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Rivero-Pino F, Casanova AG. Hepatotoxicity due to dietary supplements: state-of-the-art, gaps and perspectives. Crit Rev Toxicol 2023; 53:601-610. [PMID: 38062980 DOI: 10.1080/10408444.2023.2282415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/23/2023] [Indexed: 12/22/2023]
Abstract
Food supplements are products intended to complement the normal diet and consist of concentrated sources of nutrients or other substances with a nutritional or physiological effect. Although they are generally considered safe if the manufacturer's recommendations are followed, many of them have shown hepatotoxic properties. This can cause many diseases (e.g. steatohepatitis and cirrhosis) characterized by progressive damage and malfunction of the liver that in the long term can lead to death. A review of the literature was carried out to elucidate which dietary supplements have been associated with cases of hepatotoxicity in recent years, with emphasis on those relevant to the consumer and the new trends (e.g. cannabidiol). It has been reported that the supplements described as hepatotoxic are mainly of botanical origin (e.g. green tea or turmeric) and those used in sports (mainly anabolic androgenic steroids). There is a great variability of compounds described as causing liver damage, although sometimes it is not possible to identify them, because they are contaminants or adulterants of the products. In addition, the prevalence of toxic effects after the administration of supplements is difficult to define due to underreporting and the lack of specific studies. Globally regarding hepatotoxicity of dietary supplements, there is a paucity of well-conducted clinical trials on the efficacy of these compounds and the frequency of related liver damage, as the use of these products is largely uncontrolled.
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Affiliation(s)
- Fernando Rivero-Pino
- Department of Medical Biochemistry, Molecular Biology, and Immunology, School of Medicine, University of Seville, Seville, Spain
| | - Alfredo G Casanova
- Toxicology Unit, Universidad de Salamanca, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Group of Translational Research on Renal and Cardiovascular Diseases (TRECARD), Salamanca, Spain
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2
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Pyrzanowska J. Pharmacological activity of Aspalathus linearis extracts: pre-clinical research in view of prospective neuroprotection. Nutr Neurosci 2023; 26:384-402. [PMID: 35311618 DOI: 10.1080/1028415x.2022.2051955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Rooibos tea, a very popular everyday beverage made of Aspalathus linearis plant material and containing multiple polyphenolic compounds, reveals an expectation to positively affect various processes observed in the pathogenesis of neurodegenerative diseases as in the case of consumption of other polyphenol-abundant food products. METHODS This review is based on available data from pre-clinical in vitro and in vivo studies and presents a broad report on the pharmacological activity of the A. linearis extracts relevant for neurodegenerative diseases. RESULTS Flavonoids present in herbal infusions are absorbed from gastro-intestinal tract and may affect the central nervous system. The experimental investigations yield the results indicating to supporting role of A. linearis in the prevention of neurodegeneration, primarily owing to anti-oxidative and anti-inflammatory properties, anti-hyperglycaemic and anti-hyperlipidaemic effects as well as favourable impact on neurotransmission with following cognitive and behavioural after-math. DISCUSSION The multiple pharmacological activities and safety of Aspalathus linearis extracts are commented in the manuscript. The continuous rooibos tea consumption seems to be safe (despite anecdotal liver irritation); however, there is a risk of herbal-drug interactions.
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Affiliation(s)
- Justyna Pyrzanowska
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Centre for Preclinical Research and Technology CePT, Warsaw, Poland
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3
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Pyrzanowska J. The toxic contaminants of Aspalathus linearis plant material as well as herb-drug interactions may constitute the health risk factors in daily rooibos tea consumers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:129-142. [PMID: 34823434 DOI: 10.1080/09603123.2021.2009780] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/19/2021] [Indexed: 06/13/2023]
Abstract
Rooibos tea is brewed using Aspalathus linearis plant material sensitive to environmental contamination. This review covers the safety data from preclinical experiments as well as human studies and delivers a report on its hepatic activity. In vitro tea investigation reveals antioxidative and anti-mutagenic features and ability to modulate microsomal enzymes. In rodent research, it exerts protective or neutral impact on liver functions and morphology, yet several human case reports suggest possible acute hepatic damage. Summarizing rooibos consumption seems to be safe in terms of hepatotoxicity; however, there may be designated a group of consumers with higher risk of liver irritation. The contamination of plant material may contribute to herb-induced liver injury. Due to the impact on CYPs, there is a possible risk of herb-drug interactions affecting bioavailability of some co-administered medicines. Caution should be exercised in patients receiving the treatment with allopathic medicines to avoid untoward alteration of drug plasma concentration.
