Begum Taslima, Arzmi Mohd H, Helal Uddin A B M, Khatib Alfi, Abbas Syed A, Ahmed Qamar U
Drug Discovery and Synthetic Chemistry Research Group, Department of Pharmaceutical Chemistry, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia.
Department of Fundamental Dental and Medical Sciences, Kulliyyah of Dentistry, International Islamic University Malaysia, Kuantan, Pahang, Malaysia.
J Taibah Univ Med Sci. 2024 Dec 12;19(6):1143-1156. doi: 10.1016/j.jtumed.2024.12.002. eCollection 2024 Dec.
(Roxb.) Korth, locally known as kratom, is a traditional medicinal plant from Southeast Asia, with mitragynine as its principal alkaloid. Similar to other medicinal plants, kratom has side effects and toxicities, which have been documented in scientific studies and case reports. The mitragynine sale and possession of kratom are prohibited in Malaysia but legalized in Thailand. In the US, kratom is not lawfully marketed as a drug product, a dietary supplement, or a food additive in conventional food. Despite these restrictions, individuals continue to self-administer kratom to alleviate various health problems, often without a comprehensive understanding of the associated toxicities. Hence, the primary aim of this review is to provide a comprehensive overview of the toxicities associated with kratom, drawing from scientific studies, case reports, and other relevant sources. It also addresses the management of these toxicities, identifies gaps in existing studies, and discusses future perspectives. Therefore, a literature review search was conducted to gather essential information for this review. The studies focused on metabolizing enzymes, indirectly indicating kratom toxicity. By contrast, the results directly demonstrated kratom's toxic effects on the liver, kidneys, lungs, and brain. Case studies, primarily from Western countries, involved both single and combination use of kratom. Thus, by shedding light on these aspects, we aim to enhance awareness among healthcare professionals and the general public. Additionally, identifying existing gaps can guide future scientific studies. Since prevention is better than cure, this review holistically presents information about the toxicities associated with the use of kratom leaves, serving anyone seeking to understand and prevent kratom-related toxicities.
(Roxb.) Korth，当地称为“kratom”，是一种来自东南亚的传统药用植物，其主要生物碱为帽柱木碱。与其他药用植物类似，kratom具有副作用和毒性，科学研究和病例报告中已有记载。在马来西亚，售卖和持有kratom中的帽柱木碱是被禁止的，但在泰国是合法的。在美国，kratom在传统食品中作为药品、膳食补充剂或食品添加剂进行合法销售是不被允许的。尽管有这些限制，人们仍继续自行服用kratom以缓解各种健康问题，且往往对相关毒性缺乏全面了解。因此，本综述的主要目的是从科学研究、病例报告和其他相关来源中全面概述与kratom相关的毒性。它还涉及这些毒性的管理，识别现有研究中的空白，并讨论未来展望。因此，进行了文献综述搜索以收集本综述所需的基本信息。这些研究聚焦于代谢酶，间接表明了kratom的毒性。相比之下，这些结果直接证明了kratom对肝脏、肾脏、肺和大脑的毒性作用。主要来自西方国家的案例研究涉及kratom的单独使用和联合使用。因此，通过阐明这些方面，我们旨在提高医疗专业人员和公众的认识。此外，识别现有空白可为未来的科学研究提供指导。由于预防胜于治疗，本综述全面介绍了与使用kratom叶相关的毒性信息，为任何寻求了解和预防与kratom相关毒性的人提供帮助。
