Herb induced liver injury presumably caused by black cohosh: A survey of initially purported cases and herbal quality specifications
- Herb induced liver injury (HILI) is a particular challenge that also applies to purported cases presumably caused by black cohosh (BC), an herb commonly used to treat menopausal symptoms. We analyzed and reviewed all published case reports and spontaneous reports of initially alleged BC hepatotoxicity regarding quality of case details and causality assessments. Shortcomings of data quality were more evident in spontaneous reports of regulatory agencies compared to published case reports, but assessments with the scale of CIOMS (Council for the International Organizations of Sciences) or its updated version revealed lack of causality for BC in all cases. The applied causality methods are structured, quantitative, and liver specific with clear preference over an ad hoc causality method or the liver unspecific Naranjo scale. Reviewing the case data and the reports dealing with quality specifications of herbal BC products, there is general lack of analysis with respect to authentication of BC in the BC products used by the patients. However, in one single regulatory study, there was a problem of BC authentication in the analysed BC products, and other reports addressed the question of impurities and adulterants in a few BC products. It is concluded that the use of BC may not exert an overt hepatotoxicity risk, but quality problems in a few BC products were evident that require additional regulatory quality specifications.
Author: | Rolf TeschkeORCiDGND, Alexander SchwarzenböckGND, Wolfgang Schmidt-Taenzer, Albrecht Titus WolffGND, Karl-Heinz Hennermann |
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URN: | urn:nbn:de:hebis:30:3-765706 |
DOI: | https://doi.org/10.1016/S1665-2681(19)31536-4 |
ISSN: | 1665-2681 |
Parent Title (English): | Annals of Hepatology |
Publisher: | Mexican Association of Hepatology |
Place of publication: | México |
Document Type: | Article |
Language: | English |
Date of Publication (online): | 2019/06/21 |
Year of first Publication: | 2011 |
Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
Release Date: | 2023/10/04 |
Tag: | Actaea cimicifuga; Black cohosh; Black cohosh induced liver injury; Drug induced liver injury; Hepatotoxicity; Herb induced liver injury; Herbal hepatotoxicity |
Volume: | 10 |
Issue: | 3 |
Page Number: | 11 |
First Page: | 249 |
Last Page: | 259 |
HeBIS-PPN: | 513042520 |
Institutes: | Medizin |
Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Sammlungen: | Universitätspublikationen |
Licence (German): | Creative Commons - CC BY-NC-ND - Namensnennung - Nicht kommerziell - Keine Bearbeitungen 4.0 International |