Official websites use. Share sensitive information only on official, secure websites. Background : Traditional Chinese Medicine TCM with its focus on herbal use is popular and appreciated worldwide with increased tendency, although its therapeutic efficacy is poorly established for most herbal TCM products.
Treatment was perceived as fairly safe but discussions emerged more recently as to whether herb induced liver injury HILI from herbal TCM is a major issue; Methods : To analyze clinical and case characteristics of HILI caused by herbal TCM, we undertook a selective literature search in the PubMed database with the search items Traditional Chinese Medicine, TCM, alone and combined with the terms herbal hepatotoxicity or herb induced liver injury; Results : HILI caused by herbal TCM is rare and similarly to drugs can be caused by an unpredictable idiosyncratic or a predictable intrinsic reaction.
Clinical features of liver injury from herbal TCM products are variable, and specific diagnostic biomarkers such as microsomal epoxide hydrolase, pyrrole-protein adducts, metabolomics, and microRNAs are available for only a few TCM herbs. The diagnosis is ascertained if alternative causes are validly excluded and causality levels of probable or highly probable are achieved applying the liver specific RUCAM Roussel Uclaf Causality Assessment Method as the most commonly used diagnostic tool worldwide.
The reputation of herbal Traditional Chinese Medicine TCM has substantially improved within the past few years [ 1 , 2 , 3 ]. This was achieved through efforts closing up its gaps with modern medicine [ 4 , 5 ], considering clinical aspects [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ], as well as researching and developing new drugs [ 16 , 17 , 18 ].
Instead, the Nobel Prize was awarded to Youyou Tu for her pioneering work in drug development originating from herbal TCM and her discovery of artemisinin for the treatment of malaria [ 19 , 20 ].
