Analysis of adulterants in a traditional herbal medicinal product using liquid chromatography-mass spectrometry-mass spectrometry

Complementary and alternative medicines and liver disease

Complementary and alternative medicines (CAM) include conventional medical treatments. Patients worldwide use CAM at alarming rates; thus, reports of CAM-related DILI have been on the rise. The clinical presentations include asymptomatic liver test abnormalities, acute hepatitis with or without jaundice, acute cholestatic liver disease (bland or with hepatitis), acute liver failure, severe hepatitis with features of portal hypertension, and acute decompensation of known or unknown cirrhosis that can lead to acute-on-chronic liver failure. Acute hepatitis with or without necrosis, hepatocellular and canalicular cholestasis, herb-induced or CAM-triggered autoimmune hepatitis, granulomatous hepatitis, severe steatohepatitis, and vanishing bile duct syndrome are common liver biopsy findings in CAM-DILI. The presence of preexisting liver disease predicts severe liver injury, risk of progression to liver failure, and decreased transplant-free survival in patients with CAM-DILI. This review discusses global epidemiology and trends in CAM-DILI, clinical presentation, assessment and outcomes, commonly emerging threats in the context of hepatotoxic herbs, pragmatic assessment of "liver beneficial" herbs and health care myths, patient communication, regulatory framework, and future directions on research in CAM.

Risk characterisation of constituents present in jamu to promote its safe use

Safety in use of jamu consumption, as part of traditional medicine from Indonesia, is dependent on the complete and adequate assessment of potential hazards and risks of the botanicals and botanical constituents included. This includes especially hazards and risks related to the presence in jamu of active pharmaceutical ingredients (APIs) as well as of constituents that are genotoxic and carcinogenic. The present review presents an overview of the current state-of-the art on these hazards and risks based on case reports on adulteration, and the actual detection of genotoxic and carcinogenic ingredients of concern in jamu. Based on the overview thus obtained, it appears that drug-adulteration presents important hazards responsible for potential adverse effects, due to overdosing. The potential hazards of exposure to APIs mainly relate to the presence of constituents that may cause liver damage, renal impairment, kidney failure, steroid dependence or genotoxicity and carcinogenicity. For these APIs, a risk characterisation was performed based on comparison of health-based guidance values (HBGVs) and exposure, while for the genotoxic carcinogens the margin of exposure (MOE) approach was used. Results of this risk characterisation should be used by risk managers to impose specification for constituents of health concern to protect consumers. It is concluded that to manage the risks identified and further improve the safety in use of jamu, a collaboration between farmers, manufacturer/producers, academia, government, health professionals, and consumers is indicated.

Application of delayed luminescence measurements for the identification of herbal materials: a step toward rapid quality control

BACKGROUND

Herbal materials are widely used as medicinal products, dietary supplements, food, and spices. With increased consumption, the safety, quality, and efficacy of herbal materials are becoming more relevant. The authenticity of herbal materials plays an important role in herbal quality control, and there is an urgent need to develop a simple, direct, objective, rapid, and inexpensive measurement tool for the identification of herbal materials for the purpose of quality control.

METHODS

Delayed luminescence (DL) was used to measure authentic and counterfeit herbal materials. A hyperbolic function was used to extract four properties from the DL curves of the herbal materials. Statistical tools, including Student's t test and Principal Component Analysis, were used to differentiate authentic and counterfeit herbal materials based on the DL properties.

RESULTS

Our results showed that authentic and counterfeit herbal materials could be identified based on the DL properties as follows: (a) authentic versus counterfeit materials; (b) authentic versus adulterated materials; (c) authentic versus sulfur-fumigated materials; as well as (d) authentic versus dyed materials.

CONCLUSION

The simple, direct, rapid, and inexpensive measurements offered by DL potentially offer a novel technique for the identification of Chinese herbal materials. However, the establishment of a valid database will be the next step toward the possible application of this technique, which would contribute significantly to the development of a novel digital tool for the quality control of herbal materials.

