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Int. J. Mol. Sci. 2016, 17(4), 580;

Hepatotoxicity Induced by “the 3Ks”: Kava, Kratom and Khat

Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy
Section of Legal Medicine, Università Politecnica delle Marche, 60121 Ancona, Italy
Authors contributed equally to the manuscript.
Author to whom correspondence should be addressed.
Academic Editor: Rolf Teschke
Received: 18 February 2016 / Revised: 18 February 2016 / Accepted: 11 April 2016 / Published: 16 April 2016
(This article belongs to the Special Issue Drug, Herb, and Dietary Supplement Hepatotoxicity)
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The 3Ks (kava, kratom and khat) are herbals that can potentially induce liver injuries. On the one hand, growing controversial data have been reported about the hepatotoxicity of kratom, while, on the other hand, even though kava and khat hepatotoxicity has been investigated, the hepatotoxic effects are still not clear. Chronic recreational use of kratom has been associated with rare instances of acute liver injury. Several studies and case reports have suggested that khat is hepatotoxic, leading to deranged liver enzymes and also histopathological evidence of acute hepatocellular degeneration. Numerous reports of severe hepatotoxicity potentially induced by kava have also been highlighted, both in the USA and Europe. The aim of this review is to focus on the different patterns and the mechanisms of hepatotoxicity induced by “the 3Ks”, while trying to clarify the numerous aspects that still need to be addressed. View Full-Text
Keywords: kava; khat; kratom; hepatotoxicity; herbals; herb induced liver injury kava; khat; kratom; hepatotoxicity; herbals; herb induced liver injury

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Pantano, F.; Tittarelli, R.; Mannocchi, G.; Zaami, S.; Ricci, S.; Giorgetti, R.; Terranova, D.; Busardò, F.P.; Marinelli, E. Hepatotoxicity Induced by “the 3Ks”: Kava, Kratom and Khat. Int. J. Mol. Sci. 2016, 17, 580.

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