Poisoning by toxic plants in Hong Kong: a 15-year review

Ng, Wan Sing; Hung, Louella; Lam, Y. H.; Chan, Suk San; Pang, Kuen Shum; Chong, YK; Ching, Chor Kwan; Mak, Tony Wing Lai

doi:10.12809/hkmj187745

Cited by 9 publications

(5 citation statements)

References 30 publications

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“…Overall, in line with other reports on G. elegans, gelsenicine in this study triggered respiration failure 10 without gastrointestinal toxicity, hepatotoxicity, nephrotoxicity, and cardiotoxicity. 7 Therefore, these data suggested that gelsenicine is an acute neurotoxin that can lead to death; but it did not produce marked cumulative toxic effects and substantial organ damage in subacute toxicity.…”

Section: Discussionmentioning

confidence: 90%

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Toxicity assessment of gelsenicine and the search for effective antidotes

Yang

Long³

et al. 2022

Hum Exp Toxicol

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Background Gelsenicine, one of the most toxic alkaloids of Gelsemium elegans Benth ( G. elegans), causes severe respiratory depression. However, its toxicity mechanisms are yet to be elucidated and no effective antidotes are available. Objective This study aimed to analyse the toxicity characteristics of gelsenicine. Methods Both acute and sub-acute toxicities were evaluated. Gelsenicine distribution and elimination in the central nervous system (CNS) and blood were observed. Effective antidotes for gelsenicine poisoning were screened. Results In the acute toxicity study, gelsenicine was highly toxic, and female rats exhibited greater sensitivity to gelsenicine than male rats (LD50 0.520 mg/kg vs 0.996 mg/kg, respectively). Death was primarily caused by respiratory failure. However, in the sub-acute toxicity study, no significant organ damage was observed. Gelsenicine was easily absorbed from the gastrointestinal tract and penetrated the blood–brain barrier, reaching peak concentrations in the CNS within 15 min and rapidly decreasing thereafter. Flumazenil or diazepam combined with epinephrine reversed gelsenicine toxicity and significantly improved survival rate in mice. Conclusions Gelsenicine is a highly toxic substance that affects nerve conduction without causing damage; the potential toxic mechanism is possibly associated with GABAA receptors. Our findings provide insights into the clinical treatment of gelsenicine -related poisoning and its toxicity mechanisms.

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Section: Discussionmentioning

confidence: 90%

“…6 However, G. elegans is highly toxic with a narrow therapeutic window, and clinical studies related to it are greatly limited. 7,8 Cases of unintentional poisoning, food contamination, and suicides related to G. elegans are still being reported. [9][10][11] Gelsenicine is a gelsedine-type indole alkaloid of G. elegans.…”

Section: Introductionmentioning

confidence: 99%

Toxicity assessment of gelsenicine and the search for effective antidotes

Yang

Long³

et al. 2022

Hum Exp Toxicol

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“…The MFDS has designated 21 poisonous herbs, which are off-limits for purchase for non-licensed persons and are supplied only to TKM clinics [ 34 ]. Poisonous herbs may cause severe side effects or even death if taken above a certain level [ 35 ]. Thus, they need to be managed separated from normal herbal materials by licensed TKM pharmacists.…”

Section: Discussionmentioning

confidence: 99%

Current status and future perspective of external herbal dispensaries preparing traditional herbal medicine in South Korea: the first National-Wide Survey results

Sung

Han

Ryu

et al. 2020

BMC Complement Med Ther

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Background An external herbal dispensary (EHD) is a type of pharmacy that provides various types of personalized herbal medicines (PHMs) to other traditional Korean medicine (TKM) institutions. Such dispensaries were legalized by the Ministry of Health and Welfare (MoHW) in 2008 in South Korea. The purpose of this study is to understand the current status of the EHD facilities and their quality controls and compare them with the good manufacture practice (GMP) guidelines to contribute to the establishment of the safety and quality control criteria for PHMs. Methods We contacted 107 EHD representatives or people in charge of the preparation of PHMs (TKM pharmacists) and invited them to complete a survey questionnaire; of the total, 81 responded. The survey questionnaire was developed in 3 stages: drafting, revision by external experts, and final editing. It consisted of 20 questions covering 3 sections: basic characteristics of EHDs, facility, and quality control. The survey was hosted online from December 2017 to January 2018 as guided by the MoHW. Results The completion rate was 75.7% (n = 81). In terms of facilities, the five facilities (water supply, manufacture, pest control, hygiene management and warehousing) that corresponded to the legal requirements of EHD were mostly equipped, but the types of facilities and equipment differed. Two facilities (sterilization and cross-contamination that were not legally required for EHD were found to have mostly pharmacopuncture-EHD (P-EHD), but hardly any herbal medicine-EHD (H-EHD). In our findings regarding quality control of non-medicinal herbs, sensory evaluation that included checks for foreign bodies and deterioration were conducted. In terms of the quality control of herbal medicines, residual pesticides and heavy metals tests were performed and for pharmacopuncture, pH, salinity, sterility, and endotoxin tests along with gross examination were performed. In the end, we found that 6 of the 38 standard items as required by the Korea GMP were suitable. Conclusions In this study, detailed information for each existing EHD law was determined through a nationwide questionnaire. Moreover, the basis for its reflection in additional legal standards should be introduced so that safe herbal medicine can be prepared in EHDs.

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“…Even though, like most plant organs, they contain Vit C, their potential toxicity makes their consumption on a constant basis unfeasible, although these could have been drunk occasionally as a therapeutic remedy [66]. However, most of these vegetable organs contain turpentine and other toxic compounds that can cause various health problems, including hepatotoxicity [133]. Moreover, in pregnant women, both juniper and pine needles can pose risks to the developing fetus as the toxic substances present in needles can cross the placenta and potentially cause harm, while laboratory and animal studies have suggested that Juniperus and Pinus species share similar chemistries and have antifertility effects in both males and females [134].…”

Section: Sources Of Vitamin C For M3hmentioning

confidence: 99%

The Role of Large Mammals as Vitamin C Sources for MIS 3 Hominins

Guil‐Guerrero

2023

Quaternary

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The acquisition of large prey by hominins living during the Marine Isotope Stage 3, including Neanderthals and Anatomically Modern Humans, had nutritional and bioenergetic implications: these contain high fat amounts, provide a high energy return, and the strategies and skills required to acquire small prey were different from those required to acquire the former. Vitamin C availability at several MIS 3 periods could have had a strong seasonal variability and would have been decisive for hominin groups’ survival. During the cold periods of the MIS 3, Paleolithic hominins had variable available amounts of vitamin C-containing plants only in the short summers, and for the remainder of the year, viscera would have been their best source of vitamin C. Meanwhile, the dependence on small mammals could have caused an erratic distribution of viscera to be consumed by such hominins, thus leading to chronic scurvy, and compromising their survival. Then, the hunting of large mammals would have helped to meet the daily vitamin C needs, besides an efficient energy supply. Therefore, the decline of large prey during the MIS 3 could have been critical for hominins survival, and thus the efficient exploitation of alternative vitamin C-rich food resources such as birds and aquatic animals could have favored the evolutionary success of hominin populations.

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Poisoning by toxic plants in Hong Kong: a 15-year review

Cited by 9 publications

References 30 publications

Toxicity assessment of gelsenicine and the search for effective antidotes

Toxicity assessment of gelsenicine and the search for effective antidotes

Current status and future perspective of external herbal dispensaries preparing traditional herbal medicine in South Korea: the first National-Wide Survey results

The Role of Large Mammals as Vitamin C Sources for MIS 3 Hominins

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