Nagral Aabha, Rudra Omkar S, Menezes Sherna, Menon Sasikumar, Shailajan Sunita, Mallakmir Snehal, Reddy Rajender
Department of Gastroenterology, Jaslok Hospital & Research Centre, Peddar Road, Mumbai, India.
Department of Gastroenterology, Apollo Hospital, Navi Mumbai, India.
J Clin Exp Hepatol. 2023 Mar-Apr;13(2):360-371. doi: 10.1016/j.jceh.2022.11.001. Epub 2022 Nov 6.
(TC) is being increasingly consumed in India for its health and suggested immune-enhancing benefits in preventing and countering COVID-19. We previously published our experience of hepatotoxicity with self-medication of TC in six individuals. Since herb-induced liver injury (HILI) has been described with (TCR) consumption, it was contested that our patients may have mistakenly self-medicated with TCR which is similar in appearance to TC.
We collected the four plant samples and two commercial preparations that were consumed by our patients for further analysis. The six samples underwent high performance thin layer chromatography phytochemical analysis and DNA barcoding studies for the confirmation of the genus and species. The four plant part samples which included stems and leaves were also analysed by a botanist for the characteristic morphological and microscopic features.
Based on morphological, microscopic, phytochemical and DNA studies, the four plant part samples were identified as TC. The two commercial preparations could not be analysed on phytochemical analysis or DNA barcoding studies due to other ingredients that most likely interfered with the analysis. The herb consumed by our study subjects was confirmed to be .
We have highlighted the key morphological and phytochemical differences between these two species. We propose an algorithmic approach to accurately identify the implicated herb in cases of HILI. Future studies on causality need to focus on the serological/histopathological identification of active herb/metabolites in human tissues.
在印度，姜黄因其对健康有益且被认为具有增强免疫力以预防和对抗新冠病毒的作用，其消费量日益增加。我们之前发表了六例自行服用姜黄导致肝毒性的经验。由于已有食用姜黄属植物（郁金）导致草药性肝损伤（HILI）的描述，有人质疑我们的患者可能误服了外观与姜黄相似的郁金。
我们收集了患者食用的四种植物样本和两种商业制剂以供进一步分析。对这六个样本进行了高效薄层色谱植物化学分析和DNA条形码研究，以确认属和种。还让一位植物学家对包括茎和叶在内的四个植物部分样本进行了特征性形态和微观特征分析。
基于形态学、微观学、植物化学和DNA研究，四个植物部分样本被鉴定为姜黄。由于其他成分很可能干扰分析，所以无法对两种商业制剂进行植物化学分析或DNA条形码研究。我们研究对象食用的草药被确认为姜黄。
我们强调了这两个物种之间关键的形态和植物化学差异。我们提出了一种算法方法来准确识别HILI病例中涉及的草药。未来关于因果关系的研究需要专注于人体组织中活性草药/代谢物的血清学/组织病理学鉴定。
