EFFICACY AND SAFETY OF HERBAL MEDICINES IN ASIA

Achmad Al Baihaqi, Jutti Levita

Abstract


Herbal medicine (HM) is a part of future alternative health care. According to the World Health Organization (WHO), almost 70-80% of the population of developing countries rely on HM as an immediate need for health services, one of which is the Asian region. With the high trend of a healthy lifestyle using natural ingredients, drug safety must be a significant concern. This review article aims to provide information on studying the toxicity of Asian herbal plants to hepatotoxic and nephrotoxic activities. The research method was conducted by searching using the keywords “Herbal Medicine(HM),†“Efficacy,†“Nephrotoxicity,†“Hepatotoxicity,†“Asia,†“extract†on the Google site and Google Scholar. The primary data sources used consisted of national journals, international journals, and the WHO website. Articles were screened using the inclusion criteria of Indonesian and English journals published in the last ten years. Of the toxicity study articles discussing 10 herbs-induced liver injury (HILI) and 10 drug-induced liver injury (DILI) that we reviewed, it is known that the dose consumed has a more significant effect on the incidence of hepatotoxicity and nephrotoxicity than the duration of administration with low doses. However, the period of administration with high doses has a significant relationship with liver and kidney damage. Therefore, disseminating safety studies to the public is very important to maximize drug efficacy and avoid hepatotoxicity and nephrotoxicity.

Keywords: herbal medicine (HM); hepatotoxicity; nephrotoxicity; Asia; safety


Keywords


herbal medicine (HM); hepatotoxicity; nephrotoxicity; Asia; safety

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Silveira D, Prieto JM, Freitas MM, Mazzari ALDA. Herbal medicine and public healthcare: Current and future challenges. In: Natural Products as Source of Molecules with Therapeutic Potential: Research and Development, Challenges and Perspectives. Springer International Publishing; 2018. p. 495–515.

Kanjanahattakij N, Kwankhao P, Vathesatogkit P, Thongmung N, Gleebbua Y. Herbal or traditional medicine consumption in a Thai worker population : pattern of use and therapeutic control in chronic diseases. 2019;1–9.

UN. Economic and Social Survey of Asia and The Pacific 2020. Towards Sustainable Economies. 2020.

Astutik S, Pretzsch J, Kimengsi JN. Asian medicinal plants’ production and utilization potentials: A review. Vol. 11, Sustainability (Switzerland). 2019. p. 1–33.

Who global report on traditional and complementary medicine 2019. 2019.

Seca AML, Pinto DCGA. Biological Potential and Medical Use of Secondary Metabolites. Medicines. 2019;6(2):66.

Ahmad Khan MS, Ahmad I. Herbal Medicine: Current Trends and Future Prospects. New Look to Phytomedicine: Advancements in Herbal Products as Novel Drug Leads. Elsevier Inc.; 2018. 3–13. Available from: http://dx.doi.org/10.1016/B978-0-12-814619-4.00001-X

Yang Y. Use of herbal drugs to treat COVID-19 should be with caution. The Lancet. 2020;395(10238):1689–90. Available from: http://dx.doi.org/10.1016/S0140-6736(20)31143-0

Mithun Rudrapal D, Chetia. Herbal Drugs: Efficacy, Toxicity, and Safety Issues. Evidence Based Validation of Traditional Medicines. 2021;537–53. Available from: https://link.springer.com/chapter/10.1007/978-981-15-8127-4_26

Lv W, Piao JH, Jiang JG. Typical toxic components in traditional Chinese medicine. Expert Opinion on Drug Safety. 2012;11(6):985–1002.

Xu XL, Yang LJ, Jiang JG. Renal toxic ingredients and their toxicology from traditional Chinese medicine. Expert Opinion on Drug Metabolism and Toxicology. 2016;12(2):149–59.

