Palak A. Patel-Rodrigues, Lindsey B. Cundra, Dalal Alhaqqan, Daniel T. Gildea, S. Woo, James H. Lewis
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引用次数: 0
摘要
由于草药补充剂以及补充和替代药物的不断普及,草药诱发肝损伤(HILI)的发病率逐年上升。我们对 2021 年 3 月至 2023 年 3 月期间发表的病例报告和临床研究进行了详细的文献综述。我们讨论了 HILI 的流行病学和诊断,以及现行和拟议的法律法规。我们讨论了 2021 年 ACG 指南和 2022 年 AASLD 实践指南中关于药物和草药引起的肝损伤的诊断和管理。我们介绍了以前报道过的 HILI 病因的最新情况,如阿育吠陀、灰树精、姜黄、桔梗、绿茶提取物和藤黄。此外,还介绍了导致 HILI 的新描述的保健品,如洋金花、七叶树、碱性水等。我们讨论了在动物模型和人类肝细胞研究中新发现和以前发现的保肝草药补充剂。本综述认为,有必要对肝损伤的原因和机制进行持续研究,以确保将来能对其进行正确的诊断、预防和治疗。本综述旨在为新手和专家读者提供有关 HILI 可能病因的知识和总体概述。
Herbal- and Dietary-Supplement-Induced Liver Injury: A Review of the Recent Literature
Herbal-induced liver injury (HILI) continues to increase in prevalence each year due to the ongoing popularity of herbal supplements and complementary and alternative medicines. A detailed literature review of case reports and clinical studies published from March 2021 to March 2023 was performed. We discuss the epidemiology and diagnosis of HILI as well as the current and proposed laws and regulations. The 2021 ACG guidelines and 2022 AASLD practice guidelines for the diagnosis and management of drug and herbal-induced liver injury are discussed. We describe updates to previously reported etiologies of HILI such as ayurveda, ashwagandha, turmeric, kratom, green tea extract, and garcinia cambogia. Newly described supplements resulting in HILI, such as tinospora cordifolia, horse chestnut, alkaline water, and more, are described. We discuss newly and previously identified hepatoprotective herbal supplements as they have been reported in the study of animal models and human liver cells. This review suggests the need for ongoing research on the causes and mechanisms of HILI to ensure its proper diagnosis, prevention, and treatment in the future. The goal of this review is to provide novice and expert readers with knowledge regarding the possible etiologies of HILI and a general overview.