Analyzing the Mechanism of Traditional Chinese Medicines-induced Immune Idiosyncratic Liver Injury Using the"Three Factors Causing Toxicity"Hypothesis
Idiosyncratic drug-induced liver injury(IDILI)poses a significant challenge in the withdrawal of new drugs due to its unpredictable nature and low incidence rate.IDILI results from a synergistic effect involving individual predisposition,environmental factors,and drug characteristics.Immune response is a key factor in IDILI,attracting considerable attention.The study of traditional Chinese medicines(TCM)-induced idiosyncratic liver injury has emerged as a prominent research area due to the complexity of TCM composition and application.Based on the liver injury characteristics of Polygonum Multiflorum,we propose the"Three Factors Causing Toxicity"hypothesis,offering new insights and methods for evaluating and researching the mechanism of TCM-induced immune idiosyncratic liver injury.Therefore,based on the scientific connotation of the"Three Factors Causing Toxicity"hypothesis and using Xianling Gubao(XLGB)as an example,this paper clarifies that immune stress may be an important causative factor of its IDILI through literature reports,clinical retrospective analysis and laboratory studies;with the help of immune stress model,the material basis of its liver injury is clarified and its component types are distinguished;and its mechanism is preliminarily explored by metabolomics technology.The results showed that this hypothesis can analyse the causative mechanism of immune idiosyncratic liver injury,and it has a certain degree of universality,which can provide research ideas and scientific basis for the scientific evaluation of the prevention and control of the risk of immune idiosyncratic liver injury in TCM.
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