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Hepatic sinusoidal obstruction syndrome associated with consumption of Gynura segetum

Lin, Ge, Wang, Ji Yao, Li, Na, Li, Mi, Gao, Hong, Ji, Yuan, Zhang, Fan, Wang, Huali, Zhou, Yan, Ye, Yang, Xu, Hong Xi, Zheng, Jiang·2011·Journal of Hepatology
DOI 10.1016/j.jhep.2010.07.031
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Abstract

Background & aims One major cause of hepatic sinusoidal obstruction syndrome (HSOS) is the intake of pyrrolizidine alkaloid (PA)-containing products. Over 8000 PA-induced HSOS cases have been reported worldwide and at least 51 among them were suspected to be attributed to exposure to the Chinese medicine 'Tusanqi'. PA-induced hepatotoxicity involves cytochrome P450-mediated metabolic activation of PAs to electrophilic pyrrolic metabolites which react with macromolecules, such as proteins. However, no studies have found such protein adduction in HSOS patients. We report one HSOS case confirmed by liver biopsy, where the patient claimed taking 'Tusanqi' as self-medication. Methods The herb was analyzed by HPLC-MS, and its induced hepatotoxicity in rats was assessed by monitoring the alteration of serum ALT level and liver morphology. Blood pyrrole-protein adducts were determined by UPLC-MS. Results The herb the patient consumed was identified as Gynura segetum, an erroneous substitute of non-PA-containing Sedum aizoon, called 'Tusanqi'. Hepatotoxic PAs senecionine and seneciphylline were detected in G. segetum. In the PA-exposed patient, serum pyrrole-protein adducts were detected by a newly developed analytical approach. The animal study showed a good correlation of liver injury with the ingestion of G. segetum. Conclusions For the first time, serum pyrrole-protein adducts were unequivocally detected in a PA-induced HSOS patient, and such adducts show a potential to be develop…

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  • Starting as early as 2006 with an analysis from Hong Kong, an overall 21 reports of HILI cases were published which had been assessed for causality using RUCAM with results presented by groups with first authors having their working place in mainland China, Hong Kong, or Taiwan.

    “Starting as early as 2006 with an analysis from Hong Kong,18 an overall 21 reports of HILI cases were published which had been assessed for causality using RUCAM with results presented by groups with first authors having their working place in mainland China, Hong Kong, or Taiwan.18–38”

    From Herb-induced Liver Injury in Asia and Current Role of RUCAM for Causality Assessment in 11,160 Published Cases (2020) · cites this paper as [21]

  • On top among the Asian countries is currently China, best explained by the large population and heavy use of herbal traditional Chinese medicines, with increasing numbers of publications and cases until 2019.

    “On top among the Asian countries is currently China, best explained by the large population and heavy use of herbal traditional Chinese medicines (TCMs), with increasing numbers of publications and cases until 2019.18–38”

    From Herb-induced Liver Injury in Asia and Current Role of RUCAM for Causality Assessment in 11,160 Published Cases (2020) · cites this paper as [21]

  • There is now increasing awareness of the benefits provided by RUCAM among various countries, including China, Korea, and Singapore, as evidenced by reports initially published in 2004 from Korea and in 2006 from China and Singapore, with subsequent articles.

    “There is now increasing awareness of the benefits provided by RUCAM among various countries, including China,18–38 Korea,40–54 and Singapore,55,56 as evidenced by reports initially published in 2004 from Korea40 and in 2006 from China18 and Singapore,55 with subsequent articles (Table 1).”

    From Herb-induced Liver Injury in Asia and Current Role of RUCAM for Causality Assessment in 11,160 Published Cases (2020) · cites this paper as [21]

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Metadata

Authors
Lin, G., Wang, J. Y., Li, N., Li, M., Gao, H., Ji, Y., Zhang, F., Wang, H., Zhou, Y., Ye, Y., Xu, H. X., & Zheng, J.
Venue
Journal of Hepatology
Publisher
Elsevier BV
Published
2011-04
Volume
54
Issue
4
Pages
666-673
ISSN
0168-8278
DOI
10.1016/j.jhep.2010.07.031
Cited by
241
References
0
Language
en
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)

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