Neuman Manuela G, Cohen Lawrence, Opris Mihai, Nanau Radu M, Hyunjin Jeong
In Vitro Drug Safety and Biotechnology and Department of Pharmacology and Toxicology, University of Toronto, Canada.
J Pharm Pharm Sci. 2015;18(4):825-43. doi: 10.18433/j3bg7j.
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.
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.
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.
本文旨在1）综述含吡咯里西啶生物碱（PA）的草药所致的肝脏毒性；2）促使人们认识并预防使用补充和替代医学时遇到的常见问题；3）综述含PA草药的毒性作用。
我们使用PubMed和谷歌学术搜索引擎进行了系统的文献检索。检索不限语言。我们还对数据进行了解读。
含PA的草药可导致肝损伤，包括肝窦阻塞综合征或静脉闭塞性疾病。预防此类草药过量使用并监测其长期使用情况，可避免谷胱甘肽耗竭导致线粒体损伤，从而避免肝细胞损伤。此外，立即停用草药可防止对肝脏造成进一步损害。长期摄入肝毒性物质可导致癌症形成和发展。PA诱导的肝脏毒性中活性代谢产物的作用及其作用机制有待进一步研究。本文接受发表后评论。注册读者（见“致读者”）可通过点击本期目录页面上的“摘要”进行评论。