Tsatsakis AM, Vassilopoulou L, Kovatsi L, Tsitsimpikou C, Karamanou M, Leon G, et al. The dose response principle from philosophy to modern toxicology: The impact of ancient philosophy and medicine in modern toxicology science. Toxicology Reports. 2018:1107–13. Available from: https://doi.org/10.1016/j.toxrep.2018.10.001

Sethi G. Multifaceted role of gamma tocotrienol in cancer therapy. Journal of Clinical Trials. 2018;08:4172.

Christina I, Setyawati An, Dk Kt. Pengaruh Ekstrak Daun Dewa (Gynura Divaricata) Terhadap Kadar Sgot Dan Sgpt (Studi Eksperimental Pada Tikus Sprague Dawley Betina Model Kanker Payudara). Diponegoro Medical Journal (Jurnal Kedokteran Diponegoro) . 2016;5(4):1013–25. Available from: https://ejournal3.undip.ac.id/index.php/medico/article/view/14476

Razak RNHA, Rahman SA, Hamdan AH, Ramli R, Isa MLM, Muhammad H, et al. Evaluation of acute and sub-acute oral toxicity of the aqueous extract of aquilaria malaccensis leaves in Sprague Dawley rats. Asia-Pacific Journal of Molecular Biology and Biotechnology. 2019;27(1):20–32.

Bello I, Suliman Bakkouri A, Tabana YM, Al-Hindi B, Al-Mansoub A, Mahmud R, et al. medical sciences Acute and Sub-Acute Toxicity Evaluation of the Methanolic Extract of Alstonia scholaris Stem Bark. 2016; Available from: www.mdpi.com/journal/medsci

Zuraida. Phytocemical compounds of different species of Alstonia sp. from Palembang- South Sumatera. IOP Conference Series: Earth and Environmental Science. 2019;308(1).

Yang M, Wu Z, Wang Y, Kai G, Singor Njateng GS, Cai S, et al. Acute and subacute toxicity evaluation of ethanol extract from aerial parts of Epigynum auritum in mice. Food and Chemical Toxicology. 2019 Sep 1;131:110534.

Intan Aek, Manggau Ma, Cangara H. Studi Histopatologi Organ Hati Dan Ginjal Dari Tikus Putih (Rattus Novergicus) Setelah Pemberian Dosis Tunggal Dan Berulang Ekstrak Etanol Parang Romang (Boehmeria Virgata (Forst) Guill). Majalah Farmasi Dan Farmakologi. 2018;22(2):64–8. Available From: Http://Journal.Unhas.Ac.Id

Sari W, Fitri S, Ceriana R, Sunarti S. Efek Toksik Pemberian Ekstrak Batang Sipatah-patah (Cissus quadrangula Salisb.) Terhadap Gambaran Histologi Hati dan Ginjal Mencit. Jurnal Bioleuser. 2017;1(1). Available from: http://e-repository.unsyiah.ac.id/bioleuser/article/view/8304

Dewijanti I, Mangunwardoyo W, Astari Dwiranti, Muhammad Hanafi, Nina Artanti. Short Communication: Effects Of The Various Source Areas Of Indonesian Bay Leaves (Syzygium Polyanthum) On Chemical Content And Antidiabetic Activity. Biodiversitas Journal Of Biological Diversity. 2020;21(3):1190–5.

Nugroho RA, Cening N, Puspa S, Aryani R, Rudianto WP, Manurung H. Subchronic Toxicity Test of Indian Almond ( Terminalia catappa ) Leaves Water Extract on The Liver Histology of Mice ( Mus musculus ). 2020;4(2):177–82.

Kifayatullah M, Mustafa MohdS, Sengupta P, Sarker MdMR, Das A, Das SK. Evaluation of the acute and sub-acute toxicity of the ethanolic extract of Pericampylus glaucus (Lam.) Merr. in BALB/c mice. Journal of Acute Disease. 2015;4(4):309–15.

Algandaby MM. Assessment of acute and subacute toxic effects of the Saudi folk herb Retama raetam in rats. Journal of the Chinese Medical Association. 2015;78(12):691–701.

