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The Diagnosis and Management of Allergic Reactions Caused by Chinese Materia Medica

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Abstract

Traditional Chinese medicines (TCM) have been used in China for thousands of years. Although TCM has been generally perceived to be safe, adverse reactions to Chinese materia medica (CMM) have been reported. Most of the adverse reactions are allergic in nature, but other mechanisms may play a role. This review focuses on the mechanism and clinical presentation of these allergic reactions. Allergic reactions can occur as a result of the active and inactive ingredients of CMM. Impurities and chemicals generated during the production process can also lead to allergic or adverse reactions. Environmental factors such as temperature, humidity, and light can cause changes in the allergenicity of drugs. Human error in formulating CMM drugs also contributes to adverse drug reactions. The management of allergic reactions to CMM includes taking a good history, avoidance of medications in the same class as those which caused prior reactions, the proper training of staff, adherence to manufacturer guidelines and expiration dates, evaluation of benefit and risk balance, and the formulation of a risk management strategy for the use of CMM. A small test dose of a considered drug before using, improvements in drug purification technology, and proper storage and clinical administration help reduce allergic reactions due to CMM.

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Data Availability

All data generated or analyzed during this study are included in this published article.

Abbreviations

ACD:

Allergic contact dermatitis

ADR:

Adverse drug reactions

BC:

Blood circulation

CMM:

Chinese materia medica

CMMI:

Chinese materia medica injection

HMs:

Herbal medicines

RC:

Rheumatic condition

SHLI:

Shuanghuanglian injection

sIgE:

Specific IgE

TCHM:

Topical Chinese herbal medicine

TCM:

Traditional Chinese medicines

UTI:

Urinary tract infection

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Funding

This project was sponsored by the grants from National Natural Science Foundation of China (No.81703908, No. 81771725 and No. 81873291) and CAMS Innovation Fund for Medical Sciences (CIFMS:2016-I2M-1003).

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Author notes

  1. Yue Shi, Rui Tang and Fangmei Luo contributed equally to this paper.

Authors and Affiliations

  1. Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 100730, Beijing, China

    Yue Shi & Yuanlin Piao

  2. Department of Allergy, Peking Union Medical College Hospital, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment on Allergic Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, 100730, Beijing, China

    Rui Tang, Hong Li, Zouxian Pan, Yongshi Yang & Jin-Lyu Sun

  3. Department of Ophthalmology and Otorhinolaryngology, Qujing Chinese Traditional Medicine Hospital, Yunnan, 655000, Qujing, China

    Fangmei Luo

  4. Department of Respiratory Medicine, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Medical College of PLA, Chinese PLA General Hospital, 100853, Beijing, China

    Guogang Xu

  5. Department of Dermatology, Peking University First Hospital, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, National Clinical Research Center for Skin and Immune Diseases, 100034, Beijing, China

    Zuotao Zhao

  6. Key Laboratory of Beijing for Identification and Safety Evaluation of Chinese Medicine, Institute of Chinese Materia medical, China Academy of Medical Sciences, 10070, Beijing, China

    Aihua Liang

  7. Research Division of Clinical Pharmacology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, 210029, Nanjing, Jiangsu, China

    Ji-Fu Wei

  8. Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, CA, USA

    Christopher Chang

  9. Division of Pediatric Immunology, Allergy and Rheumatology, Joe DiMaggio Children’s Hospital, FL, Hollywood, USA

    Christopher Chang

  10. Asthma and Allergic Diseases Center, University of Virginia, Charlottesville, VA, USA

    Thomas A. E. Platts-Mills

Authors
  1. Yue Shi
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  2. Rui Tang
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  4. Hong Li
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  10. Ji-Fu Wei
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  11. Yuanlin Piao
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  12. Christopher Chang
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  13. Jin-Lyu Sun
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  14. Thomas A. E. Platts-Mills
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Corresponding authors

Correspondence to Yuanlin Piao, Christopher Chang, Jin-Lyu Sun or Thomas A. E. Platts-Mills.

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Shi, Y., Tang, R., Luo, F. et al. The Diagnosis and Management of Allergic Reactions Caused by Chinese Materia Medica. Clinic Rev Allerg Immunol 62, 103–122 (2022). https://doi.org/10.1007/s12016-020-08812-7

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