Botanicals and Hepatotoxicity

Roytman, Marina; Poerzgen, Peter; Navarro, Victor J.

doi:10.1002/cpt.1097

Cited by 26 publications

(18 citation statements)

References 66 publications

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“…The simple assumption that some structural similarities between two molecules will unequivocally cause them to possess similar or identical pharmacological/toxicological effects is deemed a futile approach or a “waste of time” by medicinal chemists [119], who know that even small structural differences may result in divergent activity. However, a reminder to healthcare practitioners and other scientists seems appropriate [2,4]. In cases where such cognitive errors (i.e., assuming there is a causal relationship between an adverse effect and a given agent based only upon the structure of an agent or a shared physiological effect, despite evidence to the contrary) are present, diagnostic errors may occur which can result in harm to patients due to inappropriate or insufficient treatment [120,121].…”

Section: Incorrect Attributions Of Causality and Treatment Errorsmentioning

confidence: 99%

“…The past inclusion of one sympathomimetic compound (1,3-dimethylpentylamine or 1,3-dimethylamylamine, formerly marketed as a decongestant, Forthane) in dietary supplements has led to speculation that due to its sympathomimetic effects upon cardiovascular and neurological systems, and superficial chemical similarity to amphetamines, it may be hepatotoxic, effectively arguing that any sympathomimetic compound has the potential for liver injury [2,3]. Similarly, speculation has also indicated that the alkaloid, ephedrine may be hepatotoxic based upon case reports where Ephedra species (i.e., Ephedra sinica or ma-huang), which contain several alkaloids including pseudoephedrine and ephedrine, were associated with liver injury [4].…”

Section: Introductionmentioning

confidence: 99%

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Sympathomimetic amine compounds and hepatotoxicity: Not all are alike—Key distinctions noted in a short review

Willson¹

2019

Toxicology Reports

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Sympathomimetic amine compounds are often pooled together and incorrectly assumed to be interchangeable with respect to potential adverse effects. A brief and specific review of sympathomimetic compounds and one instance (i.e., hepatotoxicity) where these compounds have been improperly grouped together is covered. A review of the proposed mechanisms through which known hepatotoxic sympathomimetic agents (e.g., 3,4-methylenedioxymethamphetamine or MDMA, methamphetamine and amphetamine) cause liver injury, along with a corresponding review of in vitro data, interventional data, animal model studies and observational data allow for a comparison/contrast of different agents and reveals a lack of potential toxicity for some agents (e.g., pseudoephedrine, phenylephrine, ephedrine, 1,3-dimethylamylamine, phentermine) in this broad category. Data show that compounds within the broad group of sympathomimetics display divergent pharmacological and toxicological profiles and can be clearly distinguished with respect to liver injury. These data serve as a reminder to clinicians and others, that even small structural differences between molecules can lead to drastically different pharmacological/toxicological profiles and that one should not assume that all sympathomimetic agents are hepatotoxic. Such assumptions could lead to diagnostic errors and incorrect or insufficient treatment.

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Section: Incorrect Attributions Of Causality and Treatment Errorsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sympathomimetic amine compounds and hepatotoxicity: Not all are alike—Key distinctions noted in a short review

Willson¹

2019

Toxicology Reports

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“…In such preparations, some ingredients have on occasion proved to be very harmful especially to the liver. 9,10 The difficulty of reliably reproducing a complex formulation is also an adverse feature of traditional medicines. Materials derived from the same plant from different areas can have different compositions.…”

Section: Advantages Of Modern Synthetic Chemical Strategies In Drug Dmentioning

confidence: 99%

Attenuation of acute and chronic inflammation using compounds derived from plants

Bondy

Prasad³

2020

Exp Biol Med (Maywood)

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The appearance of excessive inflammatory activity is associated with onset of many disease states. Such non-productive responses are often the basis of the mortality consequent to incurring numerous disorders. The current outbreak of coronavirus disease 2019 caused by the virus “severe acute respiratory syndrome coronavirus 2” is a striking reflection of the inadequacy of current medical science to adequately address this issue. The usefulness of a range of materials of botanical origin in the attenuation of both chronic and acute inflammatory responses to various disease stressors is described. The properties of preparations of plant-based origin often parallel those of synthesized pharmacologics, but differ from them in some key respects. These differences can lead to more traditional preparations having distinct therapeutic advantages but also a number of specific shortcomings. The strengths and weaknesses of these materials are objectively contrasted with that of a more orthodox pharmacological approach. Each of these emphases in style has specific advantages and they should not be considered as competitors, but rather as accomplices in combating adverse states involving derangement of immune function. Impact statement A large component of many disease states is the improper regulation of immune function. This commonly leads to the appearance of redundant inflammation which does not effectively address any underlying issue but actually impedes a successful response to disease-induced metabolic derangement. There is currently no means of successfully addressing this problem which is especially relevant in the ongoing viral pandemic of SARS-CoV-2. In view of this failure, new courses of action need to be contemplated. This review proposes reconsideration of the potential utility of natural compounds originating from plants in order to address this deficit. Such a new direction, in concert with more conventional strategies could help to alleviate this wide-ranging crisis.

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“…Despite these advances in the safety assessment of botanicals, certain potential toxicity end points remain challenging. The state‐of‐the‐art contribution by Roytman et al . illustrates the difficulties in identifying and assigning causality of suspected botanical phytochemical constituent(s) associated with liver injury in a clinical setting.…”

Section: Contemporary Quality and Safety Issues With Botanicalsmentioning

confidence: 99%

“Green Medicine”: The Past, Present, and Future of Botanicals

Paine

Roe

2018

Clin Pharma and Therapeutics

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Botanicals are plant-derived products that have been consumed by humans for centuries. Today, the marketing and use of botanicals for health and wellness benefits continues to thrive worldwide, with consumers projected to spend more than $140 billion globally by 2024 (Global Analysis, Inc). However, research on the quality and safety of these products has lagged behind sales. Because of this divergence, opportunities abound for collaborations amongst scientists from industry, academia, and government to address these unmet public health needs. Clinical pharmacologists and toxicologists from all of these sectors play critical roles in developing harmonized approaches to achieve the common goal of ensuring botanical products with superior quality and safety.

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Botanicals and Hepatotoxicity

Cited by 26 publications

References 66 publications

Sympathomimetic amine compounds and hepatotoxicity: Not all are alike—Key distinctions noted in a short review

Sympathomimetic amine compounds and hepatotoxicity: Not all are alike—Key distinctions noted in a short review

Attenuation of acute and chronic inflammation using compounds derived from plants

“Green Medicine”: The Past, Present, and Future of Botanicals

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