• The Journal of Internal Korean Medicine
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• v.30 no.1
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• pp.249-255
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• 2009

Currently, drug-induced liver injury (DILl) has been reported to be common cause of acute hepatitis, and oriental medicine and folk remedies are no exception. However, because many studies about DILl have been reported by western medical society. they has taken the initiative of DILl not only for western drugs but also herbs. So, academia of oriental medicine should make an effort to progress herb-related DILl studies. We describe a patient of acute liver injury which had been caused by comfrey, albizzia julibrissin, ulmus davidiana var. japonica, red ginseng. We hope that this report helps for studying the diagnosis and management of herb-derived DILl. and for establishing a standard of oriental therapy to DILL.

• Journal of Haehwa Medicine
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• v.18 no.1
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• pp.83-88
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• 2009

Recently, herbal drugs haver been used world wide. and generally regarded as safe with no serious adverse reaction. Drug-induced liver injury (DILI) is one of frequent cause of liver diseases. If DILI is not treated, it can be developed into liver cirrhosis, hepatoma, etc. Currently, DILI has been reported to be common cause of acute hepatitis, and oriental medicine and folk remedy are not exception. We encountered one case of DILI, cause by folk remedy. Patients complained chest discomfort, yellow skin and urine, nausea, vomiting. Lab test showed elevated level of aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyl transpeptidase (r-GTP), total bilirubin (TB). We estimated acute DILI and stopped taking folk medication made by himself. After 1 week of treatment, the clinical symptoms and liver function improved. Genetic and environmental factors as well as drug itself decide the hepatic toxicity, and the major DILI are belonged in acute type. So we need to get more attention to folk medication to help preventing the DILI cause by folk remedy.

• The Journal of Internal Korean Medicine
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• v.32 no.3
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• pp.444-450
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• 2011

Recently, acute toxic liver injury has been reported to be the most common cause of acute hepatitis. We witnessed one case of hepatic injury which suggested drug-induced hepatitis by herbal medication (Gamiyukgunja-tang). This patient, diagnosed cerebral infarction, was treated with herbal medication and physical therapy for improvement of right hemiparesis. In the course of treatment, this patient showed elevation of serum transaminase (ALT 129 IU/L, AST 150 IU/L), alkaline phosphatase (ALP 261 IU/L), and total bilirubin (2.0 IU/L), so we supposed toxic hepatitis by herbal medication. Saenggangeonbi-tang was administered for 8 days, ALT, AST, ALP, total bilirubin decreased within normal limits.

• Proceedings of the Plant Resources Society of Korea Conference
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• 2022.09a
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• pp.114-114
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• 2022

Excessive endogenous endotoxin, especially lipopolysaccharide (LPS) reflux from gastrointestinal (GI) tract to the liver tissue is one of the most serious reasons of severe and acute liver injury which is mainly mediated by Kupffer cell activations. However, there is no clear molecular clues to explain the exact pathophysiological mechanism and effective drugs available till nowadays. We aimed to comprehend the pathophysiological features of LPS-induced liver injury and evaluate the efficacies of potential therapeutic drug, Ga-mi-Yuk-Mi-Jihwang-Tang (GYM), which is composed of herbal plants. GYM remarkably caused to normalize hepatic inflammation and oxidations against LPS-induced liver injury by evidence of serum liver enzymes, histopathological analysis, both hepatic protein and gene expression levels of pro-inflammatory cytokines, nitric oxide levels, and hepatic tissue levels of reactive oxygen species (ROS) levels, malondialdehyde (MDA), and 4-hydroxyneoneal, respectively. To assess molecular events in the hepatic tissue, we further found hepatic Sirtuin6 (Sirt6) levels were considerably depleted by LPS injection with aberrant alterations of Nrf2/HO-1 signaling pathways, whereas administration with GYM notably exerted to normalize these abnormalities. Our results exhibited that GYM would be one of target drug to diminish hepatic inflammation as well as oxidative stress by regulation of hepatic Sirt6 levels.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.2
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• pp.149-156
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• 2018

Purpose: The purpose of this study was to determine whether hepatotoxicity could be predicted early using biochemical markers in patients with acetaminophen (AAP) poisoning and to assess the usefulness of predictive factors for acute liver injury or hepatotoxicity. Methods: This study was a retrospective observational study involving a medical records review. The participants were patients who were admitted to the emergency department (ED) with AAP overdose at two hospitals over a 10-year period. Demographic data, age, time from ingestion to visit, initial AAP level, initial hepatic aminotransferases, and initial prothrombin time were recorded. Acute liver injury was defined as a peak serum ALT >50 U/L or double the admission value, and hepatotoxicity was defined as a peak ALT >1,000 U/L. Receiver operating characteristic curve analyses were performed to compare the prognostic performance among variables. Results: A total of 97 patients were admitted to the ED with AAP overdose, of whom 26 had acute liver injury and 6 had hepatotoxicity. Acute liver injury was associated with the time interval after taking the drug, and hepatotoxicity was associated with the initial PT and the ALT level. The scoring system proposed by the authors has a significant ability to predict both acute liver injury and hepatotoxicity. Conclusion: To predict the prognosis of AAP poisoning patients, the time interval after taking AAP was important, and initial prothrombin time and ALT level were useful tests. Also a scoring system combining variables may be useful.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.15 no.2
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• pp.111-116
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• 2012

Toxic hepatitis is a rare but devastating disease in children. Herbs are widely used in oriental medicine to treat various symptoms in Korea, however, several herbs have been reported to induce liver injury. We report a case of toxic hepatitis induced by Hovenia dulcis in a 3-year-old boy. He complained of nausea, abdominal discomfort, and jaundice. The patient had consumed water boiled with hovenia dulcis for about 1 year prior to presentation. A diagnosis of toxic hepatitis was made based on his history, laboratory data, viral markers, ultrasonography, and biopsied liver tissue. We administered supportive management for acute fulminant hepatitis but his symptoms and liver function progressed. He was transferred to another hospital for further evaluation and consideration for liver transplantation. Because acute liver failure due to herbs or dietary supplement taken for a long time is often fetal, it is important to make early diagnosis and stop taking the drug as soon as drug induced liver injury is suspected.

