• The Journal of Internal Korean Medicine
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• v.44 no.5
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• pp.1011-1016
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• 2023

We have experienced a case in which herbal medicine was administered to treat drug-induced liver damage and would like to introduce it. A 49-year-old man exhibited a positive result in the interferon-gamma release assay. He had never suffered from tuberculosis in the past, and the route and time of infection could not be confirmed. He had no respiratory or systemic symptoms suggestive of active tuberculosis, and a chest X-ray examination showed no active lung lesions, so he was diagnosed with latent tuberculosis infection. He was confirmed to be within the normal range in the liver function test, renal function test, and complete blood cell count test, and started taking rifampin (600 mg qd). In the screening test performed on the 19th day of taking the drug, other test items were normal, but alanine aminotransferase (ALT) increased to 50 U/L (reference value: 4-40 U/L). In a test performed on the 29th day of taking the drug, ALT was clearly elevated to 102 U/L. Ursodeoxycholic acid and Injinho-tang were taken together with rifampin, and the patient's progress was observed. In a test performed 14 days later, ALT decreased to 26 U/L, within the normal range. It is presumed that Injinho-tang may have partially contributed to alleviating liver damage in this case.

• The Journal of Internal Korean Medicine
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• v.31 no.1
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• pp.79-83
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• 2010

Herbal hepatotoxicity is a one of the most often encountered controversial issues in medical society. Some believe herbs are totally safe while others regard treatment with herbs as a very common cause of hepatotoxicity. But there are no comparative clinical hepatotoxicity studies between herbal and conventional medicines. We investigated incidence of patients with abnormal liver function who were treated with herbal or conventional medicine at Dongguk University International Hospital. Each group consisted of 300 patients, who were admitted for longer than 30 days during the year 2008. We compared albumin, total bilirubin, AST (aspartate aminotransferase), and ALT (alanine aminotransferase) levels, and excludes patients who had abnormal liver function test or liver-related disease when admitted. As a result, incidence of total bilirubin, AST, and ALT elevation in the CT (conventional treatment) group was more frequent than in the TKM (traditional Korean medicine) group (p<0.05) during admission. Albumin level also decreased more frequently in the CT group than in the TKM group (p<0.05). According to these results, herbal medicine is not more hepatotoxic than conventional medicine, and not a main cause of liver injury in inpatients.

• The Journal of the Convergence on Culture Technology
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• v.5 no.2
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• pp.389-395
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• 2019

This study investigated the pharmaceutical extraction and the functional health food extraction, which have a beneficial effect on the human body and which can be used safely for a long period of time without adverse side effects and also have excellent effects of protecting liver and improving liver function. As the results, the cabbage extract does not show cytotoxicity, and thus can be used safely. In an experiment performed on an animal model with liver injury induced by a drug (APAP), it could be seen that the cabbage extract exhibited the effects of protecting liver and improving liver function by effectively reducing AST and ALT which are liver injury markers, indicating that the cabbage extract is effective as a pharmaceutical extraction for preventing or treating liver disease. In particular, the cabbage extract was effective in treating inflammation of the liver by reducing the expression of the inflammatory mediators iNOS and COX-2 and the proinflammatory cytokine $IL-1{\beta}$, which are involved in acute inflammatory reactions accompanying liver injury. In the results, an extract of cabbage heat-treated at a temperature of 100 to $150^{\circ}C$ had a better liver function-improving effect or anti-inflammatory effect than an extract of raw cabbage.

• Journal of Physiology & Pathology in Korean Medicine
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• v.32 no.6
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• pp.418-421
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• 2018

The purpose of this study was to evaluate the changes of liver function test before and after treatment in patients admitted to Korean medicine hospital. We checked liver function test level (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total bilirubin, direct bilirubin) of 147 patient who admitted in Korean medicine hospital from July 1, 2015 to June 30, 2018. The subjects were selected those who took herbal medicine continuously during the admission period and who performed liver function test on admission and before discharge. And the subjects were excluded those who had a history of liver and biliary disease at the time of admission or who took hepatoprotectants. Aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase significantly decreased compared with the values of admission(p<0.05), but total bilirubin and direct bilirubin were not significantly changed(p>0.05). On admission 31 patients(21.1%) had abnormal liver function and 6 patients(4.1%) had liver injury while 19 patients(12.9%) had abnormal liver function and 6 patients(4.1%) showed liver injury before discharge. This study suggests that herbal medicine may not injure liver function.

