• 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.

• 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.

• 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.

• The Journal of Internal Korean Medicine
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• v.30 no.1
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• pp.181-190
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• 2009

It is important to establish the safety of herbal medicine because of its frequent and widespread use in Korea. Several studies on the safety of herbal medicine have been performed and there have been rare serious adverse drug reactions from those reports in Korea. However, the results are not strongly supported because of not adopting appropriate enough research methodology as to make the safety issue clear. For improving the quality of the safety research on herbal medicine. including investigations of drug induced liver injury (DILl). the aim of this study was to suggest herbal medicine-induced liver injury investigation forms for performing reasonable safety research. After a systematic review of the preceding studies regarding herbal safety in Korea was performed in 2008, we assessed the quality and the limitations of the primary studies. Two investigation forms for herbal safety research were made as a following step. one a basic investigation form for herbal safety research and the other an advanced investigation form for suspected DILl cases, Those forms include the essential informations and data needed to make an appropriate assessment of whether DILl occurred during or after the use of herbal medicine. Guidelines for using those forms and other recommendations were also suggested. More rigorous studies are required for answering the safety issue of herbal medicine as well as the efficacy issue. We hope for wide use and improvement of those investigation forms in the study of herbal safety by many researchers for establishing better evidences in Korea.

• 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.

• IMMUNE NETWORK
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• v.1 no.3
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• pp.213-220
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• 2001

Background: A previous study has shown that Euonymus alatus (EA) has an antidotic activities against inflammation, suggesting possibility that EA can exert this beneficial effects to liver injury by an initial protection against drug-induced hepatocyte demage. The present study was undertaken to evaluate the protective effect of EA-extract on experimentally induced hepatitis in ICR mice and to investigate some mechanisms responsible for its action. Methods: Water EA extract was used in this experiments. The mice received i.p. a dose of 700 mg/kg galactosamine (GalN) together with $5{\mu}g/kg$ of endotoxin (LPS), or received i.v. 12 mg/kg of concanavalin A (Con A). EA (4 mg/mouse) was administrated on day -2, -1 and 0 before induction of liver injury. Liver injury was assessed by measurement of serum alanin amino-transferase (SGPT) levels on 9 hr after GaIN.LPS, or 8 hr after con A administration. Results: Treatment with either GaIN or LPS alone did not cause hepatitis. However, simultaneous administration of GalN and LPS to mice resulted in LPS-dose dependent fulminant hepatitis. GaLN/LPS-induced liver injury was reduced when mice were given EA for 3 days before induction. This preventive effect of Ea was more prominent when EA was given by intraperitoneal route rather then by oral route. Pretreatment of EA or dexamethasone inhibited significantly $TNF{\alpha}$ production in GalL/LPS-injured mice. However, EA-treatment did not influence $TNF{\alpha}$-induced hepatitis in GalN-sensitized mice, suggesting that $TNF{\alpha}$ is likely to act as one of final mediators of endotoxin action and the protective effect of EA might be manifested chiefly by inhibition of endotoxin-induced $TNF{\alpha}$ production, not by blocking the $TNF{\alpha}$-action. Injection of Con A into mice evoked remarkable liver injury in a dose dependent fashion. This liver damage was reduced by EA-pretreatment. Dexamethasone significantly reduced both GalL/LPS-induced and Con A-induced liver damages, showing synergism with EA. However, indomethacin reduced only GalN/ LPS-induced hepatitis, not for Con A-induced hepatitis. Conclusion: These results led to the conclusion that EA may be able to contribute at least in part to prevent the drug-induced hepatotoxicity, and that its anti-hepatitis effects might be manifested directly by modulation of endogenous mediators, such as leukotriese D4, $TNF{\alpha}$ and free radical, and indirectly by regulation of immune mediated responses. Also these results suggested that EA could be developed as a potential antidotic agent.

• The Journal of Pediatrics of Korean Medicine
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• v.22 no.3
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• pp.83-94
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• 2008

Objectives : The purpose of this study is to confirm severe problem caused by using a modified RUCAM scale than that officially recognized to diagnose liver injury induced by herbal medicine. Materials and Methods : Cases with liver injury induced by herbal medicine received to a related institute from January 2004 to December 2007 were collected and evaluated by the original scale and modified scale. Results : 1. Based on this study, we couldn't clinicaly confirm that the case was not excluded by the relieved first item basis of modified RUCAM scale which has to be excluded by the first item basis of orginal RUCAM scale. 2. By modified 6th item, one score was added to the total score. 3. By adding 8th item, it gaind one point to the whole the total score. Conclusions : In this study, we can clinically confirm that the modified RUCAM　application to case with liver injury induced by herbal medicine is a severe problem.

• Journal of Physiology & Pathology in Korean Medicine
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• v.28 no.1
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• pp.102-106
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• 2014

Wild ginseng pharmacopuncture is a partly used Traditional Korean Medicine's therapy with no previously well documented hepatotoxicity. We report the the first case of suspected drug-induced liver injury (DILI) after intravenous Wild ginseng Pharmacopuncture therapy. Our clinical observation based on patient's laboratory studies, medical history, detailed drug history and ruling out other possible causes. Our patient's suspected diagnosis was wild ginseng pharmacopuncture-induced liver injury with correlation between detailed drug history and laboratory studies. This diagnosis was supported by the Council for International Organizations of Medical Sciences-Roussel Uclaf Causality Assessment Method(RUCAM). This report represents the first documented cases of suspected DILI after intravenous wild ginseng pharmacopuncture therapy, highlighting the need for future research regarding potential hepatotoxicity of Wild ginseng Pharmacopuncture.

• 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.

• The Journal of Korean Medicine
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• v.37 no.2
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• pp.119-124
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• 2016

Objectives: To demonstrate a clinical course and feature of a female patient with a severe liver injury (DILI) during antituberculosis treatment for her intestinal tuberculosis, whom traditional Korean medicine completely recovered. Methods: A female patient with diagnosed as DILI by antituberculosis drugs had been treated with herbal drugs; and then the clinical outcome and biochemical parameters had been monitored. Result: A 45-year old female had taken antituberculosis drugs for about 2 months, and complained severe abdominal discomfort and dyspepsia. The RUCAM score was 10, which met the criteria for DILI (AST 584 IU/L, ALT 1212 IU/L, ALP 100 IU/L, and GGT 161 IU/L, total bilirubin 0.9 mg/dL). She had been treated with herbal drugs and acupuncture as inpatient and outpatient, and then her symptoms had been completely recovered with normalization of hepatic enzymes. Conclusion: This report provides a clinical characteristic for a severe hepatotoxicity induced by antituberculosis drugs, and showed an example of TKM-based application.