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Affiliation(s)
- Justyna Pyrzanowska
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Centre for Preclinical Research and Technology CePT, Warsaw, Poland
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4
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Gurley BJ, McGill MR, Koturbash I. Hepatotoxicity due to herbal dietary supplements: Past, present and the future. Food Chem Toxicol 2022; 169:113445. [PMID: 36183923 DOI: 10.1016/j.fct.2022.113445] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/20/2022] [Accepted: 09/23/2022] [Indexed: 11/26/2022]
Abstract
Dietary supplements (DS) constitute a widely used group of products comprising vitamin, mineral, and botanical extract formulations. DS of botanical or herbal origins (HDS) comprise nearly 30% of all DS and are presented on the market either as single plant extracts or multi-extract-containing products. Despite generally safe toxicological profiles of most products currently present on the market, rising cases of liver injury caused by HDS - mostly by multi-ingredient and adulterated products - are of particular concern. Here we discuss the most prominent historical cases of HDS-induced hepatotoxicty - from Ephedra to Hydroxycut and OxyELITE Pro-NF, as well as products with suspected hepatotoxicity that are either currently on or are entering the market. We further provide discussion on overcoming the existing challenges with HDS-linked hepatotoxicity by introduction of advanced in silico, in vitro, in vivo, and microphysiological system approaches to address the matter of safety of those products before they reach the market.
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Affiliation(s)
- Bill J Gurley
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA; Center for Dietary Supplement Research, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA.
| | - Mitchell R McGill
- Department of Environmental Health Sciences, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA; Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA; Center for Dietary Supplement Research, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA.
| | - Igor Koturbash
- Department of Environmental Health Sciences, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA; Center for Dietary Supplement Research, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA.
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5
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Hibiscus, Rooibos, and Yerba Mate for Healthy Aging: A Review on the Attenuation of In Vitro and In Vivo Markers Related to Oxidative Stress, Glycoxidation, and Neurodegeneration. Foods 2022; 11:foods11121676. [PMID: 35741873 PMCID: PMC9222775 DOI: 10.3390/foods11121676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/04/2022] [Accepted: 06/05/2022] [Indexed: 02/01/2023] Open
Abstract
The world is currently undergoing a demographic change towards an increasing number of elderly citizens. Aging is characterized by a temporal decline in physiological capacity, and oxidative stress is a hallmark of aging and age-related disorders. Such an oxidative state is linked to a decrease in the effective mechanisms of cellular repair, the incidence of post-translational protein glycation, mitochondrial dysfunction, and neurodegeneration, just to name some of the markers contributing to the establishment of age-related reduction-oxidation, or redox, imbalance. Currently, there are no prescribed therapies to control oxidative stress; however, there are strategies to elevate antioxidant defenses and overcome related health challenges based on the adoption of nutritional therapies. It is well known that herbal teas such, as hibiscus, rooibos, and yerba mate, are important sources of antioxidants, able to prevent some oxidation-related stresses. These plants produce several bioactive metabolites, have a pleasant taste, and a long-lasting history as safe foods. This paper reviews the literature on hibiscus, rooibos, and yerba mate teas in the context of nutritional strategies for the attenuation of oxidative stress-related glycoxidation and neurodegeneration, and, here, Alzheimer’s Disease is approached as an example. The focus is given to mechanisms of glycation inhibition, as well as neuroprotective in vitro effects, and, in animal studies, to frame interest in these plants as nutraceutical agents related to current health concerns.
