Contaminant hepatotoxins as culprits for kava hepatotoxicity--fact or fiction?

Phytotherapy Research : PTR
R TeschkeVincent Lebot

Abstract

The culprit of kava hepatotoxicity will continue to remain a mystery in humans, if the underlying reaction is of idiosyncratic, unpredictable, and dose-independent nature due potentially to some metabolic aberration in a few individuals emerging from kava use. In addition, kava hepatotoxicity is presently not reproducible experimentally in preclinical models, as demonstrated by studies showing whole kava extracts are not hepatotoxic. This led us to propose our 'working hypothesis' that contaminant hepatotoxins including moulds might have caused rare kava hepatotoxicity in humans. Further studies are now warranted to proof or disproof our working hypothesis, because kava hepatotoxicity possibly based on contaminant hepatotoxins could be a preventable disease. In the meantime, however, for minimizing toxicity risk in kava users, a pragmatic approach should focus on the medicinal use of an aqueous extract derived from peeled rhizomes and roots of a non-mouldy noble kava cultivar, limited to maximum 250-mg kavalactones daily for acute or intermittent use.

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Citations

Dec 10, 2013·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Rolf TeschkeAxel Eickhoff
Apr 22, 2014·Expert Opinion on Drug Metabolism & Toxicology·Walid M ChalhoubJames H Lewis
May 4, 2013·Alimentary Pharmacology & Therapeutics·J H Lewis, J G Stine
Feb 17, 2015·Forensic Science International : Synergy·Raimo A KetolaSirkka Goebeler
Apr 20, 2016·International Journal of Molecular Sciences·Flaminia PantanoEnrico Marinelli
Apr 30, 2016·International Journal of Molecular Sciences·Christian Frenzel, Rolf Teschke
Apr 11, 2017·Natural Product Research·Jia-Ling SongSheng-Xiang Qiu
Sep 29, 2020·Scientific Reports·Antonio CelentanoMichael McCullough
May 25, 2013·World Journal of Gastroenterology : WJG·Rolf TeschkeAxel Eickhoff
Jul 28, 2020·International Journal of Molecular Sciences·Nguyen Van QuanRolf Teschke
Oct 9, 2020·Nutrients·Tengfei BianChengguo Xing
Aug 23, 2020·Food and Chemical Toxicology : an International Journal Published for the British Industrial Biological Research Association·Gulcin TugcuAhmet Aydın
Sep 4, 2014·Chemical Research in Toxicology·Sreekanth C NarayanapillaiChengguo Xing
Jul 3, 2019·Chemical Research in Toxicology·Pengcheng WangXiaochao Ma

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