Recently the use of herbal preparations as remedies for various medical conditions, has been rapidly increasing in Korea. In our previous study, 38.9% of patients with chronic liver disease were found to use some sorts of herbal preparations. They believe herbal preparations are safe although the ingredients has never been rigorously substantiated. Toxicities of certain herbal preparations are caused by their contaminants and adulterated ingredients or concurrently used conventional drugs rather than specific components of the herbal preparations. Furthermore, in most instances, multiple herbal ingredients are used by the prescribers of oriental medicine. All of these conditions frequently impose diagnostic difficulties. There are myriads of plant-derived hepatotoxic substances which may or may not cause liver injury in individuals. The severity of liver injury depends largely on the toxicity of the substance, the amount of exposure and the individual's susceptibility. These toxic substances cause liver injury not only through the mechanism of intrinsic hepatotoxicity but also through the idiosyncrasy as in conventional drug-induced injury. Therefore, theoretically, it is possible to apply pre-existing CAMs (Causality Assessment Methods) to the assessment of causality in cases with diagnostic difficulties.
English Abstract ; Humans ; Liver Diseases/*chemically induced ; Phytotherapy/*adverse effects ; Plant Preparations/*adverse effects

Along with the development of Chinese medicine and pharmacy (CMP), Chinese materia medica (CMM) has been used more and more widely at home and abroad. But we have to confront worsening problems such as lack of safety evidence, immature self -formulation technologies, lack of knowledge about their toxicities, and public misunderstanding, especially for patients with cardiovascular disease (CVD). Therefore, we cardiovascular physicians are requested improve knowledge for CMM preparations and their effects and side effects, supervise and identify the interactions between CMM and Westem medicine. Meanwhile, the researchers are also requested to assess the safety and efficacy of CMM through rigorous experimental designs, further improve the quality, safety, and efficacy of CMM, strictly formulate the specification of CMM products, guide the rational use of CMM by clinicians and the general public.
Cardiovascular Diseases ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Humans ; Phytotherapy ; adverse effects ; Safety

There is a new research model named 'registry study/patient registry' in Western medicine, which could be referred to by Chinese medicine researchers, such as active safety surveillance. This article will introduce registry study from different aspects as the developing history, features, and application in order to inform Chinese medicine researchers of future studies.
Marketing ; Medicine, Chinese Traditional ; adverse effects ; economics ; Phytotherapy ; adverse effects ; economics ; Registries ; Safety Management ; methods

Aloe has been widely used in phytomedicine. Phytomedicine describes aloe as a herb which has anti-inflammatory, anti-proliferative, anti-aging effects. In recent years several cases of aloe-induced hepatotoxicity were reported. But its pharmacokinetics and toxicity are poorly described in the literature. Here we report three cases with aloe-induced toxic hepatitis. A 57-yr-old woman, a 62-yr-old woman and a 55-yr-old woman were admitted to the hospital for acute hepatitis. They had taken aloe preparation for months. Their clinical manifestation, laboratory findings and histologic findings met diagnostic criteria (RUCAM scale) of toxic hepatitis. Upon discontinuation of the oral aloe preparations, liver enzymes returned to normal level. Aloe should be considered as a causative agent in hepatotoxicity.
Aloe/*adverse effects ; Animals ; Dietary Supplements/adverse effects ; *Drug-Induced Liver Injury/enzymology/pathology/physiopathology ; Female ; Humans ; Middle Aged ; Phytotherapy/adverse effects ; Plant Extracts/adverse effects

Aged ; Astragalus Plant ; adverse effects ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Humans ; Injections, Intravenous ; adverse effects ; Low Back Pain ; etiology ; Male ; Phytotherapy ; adverse effects

Arthritis, Rheumatoid ; drug therapy ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Humans ; Phytotherapy ; Tripterygium ; adverse effects ; chemistry

The roots of Angelica sinensis (RAS), are a Chinese herbal medicine traditionally used in prescriptions for replenishing blood, treating abnormal menstruation, and other women's diseases. It has also been widely marketed as health food for women's care in Asia, and as a dietary supplement in Europe and America. RAS is well-known for its hematopoietic, antioxidant, and immunoregulatory activities. RAS also possesses anti-cancer, memory, radioprotective, and neuroprotective effects. Phytochemical investigations on this plant led to organic acids, phthalides, polysaccharides, and other metabolites. Based on recent animal studies and clinical trials, RAS has been used in the treatment of gynecologic diseases, cardio-cerebrovascular disease, nervous system diseases, and nephrotic syndrome. In this review, the recent phytochemical and pharmacological studies, drug-drug interactions, clinical applications, and toxicity of RAS are summarized.
Angelica sinensis ; adverse effects ; chemistry ; Animals ; Drugs, Chinese Herbal ; adverse effects ; chemistry ; pharmacology ; Humans ; Phytotherapy ; Plant Roots ; chemistry