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6
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Gabuza KB, Buthelezi N, Kappo AP, Mabuda TI, Mosa R, Louw J, Muller CJ. In vitro and in vivo hepatotoxicity study of Afriplex™ GRT through an inflammatory response. Toxicol Rep 2022; 9:1920-1928. [DOI: 10.1016/j.toxrep.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 10/04/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
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Rooibos, a supportive role to play during the COVID-19 pandemic? J Funct Foods 2021; 86:104684. [PMID: 34422116 PMCID: PMC8367744 DOI: 10.1016/j.jff.2021.104684] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 07/21/2021] [Accepted: 08/14/2021] [Indexed: 02/08/2023] Open
Abstract
This article presents the potential health benefits of Rooibos to be considered a support during the COVID-19 pandemic. The recent pandemic of COVID-19 has led to severe morbidity and mortality. The highly infectious SARS-CoV-2 is known to prime a cytokine storm in patients and progression to acute lung injury/acute respiratory distress syndrome. Based on clinical features, the pathology of acute respiratory disorder induced by SARS-CoV-2 suggests that excessive inflammation, oxidative stress, and dysregulation of the renin angiotensin system are likely contributors to the COVID-19 disease. Rooibos, a well-known herbal tea, consumed for centuries, has displayed potent anti-inflammatory, antioxidant, redox modulating, anti-diabetic, anti-cancer, cardiometabolic support and organoprotective potential. This article describes how Rooibos can potentially play a supportive role by modulating the risk of some of the comorbidities associated with COVID-19 in order to promote general health during infections.
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8
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Teschke R, Eickhoff A, Schulze J, Danan G. Herb-induced liver injury (HILI) with 12,068 worldwide cases published with causality assessments by Roussel Uclaf Causality Assessment Method (RUCAM): an overview. Transl Gastroenterol Hepatol 2021; 6:51. [PMID: 34423172 PMCID: PMC8343418 DOI: 10.21037/tgh-20-149] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 04/13/2020] [Indexed: 12/11/2022] Open
Abstract
Herbal products including herbal medicines are worldwide used in large amounts for treating minor ailments and for disease prevention. However, efficacy of most herbal products has rarely been well documented through randomized controlled trials in line with evidence-based medicine concepts, which could be used to estimate the benefit/risk ratio. Instead, much better documented are adverse reactions such as liver injury associated with the consumption of some herbal products, so called herb-induced liver injury (HILI), which represents a clinical challenge. In order to establish HILI as valid diagnosis, the use of a diagnostic algorithms such as Roussel Uclaf Causality Assessment Method (RUCAM) is widely recommended, although physicians in some countries are reluctant to use RUCAM for their HILI cases. This review on worldwide HILI and RUCAM, developed as part of the artificial intelligence ideas, reveals that China is the leading country with 24 publications on HILI cases that were all assessed for causality using RUCAM, followed by Korea with 15 reports, Germany with 9 reports, the US with 7 reports, and Spain with 6 reports, whereas the remaining countries provided less than 4 reports. The total number of assessed HILI cases is 12,068 worldwide derived from 80 publications but in each report HILI case numbers were variable in a range from 1 up to 6,971. This figure compares with 46,266 cases of drug-induced liver injury (DILI) published worldwide from 2014 to early 2019 also assessed for causality by RUCAM. The original version of RUCAM was validated and established in 1993 and updated in 2016 that should be used in future HILI cases. RUCAM is an objective, structured, and validated method, specifically designed for liver injury. It is a scoring system including case data elements to be assessed and scored individually to provide a final score in five causality gradings. Among the 11,404/12,068 HILI (94.5%) cases assessable for evaluation, causality gradings were highly probable in 4.2%, probable in 15.5%, possible in 70.3%, and unlikely or excluded in 10.0%. To improve the future reporting of RUCAM based HILI cases, recommendations include the strict adherence to instructions outlined in the updated RUCAM and, in particular, to follow prospective data collection on the cases to ensure completeness of case data. In conclusion, RUCAM can well be used to assess causality in suspected HILI cases, and additional efforts are now required to increase the quality of the reported cases.