Common risks of adulterated and mislabeled herbal preparations

Due to the growing trend of returning to nature and the fear of adverse reactions from conventional medicines, people are increasingly resorting to the use of herbal preparations. Because of long-term use and natural origin these preparations give a sense of security. But herbal formulations also possess undesirable effects and, among other dangers, present a risk connected with deliberate addition of synthetic compounds, deliberate or unintentional replacement of the plant species or simply a risk of mislabeling. While the replacement of the plant species occurs in a very different groups of herbal products, reports of added illicit synthetic substances often include groups of herbal weight-loss preparations, sexual enhancers, preparations for treatment of rheumatic and inflammatory diseases, antidiabetic and blood pressure lowering preparations. In the world of Internet ordering, these are the dangers that everyone should be aware of. In this article, we reviewed the safety issues related to adulterated or mislabeled herbal products.

Quality Control Standardization and Evaluation of Antimicrobial Potential of Daruhaldi (Berberis aristata DC) Stem Bark

Berberis aristata is used for the treatment of diabetes, piles, and liver diseases. As the drug is broadly used in Indigenous systems of medicine, it was designed to set the quality standards and antimicrobial potential for the stem bark of Berberis aristata. Botanical, physicochemical, pharmacotoxicological, fluorescence, microbial load, and phytochemical parameters of the stem bark were determined. High-performance thin-layer chromatography (HPTLC) was carried out by the CAMAG-HPTLC system. Berberine, total phenolics, and flavonoids were estimated. The antimicrobial potential was determined against the bacteria Bacillus subtilis and Escherichia coli and fungi Penicillium citrinum and Aspergillus terreus. The foreign matter, foaming index, swelling index, bitterness value, resin content, loss on drying, total ash, acid-insoluble ash, water-soluble ash, heavy metals, microbial load, berberine content, total phenolic content, and total flavonoid content were found to be 0, 0, 5, 1.34, 0.86%, 2.07%, 4.33%, 0.28%, 2.66%, within limits, 6 colonies in 1/100 dilution, 0.032 mg/g, 144.04 µg/ml, and 85.61 µg/ml, respectively. Phytochemicals such as phenolics, flavonoids, and sterols were present in the methanolic extract. The fluorescences observed in UV light were of different colors in different solvents. The methanolic extract and standards exhibited antimicrobial activity at the tested concentrations against the microbial strains. Results confirmed the quality and purity of the drug B. aristata. Results also confirmed that methanolic extract of B. aristata stem bark possesses potent antimicrobial activity. Thus, the use of this quality-controlled plant-derived drug with established antimicrobial property could be of great significance in quality-control standardization and preventive and therapeutic approaches to infectious diseases.

Analysis of trace amounts of adulterants found in powders/supplements utilizing Raman spectroscopy coupled to direct analyte-probed nanoextraction-nanospray ionization-mass spectrometry

In the United States, all food products have to be regulated to inform the consumers of the ingredients contained within. Some ingredients are not included on the label and yet are still found in the products. Presented is a Raman imaging technique for rapid, nondestructive, and spatially relevant localization of adulterants in powders. Raman spectroscopy followed by direct analyte-probed nanoextraction coupled to nanospray ionization-mass spectrometry allows rapid determination of the presence of each adulterant, leading to positive identifications such as melamine. The location and identification of these trace particles can then be extracted using a nanomanipulator. The nanomanipulation technique uses a solvent filled capillary tip which can be positioned on the particle of interest. Direct mass spectrometric analysis via nanospray of the particulate of interest eliminates time consuming chromatographic techniques prior to mass spectrometry analysis. This coupled technique combines rapid Raman spectroscopy techniques with direct mass spectrometry to confirm the presence of an adulterant. This technique was applied to an FDA supplied test sample, in which sibutramine, phenolphthalein, and melamine were confirmed to be present.

