"""Dose-effect-response"" Relationships of Paeoniae Radix Rubra on α-Naphthylisothiocyanate-induced Acute Cholestatic Hepatitis in Rats" / 中草药·英文版

Objective To investigate the hepatoprotective effects of Paeoniae Radix Rubra (PRR) at different doses against α-naphthylisothiocyanate (α-NIT)-induced acute cholestatic hepatitis in rats.Methods Rats were ig administrated with vehicle or PRR [(1,9,18,36,54,72,and 81 g/(kg·d)] 3 d before and 2 d after α-NIT (60 mg/kg) ig administration.The general status of rats,histopathology of liver,serum alanine aminotransaminase,aspartate aminotransaminase,total bilirubin,direct bilirubin,and alkaline phosphatase levels,were observed at respective time points (24 and 48 h) after α-NIT administration.Using cluster analysis and correspondence analysis,the dose-effect-response relationships of PRR were evaluated.Results The results showed that compared with model group,the serum biochemistry index significantly decreased with the increasing of PRR dosage (P ＜ 0.01),and the change and necrosis of hepatic cellula,and inflammatory cell infiltration were gradually alleviated.However,the improvement was not obviously found in the low-dose group [1 g/(kg·d)].The cluster analysis and correspondence analysis results showed that different doses of PRR could significantly ameliorate α-NIT-induced acute cholestatic hepatitis of rats in a dose-dependent manner.Conclusion The experiments show that administration doses of PRR in clinical use should be added properly in order to gain the expectant therapeutic effect,especially in the treatment of heavy acute cholestasis hepatitis.

A Case of Acute Cholestatic Hepatitis Associated with Orlistat / 대한간학회지

Orlistat(Xenical(R), Roche) is considered a safe and effective drug to treat obesity by reduced absorption of 30% digested fat. To date, no serious adverse effects affecting the liver have been published except a case of subacute hepatic failure leading to liver transplantation in a young women with moderate obesity treated with orlistat. We report a case of acute cholestatic hepatitis in a young woman with moderate obesity treated with orlistat: a 33-year-old female admitted for the evaluation of jaundice. Abdominal ultrasonography, ERCP, routine chemistry, viral markers, and a fine needle biopsy of liver were performed. Microscopic findings of the liver biopsy specimen were compatible with acute cholestatic hepatitis. After steroid therapy, liver function was improved.

A Case of Acute Cholestatic Hepatitis Caused By the Seeds of Psoralea-corylifolia / 대한간학회지

The potential hepatotoxicity of herbal remedies is usually ignored in daily life. One such compound, Boh-Gol-Zhee (in Chinese, Bu Ku Zi), appeared to be the cause for acute cholestatic hepatic injury in the following case. Psoralea corylifolia is known to contain a sufficient amount of phyto-estrogen. Some alternative medicine therapists claim that Psoralea corylifolia is effective for the treatment of osteoporosis. So far, at least 35 chemical components in the fruits of Psoralea corylifolia have been identified. High concentrations of phyto-estrogen, such as genistein, have been found in the leaves of Psoralea corylifolia. Phyto-estrogen has structural similarity to estrogen and exhibits beneficial effects on osteoporosis under estrogen-deficient conditions. The authors observed a case of acute cholestatic hepatitis in a post-menopausal woman caused by seeds of Psoralea corylifolia in amounts over 10 times the usual dose. Other possible causes of liver injury were excluded by laboratory tests and imaging studies. After discontinuation of this remedy, elevated liver enzyme and total bilirubin rapidly returned to normal. Liver biopsy showed zone 3 necrosis, degenerating cells, cholestasis and infiltrations with inflammatory cells. This case stresses the need to warn the potential hepatotoxicity of Psoralea corylifolia seeds, especially in a large dose.