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Affiliation(s)
- Rolf Teschke
- Division of Gastroenterology and Hepatology, Department of Internal Medicine II, Klinikum Hanau, Hanau, Academic Teaching Hospital of the Medical Faculty, Goethe University Frankfurt/ Main, Frankfurt/Main, Germany
| | - Axel Eickhoff
- Division of Gastroenterology and Hepatology, Department of Internal Medicine II, Klinikum Hanau, Hanau, Academic Teaching Hospital of the Medical Faculty, Goethe University Frankfurt/ Main, Frankfurt/Main, Germany
| | - Johannes Schulze
- Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt/Main, Frankfurt/Main, Germany
| | - Gaby Danan
- Pharmacovigilance consultancy, Paris, France
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9
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Wang J, Zhou B, Hu X, Dong S, Hong M, Wang J, Chen J, Zhang J, Zhang Q, Li X, Shikov AN, Hu S, Hu X. Deciphering the Formulation Secret Underlying Chinese Huo-Clearing Herbal Drink. Front Pharmacol 2021; 12:654699. [PMID: 33967798 PMCID: PMC8100228 DOI: 10.3389/fphar.2021.654699] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 02/26/2021] [Indexed: 12/26/2022] Open
Abstract
Herbal teas or herbal drinks are traditional beverages that are prevalent in many cultures around the world. In Traditional Chinese Medicine, an herbal drink infused with different types of medicinal plants is believed to reduce the ‘Shang Huo’, or excessive body heat, a status of sub-optimal health. Although it is widely accepted and has a very large market, the underlying science for herbal drinks remains elusive. By studying a group of herbs for drinks, including ‘Gan’ (Glycyrrhiza uralensis Fisch. Ex DC.), ‘Ju’ (Dendranthema morifolium (Ramat.) Tzvelev), ‘Bu’ (Microcos paniculata L.), ‘Jin’ (Lonicera japonica Thunb.), ‘Xia’ (Prunella vulgaris L.), and ‘Ji’ (Plumeria rubra L.), the long-term jargon is connected with the inflammation of modern immunology through a few pro-inflammatory markers. In vitro studies have indicated that cellular inflammation is lowered by Ju and Jin either individually or synergistically with Gan. Among all herbs, only Gan detoxicated cellular toxicity of Bu in a dose dependent manner. The synergistic formulation of Ju and Gan, or Jin and Gan, in a reduction of Shang Huo, was tested in vivo. Both combinations exhibited a lower percentage of neutrophils, monocytes, and CD4+/CD8+ ratio in the blood, as well as inflammatory cytokines. Furthermore, body weight in the combinatory groups was more stable than treatments using single herbs. The combination of old traditional oriental methods with Western science logistics, has resulted in the formulation of different herbs into one concoction for the use of detoxification and synergism.