A comparison of patterns of spontaneous adverse drug reaction reporting with St. John's Wort and fluoxetine during the period 2000-2013

Herbal medicines are perceived to be safe by the general public and medical practitioners, despite abundant evidence from clinical trials and case reports that show herbal preparations can have significant adverse effects. The overall impact of adverse events to herbal medicines in Australia is currently unknown. Post marketing surveillance of medications through spontaneous adverse drug reaction (ADR) reports to the Therapeutic Goods Administration (TGA) is one way to estimate this risk. The patterns of spontaneously reported ADRs provide insight to herbal dangers, especially when compared with patterns of a mechanistically similar conventional drug. The study compared the pattern of spontaneously reported ADRs to St. John's Wort (Hypericum perforatum), a common herbal treatment for depression which contains selective serotonin reuptake inhibitors (SSRI), to fluoxetine, a commonly prescribed synthetic SSRI antidepressant. Spontaneous ADR reports sent to the TGA between 2000-2013 for St. John's Wort (n = 84) and fluoxetine (n = 447) were obtained and analysed. The demographic information, types of interaction, severity of the ADR, and the body systems affected (using the Anatomical Therapeutic Chemical classification system) were recorded for individual ADR cases. The majority of spontaneously reported ADRs for St. John's Wort and fluoxetine were concerning females aged 26-50 years (28.6%, 22.8%). The organ systems affected by ADRs to St John's Wort and fluoxetine have a similar profile, with the majority of cases affecting the central nervous system (45.2%, 61.7%). This result demonstrates that herbal preparations can result in ADRs similar to those of prescription medications.

Mass spectrometric analysis of pharmaceutical adulterants in products labeled as botanical dietary supplements or herbal remedies: a review

The increased availability and use of botanical dietary supplements and herbal remedies among consumers has been accompanied by an increased frequency of adulteration of these products with synthetic pharmaceuticals. Unscrupulous producers may add drugs and analogues of various classes, such as phosphodiesterase type 5 (PDE-5) inhibitors, weight loss, hypoglycemic, antihypertensive and anti-inflammatory agents, or anabolic steroids, to develop or intensify biological effects of dietary supplements or herbal remedies. The presence of such adulterated products in the marketplace is a worldwide problem and their consumption poses health risks to consumers. Analytical methods that allow rapid and reliable testing of dietary supplements for the presence of synthetic drugs are needed to address such fraudulent practices. Mass spectrometry (MS) and hyphenated techniques such as liquid chromatography-mass spectrometry (LC-MS) and gas chromatography-mass spectrometry (GC-MS) have become primary tools in this endeavor. The present review critically assesses the role and summarizes the applications of MS in the analysis of pharmaceutical adulterants in botanical dietary supplements and herbal remedies. The uses of MS techniques in detection, confirmation, and quantification of known pharmaceutical adulterants as well as in screening for and structure elucidation of unexpected adulterants and novel designer drugs are discussed.

A quantitative documentation of the composition of two powdered herbal formulations (antimalarial and haematinic) using ethnomedicinal information from ogbomoso, Nigeria

The safety of many African traditional herbal remedies is doubtful due to lack of standardization. This study therefore attempted to standardize two polyherbal formulations from Ogbomoso, Oyo State, Nigeria, with respect to the relative proportions (weight-for-weight) of their botanical constituents. Information supplied by 41 local herbal practitioners was statistically screened for consistency and then used to quantify the composition of antimalarial (Maloff-HB) and haematinic (Haematol-B) powdered herbal formulations with nine and ten herbs, respectively. Maloff-HB contained the stem bark of Enantia chlorantha Oliv. (30.0), Alstonia boonei De Wild (20.0), Mangifera indica L. (10.0), Okoubaka aubrevillei Phelleg & Nomand (8.0), Pterocarpus osun Craib (4.0), root bark of Calliandra haematocephala Hassk (10.0), Sarcocephalus latifolius (J. E. Smith) E. A. Bruce (8.0), Parquetina nigrescens (Afz.) Bullock (6.0), and the vines of Cassytha filiformis L. (4.0), while Haematol-B was composed of the leaf sheath of Sorghum bicolor Moench (30.0), fruit calyx of Hibiscus sabdariffa L. (20.0), stem bark of Theobroma cacao L. (10.0), Khaya senegalensis (Desr.) A. Juss (5.5), Mangifera indica (5.5), root of Aristolochia ringens Vahl. (7.0), root bark of Sarcocephalus latifolius (5.5), Uvaria chamae P. Beauv. (5.5), Zanthoxylum zanthoxyloides (Lam.) Zepern & Timler (5.5), and seed of Garcinia kola Heckel (5.5). In pursuance of their general acceptability, the two herbal formulations are recommended for their pharmaceutical, phytochemical, and microbial qualities.

