Adelaide Medical School, The University of Adelaide, Level 2 Helen Mayo North Building, Frome Road, Adelaide, SA, 5005, Australia.
Department of Infectious Diseases, The University of Melbourne, Melbourne, VIC, 3010, Australia.
Forensic Sci Med Pathol. 2022 Dec;18(4):403-406. doi: 10.1007/s12024-022-00490-5. Epub 2022 Jun 24.
Unexpected hepatic failure with liver necrosis is sometimes encountered during a forensic autopsy. Determining the etiology may sometimes be difficult, although increasingly herbal medicines are being implicated. To determine whether such effects might also be caused by foodstuffs, the following in vitro study was undertaken. Four formulations of traditional herbal soup advertised as bak kut teh were prepared and added to cultures of liver carcinoma cells (HepG2). Cell viability was assessed using an MTT colorimetric assay at 48 h demonstrating that all formulations had significant toxicity prior to dilution (p < 0.05). Formulation #1 showed 21% cell death (p = 0.023), Formulation #2 30% (p = 0.009), and Formulation #3 41% (p < 0.0001). Formulations #1-3 showed no significant toxicity once diluted (p > 0.05). Formulation 4 showed approximately 83% cell death before dilution (p < 0.0001) and persistent toxicity even with dilutions at 1:10 (15% ± 3.7, p = 0.023) and 1:1000 (14% ± 3.8, p = 0.024). This study has shown that herbal foodstuffs such as bak kut teh may be responsible for variable degrees of in vitro hepatotoxicity, thus extending the range of herbal products that may be potentially injurious to the liver. If unexpected liver damage is encountered at autopsy, information on possible recent ingestion of herbal food preparations should be sought, as routine toxicology screening will not identify the active components. Liver damage may therefore be caused not only by herbal medicines but possibly by herbal products contained in food.
在法医解剖中，有时会意外发现肝坏死导致肝衰竭。虽然越来越多的草药被认为与这种情况有关，但确定病因有时可能很困难。为了确定这种影响是否也可能是由食物引起的，进行了以下体外研究。制备了四种广告宣传为肉骨茶的传统草药汤配方，并将其添加到肝癌细胞（HepG2）的培养物中。在 48 小时使用 MTT 比色法评估细胞活力，结果表明所有配方在稀释前均具有显著毒性（p<0.05）。配方 #1 显示 21%的细胞死亡（p=0.023），配方 #2 显示 30%（p=0.009），配方 #3 显示 41%（p<0.0001）。稀释后配方 #1-3 没有表现出明显的毒性（p>0.05）。配方 4 在稀释前显示约 83%的细胞死亡（p<0.0001），即使在 1:10（15%±3.7，p=0.023）和 1:1000（14%±3.8，p=0.024）的稀释度下也保持毒性。本研究表明，肉骨茶等草药食品可能导致不同程度的体外肝毒性，从而扩大了可能对肝脏造成潜在伤害的草药产品范围。如果在尸检中意外发现肝损伤，应寻找可能最近摄入草药食品制剂的信息，因为常规毒物筛查不会识别出活性成分。因此，肝损伤不仅可能由草药药物引起，还可能由食物中含有的草药产品引起。