Nasri H, Rafieian-Kopaei M. Nephrotoxicity of hydroalcoholic extract of teucrium polium in wistar rats. Journal of Isfahan Medical School. 2014;32(290):938–46.

Rasyad A, Mahendra P, Hamdani Y. Uji Nefrotoksik dari Ekstrak Etanol Biji Mahoni (Swietenia Mahagoni Jacq.) terhadap Tikus Putih Jantan Galur Wistar. Jurnal Penelitian Sains. 2012;15(2):168083.

Taghikhani M, Nasri H, Asgari A, Afrough H, Namjoo AR, Ansari-Samani R, et al. The renal toxicity of hydroalcoholic extract of stachys lavandulifolia Vahl in Wistar rats. Life Science Journal. 2012;9(4):3025–31.

Dv PLX, Trianto HF, Fitrianingrum I. Efek Nefrotoksik Pemberian Ekstrak Etanol 70 % Daun Karamunting ( Rhodomyrtus tomentosa ( Aiton ) Hassk .) terhadap Kadar Ureum dan Kreatinin Serum Tikus Galur Wistar. 2015;293–305.

Benzakour G, Benkirane N, Amrani M, Oudghiri M. Immunostimulatory potential of Aristolochia longa L . induced toxicity on liver , intestine and kidney in mice. Journal of Toxicology and Environmental Health Sciences. 2011;3(8):214–22.

Yun JW, You JR, Kim YS, Kim SH, Cho EY, Yoon JH, et al. In vitro and in vivo safety studies of cinnamon extract (Cinnamomum cassia) on general and genetic toxicology. Regulatory Toxicology and Pharmacology. 2018;95:115–23.

Han HY, Huh JI, Han SR, Kang MG, Yoon S, Han JS, et al. Assessing the safety of an Ephedrae Herba aqueous extract in rats: A repeat dose toxicity study. Regulatory Toxicology and Pharmacology. 2018;94:144–51.

Chen H, Sha X, Luo Y, Chen J, Li X, Wang J, et al. Acute and subacute toxicity evaluation of Houttuynia cordata ethanol extract and plasma metabolic profiling analysis in both male and female rats. Journal of Applied Toxicology. 2021;jat.4198. Available from: https://onlinelibrary.wiley.com/doi/10.1002/jat.4198

Kang C, Lee H, Hah DY, Heo JH, Kim CH, Kim E, et al. Protective effects of Houttuynia cordata Thunb. on gentamicin-induced oxidative stress and nephrotoxicity in rats. Toxicological Research. 2013;29(1):61–7.

Fowotade A, Fowotade A, Enaibe B, Avwioro G. Evaluating Toxicity Profile Of Garlic (Allium Sativum) On The Liver, Kidney And Heart Using Wistar Rat Model. International Journal Of Tropical Disease & Health. 2017;26(2):1–12.

Hashemnia M, Rezaei F, Nikousefat Z, Bahiraei M. Toxicological evaluation of chronic oral administration of Melissa officinalis hydro-ethanol extract in Sprague-Dawley rats. Veterinary Science Development. 2017;7(1). Available from: https://www.pagepress.org/journals/index.php/vsd/article/view/6298

Secretariat A. e-Health Bulletin Towards Harmonisation of Traditional Medicine Practices ASEAN + 3 FETN : A Step Forward in. e-Health Bulletin. 2012;(2):1–8.

Sen S, Chakraborty R, De B. Challenges and opportunities in the advancement of herbal medicine: India’s position and role in a global context. Journal of Herbal Medicine. 2011;1(3–4):67–75.

Peltzer K, Pengpid S. Prevalence and Determinants of Traditional, Complementary and Alternative Medicine Provider Use among Adults from 32 Countries. Chinese Journal of Integrative Medicine. 2018;24(8):584–90.

Peltzer K, Pengpid S. Utilization and practice of traditional/complementary/alternative medicine (T/CAM) in southeast asian nations(ASEAN) member states. Studies on Ethno-Medicine. 2015;9(2):209–18.

