A review of herb-induced liver injury in mainland china

Abstract

Traditional medicines have greatly contributed to people’s health worldwide. However, in recent years, the frequent occurrence of herb-induced liver injury (HILI) has raised public concerns regarding the safety of herbs. HILI not only severely impacts public health, thus increasing its medical burden, but also consumes medical resources. However, the pharmacoepidemiology and risk factors of HILI are still unclear due to the complexity of herbs (medication theory, drug composition, dual properties of drugs and food, etc.). China is the country with the most extensive use of herbs and cases of HILI worldwide. The safety profile of herbs (especially with respect to HILI) has also affected the use of herbs internationally. Therefore, this review focuses on the epidemic situation of HILI in mainland China to compile its characteristics, while focusing on the three main aspects of patients, drugs, and unreasonable prescriptions to explore the potential risk factors. Our objective was to provide a reference for HILI pharmacovigilance and risk prevention and control and contribute to Chinese knowledge of the realisation of the “Medication without Harm” global safe medication strategic goal of the World Health Organization.

Growing attention on the toxicity of Chinese herbal medicine: a bibliometric analysis from 2013 to 2022

“…Hence, adverse events caused by the toxicity of CHM occurs in both clinical practice and the public health field. Notably, China experiences a higher proportion of toxic incidents caused by herbs compared to other countries ( Yang et al, 2022 ). As one of the oldest herbal remedies, CHM is often overused outside of prescription.…”

“…Fortunately, the toxicity of CHM garnered increased attention in recent years, with various safety regulatory standards, clinical practice guidelines and manifestos highlighting the urgency of this issue ( Yang et al, 2022 ). However, existing studies mainly focused on specific toxicities, resulting in a lack of overview to the overall safety of CHM.…”

The enhanced hepatotoxicity of isobavachalcone in depigmented zebrafish due to calcium signaling dysregulation and lipid metabolism disorder

“…The drug-induced liver injury associated with BXP mostly occurred in patients with immune-related diseases such as vitiligo and psoriasis (Yang et al, 2022). These reports of liver injury suggest that patients with vitiligo are prone to liver injury when taking Psoraleae Fructus.…”

“…Psoraleae Fructus is often combined with other traditional Chinese medicinal herbs to form compound preparations, such as Baixianpi (BXP) with Dictamni Cortex. Some reports (retrospective observation) have illustrated that the middle‐aged women with immune‐associated diseases present a higher risk of herb‐induced liver injury (Yang et al, 2022). The drug‐induced liver injury associated with BXP mostly occurred in patients with immune‐related diseases such as vitiligo and psoriasis (Yang et al, 2022).…”

“…Some reports (retrospective observation) have illustrated that the middle‐aged women with immune‐associated diseases present a higher risk of herb‐induced liver injury (Yang et al, 2022). The drug‐induced liver injury associated with BXP mostly occurred in patients with immune‐related diseases such as vitiligo and psoriasis (Yang et al, 2022). These reports of liver injury suggest that patients with vitiligo are prone to liver injury when taking Psoraleae Fructus.…”