• Nutrition Research and Practice
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• v.3 no.2
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• pp.95-101
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• 2009

It has been reported that dietary polyunsaturated fats (PUFA) increase liver injury in response to ethanol feeding. We tested the hypothesis that diets rich in linoleic acid (18:2n-6) would affect acute liver injury after acetaminophen injection and that protein restriction might exacerbate the liver injury. We examined effects of feeding diets with either 15% (wt/wt) corn oil or 14% beef tallow and 1% corn oil for six weeks with either 6 or 20 g/100 g protein on acute hepatotoxicity. After the feeding period, liver injury was induced by injecting either with 600 mg/kg body weight acetaminophen suspended in gum arabic-based vehicle, or with vehicle alone during fasting status. Samples of liver and plasma were taken for analyses of hepatic glutathione (GSH) levels and liver-specific enzymes [(Glutamate-pyruvate transaminase (GPT) and glutamate-oxaloacetate transaminase (GOT)], respectively. Whereas GSH level was significantly lower in only group fed 15% corn oil with 6 g/100 g protein among acetaminophen-treated groups, activities of GPT and GOT were significantly elevated in all groups except the one fed beef tallow with 20 g/100 g protein, suggesting low protein might exacerbate drug-induced hepatotoxicity. The feeding regimens changed the ratio of 18:2n-6 to oleic acid (18:1n-9) in total liver lipids approximately five-fold, and produced modest changes in arachidonic acid (20:4n-6). We conclude that diets with high 18:2n-6 promote acetaminophen-induced liver injury compared to diets with more saturated fatty acids (SFA). In addition, protein restriction appeared to exacerbate the liver injury.

• The Journal of Internal Korean Medicine
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• v.33 no.4
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• pp.609-614
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• 2012

Drug-induced liver injury (DILI) is a common cause of acute hepatitis. Regarding the risk of DILI from herbal preparations, there are controversial issues such as exaggerated reports straying far from the truth and lack of discrimination between herbal drugs and folk remedies or food supplements. This study reported one case of a patient with DILI caused by Smilacis Chinae Radix and cured in an Oriental hospital. Smilacis Chinae Radix has been used as an anti-inflammatory, anti-microbial, detoxification and anticancer compound, as a folk remedy. This report would provide helpful information for management of DILI by folk remedies or herbal drugs.

• Herbal Formula Science
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• v.11 no.2
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• pp.135-146
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• 2003

Objectives : Wolguk-whan has been used as a prescription of natural drug for the treatment of stress digestive system disease. Recently, we reported that Wolguk-whan methnol extract (WGWM) exerted a significant protective effect against oxidative damage to the liver of ICR mice. This study was purposed to investigate the effects of Wolguk-whan water extract (WGWW) on liver injury induced by oxidative stress. Methods : In order to investigate the effects of WGWW on acute liver injury, ICR mice were pretreated with WGWW for 6days, starved for 24hrs, and administerated acetamirtophen(500mg/kg, i.p.). In the liver homogenates, lipid peroxide and glutathione(GSH) levels were measured. In addition, activities of hepatic enzyme, such as catalase, glutathione peroxidase(GSH-Px), glutathione S-transferase(GST) were measured in the hepatic mitochondrial and cytosolic fractions. Results : In vivo administeration of WGWW showed effective inhibition of acetaminophen induced lipid peroxidation, and showed elevations of GSH level, catalase, GSH-Px, GST activities. Conclusions : These results suggested that WGWW might suppress the formation of oxidative metabolites, and prevent acetaminophen induced hepatotoxicity.

• The Korea Journal of Herbology
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• v.21 no.3
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• pp.69-74
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• 2006

Objectives : This study was undertaken to determine if a combined(SPe) has a protective effect against functional failure induced by $CCl_4$ in rat liver. Methods : Acute liver injury which initiated from free radical induced by $CCl_4$, were applied to rats and data were obtained. Liver injury was estimated by measuring aspartate aminotransferase(AST) and alanine aminotransferase(ALT) activity in serum. Lipid peroxidation was examined by measuring malondialdehyde, a product of lipid peroxidation. GSH activities in liver tissues were also measured. Results : When rats were treated intraperitoneally with $CCl_4$, serum AST and ALT were increased compared with the control, which was significantly inhibited by pretreatment of SPe. SPe also prevented reduction in GSH induced by $CCl_4$. Conclusion : Above results suggest that SPe exerts protective effect against $CCl_4$ by its antioxidant action in liver tissues. Thus, SPe may be used in prevention and treatment of drug-induced liver cell injury. However, the precise mechanisms of SPe protection remain to be determined.