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Affiliation(s)
- Jianan Wang
- Laboratory of Drug Discovery and Molecular Engineering, Department of Medicinal Plants, College of Plant Science and Technology, Huazhong Agricultural University, Wuhan, China.,National and Local Joint Engineering Research Center (Hubei) for Medicinal Plant Breeding and Cultivation, Wuhan, China.,Hubei Provincial Engineering Research Center for Medicinal Plants, Wuhan, China
| | - Bo Zhou
- Laboratory of Drug Discovery and Molecular Engineering, Department of Medicinal Plants, College of Plant Science and Technology, Huazhong Agricultural University, Wuhan, China.,National and Local Joint Engineering Research Center (Hubei) for Medicinal Plant Breeding and Cultivation, Wuhan, China.,Hubei Provincial Engineering Research Center for Medicinal Plants, Wuhan, China
| | - Xiangdong Hu
- Laboratory of Drug Discovery and Molecular Engineering, Department of Medicinal Plants, College of Plant Science and Technology, Huazhong Agricultural University, Wuhan, China.,National and Local Joint Engineering Research Center (Hubei) for Medicinal Plant Breeding and Cultivation, Wuhan, China.,Hubei Provincial Engineering Research Center for Medicinal Plants, Wuhan, China
| | - Shuang Dong
- Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ming Hong
- Laboratory of Drug Discovery and Molecular Engineering, Department of Medicinal Plants, College of Plant Science and Technology, Huazhong Agricultural University, Wuhan, China.,National and Local Joint Engineering Research Center (Hubei) for Medicinal Plant Breeding and Cultivation, Wuhan, China.,Hubei Provincial Engineering Research Center for Medicinal Plants, Wuhan, China
| | - Jun Wang
- Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jian Chen
- Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiuliang Zhang
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan, China
| | - Qiyun Zhang
- Laboratory of Drug Discovery and Molecular Engineering, Department of Medicinal Plants, College of Plant Science and Technology, Huazhong Agricultural University, Wuhan, China.,National and Local Joint Engineering Research Center (Hubei) for Medicinal Plant Breeding and Cultivation, Wuhan, China.,Hubei Provincial Engineering Research Center for Medicinal Plants, Wuhan, China
| | - Xiaohua Li
- Laboratory of Drug Discovery and Molecular Engineering, Department of Medicinal Plants, College of Plant Science and Technology, Huazhong Agricultural University, Wuhan, China.,National and Local Joint Engineering Research Center (Hubei) for Medicinal Plant Breeding and Cultivation, Wuhan, China.,Hubei Provincial Engineering Research Center for Medicinal Plants, Wuhan, China
| | - Alexander N Shikov
- Department of Technology of pharmaceutical formulations, Saint-Petersburg State Chemical Pharmaceutical University, Saint-Petersburg, Russia
| | - Sheng Hu
- Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuebo Hu
- Laboratory of Drug Discovery and Molecular Engineering, Department of Medicinal Plants, College of Plant Science and Technology, Huazhong Agricultural University, Wuhan, China.,National and Local Joint Engineering Research Center (Hubei) for Medicinal Plant Breeding and Cultivation, Wuhan, China.,Hubei Provincial Engineering Research Center for Medicinal Plants, Wuhan, China
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10
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Carrier P, Debette-Gratien M, Jacques J, Grau M, Loustaud-Ratti V. Rooibos, a fake friend. Clin Res Hepatol Gastroenterol 2021; 45:101499. [PMID: 32828746 DOI: 10.1016/j.clinre.2020.06.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/19/2020] [Indexed: 02/04/2023]
Abstract
Rooibos is consumed worldwide and its use considered safe. It contains scavengers of free radicals and is so is deemed to be a liver protector. Nevertheless, hepatic toxicity exists even if rare. It is probably underdiagnosed and clinicians should think about it in case of acute hepatitis. We report a case of liver injury attributed to Rooibos.
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Affiliation(s)
- Paul Carrier
- Hepatology Unit, Limoges Dupuytren Teaching Hospital, Avenue Martin Luther King, 87042 Limoges, France.