Analytical methods for the detection of undeclared synthetic drugs in traditional herbal medicines as adulterants

Traditional herbal medicines (THMs) are gaining popularity worldwide as an alternative approach to prescription drugs for many reasons including a general perception that they are safe. But recently there have been number of reported studies that reveal adulteration of THMs with undeclared synthetic drugs, which may potentially cause serious toxic adverse effects. This paper reviews the various classes of synthetic drugs that were found to be adulterated in THMs worldwide. The main focus is to highlight newer analytical tools used to detect adulteration. Due to the advancement in hyphenated techniques like liquid chromatography tandem mass spectrometry (LC-MS/MS), gas chromatography-tandem mass spectrometry (GC-MS/MS) and other conventional tools, it has become possible to detect synthetic drugs and their structural analogues as adulterants even if they are present in small quantities. This review also gives an overview of health-related risks after consuming such spurious products and challenges for future perspectives to control such type of malpractices.

Rapid detection and identification of counterfeit and [corrected] adulterated products of synthetic phosphodiesterase type-5 inhibitors with an atmospheric solids analysis probe

The market success of the three approved synthetic phosphodiesterase type-5 (PDE-5) inhibitors for the treatment of erectile dysfunction has led to an explosion in counterfeit versions of these drugs. In parallel a large market has developed for herbal products claimed to be natural alternatives to these synthetic drugs. The herbal products are heavily advertised on the internet and are freely available to purchase without prescription. Furthermore, adulteration of these supposed natural medicines is a very common and serious phenomenon. Recent reports have shown that the adulteration has extended to the analogues of the three approved synthetic PDE-5 inhibitors. An Atmospheric Solids Analysis Probe (ASAP) was used for the direct analysis of the counterfeit pharmaceuticals and herbal products. Using the ASAP combined with time-of-flight mass spectrometry (TOF MS) it was possible to detect fraudulent counterfeit tablets. The physical appearance of the pills resembled the pills from the original manufacturer but contained the wrong active pharmaceutical ingredient (API). Detecting adulteration for five herbal supplements marketed as natural alternatives to PDE-5 inhibitors was also possible using the ASAP. Three types of adulteration were found in the five samples: adulteration with tadalafil or sildenafil, mixed adulteration (tadalafil and sildenafil), and adulteration with analogues of these drugs.

[Significance of herbal drugs legislation for their rational use]

<zakljucak> Kvalitet i bezbednost upotrebe biljnih preparata ostaju i dalje prioritet koji treba zakonski urediti na svetskom nivou. Za registraciju biljnog preparata kao leka postoje isti zahtevi kao i za registraciju drugih lekova u pogledu dokumentacije koja treba da sadrzi predklinicka i klinicka ispitivanja. Ovakva ispitivanja vrlo su zahtevna, a kako slozenost molekulske gradje, cak i jednokomponentnih biljnih preparata, ometa utvrdjivanje jedinstvenih kriterijuma za jasno pracenje njihovih terapijskih efekata, ispunjavanje zahteva za registrovanje biljnih preparata kao lekova u praksi jos uvek je izazov i za naucnike i za proizvodjace.

