ABSTRACT
A case series of hepatotoxicity associated with an extract of Artemisia annua L. was identified through the New Zealand spontaneous adverse drug reaction reporting system. A. annua extract, produced using a supercritical carbon dioxide extraction method and formulated with grapeseed oil, has been marketed in New Zealand as a natural product for joint health. As of 31 January 2019, the New Zealand Pharmacovigilance Centre had received 29 reports of hepatic adverse reactions occurring in patients taking A. annua extract in grapeseed oil. The case reports were assessed for patient and adverse reaction characteristics, patterns of A. annua extract use and causality (based on the WHO-UMC system for standardized case causality assessment). Patients were aged 47 to 93 years (median 67). Time to onset of hepatotoxicity from starting A. annua extract was 7 days to approximately 12 months in the 23 reports with this information. Nineteen of these reports indicated onset within 12 weeks. A. annua extract was the sole suspect medicine in 27 reports. A few patients had possible predisposing conditions. Twenty-seven patients were reported to have recovered or improved on stopping A. annua extract. Nine patients required hospital admission. The pattern of hepatic injury varied. Jaundice, often with pruritus and dark urine, was experienced by 16 patients. There was considerable consistency across case reports from various reporters. We assessed the case reports as a series using the Bradford Hill guidelines for causal inference and concluded that there was a safety signal of a causal association between the A. annua extract and hepatotoxicity sufficient to be communicated and investigated further.
ABSTRACT
4,4'-Methylenedianiline (MDA) is a primary aromatic amine used in the plastics industry and is classified by the International Agency for Research on Cancer as an animal carcinogen and possible human carcinogen. In order to estimate human exposure it is useful to determine percutaneous penetration. Previous studies have suggested that both rat and human skin were permeable to MDA, with greater penetration being seen through human skin. In this study no significant difference was seen between the percutaneous penetration of MDA through human or rat skin for three different treatment levels: 0.01, 0.1 and 1mg per skin membrane (0.32 cm(2)). The apparent dermal flux was calculated as 0.7 +/- 0.3 and 10.1 +/- 2.0 microg/cm(2)/h for the 0.01 and 0.1mg treatments, respectively. The permeability constant K(p) was estimated at 1.8 x 10(-3) cm/h and the lag time at 3.5 +/- 0.5 h. MDA absorbed into the skin was found to be bioavailable. Experiments also showed that after application of 0.1mg MDA, 4% penetrated through latex and nitrile gloves, respectively. The potential genotoxicity of MDA in human skin was assessed by DNA (32)P-postlabelling; levels of DNA adducts were detected, following the treatment and penetration of 1mg MDA.
Subject(s)
Aniline Compounds/pharmacokinetics , Aniline Compounds/toxicity , Mutagens/pharmacokinetics , Mutagens/toxicity , Skin Absorption , Animals , DNA/drug effects , DNA/genetics , DNA/isolation & purification , DNA Adducts/drug effects , Diffusion Chambers, Culture , Humans , In Vitro Techniques , Latex , Male , Nitriles , Permeability , Peroxidases/metabolism , Rats , Rats, Sprague-DawleyABSTRACT
Methionine dependence has been reported in tumour cells and suggested as a possible target for chemotherapeutic drugs. The underlying defect has not been extensively researched, nor have levels of sulphur amino acids been examined in these cells. This study compared two rat liver tumour cell lines. One was found to be methionine dependent (HTC) and the other found to be methionine independent (Phi-1). The methionine-dependent cell line (HTC) was discovered to contain markedly less methionine synthase activity, the enzyme activity being less responsive to methionine concentration than in the methionine-independent cells (Phi-1). HTC cells had lower cysteine requirements and contained larger concentrations of reduced glutathione (GSH) and taurine than the Phi-1 cells. Also, in contrast to Phi-1 cells, no glutathione was found in the media of the HTC cells, although large quantities of cysteinylglycine were detected. These results suggested that differences in methionine synthase activity might be partly responsible for methionine dependence and that methionine-dependent cells may have different metabolic requirements for other sulphur amino acids.
