Format

Send to

Choose Destination
Complement Ther Med. 2019 Feb;42:286-291. doi: 10.1016/j.ctim.2018.11.028. Epub 2018 Dec 6.

Literature review of liver injury induced by Tinospora crispa associated with two cases of acute fulminant hepatitis.

Author information

1
Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.
2
Department of Chinese Medicine pharmacy, China Medical University Hospital, Taichung, Taiwan.
3
Traditional Chinese Medicine Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
4
Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan; School of Chinese Medicine, China Medical University, Taichung, Taiwan; Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; Chinese Medicine Research Center, China Medical University, Taichung, Taiwan; Research Center for Chinese Herbal Medicine, China Medical University, Taichung, Taiwan. Electronic address: sheng.teng@yahoo.com.

Abstract

INTRODUCTION:

Species of Tinospora are used as herbal remedies for the treatment of various diseases with very few toxic effects having been reported. Tinospora cordifolia (TCF) has been reported to effectively prevent hepatotoxicity. However, there are an increasing number of cases revealing that Tinospora crispa (TCP) might have the negative effect of inducing hepatotoxicity. Because of the similar leaves, people may mistake TCP for TCF, and consume it with the purpose of protecting liver function.

OBJECTIVE:

Find out the misusing level of TCP and TCF and which chemical compound in TCP might induce hepatotoxicity.

METHODS:

We report two cases of acute fulminant hepatitis associated with chronic use of TCP. Given that the two herbs were misidentified in these two reports, we investigated the frequency of erroneous identification by using three keywords ("Guduchi", "Tinospora cordifolia", "Tinospora crispa") to search images from the Google Images database. To further clarify the influence of liver function between TCP and TCF, we searched PubMed (up to 29 July 2018) for relevant publications on clinical trials or case reports.

RESULTS:

Based on web review, over 35 percent of websites failed to accurately identify these two herbs. The different effects on liver function between TCP and TCF were compared through literature review. It indicated that TCF exerted liver protection, TCP had a contrary effect, suggesting its cis-Clerodane-type furano-diterpenoids might be an important factor of inducing hepatotoxicity.

CONCLUSIONS:

We concluded that people might cause hepatic injury or even death without correctly identifying these two Tinospora species.

KEYWORDS:

Chronic liver diseases; Guduchi; Hepatotoxicity; Herbal medicine; Tinospora cordifolia; Tinospora crispa

PMID:
30670256
DOI:
10.1016/j.ctim.2018.11.028
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center