Widowati L, Nurhayati. The Use of Traditional Health Care Among Indonesian Family. Health Science Journal of Indonesia. 2017;8(1):30–5. Available from: http://ejournal.litbang.depkes.go.id/index.php/HSJI/article/download/5600/5238

Pengpid S, Peltzer K. Utilization of traditional and complementary medicine in Indonesia: Results of a national survey in 2014–15. Complementary Therapies in Clinical Practice. 2018;33:156–63.

Kalra A, Tuma F. Physiology, Liver [Internet]. StatPearls. StatPearls Publishing; 2018 [cited 2021 Jun 10]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/30571059

Mishra S, Aeri V, Katare DP. Hepatoprotective medication for liver injury. World Journal of Pharmacy adn Pharmaceutical Sciences. 2014;3(5):891–932.

Leise MD, Poterucha JJ, Talwalkar JA. Drug-Induced Liver Injury. Mayo Clinic Proceedings [Internet]. 2014;89(1):95–106. Available from: http://dx.doi.org/10.1016/j.mayocp.2013.09.016

Lin N, Yang H, Su Y, Chang C. Herb induced liver injury after using herbal medicine. 2018;

Amadi CN. An Update. 2018;(Dili).

Villanueva-Paz M, Morán L, López-Alcántara N, Freixo C, Andrade RJ, Lucena MI, et al. Oxidative stress in drug-induced liver injury (Dili): From mechanisms to biomarkers for use in clinical practice. Antioxidants. 2021;10(3):1–35.

Suk KT, Kim DJ. Drug-induced liver injury: present and future. Clinical and molecular hepatology. 2012;18(3):249–57.

Roussel Uclaf Causality Assessment Method (RUCAM) in Drug Induced Liver Injury. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. 2019 May 4 [cited 2021 Jul 25]; Available from: https://www.ncbi.nlm.nih.gov/books/NBK548272/

Danan G, Teschke R. RUCAM in Drug and Herb Induced Liver Injury: The Update. International Journal of Molecular Sciences 2016, Vol 17, Page 14. 2015;17(1):14. Available from: https://www.mdpi.com/1422-0067/17/1/14/htm

Barnett LMA, Cummings BS. Nephrotoxicity and renal pathophysiology: A contemporary perspective. Toxicological Sciences. 2018;164(2):379–90.

Skinner R. Nephrotoxicity - What do we know and what don’t we know? Journal of Pediatric Hematology/Oncology. 2011;33(2):128–34.

Dhodi DK, Bhagat SB, Pathak D, Pathel SB. Drug-induced nephrotoxicity. International Journal of Basic & Clinical Pharmacology. 2014;3(4). Available from: doi: 10.5455/2319-2003.ijbcp20140826

Vormann MK, Gijzen L, Hutter S, Boot L, Nicolas A, van den Heuvel A, et al. Nephrotoxicity and Kidney Transport Assessment on 3D Perfused Proximal Tubules. AAPS Journal. 2018;20(5):1–11.

Zarjou A, Agarwal A. Sepsis and acute kidney injury. Journal of the American Society of Nephrology. 2011;22(6):999–1006.

Pelkonen O, Duez P, Vuorela PM, Vuorela H. Toxicology of herbal products. Toxicology of Herbal Products. 2017. 1–479.

Anger EE, Yu F, Li J. Molecular Sciences Aristolochic Acid-Induced Nephrotoxicity: Molecular Mechanisms and Potential Protective Approaches. 2020; Available from: www.mdpi.com/journal/ijms

Dickman KG, Sweet DH, Bonala R, Ray T, Wu A. Physiological and molecular characterization of aristolochic acid transport by the kidney. Journal of Pharmacology and Experimental Therapeutics. 2011;338(2):588–97. Available from: https://jpet.aspetjournals.org/content/338/2/588

Kiliś-Pstrusińska K, Wiela-Hojeńska A. Nephrotoxicity of herbal products in europe—a review of an underestimated problem of nephrotoxicity of herbal products. International Journal of Molecular Sciences. 2021;22(8).

