Although evidence for their therapeutic efficacy is limited, herbal traditional Chinese medicine preparations increasingly gain popularity.
In contrast to other herbal products, adverse effects by herbal traditional Chinese medicine including liver toxicity were rarely reported.
In recent years, more cases were published, providing new clinical challenges.
Dr Teschke and colleagues from Germany summarized comprehensively the literature on herbal traditional Chinese medicine hepatotoxicity since 2011.
PubMed was searched using key words related to traditional Chinese medicine, the results were restricted to full English-language publications and abstracts published since 2011.
|Developments include a new diagnostic serum marker for hepatotoxicity caused by pyrrolizidine alkaloids|
|Alimentary Pharmacology & Therapeutics|
In addition, the database of the National Institutes of Health and LiverTox was accessed under the topic ‘Drug record: Chinese and other Asian herbal medicines’.
Since 2011, the team noted that new case reports and case series provided evidence for herbal hepatotoxicity by traditional Chinese medicine, focusing on 9 traditional Chinese medicine herbal mixtures and 4 individual traditional Chinese medicine herbs with potential health hazards.
These were the traditional Chinese medicine products Ban Tu Wan, Chai Hu, Du Huo, Huang Qin, Jia Wei Xia Yao San, Jiguja, Kamishoyosan, Long Dan Xie Gan Tang, Lu Cha, Polygonum multiflorum products, Shan Chi, ‘White flood’ containing the herbal traditional Chinese medicine Wu Zhu Yu and Qian Ceng Ta, and Xiao Chai Hu Tang.
The team reported that other developments include the establishment of a new and early diagnostic serum marker for hepatotoxicity caused by pyrrolizidine alkaloids, assessed using ultra performance liquid chromatography–mass spectrometry analysis, and new regulatory details to improve herbal traditional Chinese medicine product quality and safety.
Dr Teschke's team concluded, "Stringent evaluation of the risk/benefit ratio is essential to protect traditional Chinese medicines users from health hazards including liver injury."