| | - Marilyne Debette-Gratien
- Hepatology Unit, Limoges Dupuytren Teaching Hospital, Avenue Martin Luther King, 87042 Limoges, France; INSERM U-1248, Faculté de Médecine et de Pharmacie, Rue du Docteur Marcland, 87042 Limoges, France
| | - Jérémie Jacques
- Hepatology Unit, Limoges Dupuytren Teaching Hospital, Avenue Martin Luther King, 87042 Limoges, France
| | - Muriel Grau
- Pharmacology Unit, Limoges Dupuytren Teaching Hospital, Limoges 87042, France
| | - Véronique Loustaud-Ratti
- Hepatology Unit, Limoges Dupuytren Teaching Hospital, Avenue Martin Luther King, 87042 Limoges, France; INSERM U-1248, Faculté de Médecine et de Pharmacie, Rue du Docteur Marcland, 87042 Limoges, France
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11
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Millar DA, Bowles S, Windvogel SL, Louw J, Muller CJF. Effect of Rooibos (Aspalathus linearis) extract on atorvastatin-induced toxicity in C3A liver cells. J Cell Physiol 2020; 235:9487-9496. [PMID: 32458430 PMCID: PMC7586973 DOI: 10.1002/jcp.29756] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/22/2020] [Accepted: 04/22/2020] [Indexed: 01/15/2023]
Abstract
Rooibos (Aspalathus linearis) has various health benefits. Two case studies have associated chronic Rooibos consumption with conventional prescription medications, including atorvastatin (ATV), with hepatotoxicity. Statins act by inhibiting hydroxymethylglutaryl‐coenzyme A reductase, a rate‐limiting enzyme in cholesterol synthesis. Although rare, statins are potentially hepatotoxic. The aim was to investigate interactions between aspalathin‐rich Rooibos extract GRT™ and ATV‐induced hepatotoxicity in C3A liver cells cultured with and without palmitate. Effects of co‐treatment of GRT + ATV on cell viability, oxidative stress, apoptosis, mitochondrial integrity, and cellular reactive oxygen species (ROS) production were assessed. Significantly increased ROS production was observed in cells exposed to ATV and palmitate. Combination therapy of GRT + ATV also showed significant increases in ROS production. Under palmitate‐treated conditions, ATV‐induced significant apoptosis which was not ameliorated by GRT + ATV co‐treatment. Despite studies purporting hepatoprotection from Rooibos, our study showed that GRT was unable to modulate ATV‐induced hepatotoxic effects in this model.
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Affiliation(s)
- Danielle A Millar
- Biomedical Research and Innovation Platform, Grants, Innovation and Product Development Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Sandra Bowles
- Biomedical Research and Innovation Platform, Grants, Innovation and Product Development Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Shantal Lynn Windvogel
- Centre for Cardio-metabolic Research in Africa (CARMA), Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.,Division of Medical Physiology, Faculty of Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Johan Louw
- Biomedical Research and Innovation Platform, Grants, Innovation and Product Development Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Christo J F Muller
- Biomedical Research and Innovation Platform, Grants, Innovation and Product Development Unit, South African Medical Research Council, Tygerberg, South Africa.,Division of Medical Physiology, Faculty of Health Sciences, Stellenbosch University, Tygerberg, South Africa.,Department of Biochemistry and Microbiology, University of Zululand, Kwadlangezwa, South Africa
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12
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Fantoukh OI, Dale OR, Parveen A, Hawwal MF, Ali Z, Manda VK, Khan SI, Chittiboyina AG, Viljoen A, Khan IA. Safety Assessment of Phytochemicals Derived from the Globalized South African Rooibos Tea ( Aspalathus linearis) through Interaction with CYP, PXR, and P-gp. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2019; 67:4967-4975. [PMID: 30955332 DOI: 10.1021/acs.jafc.9b00846] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Rooibos tea ( Aspalathus linearis) is a well-known South African herbal tea enjoyed worldwide. Limited reports indicate the potential of rooibos tea to alter the activity of certain cytochrome P450 (CYP450) isozymes. In this study, the phytochemical investigation of MeOH extract of A. linearis (leaves and stems) resulted in the isolation and characterization of 11 phenolic compounds. The MeOH extract exhibited significant inhibition of the major human CYP450 isozymes (CYP3A4, CYP1A2, CYP2D6, CYP2C9, and CYP2C19). The strongest inhibition was observed by the extract for CYP3A4 (IC50 1.7 ± 0.1 μg/mL) followed by CYP2C19 (IC50 4.0 ± 0.3 μg/mL). Among the tested phytochemicals, the most potent inhibitors were isovitexin on CYP3A4 (IC50 3.4 ± 0.2 μM), vitexin on CYP2C9 (IC50 8.0 ± 0.2 μM), and thermopsoside on CYP2C19 (IC50 9.5 ± 0.2 μM). The two major, structurally related compounds aspalathin and nothofagin exhibited a moderate pregnane-X receptor (PXR) activation, which was associated with increased mRNA expression of CYP3A4 and CYP1A2, respectively. These results indicate that a high intake of nutraceuticals containing rooibos extracts may pose a risk of herb-drug interactions when consumed concomitantly with clinical drugs that are substrates of CYP enzymes.