High-performance liquid chromatographic fingerprint analysis for different origins of sea buckthorn berries

Using high-performance liquid chromatography (HPLC), a chemical fingerprint method was developed for investigating and demonstrating the variance of flavonoids among different origins of sea buckthorn berries. Thirty-four samples were analyzed including 15 RS (Hippophae rhamnoides ssp. sinensis) samples, 7 RY (H. rhamnoindes ssp. yunnanensis) samples, 5 RW (H. rhamnoides ssp. wolongensis) samples, 4 NS (H. neurocarpa ssp. stellatopilosa) samples and 3 TI (H. tibetana) samples. In the HPLC chromatograms, 12 compounds were identified as flavonoids, including quercetin 3-O-sophoroside-7-rhamnoside, kaempferol 3-O-sophoroside-7-O-rhamnoside, isorhamnetin 3-O-sophoroside-7-O-rhamnoside, isorhamnetin 3-O-glucoside-7-O-rhamnoside, quercetin 3-O-rutinoside, quercetin 3-O-glucoside, isorhamnetin 3-O-rutinoside, isorhamnetin 3-O-glucoside, quercetin, kaempferol 7-O-rhamnoside, kaempferol and isorhamnetin. Both correlation coefficient of similarity in chromatograms and relative peak areas of characteristic compounds were calculated for quantitative expression of the HPLC fingerprints. Our results revealed that the chromatographic fingerprint combining similarity evaluation could efficiently identify and distinguish sea buckthorn berries from different species. However, no obvious difference between RS and RY suggested that the two subspecies might have very close relationship in terms of chemotaxonomy. The established method was considered to be suitable for fingerprint analysis to check the genuine origin and control the quality of sea buckthorn berries and extracts.

A comparative study of multilayer perceptron neural networks for the identification of rhubarb samples

Artificial neural networks have gained much attention in recent years as fast and flexible methods for quality control in traditional medicine. Near-infrared (NIR) spectroscopy has become an accepted method for the qualitative and quantitative analyses of traditional Chinese medicine since it is simple, rapid, and non-destructive. The present paper describes a method by which to discriminate official and unofficial rhubarb samples using three layer perceptron neural networks applied to NIR data. Multilayer perceptron neural networks were trained with back propagation, delta-bar-delta and quick propagation algorithms. Results obtained using these methods were all satisfactory, but the best outcomes were obtained with the delta-bar-delta algorithm.

High-performance thin-layer chromatographic fingerprints of isoflavonoids for distinguishing between Radix Puerariae Lobate and Radix Puerariae Thomsonii

The roots of Pueraria lobata (Wild.) Ohwi and Pueraria thomsonii Benth have been officially recorded in all editions of Chinese Pharmacopoeia under the same monograph 'Gegen' (Radix Puerariae, RP). However, in its 2005 edition, the two species were separated into both individual monographs, namely 'Gegen' (Radix Puerariae Lobatae, RPL) and 'Fenge' (Radix Puerariae Thomsonii, RPT), respectively, due to their obvious content discrepancy of puerarin, the major active constituent. In present paper, the fingerprint of high-performance thin-layer chromatography (HPTLC) combining digital scanning profiling was developed to identify and distinguish the both species in detail. The unique properties of the HPTLC fingerprints were validated by analyzing ten batches of Pueraria lobata and P. thomsonii samples, respectively. The common pattern of the HPTLC images of the roots of Pueraria spp. and the respective different ratios of the chemical distribution can directly discern the two species. The corresponding digital scanning profiles provided an easy way for quantifiable comparison among the samples. Obvious difference in ingredient content and HPTLC patterns of the two species questioned their bio-equivalence and explained that recording both species separately in the current edition of Chinese Pharmacopoeia (2005 edition) is reasonable due to not only the content of major constituent, puerarin, but also the peak-to-peak distribution in the fingerprint and integration value of the total components. Furthermore, the HPTLC fingerprint is also suitable for rapid and simple authentication and comparison of the subtle difference among samples with identical plant resource but different geographic locations.

