Toxic hepatitis has been reported as a major cause of acute hepatitis, but its potential induction by herbal remedies and/or health foods is usually neglected. We experienced a case of toxic hepatitis associated with Polygoni multiflori, a Chinese herb commonly known as Ho-Shou-Wu. A 54-year-old woman consumed Ho-Shou-Wu for 1 month, after which she experienced fatigue and overall weakness. A diagnosis of toxic hepatitis was made based on her clinical history, the findings for viral markers and other laboratory data, and ultrasonography. Her condition improved considerably after she stopped taking Ho-Shou-Wu. However, she resumed taking Ho-Shou-Wu immediately after discharge from hospital, which aggravated her symptoms and liver function. She was immediately readmitted and stopped taking Ho-Shou-Wu. Her relapse into hepatitis immediate after resuming consumption of the herb is strongly indicative of the validity of Koch's postulate in this case.
Drug-Induced Liver Injury/*diagnosis/pathology/ultrasonography ; Female ; Humans ; Middle Aged ; Plant Extracts/toxicity ; Polygonum/*toxicity

OBJECTIVETo observe the liver injury degree of SD rats after 28-day administration of aqueous extracts of Polygonum multiflorum (AEPM) and the correlation with cholestasis mechanism.

METHODAdult SD rats were orally administered with 30, 60 g x kg(-1) of APEM once every day for 28 d. After 28 d, the general condition of rats such as weight were observed, liver function-related indicators were detected. Bile was collected to determine total bile acid output, flow rate and density and changes in major compositions. Their livers were weighed then sent for histopathological examination.

RESULTAEPM did not change the general conditions and weights of rats. From the results of the related indicators of liver function and cholestasis, AEPM did not change the contents of ALT and AST in serum, but high dose of AEPM can increase the contents of ALP, GGT and TBA in serum (P < 0.05, P < 0.01) and decrease the content of TBIL in serum (P < 0.05). And the contents of GGT in serum of low dose rats were increased (P < 0.05). The bile flow was not changed by AEPM, but bile compositions of high dose male rats were obviously changed (TG increase, TBIL decrease, TBA decrease). The weights of liver and ratio of liver of the high dose rats were increased but showed no statistical significance. Pathologic examination displayed that there were only small pieces of necrosis in livers of several rats, without any severe disease.

CONCLUSIONAEPM can obviously injure bile duct epithelial cells, intervene liver cell functions and change bile compositions in rats, thus it is proved to induce cholestasis without severe liver injury.

Administration, Oral ; Animals ; Bile ; chemistry ; drug effects ; Cholestasis ; chemically induced ; Female ; Liver ; drug effects ; pathology ; Male ; Plant Extracts ; toxicity ; Polygonum ; toxicity ; Rats ; Rats, Sprague-Dawley

To investigate the difference of liver injury in rats gavaged with crude and processed Polygoni Multiflori Radix. The 75% ethanol extract of crude and processed Polygoni Multiflori Radix (50 g · kg(-1) crude medicine weight/body weight) were continuous oral administered to rats for 6 weeks. Serum biochemical indicators were dynamically detected, the change of liver histopathology was assessed 6 weeks later. Principal component analysis (PCA) was adopted to screen sensitive indicator of the liver damage induced by polygoni multiflori radix. Biochemical tests showed that the crude Polygoni Multiflori Radix group had significant increase of serum ALT, AST, ALP, DBIL and TBIL (P < 0.01 or P < 0.05) and significant decreases of serum IBIL and TBA (P < 0.01 or P < 0.05), while the processed Polygoni Multiflori Radix group showed no obvious changes, compared to the untreated normal group. Histopathologic analysis revealed that crude Polygoni Multiflori Radix group exhibited significant inflammatory cells infiltration in portal area around the blood vessels, tissue destruction and local necrosis of liver cells. There were not obvious pathological changes in processed Polygoni Multiflori Radix group. The results demonstrated that the injury effect of processed Polygoni Multiflori Radix on liver injury of rats was significantly lower than that of unprocessed, and that processing can effectively reduce the hepatotoxicity of Polygoni Multiflori Radix. Traditional transaminase liver function indicators were not sensitive for crude Polygoni Multiflori Radix induced liver damage. The serum content of DBIL and TBIL can reflect the liver damage induced by crude Polygoni Multiflori Radix early and can be sensitive indicators for clinical monitoring the usage of it.
Animals ; Chemical and Drug Induced Liver Injury ; etiology ; Chemistry, Pharmaceutical ; methods ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; toxicity ; Female ; Liver ; drug effects ; injuries ; Male ; Plant Roots ; chemistry ; toxicity ; Polygonum ; chemistry ; toxicity ; Rats

