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The hepatotoxicity of Polygonum multiflorum: The emerging role of the immune-mediated liver injury.
Acta Pharmacologica Sinica ( IF 6.9 ) Pub Date : 2020-03-02 , DOI: 10.1038/s41401-020-0360-3 Tai Rao 1, 2, 3, 4 , Ya-Ting Liu 1, 2, 3, 4 , Xiang-Chang Zeng 1, 2, 3, 4 , Chao-Peng Li 5 , Dong-Sheng Ou-Yang 1, 2, 3, 4, 5
Acta Pharmacologica Sinica ( IF 6.9 ) Pub Date : 2020-03-02 , DOI: 10.1038/s41401-020-0360-3 Tai Rao 1, 2, 3, 4 , Ya-Ting Liu 1, 2, 3, 4 , Xiang-Chang Zeng 1, 2, 3, 4 , Chao-Peng Li 5 , Dong-Sheng Ou-Yang 1, 2, 3, 4, 5
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Herbal and dietary supplements (HDS)-induced liver injury has been a great concern all over the world. Polygonum multiflorum Thunb., a well-known Chinese herbal medicine, is recently drawn increasing attention because of its hepatotoxicity. According to the clinical and experimental studies, P. multiflorum-induced liver injury (PM-DILI) is considered to be immune-mediated idiosyncratic liver injury, but the role of immune response and the underlying mechanisms are not completely elucidated. Previous studies focused on the direct toxicity of PM-DILI by using animal models with intrinsic drug-induced liver injury (DILI). However, most epidemiological and clinical evidence demonstrate that PM-DILI is immune-mediated idiosyncratic liver injury. The aim of this review is to assess current epidemiological, clinical and experimental evidence about the possible role of innate and adaptive immunity in the idiosyncratic hepatotoxicity of P. multiflorum. The potential effects of factors associated with immune tolerance, including immune checkpoint molecules and regulatory immune cells on the individual's susceptibility to PM-DILI are also discussed. We conclude by giving our hypothesis of possible immune mechanisms of PM-DILI and providing suggestions for future studies on valuable biomarkers identification and proper immune models establishment.
中文翻译：
何首乌的肝毒性：免疫介导的肝损伤的新作用。
草药和膳食补充剂（HDS）引起的肝损伤一直是全世界关注的焦点。何首乌是一种著名的中草药，近年来因其肝毒性而受到越来越多的关注。根据临床和实验研究，何首乌引起的肝损伤（PM-DILI）被认为是免疫介导的特异质性肝损伤，但免疫反应的作用及其潜在机制尚未完全阐明。先前的研究主要通过使用具有内在药物性肝损伤（DILI）的动物模型来研究PM-DILI的直接毒性。然而，大多数流行病学和临床证据表明，PM-DILI 是免疫介导的特异质肝损伤。本综述的目的是评估当前的流行病学、临床和实验证据，了解先天性和适应性免疫在何首乌特异性肝毒性中可能发挥的作用。还讨论了与免疫耐受相关的因素（包括免疫检查点分子和调节性免疫细胞）对个体对 PM-DILI 易感性的潜在影响。最后，我们给出了 PM-DILI 可能的免疫机制的假设，并为未来有价值的生物标志物鉴定和适当的免疫模型建立的研究提供了建议。
更新日期：2020-04-24
中文翻译：
何首乌的肝毒性：免疫介导的肝损伤的新作用。
草药和膳食补充剂（HDS）引起的肝损伤一直是全世界关注的焦点。何首乌是一种著名的中草药，近年来因其肝毒性而受到越来越多的关注。根据临床和实验研究，何首乌引起的肝损伤（PM-DILI）被认为是免疫介导的特异质性肝损伤，但免疫反应的作用及其潜在机制尚未完全阐明。先前的研究主要通过使用具有内在药物性肝损伤（DILI）的动物模型来研究PM-DILI的直接毒性。然而，大多数流行病学和临床证据表明，PM-DILI 是免疫介导的特异质肝损伤。本综述的目的是评估当前的流行病学、临床和实验证据，了解先天性和适应性免疫在何首乌特异性肝毒性中可能发挥的作用。还讨论了与免疫耐受相关的因素（包括免疫检查点分子和调节性免疫细胞）对个体对 PM-DILI 易感性的潜在影响。最后，我们给出了 PM-DILI 可能的免疫机制的假设，并为未来有价值的生物标志物鉴定和适当的免疫模型建立的研究提供了建议。
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