZGGJW induced liver injury, increased the level of malondialdehyde (MDA), and decreased the levels of total antioxidation capability (T-AOC), superoxide dismutase (SOD), interleukin-22 (IL-22), and signal transducer and activator of transcription factor 3 (STAT3) in the liver of normal rats, while liver injury was alleviated and showed different tendencies in the above markers for ACLT and partial MMx induction rats and ovariectomy combined with ACLT and partial MMx induction rats after ZGGJW treatment. In the OA disease states, hepatic injury induced by ZGGJW could be associated with an impairment in antioxidant capacity and the high levels of IL-22 and STAT3 after ZGGJW treatment may be responsible for the slight hepatic injury of ZGGJW based on the subtype of OA. This study provides a novel approach to better understanding of the risks and limitations when using potentially toxic Chinese patent medicine in clinical applications.
Highlights
Traditional Chinese medicine (TCM) has been considered to be safe by the general public, since its components are naturally occurring and have been used for thousands of years
traditional Chinese medicine (TCM) is accepted by an increasing number of people worldwide, due to its proved clinical efficacy and because it is natural and has comparatively good tonifying properties when compared with conventional medicine [1, 2]
Normal joint structure and smooth articular cartilage surfaces were observed in the Con and ConT groups
Summary
Traditional Chinese medicine (TCM) has been considered to be safe by the general public, since its components are naturally occurring and have been used for thousands of years. TCM is accepted by an increasing number of people worldwide, due to its proved clinical efficacy and because it is natural and has comparatively good tonifying properties when compared with conventional medicine [1, 2]. The potential toxicity of Chinese patent medicine, drug-induced liver injury (DILI), has become a medical issue of concern with the use of herbal medicine rapidly increasing globally [8,9,10,11,12]. Liver injury from Chinese patent medicine is a major challenge that deserves special clinical and regulatory attention to improve the quality of case evaluations and ascertain the safety and benefit of these medicines [13, 14].
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