Zhu S, Wang Y, Jin J, Guan C, Li M, Xi C, et al. Endoplasmic reticulum stress mediates aristolochic acid I-induced apoptosis in human renal proximal tubular epithelial cells. Toxicology in Vitro. 2012;26(5):663–71. Available from: http://dx.doi.org/10.1016/j.tiv.2012.03.005

Xu X, Zhu R, Ying J, Zhao M, Wu X, Cao G, et al. Nephrotoxicity of Herbal Medicine and Its Prevention. Vol. 11, Frontiers in Pharmacology. Frontiers Media S.A.; 2020.

Umayah Ulfa E, Rachmawati E.. Artikel Penelitian Global Medical And Health Communication Uji Toksisitas Subkronik Ekstrak Kayu Kuning (Arcangelisia Flava Merr) Terhadap Hepar Dan Ginjal. Global Medical And Health Communication. 2018;6(1):1–6. Available from: http://ejournal.unisba.ac.id/index.php/gmhc

Kaplowitz N, DeLeve LD. Drug-Induced Liver Disease. Drug-Induced Liver Disease. Elsevier Inc.; 2013.

Calitz C, Plessis L du, Gouws C, Steyn D, Steenekamp J, Muller C, et al. Herbal hepatotoxicity: current status, examples, and challenges. http://dx.doi.org/101517/1742525520151064110. 2015;11(10):1551–65. Available from: https://www.tandfonline.com/doi/abs/10.1517/17425255.2015.1064110

Teschke R, Frenzel C, Glass X, Schulze J, Eickhoff A. Herbal hepatotoxicity: A critical review. British Journal of Clinical Pharmacology. 2013 Mar;75(3):630–6.

Locke AB, Kirst N, Shultz CG. Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults [Internet]. Vol. 91, American Family Physician. 2015 May [cited 2021 Jun 12]. Available from: www.aafp.org/afpAmericanFamilyPhysician617

Worland T, Chin KL, Rodrigues B, Nicoll A. A Retrospective Case-Controlled Cohort Study Of Inpatient Drug Induced Liver Injury: The RIDDLE Study. Translational Gastroenterology And Hepatology [Internet]. 2020 Jul 5 [Cited 2021 Jun 12];5. Available From: /Pmc/Articles/PMC7063506/

Gerussi A, Natalini A, Antonangeli F, Mancuso C, Agostinetto E, Barisani D, et al. Immune-mediated drug-induced liver injury: Immunogenetics and experimental models [Internet]. Vol. 22, International Journal of Molecular Sciences. MDPI AG; 2021 [cited 2021 Jun 12]. p. 4557. Available from: https://doi.org/10.3390/ijms22094557

Ekor M, Pistelli L. The growing use of herbal medicines: issues relating to adverse reactions and challenges in monitoring safety. 2014; Available from: www.frontiersin.org

Pillai PG, Suresh P, Mishra G, Annapurna M. Evaluation of the acute and sub acute toxicity of the methanolic leaf extract of Plectranthus amboinicus (Lour) Spreng in Balb C mice. European Journal of Experimental Biology. 2011;1(3):236–45. Available from: http://www.imedpub.com/articles/evaluation-of-the-acute-and-sub-acute-toxicity-of-the-methanolic-leafextract-of-iplectranthus-amboinicusi-lour-spreng-in-balb-c-mi.pdf

Paniagua AC, Amariles P. Hepatotoxicity by Drugs. In: Pharmacokinetics and Adverse Effects of Drugs - Mechanisms and Risks Factors [Internet]. InTech; 2018 [cited 2021 Jun 12]. Available from: http://dx.doi.org/10.5772/intechopen.72005

Sari A. Nephrotoxic Effects of Drugs. In: Poisoning in the Modern World - New Tricks for an Old Dog? [Internet]. IntechOpen; 2019 [cited 2021 Jun 12]. Available from: www.intechopen.com




DOI: http://dx.doi.org/10.52434/jfb.v12i2.1244

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