Application of LC-ESI-MS-MS for detection of synthetic adulterants in herbal remedies

Adulteration of allegedly "natural herbal medicines" with undeclared synthetic drugs is a common and dangerous phenomenon of alternative medicine. The purpose of the study was to develop a procedure for detection of most common synthetic adulterants in herbal remedies, using high-pressure liquid chromatography-electrospray tandem mass spectrometry (LC-ESI-MS-MS). Eighty drugs belonging to various pharmacological classes were included in the study. For most drugs two transitions were monitored, using protonated or deprotonated molecules as precursor ions. The drugs were isolated from herbal remedies using simple methanol extraction. Chromatographic separation was done in gradient of acetonitrile-10 mM ammonium formate buffer (pH 3.0). Drugs tested were grouped in suites, comprising analgesic drugs, antibiotics, antidiabetic drugs, antiepileptic drugs, aphrodisiacs, hormones and anabolic drugs, psychotropic drugs, and weight reducing compounds. These suites were used according to the declared benefits of examined preparations. Limits of detection ranged from 5 pg to 1 ng per injected sample. Drug-free herbal remedy spiked with eight various pharmaceuticals occurring in adulterated herbal preparations was used for internal proficiency testing. The recoveries of spiked drugs ranged from 63 to 100%. The procedure was applied in everyday casework. Several undeclared drugs were identified in "herbal" remedies, like e.g. sildenafil, tadalafil, testosterone, or glibenclamide. Pharmacological properties of detected drugs always corresponded with the claims of the "natural" remedies. The method presents a valuable extension of standard GC-MS screening used for this purpose.

Fingerprint quality control of Tianjihuang by high-performance liquid chromatography–photodiode array detection

A novel, simple and accurate fingerprint method was developed using high-performance liquid chromatography-photodiode array detection (HPLC-DAD) for the quality control of Hypericum japonicum thunb (Tianjihuang), a Chinese herbal medicine used for the treatment of several bacterial diseases, infectious hepatitis, gastrointestinal disorder, internal hemorrhage and tumors. For the first time, the feasibility and advantages of employing chromatographic fingerprint were investigated and demonstrated for the evaluation of Tianjihuang by systematically comparing chromatograms with a professional analytical software recommended by State Food and Drug Administration (SFDA). Our results revealed that the chromatographic fingerprint combining similarity evaluation could efficiently identify and distinguish raw herbs of Tianjihuang from different sources. The effects resulted from collecting locations, harvesting time and storage time on herbal chromatographic fingerprints were also examined.

Regulatory control of Chinese Proprietary Medicines in Singapore

In Singapore, there has been a growing public interest in traditional Chinese medicine (TCM), which plays an important role in the healthcare system. With effect from 1 September 1999, the control on Chinese Proprietary Medicines (CPM) was implemented in three phases over a span of 3 years. Under the CPM regulatory framework, CPM importers, wholesalers, manufacturers and re-packers must be licensed and CPM products assessed and listed by the health authority before they are allowed for sale. Product assessment is based on the criteria of safety and quality which include limits of toxic heavy metals and microbial contents. During the 3-year CPM listing exercise, irregularities were detected, including intrinsic toxicity, adulteration, substitution, contamination, misidentification, non-traditional and/or inappropriate usage, incorrect preparation, inappropriate labelling, exaggerated claims and/or advertising. The full implementation of CPM control by September 2001 saw the listing of 7943 CPM products and brought about an improvement in the quality and safety of CPM in Singapore as well as the removal of sub-standard, fake/imitation and adulterated products. The standards of practices by local CPM dealers have also been raised. These improvements have, in turn, increased the level of public confidence in CPM products in Singapore.

Recent advances in analysis of Chinese medical plants and traditional medicines

Chinese herbal medicine is gaining increasing popularity worldwide for health promotion and adjuvant therapy. Thus, selective and efficient analytical methods are required not only for quality assurance but also for authentication of the plant material. Applications of both chromatographic and electrophoretic techniques to the analysis of medicinal plants and Chinese traditional medicine preparations over the last 3 years are outlined in this review. The role of chemical fingerprinting is highlighted and a brief survey of determination of toxic components, natural and synthetic adulterants is also included. Moreover, different sample pretreatment and extraction methods are discussed.