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Herbal Products for Liver Diseases:
A Therapeutic Challenge for the New Millennium

table  1.   Selection of Herbal Preparations With Proven Hepatotoxicity
Causative Plants Toxic Agents Symptoms Mechanism/Pathology
Crotalaria
Senecio
Heliotropium
Symphytum officinale (Comfrey)		 Pyrrolizidine alkaloids Veno-occlusive disease Endothelial cell glutathione depletion, central vein necrosis, thrombosis, and fibrosis
Atractylis gummifera Atractylate, gummiferin Hepatitis Inhibition of oxidative phosphorylation, hepatic necrosis
Callilepsis laureola Atractylate Hepatitis Hepatocyte necrosis
Chelidonum majus (greater celandine) Chelidonine, sanguinarine, berberine, coptisine? Hepatitis (cholestatic) Lymphocyte infiltration
Larrea tridentata (chaparral) Guaiaretic acid derivatives Hepatitis ?
Teucrium chamaedrys (germander) Furano-diterpenoids Hepatitis Hepatocyte glutathione depletion and apoptosis
Chinese herbal mixtures (artemisia, hare's ear, chrysanthemum, plantago seed, gardinia, red peony root, etc.) Largely undefined Hepatitis ?
NOTE. Data are selected from Larrey and Pageaux,5 Kaplowitz,6 Benninger et al.,9 and Yoshida et al.4

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