HLA-B*35:01 and Green Tea-Induced Liver Injury.
HLA-B*35:01 and Green Tea-Induced Liver Injury.
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HLA-B*35：01和绿色茶诱导的肝损伤。
DOI：
10.1002/hep.31538
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Drug-Induced Liver Injury Network
中科院分区：
文献类型：
--
作者：
Hoofnagle JH;Bonkovsky HL;Phillips EJ;Li YJ;Ahmad J;Barnhart H;Durazo F;Fontana RJ;Gu J;Khan I;Kleiner DE;Koh C;Rockey DC;Seeff LB;Serrano J;Stolz A;Tillmann HL;Vuppalanchi R;Navarro VJ;Drug-Induced Liver Injury Network
草药补充剂，特别是多成分产品已成为急性肝损伤的常见原因。绿色茶是涉事产品中的常见成分，但其在肝损伤中的作用存在争议。在美国药物性肝损伤网络招募的1414例患者中，40例（3%）归因于绿色茶，202例归因于不含绿色茶的膳食补充剂，1142例归因于常规药物。详细分析了绿色茶病例的临床特征及HLA I类和II类等位基因在病例组和对照组中的代表性。与绿色茶相关的肝损伤患者的年龄范围为17至69岁（中位数= 40），在开始使用相关药物后15至448天（中位数= 72）出现症状。肝损伤通常为肝细胞性（95%），血清转氨酶显著升高，碱性磷酸酶仅中度升高。大多数患者有黄疸（83%）和症状（88%）。14例患者（35%）的病程被判定为严重，3例（8%）需要肝移植，但很少导致慢性损伤（3%）。在三种情况下，再次接触绿色茶后损伤复发，具有相似的临床特征，但发作时间较短。HLA分型显示HLA-B*35：01的高患病率，在72%的患者中发现，（95% CI：58%至87%）的绿色茶病例，但只有15%（95% CI：10%至20%）的其他补充剂和12%（95% CI：10%至14%）归因于药物，后者的比例与人口控制（95% CI：11%：10.5%至11.5%）。绿色茶相关性肝损伤具有独特的临床特征，与HLA-B*35：01密切相关，提示其为特异质性和免疫介导性肝损伤。
Herbal supplements and particularly multi-ingredient products have become increasingly common causes of acute liver injury. Green tea is a frequent component in implicated products, but its role in liver injury is controversial. Among 1414 patients enrolled in the U.S. Drug Induced Liver Injury Network who underwent formal causality assessment, 40 cases (3%) were attributed to green tea, 202 to dietary supplements without green tea, and 1142 to conventional drugs. The clinical features of green tea cases and representation of HLA class I and II alleles in cases and controls were analyzed in detail. Patients with green tea-associated liver injury ranged in age from 17 to 69 years (median = 40) and developed symptoms 15 to 448 days (median = 72) after starting the implicated agent. The liver injury was typically hepatocellular (95%) with marked serum aminotransferase elevations and only modest increases in alkaline phosphatase. Most patients were jaundiced (83%) and symptomatic (88%). The course was judged as severe in 14 patients (35%), necessitating liver transplantation in 3 (8%), but rarely resulting in chronic injury (3%). In three instances, injury recurred upon re-exposure to green tea with similar clinical features but shorter time to onset. HLA typing revealed a high prevalence of HLA-B*35:01, found in 72% (95% CI: 58% to 87%) of green tea cases but only 15% (95% CI: 10% to 20%) caused by other supplements and 12% (95% CI: 10% to 14%) attributed to drugs, the latter rate being similar to population controls (95% CI: 11%: 10.5% to 11.5%). Green tea-related liver injury has distinctive clinical features and close association with HLA-B*35:01 suggesting that it is idiosyncratic and immune-mediated.
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DOI：
10.1002/hep.28813
发表时间：
2017-01
期刊：
Hepatology (Baltimore, Md.)
影响因子：
--
作者：
Navarro VJ;Khan I;Björnsson E;Seeff LB;Serrano J;Hoofnagle JH
通讯作者：
Hoofnagle JH
影响因子：
4.2
作者：
Fontana RJ;Watkins PB;Bonkovsky HL;Chalasani N;Davern T;Serrano J;Rochon J;DILIN Study Group
通讯作者：
DILIN Study Group
影响因子：
29.4
作者：
Nicoletti P;Aithal GP;Bjornsson ES;Andrade RJ;Sawle A;Arrese M;Barnhart HX;Bondon-Guitton E;Hayashi PH;Bessone F;Carvajal A;Cascorbi I;Cirulli ET;Chalasani N;Conforti A;Coulthard SA;Daly MJ;Day CP;Dillon JF;Fontana RJ;Grove JI;Hallberg P;Hernández N;Ibáñez L;Kullak-Ublick GA;Laitinen T;Larrey D;Lucena MI;Maitland-van der Zee AH;Martin JH;Molokhia M;Pirmohamed M;Powell EE;Qin S;Serrano J;Stephens C;Stolz A;Wadelius M;Watkins PB;Floratos A;Shen Y;Nelson MR;Urban TJ;Daly AK;International Drug-Induced Liver Injury Consortium, Drug-Induced Liver Injury Network Investigators, and International Serious Adverse Events Consortium
通讯作者：
International Drug-Induced Liver Injury Consortium, Drug-Induced Liver Injury Network Investigators, and International Serious Adverse Events Consortium
DOI：
10.1111/j.2517-6161.1995.tb02031.x
发表时间：
1995-01-01
影响因子：
5.8
作者：
BENJAMINI, Y;HOCHBERG, Y
通讯作者：
HOCHBERG, Y
影响因子：
120.7
作者：
Kuriyama, Shinichi;Shimazu, Taichi;Tsuji, Ichiro
通讯作者：
Tsuji, Ichiro