Special Issue "Traditional Chinese Medicine (TCM) and Herbal Hepatotoxicity"

A special issue of Medicines (ISSN 2305-6320).

Deadline for manuscript submissions: closed (31 July 2017).

Special Issue Editor

Prof. Dr. Rolf Teschke
Website
Guest Editor
Department of Internal Medicine II, Division of Gastroenterology and Hepatology, Klinikum Hanau, Teaching Hospital of the Goethe University Frankfurt/Main, Germany
Interests: alcoholic liver disease; alcoholic liver injury; alcohol metabolism; microsomal ethanol-oxidizing system; drug induced liver injury; herb induced liver injury; herbal traditional Chinese medicine (TCM); dietary supplements; causality assessment
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Special Issue Information

Dear Colleagues,

Traditional Chinese Medicine (TCM) with its herbal sector is popular in China and all over the world. Although commonly well tolerated by most consumers, the use of some TCM herbs may be associated with rare adverse events, including herb induced liver injury (HILI), raising questions of balance regarding efficacy and risks. Because this type of injury is a major clinical and regulatory challenge, the upcoming special issue will attempt to clarify some of the uncertainties relevant in this field and to discuss associated controversial issues. The authors of invited features papers and other contributors are encouraged to shed more light into this fascinating topic of HILI by TCM and to provide argumants for a broad and stimutating discussion. In the context of this Special Issue, it is planned to cover topics such as evidence based clinical trials and their role in ensuring a favorable risk benefit balance; building up a Chinese Herb Induced Liver Injury (HILI) registry with RUCAM for essential causality assessment; hepatic sinusoidal syndrome and the dilemma of pyrrolizidine alkaloid containing herbs; comparison with drug induced liver injury; clinical and case analysis, diagnostic biomarkers, and preference for RUCAM; the TCM green tea and its hepatotoxic extracts, a clinical and regulatory issue; comprehensive analysis and compilation of cases from the Chinese literature, also with special reference to RUCAM; regulatory and manufactural challenges in China; pathogenetic issues of plant misidentification, contamination, and adulteration; and liver histology with its potential contribution to clinical assessment, prognosis, and recognition of preexisting liver disease. Therefore, the focus is on clinical aspects, case evaluation, causality assessment, regulatory challenges, and critical analysis, but other aspects, such as experimental studies, may be considered if innovative and of potential benefit for humans and their diseases.

Prof. Rolf Teschke, M.D.
Guest Editor

Manuscript Submission Information

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Published Papers (2 papers)

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Open AccessReview
Ginseng for Liver Injury: Friend or Foe?
Medicines 2016, 3(4), 33; https://doi.org/10.3390/medicines3040033 - 17 Dec 2016
Cited by 3
Abstract
Panax sp., including Panax ginseng Meyer, Panax quiquifolius L., or Panax notoginseng (Burk.) FH Chen, have been used as functional foods or for traditional Chinese medicine for diabetes, inflammation, stress, aging, hepatic injury, and cancer. In recent decades, a number of both in [...] Read more.
Panax sp., including Panax ginseng Meyer, Panax quiquifolius L., or Panax notoginseng (Burk.) FH Chen, have been used as functional foods or for traditional Chinese medicine for diabetes, inflammation, stress, aging, hepatic injury, and cancer. In recent decades, a number of both in vitro and in vivo experiments as well as human studies have been conducted to investigate the efficacy and safety of various types of ginseng samples and their components. Of these, the hepatoprotective and hepatotoxic effects of ginseng and their ginsenosides and polysaccharides are reviewed and summarized. Full article
(This article belongs to the Special Issue Traditional Chinese Medicine (TCM) and Herbal Hepatotoxicity)
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Open AccessFeature PaperReview
Traditional Chinese Medicine (TCM) and Herbal Hepatotoxicity: RUCAM and the Role of Novel Diagnostic Biomarkers Such as MicroRNAs
Medicines 2016, 3(3), 18; https://doi.org/10.3390/medicines3030018 - 19 Jul 2016
Cited by 42
Abstract
Background: Traditional Chinese Medicine (TCM) with its focus on herbal use is popular and appreciated worldwide with increased tendency, although its therapeutic efficacy is poorly established for most herbal TCM products. Treatment was perceived as fairly safe but discussions emerged more recently [...] Read more.
Background: Traditional Chinese Medicine (TCM) with its focus on herbal use is popular and appreciated worldwide with increased tendency, although its therapeutic efficacy is poorly established for most herbal TCM products. Treatment was perceived as fairly safe but discussions emerged more recently as to whether herb induced liver injury (HILI) from herbal TCM is a major issue; Methods: To analyze clinical and case characteristics of HILI caused by herbal TCM, we undertook a selective literature search in the PubMed database with the search items Traditional Chinese Medicine, TCM, alone and combined with the terms herbal hepatotoxicity or herb induced liver injury; Results: HILI caused by herbal TCM is rare and similarly to drugs can be caused by an unpredictable idiosyncratic or a predictable intrinsic reaction. Clinical features of liver injury from herbal TCM products are variable, and specific diagnostic biomarkers such as microsomal epoxide hydrolase, pyrrole-protein adducts, metabolomics, and microRNAs are available for only a few TCM herbs. The diagnosis is ascertained if alternative causes are validly excluded and causality levels of probable or highly probable are achieved applying the liver specific RUCAM (Roussel Uclaf Causality Assessment Method) as the most commonly used diagnostic tool worldwide. Case evaluation may be confounded by inappropriate or lacking causality assessment, poor herbal product quality, insufficiently documented cases, and failing to exclude alternative causes such as infections by hepatotropic viruses including hepatitis E virus infections; Conclusion: Suspected cases of liver injury from herbal TCM represent major challenges that deserve special clinical and regulatory attention to improve the quality of case evaluations and ascertain patients’ safety and benefit. Full article
(This article belongs to the Special Issue Traditional Chinese Medicine (TCM) and Herbal Hepatotoxicity)
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