Traditional Chinese Medicine (TCM) and Herbal Hepatotoxicity

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

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