Caution in the use of boldo in herbal laxatives: A case of hepatotoxicity

Piscaglia, Fabio; Leoni, Simona; Venturi, A.; Graziella, Franceschini; Donati, Gabriele; Bolondi, Luigi

doi:10.1080/00365520410009537

Cited by 17 publications

(6 citation statements)

References 7 publications

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“…However, a reorganization of the actin filaments and increased transcriptional level of relevant markers of cellular activation occured (Fig. 2), suggesting profibrotic signaling activation, which corroborates studies that point to P. barbatus toxicity when used in high concentrations [65, 66]. Moreover, the extract also acted directly on cellular lipid metabolism, reinforcing popular culture, which uses the extracts as a liver fat metabolizer [16, 67, 68].…”

Section: Discussionsupporting

confidence: 80%

Cellular and molecular effects of Baccharis dracunculifolia D.C. and Plectranthus barbatus Andrews medicinal plant extracts on retinoid metabolism in the human hepatic stellate cell LX-2

Silva

Caetano

Pereira

et al. 2019

BMC Complement Altern Med

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Background Chronic hepatic diseases are serious problems worldwide, which may lead to the development of fibrosis and eventually cirrhosis. Despite the significant number of people affected by hepatic fibrosis, no effective treatment is available. In the liver, hepatic stellate cells are the major fibrogenic cell type that play a relevant function in chronic liver diseases. Thus, the characterization of components that control the fibrogenesis in the hepatic stellate cells is relevant in supporting the development of innovative therapies to treat and/or control liver fibrosis. The present study investigated the effects of Baccharis dracunculifolia D.C. and Plectranthus barbatus Andrews medicinal plant extracts in LX-2 transdifferentiation. Methods LX-2 is a human immortalized hepatic stellate cell that can transdifferentiate in vitro from a quiescent-like phenotype to a more proliferative and activated behavior, and it provides a useful platform to assess antifibrotic drugs. Then, the antifibrotic effects of hydroalcoholic extracts of Baccharis dracunculifolia and Plectranthus barbatus medicinal plants on LX-2 were evaluated. Results The results in our cellular analyses, under the investigated concentrations of the plant extracts, indicate no deleterious effects on LX-2 metabolism, such as toxicity, genotoxicity, or apoptosis. Moreover, the extracts induced changes in actin filament distribution of activated LX-2, despite not affecting the cellular markers of transdifferentiation. Consistent effects in cellular retinoid metabolism were observed, supporting the presumed activity of the plant extracts in hepatic lipids metabolism, which corroborated the traditional knowledge about their uses for liver dysfunction. Conclusion The combined results suggested a potential hepatoprotective effect of the investigated plant extracts reinforcing their safe use as coadjuvants in treating imbalanced liver lipid metabolism.

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Section: Discussionsupporting

confidence: 80%

Cellular and molecular effects of Baccharis dracunculifolia D.C. and Plectranthus barbatus Andrews medicinal plant extracts on retinoid metabolism in the human hepatic stellate cell LX-2

Silva

Caetano

Pereira

et al. 2019

BMC Complement Altern Med

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“…In this study, the use of leaves-derived aqueous extract A case is reported in which a several-fold increase in transaminases and g-GT was detected in an elderly male patient with fatty liver in use a laxative with addition of boldo leaf extracts concluding this extracts might be hepatotoxic, at least in elderly patients with fatty liver 27 . On the other hand, lower doses of the same extract, ranging from 20 to 40 mg/Kg, have demonstrated to ameliorate toxicity generated by cisplatin in liver tissue in vivo 11 .…”

Section: Discussionmentioning

confidence: 79%

The effect of the aqueous extract Peumus boldus on the proliferation of hepatocytes and liver function in rats submitted to expanded hepatectomy

Figueiredo

Santana²,

Nardelli

et al. 2016

Acta Cir. Bras.

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PURPOSE:To assess the effect of aqueous extract of Peumus Boldus (AEPB) on the liver proliferative response after parcial hepatectomy of 70% (PH) in rodents. METHODS:Twenty Wistar rats were divided in two groups: AEPB100 (whose rats received 100mg/Kg of AEPB, once a day, orally, in 4 days prior to the first surgical procedure) and Vehicle (whose rats were treated similarly with distilled water). Both groups underwent PH. After 24 hours the remaining livers were removed for studying the proliferation of hepatocytes by Ki-67 and 2mL of blood were collected for serological assessment: cholesterol, glucose, triglycerides, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and total, direct and indirect bilirubin. All data were analyzed by Gaussian distribution. Statistically significant differences between mean values were analyzed using T Student's test. Non-Gaussian data were analyzed using Mann-Whitney's test. RESULTS:The liver of all these rats presented positive staining of Ki-67, indicating liver proliferation. Laboratory results showed no significant difference in serum values between the analyzed groups. The analysis of Ki-67 was significantly more positive in AEPB100 group than in Vehicle group. CONCLUSION:Aqueous extract of Peumus Boldus acute administration exerts significant positive effect on liver regeneration after 24h in rats that underwent parcial hepatectomy, while maintaining unchanged hepatic function.

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“…Peumus boldus is a tree which grows in the South American Andes and is traditionally used for symptomatic treatment of dyspepsia, mild gastrointestinal spasmodic disorders and painful joints [2] . However, the number of reported cases of possible hepatotoxicity is increasing [1,3] . It is still not widely known that herbal medicines commonly cause adverse events, and their pathogenic mechanisms have not been sufficiently investigated.…”

Section: Discussionmentioning

confidence: 99%

Boldo-Induced Hepatotoxicity: A Case of Unexplained Jaundice

Sá

Pimentel

Oliveira

2020

European Journal of Case Reports in Internal Medicine

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An 87-year-old man was admitted with a 2-week history of asthenia, anorexia and jaundice. Blood tests showed increased serum liver enzymes. The aetiological study was inconclusive. The patient had a favourable clinical evolution during hospitalization with supportive care. His wife revealed that the patient had repeatedly consumed infusions of Peumus boldus (commonly known as boldo) leaves during the previous month. After common causes of hepatobiliary pathology were excluded, boldo-induced hepatotoxicity was considered probable. Cessation of its consumption led to complete clinical and laboratory recovery within a week.

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Caution in the use of boldo in herbal laxatives: A case of hepatotoxicity

Cited by 17 publications

References 7 publications

Cellular and molecular effects of Baccharis dracunculifolia D.C. and Plectranthus barbatus Andrews medicinal plant extracts on retinoid metabolism in the human hepatic stellate cell LX-2

Cellular and molecular effects of Baccharis dracunculifolia D.C. and Plectranthus barbatus Andrews medicinal plant extracts on retinoid metabolism in the human hepatic stellate cell LX-2

The effect of the aqueous extract Peumus boldus on the proliferation of hepatocytes and liver function in rats submitted to expanded hepatectomy

Boldo-Induced Hepatotoxicity: A Case of Unexplained Jaundice

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