• The Journal of Internal Korean Medicine
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• v.44 no.3
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• pp.402-417
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• 2023

Objective: Liver fibrosis is a highly conserved wound-healing response and the final common pathway of chronic inflammatory injury. This study aimed to evaluate the potential anti-fibrotic effect of the combination of Rhei Radix et Rhizoma water extract (RW) and silymarin in a thioacetamide (TAA)-induced liver fibrosis model. Methods: The liver fibrosis mouse model was established through the intraperitoneal injection of TAA (1 week 100 mg/kg, 2-3 weeks 200 mg/kg, 4-8 weeks 400 mg/kg) three times per week for eight weeks. Animal experiments were conducted in five groups; Normal, Control (TAA-induced liver fibrosis mice), Sily (silymarin 50 mg/kg), RSL (RW 50 mg/kg+silymarin 50 mg/kg), and RSH (RW 100 mg/kg+silymarin 50 mg/kg). Biochemical analyses were measured in serum, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), malondialdehyde (MDA), and ammonia levels. Liver inflammatory cytokines and fibrous biomarkers were measured by Western blot analysis, and liver histopathology was evaluated through tissue staining. Results: A significant decrease in the liver function markers AST and ALT and a reduction in ammonia and total bilirubin were observed in the group treated with RSL and RSH. Measurement of reactive oxygen species and MDA revealed a significant decrease in the RSL and RSH administration group compared to the TAA induction group. The expression of extracellular matrix-related proteins, such as transforming growth factor β1, α-smooth muscle actin, and collagen type I alpha 1, was likewise significantly decreased. All drug-administered groups had increased matrix metalloproteinase-9 but a decreasing tissue inhibitor of matrix metalloproteinase-1. RSL and RSH exerted a significant upregulation of NADPH oxidase 2, p22^phox, and p47^phox, which are oxidative stress-related factors. Furthermore, pro-inflammatory proteins such as cyclooxygenase 2 and interleukin-1β were markedly suppressed through the inhibition of nuclear factor kappa B activation. Conclusions: The administration of RW and silymarin suppressed the NADPH oxidase factor protein level and showed a tendency to reduce inflammation-related enzymes. These results suggest that the combined administration of RW and silymarin improves acute liver injury induced by TAA.

• Korean Journal of Biological Psychiatry
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• v.18 no.3
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• pp.159-162
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• 2011

Venlafaxine is among the most widely prescribed antidepressants. It is extensively metabolized to O-desmethylvenlafaxine via cytochrome P450 (CYP) 2D6. We report a case of acute toxic hepatitis resulting from venlafaxine in a 54-year-old woman with pain disorder. During venlafaxine treatment, laboratory tests revealed elevated liver enzymes with a maximum of 169 IU/L for aspartate transaminase (AST) and 166 IU/L for alanine transaminase (ALT). AST and ALT levels returned to normal after 6 days of discontinuation of venlafaxine. The patient was finally diagnosed with acute toxic hepatitis through liver biopsy. This case indicates the importance that clinicians should be aware of the hepatotoxicity of venlafaxine in practice.

• The Journal of Korean Medicine
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• v.31 no.2
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• pp.149-157
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• 2010

Objective: The purpose of this study was to investigate the level of safety on liver functions when Korean herbal medicine was taken internally. Method: 101 inpatients who took Korean herbal medicine were enrolled and liver function test (aspartic aminotransferase, alanine aminotransferase, alkaline phosphatase, total bilirubin, gamma glutamyltranspeptidase, albumin, lactate dehydrogenase) was performed on admission and 1 month later. Results: In 101 patients, alkaline phosphatase and gamma glutamyltranspeptidase decreased significantly compared with the value taken on admission (p<0.05) but aspartic aminotransferase, alanine aminotransferase, total bilirubin, albumin, and lactate dehydrogenase were not significantly changed (p>0.05). In the patients who took Scutellaria baicalensis (n=34), alkaline phosphatase decreased and albumin increased significantly (p<0.05). Among the patients who took Atractylodes macrocephala (n=29), alkaline phosphatase decreased significantly (p<0.05). In the patients who took Glycyrrhiza uralensis or Paeonia lactiflora, liver function parameters were not significantly changed (p>0.05). On admission 11 patients had abnormal liver function and 2 patients had liver injury while 7 patients had abnormal liver function and 2 patients showed liver injury 1 month later. Conclusions: This study suggests that prescribed Korean herbal medicine does not injure liver function.