The liver injury induced by Polygonum multiflorum Thunb. (PM) was investigated based on idiosyncratic hepatotoxicity model co-treated with lipopolysaccharide (LPS) at a non-hepatotoxic dose. Sprague-Dawley (SD) rats were intragastrically administered with three doses (18.9, 37.8, 75.6 g crude drug per kg body weight) of 50% alcohol extracts of PM alone or co-treated with non-toxic dose of LPS (2.8 mg·kg(-1)) via tail vein injection. The plasma alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities were assayed and the isolated livers were evaluated for histopathological changes. The dose-toxicity relationships of single treatment of PM or co-treatment of LPS were investigated comparatively to elucidate the idiosyncratic hepatotoxicity of PM. The results showed that no significant alterations of plasma ALT and AST activities were observed in the groups of solo-administration of LPS (2.8 mg·kg(-1), i.v.) or different dosage (18.9, 37.8 and 75.6 g·kg(-1), i.g.) of PM, compared to normal control group (P > 0.05); while significant elevations were observed in the co-administration groups of PM and LPS. Treatment with LPS alone caused slight infiltration of inflammatory cells in portal area but no evident hepatocytes injury. Co-treatment with LPS and PM (75.6 g·kg(-1), i.g.) caused hepatocyte focal necrosis, loss of central vein intima and a large number of inflammatory cell infiltration in portal areas. When further reduce the dosage of PM, significant increases of plasma ALT and AST activities (P < 0.05) were still observed in co-administration groups of LPS and PM (1.08 or 2.16 g·kg(-1)), but not in LPS or PM solo-administration groups. Nevertheless, the co-treatment of low dosage of PM (0.54 g·kg(-1)) with LPS did not induce any alteration of plasma ALT and AST. In conclusion, intragastric administration with 75.6 g·kg(-1) of PM did not induce liver injury in normal rats model; while the 2 folds of clinical equivalent dose of PM (1.08 g·kg(-1)) could result in liver injury in the LPS-based idiosyncratic hepatotoxicity model, which could be used to evaluate the idiosyncratic hepatotoxicity of PM.
Alanine Transaminase ; blood ; Animals ; Aspartate Aminotransferases ; blood ; Chemical and Drug Induced Liver Injury ; pathology ; Hepatocytes ; pathology ; Lipopolysaccharides ; Polygonum ; toxicity ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo study the protective effect of flowers, branch with leaves and main stem of Polygonum orientale on H9c2 myocardial cells oxidative injury induced by H202 and discuss its efficacious substance foundation of anti-myocardial ischemia.

METHODUPLC fingerprint was established for flowers, branch with leaves and main stem of P. orientale, and the chromatographic peak was identified. Meanwhile, the protective effect of composites of flowers, branch with leaves and main stem of P. orientale in different proportions on myocardial cells oxidative injury was observed (with MTT method as indicators of concentration screening and cell livability) and MDA were detected. The correlation analysis was made between activity information of composites and chemical information of UPLC fingerprint to infer efficacious substance foundation.

RESULTBranch with leaves and flowers from Polygonum orientale showed a protective effect on H9c2 myocardial cells oxidative injury. According to the study on spectrum-activity relationship, peak 3-5, 11-14, 18-19, 21-25 showed a positive correlation with their antioxidant activities.

CONCLUSIONThis study determined activity of Polygonum orientale on anti-oxidative injury, laying an experimental foundation for in-depth study and development of P. orientale herbs.

Cell Line ; Drugs, Chinese Herbal ; analysis ; pharmacology ; Humans ; Hydrogen Peroxide ; toxicity ; Myocytes, Cardiac ; drug effects ; metabolism ; Oxidative Stress ; drug effects ; Polygonum ; chemistry ; Protective Agents ; analysis ; pharmacology

This article retrospectively analyzed the safety reports published abroad regarding Polygonum multiflorum and its preparations in terms of drug use and liver damage. The authors found that the foreign drug regulatory authorities are lack of in-depth analysis and investigation on the safety information of P. multiflorum and its preparations in the process of reporting and warning. Therefore, the authors consider the following factors are significant for scientific evaluation of traditional Chinese medicine (TCM) safety: follow-up and investigation of the information based on literature study, establishment of the safety-related information communication and feedback mechanism with foreign drug regulatory authorities and drafting of the guidelines for rational use of TCM.
Animals ; Australia ; Canada ; Drug Evaluation ; legislation & jurisprudence ; standards ; Drug-Related Side Effects and Adverse Reactions ; Drugs, Chinese Herbal ; standards ; toxicity ; England ; Humans ; Legislation, Drug ; standards ; Liver ; drug effects ; Polygonum ; chemistry