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Affiliation(s)
- Omer I Fantoukh
- National Center for Natural Products Research, School of Pharmacy , The University of Mississippi , University , Mississippi 38677 , United States
- Division of Pharmacognosy, Department of BioMolecular Sciences , School of Pharmacy, The University of Mississippi , University , Mississippi 38677 , United States
- Department of Pharmacognosy, College of Pharmacy , King Saud University , Riyadh 4545 , Saudi Arabia
| | - Olivia R Dale
- National Center for Natural Products Research, School of Pharmacy , The University of Mississippi , University , Mississippi 38677 , United States
| | - Abidah Parveen
- National Center for Natural Products Research, School of Pharmacy , The University of Mississippi , University , Mississippi 38677 , United States
- Division of Pharmacognosy, Department of BioMolecular Sciences , School of Pharmacy, The University of Mississippi , University , Mississippi 38677 , United States
| | - Mohammed F Hawwal
- National Center for Natural Products Research, School of Pharmacy , The University of Mississippi , University , Mississippi 38677 , United States
- Division of Pharmacognosy, Department of BioMolecular Sciences , School of Pharmacy, The University of Mississippi , University , Mississippi 38677 , United States
- Department of Pharmacognosy, College of Pharmacy , King Saud University , Riyadh 4545 , Saudi Arabia
| | - Zulfiqar Ali
- National Center for Natural Products Research, School of Pharmacy , The University of Mississippi , University , Mississippi 38677 , United States
| | - Vamshi K Manda
- National Center for Natural Products Research, School of Pharmacy , The University of Mississippi , University , Mississippi 38677 , United States
| | - Shabana I Khan
- National Center for Natural Products Research, School of Pharmacy , The University of Mississippi , University , Mississippi 38677 , United States
- Division of Pharmacognosy, Department of BioMolecular Sciences , School of Pharmacy, The University of Mississippi , University , Mississippi 38677 , United States
| | - Amar G Chittiboyina
- National Center for Natural Products Research, School of Pharmacy , The University of Mississippi , University , Mississippi 38677 , United States
| | - Alvaro Viljoen
- Department of Pharmaceutical Sciences and SAMRC Herbal Drugs Research Unit , Tshwane University of Technology , Pretoria 0183 , South Africa
| | - Ikhlas A Khan
- National Center for Natural Products Research, School of Pharmacy , The University of Mississippi , University , Mississippi 38677 , United States
- Division of Pharmacognosy, Department of BioMolecular Sciences , School of Pharmacy, The University of Mississippi , University , Mississippi 38677 , United States
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Sasaki M, Nishida N, Shimada M. A Beneficial Role of Rooibos in Diabetes Mellitus: A Systematic Review and Meta-Analysis. Molecules 2018; 23:molecules23040839. [PMID: 29642387 PMCID: PMC6017582 DOI: 10.3390/molecules23040839] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 03/28/2018] [Accepted: 04/05/2018] [Indexed: 12/20/2022] Open
Abstract
In a rapid increase in cases of diabetes mellitus worldwide, there has been interested in the use of plant-derived polyphenols as nutraceuticals to prevent the onset and progression of diabetes mellitus and its associated complications. Aspalathus linearis, commonly known as rooibos, is a rich source of uncommon glycosylated plant polyphenols with various critical health-promoting properties, including the prevention and treatment of diabetes mellitus (DM). This study aimed to examine these effects by meta-analyzing the current evidence in diabetic rodent models. Peer-reviewed studies written in English from two databases, PubMed and Embase, were searched up to 28 February 2018. Studies reporting blood glucose levels in diabetic rodents with and without receiving rooibos extracts or their major phenolic compounds are included. Twelve studies enrolling 88 diabetic rodents treated with rooibos extracts or their polyphenols and 85 diabetic control males reported blood glucose levels. The pooled effect size was -0.89 (95% CI: -1.44 to -0.35) with a substantial heterogeneity (I² = 67.0%). This effect was likely to be modified by type of rooibos extracts and their polyphenols and treatment period. Blood glucose levels were significantly lower in diabetic rodent models treated with the phenolic compound rich in rooibos extracts, PPAG.
