An accidental case of aconite poisoning due to Kampo herbal medicine ingestion

Ono, Takiyoshi; Hayashida, Makiko; Uekusa, Kyoko; Lai, Cui Fan; Hayakawa, Hideyuki; Nihira, Makoto; Ohno, Youkichi

doi:10.1016/j.legalmed.2008.11.001

Cited by 21 publications

(10 citation statements)

References 5 publications

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“…Due to its toxicity, scientists analyzed the alkaloid content, nuclear DNA region, and internal transcribed spacer (ITS) from 107 Aconitum plants in Japan [67] and set the standard analytical method in the Japanese pharmacopeia [68]. The pharmacokinetics and toxicology of Aconitum preparations or powders were also studied [69,70]. It was revealed that aconite tuber can regulate peripheral vascular function by increasing the plasma levels of nitrite and nitrate, which was in agreement with the theory of Kampo medicine [71].…”

Section: Aconite Preparations In Kampo Medicinementioning

confidence: 99%

Clinical Aspects of Aconitum Preparations

Tai

El-Shazly

et al. 2015

Planta Med

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Aconitum, also known as monkshood, wolfʼs bane, or devilʼs helmet, has been widely used in folk medicine in China, India, and certain parts of Europe [1-4]. The genus Aconitum (Ranunculaceae) comprises 300 species distributed all over the world [5]. The most common species are Aconitum carmichaelii Deb. and Aconitum kusnezoffii Rchb. in China, Aconitum japonicum Thunb. in Japan, Aconitum napellus L. in Europe, Aconitum ferox Wall. ex Ser. in India, and Aconitum noveboracense A. Gray ex Coville in the United States [5]. Several classes of secondary metabolites, especially alkaloids, have been isolated from different Aconitum sp. [6]. The type of the isolated major alkaloids may vary depending on the species such as aconitine, hypaconitine, and mesaconitine from A. carmichaelii, aconitine from A. napellus, hypaconitine from A. septentrionale Koelle, mesaconitine from A. kusnezoffii, bikhaconitine from A. ferox, talatisamine from A. kongboense Lauener, atisine from A. anthora L., and A. heterophyllum Wall. ex Royle, and lycaconitine from A. vulparia Rchb. [6]. Several isoquinoline alkaloids and phenethylamine derivatives have also been isolated, such as higenamine from A. japonicum, magnoflorine from A. vulparia and A. napellus, coryneine from A. carmichaelii, and N-methyl adrenaline from A. nasutum Fisch. ex Rchb. [6]. Lipo-alkaloids including lipoaconitines, lipomesaconitines, lipodeoxyaconitines, and lipohypaconitines were also isolated [7, 8]. The efficacy of Aconitum sp. in resolving critical clinical conditions has been proven by doctors practicing traditional Chinese medicine (TCM) and Ayurvedic medicine for centuries. However, the long history of Aconitum sp. misuse in homicide cases has shaken the faith in the potential safe application of this herb in therapy [9, 10]. The recent developments in analytical techniques which can identify and determine the concentrations of toxic compounds in herbal products with impressive accuracy and reliability have rekindled the interest in Aconitum preparations [1, 5, 6, 11, 12].

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Section: Aconite Preparations In Kampo Medicinementioning

confidence: 99%

Clinical Aspects of Aconitum Preparations

Tai

El-Shazly

et al. 2015

Planta Med

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“…The lethal dose of aconitine alkaloids for humans is estimated to be 1-2 mg. Several cases of accidental or suicidal ingestion of aconitum have been reported in Japan and other countries [1,2]. Although homicidal death is extremely rare, homicidal poisoning cases have been reported [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Identification and Quantification of Aconitines and Colchicine in Serum, Urine, and Plants using MonoSpin C18 and LC-MSMS

et al. 2015

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“…These plants and their herbal formulations have been widely used in clinical applications, which include anti-inflammatory and analgesic functions [ 1 – 3 ]. However, the toxicity resulting from the main alkaloids in these plants, such as aconitine, cannot be neglected [ 4 – 7 ]. Processing and compatibility are the two main methods that can reduce the toxicity of aconite tubers through decreasing the content of toxic alkaloids [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Quantitative Assessment of the Influence of Rhizoma Zingiberis on the Level of Aconitine in Rat Gut Sacs and Qualitative Analysis of the Major Influencing Components of Rhizoma Zingiberis on Aconitine Using UPLC/MS

Yang

Liu

2015

PLoS ONE

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This study attempted to clarify the material basis for the detoxification of Rhizoma Zingiberis (RZ) on aconitine, an analgesic drug, by quantitatively assessing the influence of RZ on the in vitro intestinal concentration of aconitine using an everted gut sac model and by qualitatively identifying the components in the RZ extract. To quantify aconitine in rat everted gut sacs, both an accurate processing method and a sensitive detection method were required. We developed a three-step sample processing method to protect the components from decomposition and applied ultra-performance liquid chromatography coupled with triple quadrupole mass spectrometry (UPLC/TQMS) to quantify aconitine, glucose and digoxin. In addition, ultra-performance liquid chromatography coupled with linear ion trap mass spectrometry (UPLC/ITMS) was applied to detect the potential antidotal components in the RZ extract. Finally, the RZ extract reduced the level of aconitine in everted gut sacs, and eleven gingerols were successfully identified, which could be considered potential antidotal components for aconitine. This study demonstrated the application of two UPLC/MS methods for analyzing the material basis for the reciprocity between Chinese medicine components in everted gut sacs.

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An accidental case of aconite poisoning due to Kampo herbal medicine ingestion

Cited by 21 publications

References 5 publications

Clinical Aspects of Aconitum Preparations

Clinical Aspects of Aconitum Preparations

Identification and Quantification of Aconitines and Colchicine in Serum, Urine, and Plants using MonoSpin C18 and LC-MSMS

Quantitative Assessment of the Influence of Rhizoma Zingiberis on the Level of Aconitine in Rat Gut Sacs and Qualitative Analysis of the Major Influencing Components of Rhizoma Zingiberis on Aconitine Using UPLC/MS

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