Proposal for a Kava Quality Standardization Code

Teschke, Rolf; Lebot, Vincent

doi:10.1016/j.fct.2011.06.075

Cited by 50 publications

(79 citation statements)

References 62 publications

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“…The safety of kava consumption has been a topic of debate in recent years (Anke and Ramzan 2004;Russmann et al 2001;Anon 2001;Campo et al 2002;Gow et al 2003;Brauer et al 2003). In general, the kava beverage and products made from rhizomes and roots have been considered being safe (Teschke and Lebot 2011).…”

Section: Introductionmentioning

confidence: 99%

Kavalactone content and chemotype of kava beverages prepared from roots and rhizomes of Isa and Mahakea varieties and extraction efficiency of kavalactones using different solvents

Wang

Bittenbender

et al. 2013

J Food Sci Technol

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The South Pacific islanders have consumed kava beverage for thousands of years. The quality of kava and kava beverage is evaluated through determination of the content of six major kavalactones including methysticin, dihydromethysticin, kavain, dihydrokavain, yangonin and desmethoxyyangonin. In this study, we determined contents of kavalactones in and chemotype of kava beverages prepared from roots and rhizomes of Isa and Mahakea varieties and extraction efficiency of five different solvents including hexane, acetone, methanol, ethanol and ethyl acetate. The six major kavalactones were detected in all kava beverages with Jun Wang and Weiyue Qu contributed equally to this work.

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Section: Introductionmentioning

confidence: 99%

Kavalactone content and chemotype of kava beverages prepared from roots and rhizomes of Isa and Mahakea varieties and extraction efficiency of kavalactones using different solvents

Wang

Bittenbender

et al. 2013

J Food Sci Technol

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“…As an example, several hundred kava varieties exist [8][9][10][11] , but specific information on kava variety identification was missing in all spontaneous reports and case report publications of suspected hepatotoxicity. This leaves open which kava variety had to be incriminated [9][10][11][12][13][14][15][16][17] .…”

Section: Herbal Product Essentialsmentioning

confidence: 99%

“…It details standardization of overall herbal quality and specifically addresses chemical, agricultural, manufacturing, nutritional, regulatory, and legislation standardizations. In addition, labelling and consumer leaflet of herbal drugs and herbal dietary supplements should mandatorily provide a clear definition and identification of the plant family, subfamily, species, subspecies, and variety as classical botanical description for any herb used as an ingredient of a herbal product (Table 1) [4,8] .…”

Section: Herbal Product Essentialsmentioning

confidence: 99%

“…The products are destined for human use and must meet the highest possible quality based on specific standards (Table 1) [4][5][6][7] . Despite fulfilment of quality standards, batch and product variability is common [4,[8][9][10] . Therefore, additional specific production quality standards have been described, for instance, as a proposal for a Kava Quality Standardization Code [8] .…”

Section: Herbal Product Essentialsmentioning

confidence: 99%

“…Despite fulfilment of quality standards, batch and product variability is common [4,[8][9][10] . Therefore, additional specific production quality standards have been described, for instance, as a proposal for a Kava Quality Standardization Code [8] . It details standardization of overall herbal quality and specifically addresses chemical, agricultural, manufacturing, nutritional, regulatory, and legislation standardizations.…”

Section: Herbal Product Essentialsmentioning

confidence: 99%

See 2 more Smart Citations

Herbal hepatotoxicity: Challenges and pitfalls of causality assessment methods

Teschke¹,

Frenzel²,

Schulze³

et al. 2013

WJG

Self Cite

156

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totoxicity cases, compared to numerous other causality assessment methods, which are inferior on various grounds. Among these disputed methods are the Maria and Victorino scale, an insufficiently qualified, shortened version of the CIOMS scale, as well as various liver unspecific methods such as the ad hoc causality approach, the Naranjo scale, the World Health Organization (WHO) method, and the Karch and Lasagna method. An expert panel is required for the Drug Induced Liver Injury Network method, the WHO method, and other approaches based on expert opinion, which provide retrospective analyses with a long delay and thereby prevent a timely assessment of the illness in question by the physician. In conclusion, HILI causality assessment is challenging and is best achieved by the liver specific CIOMS scale, avoiding pitfalls commonly observed with other approaches.© 2013 Baishideng. All rights reserved.Key words: Herbal hepatotoxicity; Herb induced liver injury; Herbs; Drug hepatotoxicity; Drug induced liver injury; Causality assessment Core tip: This review focuses on diagnostic causality assessment algorithms that have been used so far in herb induced liver injury (HILI) cases. Detailed information of the various methods with their strengths and weaknesses is provided including their challenges and pitfalls that emerged during the assessing course. For the physician caring for a patient with suspected HILI, the Council for International Organizations of Medical Sciences (CIOMS) scale is the preferred tool for assessing causality compared to numerous other causality assessment methods, which are inferior on various grounds. CIOMS based assessment should start at the day HILI is suspected to ensure completeness of clinical data. AbstractThe diagnosis of herbal hepatotoxicity or herb induced liver injury (HILI) represents a particular clinical and regulatory challenge with major pitfalls for the causality evaluation. At the day HILI is suspected in a patient, physicians should start assessing the quality of the used herbal product, optimizing the clinical data for completeness, and applying the Council for International Organizations of Medical Sciences (CIOMS) scale for initial causality assessment. This scale is structured, quantitative, liver specific, and validated for hepatotoxicity cases. Its items provide individual scores, which together yield causality levels of highly probable, probable, possible, unlikely, and excluded. After completion by additional information including raw data, this scale with all items should be reported to regulatory agencies and manufacturers for further evaluation. The CIOMS scale is preferred as tool for assessing causality in hepa-

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Use of Kava as a Phytotherapeutic Agent and Kava‐related Hepatotoxicity

Ramzan

2015

Phytotherapies

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Proposal for a Kava Quality Standardization Code

Cited by 50 publications

References 62 publications

Kavalactone content and chemotype of kava beverages prepared from roots and rhizomes of Isa and Mahakea varieties and extraction efficiency of kavalactones using different solvents

Kavalactone content and chemotype of kava beverages prepared from roots and rhizomes of Isa and Mahakea varieties and extraction efficiency of kavalactones using different solvents

Herbal hepatotoxicity: Challenges and pitfalls of causality assessment methods

Use of Kava as a Phytotherapeutic Agent and Kava‐related Hepatotoxicity

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