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Affiliation(s)
- Moe Sasaki
- Graduate School of Nutritional Science, Sagami Women's University, 2-1-1 Bunkyo, Minami-ku, Sagamihara, Kanagawa 252-0383, Japan.
| | - Nami Nishida
- Faculty of Nutritional Science, Sagami Women's University, 2-1-1 Bunkyo, Minami-ku, Sagamihara, Kanagawa 252-0383, Japan.
| | - Masako Shimada
- Graduate School of Nutritional Science, Sagami Women's University, 2-1-1 Bunkyo, Minami-ku, Sagamihara, Kanagawa 252-0383, Japan.
- Faculty of Nutritional Science, Sagami Women's University, 2-1-1 Bunkyo, Minami-ku, Sagamihara, Kanagawa 252-0383, Japan.
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Hepatotoxicity due to red bush tea consumption: a case report. J Clin Anesth 2016; 35:96-98. [DOI: 10.1016/j.jclinane.2016.07.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 06/09/2016] [Accepted: 07/14/2016] [Indexed: 11/18/2022]
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Teschke R, Eickhoff A. Herbal hepatotoxicity in traditional and modern medicine: actual key issues and new encouraging steps. Front Pharmacol 2015; 6:72. [PMID: 25954198 PMCID: PMC4407580 DOI: 10.3389/fphar.2015.00072] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 03/18/2015] [Indexed: 12/19/2022] Open
Abstract
Plants are natural producers of chemical substances, providing potential treatment of human ailments since ancient times. Some herbal chemicals in medicinal plants of traditional and modern medicine carry the risk of herb induced liver injury (HILI) with a severe or potentially lethal clinical course, and the requirement of a liver transplant. Discontinuation of herbal use is mandatory in time when HILI is first suspected as diagnosis. Although, herbal hepatotoxicity is of utmost clinical and regulatory importance, lack of a stringent causality assessment remains a major issue for patients with suspected HILI, while this problem is best overcome by the use of the hepatotoxicity specific CIOMS (Council for International Organizations of Medical Sciences) scale and the evaluation of unintentional reexposure test results. Sixty five different commonly used herbs, herbal drugs, and herbal supplements and 111 different herbs or herbal mixtures of the traditional Chinese medicine (TCM) are reported causative for liver disease, with levels of causality proof that appear rarely conclusive. Encouraging steps in the field of herbal hepatotoxicity focus on introducing analytical methods that identify cases of intrinsic hepatotoxicity caused by pyrrolizidine alkaloids, and on omics technologies, including genomics, proteomics, metabolomics, and assessing circulating micro-RNA in the serum of some patients with intrinsic hepatotoxicity. It remains to be established whether these new technologies can identify idiosyncratic HILI cases. To enhance its globalization, herbal medicine should universally be marketed as herbal drugs under strict regulatory surveillance in analogy to regulatory approved chemical drugs, proving a positive risk/benefit profile by enforcing evidence based clinical trials and excellent herbal drug quality.
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Affiliation(s)
- Rolf Teschke
- Division of Gastroenterology and Hepatology, Department of Internal Medicine II, Klinikum Hanau, Academic Teaching Hospital of the Medical Faculty of the Goethe University Frankfurt MainFrankfurt, Germany
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