• The Journal of the Convergence on Culture Technology
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• v.5 no.2
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• pp.397-404
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• 2019

This study was carried out to investigate the heat-treated broccoli extraction which have a beneficial effect on the human body and which can be used safely for a long period of time without adverse side effects and also have excellent effects of protecting liver and improving liver function. The heat-treated broccoli extract does not show cytotoxicity, and thus can be used safely. In an experiment performed on an animal model with liver injury induced by a drug (APAP), it could be seen that the heat-treated cabbage extract exhibited the effects of protecting liver and improving liver function by effectively reducing AST and ALT which are liver injury markers, indicating that the heat-treated brocoli extract is effective as a pharmaceutical extraction for preventing or treating liver disease. In particular, the heat-treated broccoli extract was effective in treating inflammation of the liver by reducing the expression of the inflammatory mediators iNOS and COX-2 and the proinflammatory cytokine $IL-1{\beta}$, which are involved in acute inflammatory reactions accompanying liver injury.

• Preventive Nutrition and Food Science
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• v.8 no.3
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• pp.239-244
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• 2003

Recently, we reported (J Korean Soc Food Sci Nutr, 31(3): 516-520, 2002) that Semisulcospira libertina (Marsh Snail) pretreatment has a hepatoprotective effect on $CCl_4$-induced liver damage in rats. The purpose of this study was to investigate the possible mechanisms of hepatoprotection by S. libertina (SL) on liver injury induced by acetaminophen (AA). Male ICR mice were pretreated with dehydrated powder of SL once daily for three consecutive days, given a single toxic dose of AA (450 mg/kg) and liver function determined 24 h later. Liver damage was assessed by quantifying serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and sorbitol dehydrogenase (SDH) activities, and by measuring hepatic lipid peroxidation. To confirm possible mechanism(s), the content of hepatic glutathione (GSH) and gene expression of tumor necrosis factor a (TNF $\alpha$) mRNA by reverse transcription-polymerase chain reaction (RTPCR) were also measured. Pretreatment with SL dramatically lowered AA-elevated ALT, AST and SDH activities. SL pretreatment decreased AA-produced lipid peroxidation by 11% and restored the AA-depleted hepatic GSH by 27%. Furthermore, SL markedly suppressed the expression of TNF $\alpha$ mRNA induced by AA. Our findings revealed that the possible hepatoprotective mechanisms of SL could be attributed, at least in part, to the glutathione-mediated detoxification as well as the regulation of TNF $\alpha$ mRNA expression.

• Natural Product Sciences
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• v.27 no.3
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• pp.201-207
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• 2021

We have previously reported that Acer tegmentosum extract, which is traditionally used in Korea to reduce alcohol-related liver injury, suppresses liver inflammation caused by excessive alcohol consumption and might improve metabolism. The active ingredient, 6-O-galloylsalidroside (GAL), was isolated from A. tegmentosum, and we hypothesized that GAL could provide desirable pharmacological benefits by ameliorating physiological conditions caused by alcohol abuse. Therefore, this study focused on whether GAL could ameliorate alcoholic fat accumulation and repair liver injury in mice. During chronic alcohol consumption plus binge feeding in mice, GAL was administered orally once per day for 11 days. Intrahepatic lipid accumulation was measured in vivo using a noninvasive method, ¹H magnetic resonance imaging, and confirmed by staining with hematoxylin and eosin and Oil Red O. The serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured using a Konelab system, and the triglyceride content was measured in liver homogenates using an enzymatic peroxide assay. The results suggested that GAL alleviated alcohol-induced steatosis,e as indicated by decreased hepatic and serum triglyceride levels in ethanol-fed mice. GAL treatment also correlated with a decrease in the Cd36 mRNA expression, thus potentially inhibiting the development of alcoholic steatosis via the hepatic de novo lipogenesis pathway. Furthermore, treatment with GAL inhibited the expression of cytochrome P450 2E1 and attenuated hepatocellular damage, as reflected by a reduction in ALT and AST levels. These findings suggest that GAL extracted from A. tegmentosum has the potential to serve as a bioactive agent for the treatment of alcoholic fatty liver and liver damage.