The meaning of "poisonous" in Traditional Chinese Medicine (TCM) is different from that of modern medicine. Narrow meaning of "poisonous" in TCM refers to harmful reaction to human body. Otherwise, generalized meaning of "poisonous" has two main implications: general title of drug and eccentric nature for drug. To fully reveal the scientific content of Chinese herbal toxic theory, we should carry out our research on the relationship between Chinese herbal toxicity and body state under the guidance of TCM theory. Moreover, comprehensive study on toxic information is also necessary for clarifying the natural characteristics of Chinese herbal medicine.
Drug-Related Side Effects and Adverse Reactions ; chemically induced ; Drugs, Chinese Herbal ; toxicity ; Humans ; Medicine, Chinese Traditional ; adverse effects ; trends ; Phytotherapy ; adverse effects ; Research ; trends

BACKGROUNDDue to safety concerns and side effects of many antidepressant medications, herbal psychopharmacology research has increased, and herbal remedies are becoming increasingly popular as alternatives to prescribed medications for the treatment of major depressive disorder (MDD). Of these, accumulating trials reveal positive effects of the spice saffron (Crocus sativus L.) for the treatment of depression. A comprehensive and statistical review of the clinical trials examining the effects of saffron for treatment of MDD is warranted.

OBJECTIVEThe purpose of this study was to conduct a meta-analysis of published randomized controlled trials examining the effects of saffron supplementation on symptoms of depression among participants with MDD.

SEARCH STRATEGYWe conducted electronic and non-electronic searches to identify all relevant randomized, double-blind controlled trials. Reference lists of all retrieved articles were searched for relevant studies.

INCLUSION CRITERIAThe criteria for study selection included the following: (1) adults (aged 18 and older) with symptoms of depression, (2) randomized controlled trial, (3) effects of saffron supplementation on depressive symptoms examined, and (4) study had either a placebo control or antidepressant comparison group.

DATA EXTRACTION AND ANALYSISUsing random effects modeling procedures, we calculated weighted mean effect sizes separately for the saffron supplementation vs placebo control groups, and for the saffron supplementation vs antidepressant groups. The methodological quality of all studies was assessed using the Jadad score. The computer software Comprehensive Meta-analysis 2 was used to analyze the data.

RESULTSBased on our pre-specified criteria, five randomized controlled trials (n = 2 placebo controlled trials, n = 3 antidepressant controlled trials) were included in our review. A large effect size was found for saffron supplementation vs placebo control in treating depressive symptoms (M ES = 1.62, P < 0.001), revealing that saffron supplementation significantly reduced depression symptoms compared to the placebo control. A null effect size was evidenced between saffron supplementation and the antidepressant groups (M ES = -0.15) indicating that both treatments were similarly effective in reducing depression symptoms. The mean Jadad score was 5 indicating high quality of trials.

CONCLUSIONFindings from clinical trials conducted to date indicate that saffron supplementation can improve symptoms of depression in adults with MDD. Larger clinical trials, conducted by research teams outside of Iran, with long-term follow-ups are needed before firm conclusions can be made regarding saffron's efficacy and safety for treating depressive symptoms.

Oplopanax elatus (Nakai) Nakai, a member of the ancient angiosperm plant family Araliaceae, is used for the treatment of different disorders in the medicine systems of China, Russia, and Korea, and was designated in Russia as a classical adaptogen. Despite extensive studies of classical adaptogens, there are comparatively few reports concerning the chemical composition and pharmacological effects of O. elatus in English. The plant is a potential source of saponins, flavonoids, anthraquinones, terpenes, and other active compounds. Experimental studies and clinical applications have indicated that O. elatus possesses a number of pharmacological activities, including adaptogenic, anti-convulsant, anti-diabetic, anti-fungal, anti-inflammatory, anti-oxidant, blood pressure modulating, and reproductive function effects. In this review, the chemistry, safety, and therapeutic potential of O. elatus are summarized and highlighted to encourage the further development of this plant.
Animals ; Humans ; Medicine, Traditional ; Oplopanax ; chemistry ; Phytotherapy ; Plant Extracts ; adverse effects ; chemistry ; pharmacology