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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="All Drug Records" href="/books/n/livertox/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-livertox-lrg.png" alt="Cover of LiverTox" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK603561_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK603561_dtls__"><div>Bethesda (MD): <a href="https://www.niddk.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Diabetes and Digestive and Kidney Diseases</a>; 2012-.</div></div><div class="half_rhythm"><ul class="inline_list"><li style="margin-right:1em"><a class="bk_cntns" href="/books/n/livertox/">Drug Records</a></li></ul></div><div class="bk_noprnt"><form method="get" action="/books/n/livertox/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div><div class="icnblk_cntnt two_col"><div class="pagination bk_noprnt"><a class="active page_link prev" href="/books/n/livertox/Cenobamate/" title="Previous page in this title">< Prev</a><a class="active page_link next" href="/books/n/livertox/CNSStimulants/" title="Next page in this title">Next ></a></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK603561_"><span class="title" itemprop="name">Centella asiatica</span></h1><p class="small">Last Update: <span itemprop="dateModified">April 24, 2024</span>.</p></div><div class="body-content whole_rhythm" itemprop="text"><div id="Centella.OVERVIEW"><h2 id="_Centella_OVERVIEW_">OVERVIEW</h2><div id="Centella.Introduction"><h3>Introduction</h3><p>Centella asiatica, commonly known as gotu kola or Asian pennywort, is a herbaceous, flowering, perennial plant native to tropical areas of Southeast Asia and Australia and used as a food as well as in traditional medicine. While generally regarded as safe, Centella has been linked to rare instances of clinically apparent acute liver injury with jaundice.</p></div><div id="Centella.Background"><h3>Background</h3><p>Centella also known as gotu kola, tiger grass or Indian pennywort is made from fresh or dried leaves of Centella asiatica a creeping herbaceous, flowering plant native to tropical swampy areas of Southeast Asia and Australia but now found in many tropical and subtropical areas of the world. It is eaten as a vegetable and in salads and has been used for centuries in traditional Ayurvedic and Chinese medicine for a large variety of conditions. Centella extracts contain more than 100 constituents including polyacetylenes, flavonoids, flavones, sterols and lipids. The active ingredients are thought to be the pentacyclic triterpenoid glycosides, asiaticoside, centelloside, and madecassoside, and their aglycones, asiatic acid and madecassic acid. In vitro and in vivo studies suggest that these triterpenoids have anxiolytic, antiinflammatory, antioxidant, antiulcer, anticancer, neuroprotective, and wound healing properties. In traditional medicine, gotu kola has been used to treat a wide variety of conditions including minor wounds, psoriasis, cellulitis, chronic venous insufficiency, ulcers, hypertension, bronchitis, asthma, kidney disorders, urethritis, edema, diabetic microangiopathy, obesity, leprosy, smallpox, syphilis, and miscellaneous liver, kidney, pulmonary, and heart diseases. It is purported to promote immune function, to extend longevity, and to boost memory and cognitive function. However, none of these properties have been proven in prospective, controlled trials in humans, and Centella asiatica is not approved in the United States as therapy of any medical condition. Nevertheless, it is widely available as capsules, tablets, powders, solutions, and skin creams in over-the-counter herbal products. The typical oral dose is 60 to 120 mg daily of purified extracts, but may be 600 to 1800 mg daily of capsules or powders of dried leaves. Centella has few if any adverse events and no known proven severe adverse effects. In small trials, Centella asiatica extracts have appeared to be well tolerated with only mild, transient, and nonspecific adverse effects (headache, dizziness, bloating, diarrhea, nausea), which often have been similar in frequency among persons receiving placebo or alternative treatments. Rare instances of allergic reactions have been reported, particularly with topical therapy of skin diseases and wounds. <a class="def" href="/books/n/livertox/glossary/def-item/glossary.hepatotoxicity/">Hepatotoxicity</a> has also been reported but is very rare.</p></div><div id="Centella.Hepatotoxicity"><h3>Hepatotoxicity</h3><p>Centella extracts have not been linked to serum enzyme elevations during therapy, although there have been few prospective studies in humans that have reported on laboratory test results during treatment. Nevertheless, rare instances of acute and symptomatic liver injury have been published, including a case series in 2008 of three Argentinian women who developed liver injury with jaundice after use of centella for weight loss (Case 1) and a single short case report from Switzerland in 2011 after its oral use for acne. The time to onset ranged from 3 to 8 weeks and the injury was described as hepatocellular, resolving completely within 1 to 2 months after stopping. Immunoallergic and autoimmune features were present in some cases. The possibility of contamination or presence of other potential hepatotoxins in the commercial products was not ruled out in the clinical reports of hepatotoxicity of centella.</p><p><a class="def" href="/books/n/livertox/glossary/def-item/glossary.likelihood-score/">Likelihood score</a>: C (probable rare cause of clinically apparent liver injury).</p></div><div id="Centella.Mechanism_of_liver_injury"><h3>Mechanism of liver injury</h3><p>The mechanism of liver injury attributed to Centella asiatica is not known, but the rare events suggest idiosyncratic, perhaps immune mediated injury due to one of the many components of the herb or one of its metabolites.</p></div><div id="Centella.Outcome_and_Management"><h3>Outcome and Management</h3><p>Gotu kola hepatotoxicity is generally self-limited and only mild-to-moderate in severity. Appearance of clinically evident liver injury developing during therapy should lead to prompt withdrawal of the herbal product. <a class="def" href="/books/n/livertox/glossary/def-item/glossary.rechallenge/">Rechallenge</a> should be avoided.</p></div></div><div id="Centella.CASE_REPORT"><h2 id="_Centella_CASE_REPORT_">CASE REPORT</h2><div id="Centella.Case_1_Acute_granulomatous_hepa"><h3>Case 1. Acute granulomatous hepatitis developing during weight loss treatment with Centella asiatica. (<a class="bk_pop" href="#Centella.REF.1">1</a>)</h3><p>A 61 year old previously healthy woman developed abdominal pain, arthralgias, and weakness followed by dark urine and jaundice after taking tablets of Centella asiatica for 30 days as a weight loss agent. On examination she was jaundiced and had tender hepatomegaly. Laboratory tests (Table) showed marked elevations of serum <a class="def" href="/books/n/livertox/glossary/def-item/glossary.alanine-aminotransferase-alt-/">ALT</a> and <a class="def" href="/books/n/livertox/glossary/def-item/glossary.aspartate-aminotransferase-ast-/">AST</a> (30 and 26 times the upper limit of normal [ULN]) with mild elevations in alkaline phosphatase (1.7 times ULN) and bilirubin (4.2 mg/dL). Viral serology showed no evidence of hepatitis A, B or C, while autoantibody testing showed high titers of SMA (1:160) and AMA (1:320) with no detectable ANA or anti-LKM, and normal total globulin levels. Liver ultrasound was normal. A liver biopsy showed an acute hepatitis with granulomas. She was treated with ursodiol and recovered. Two months later all laboratory results were normal or negative including SMA and AMA. She did well until 7 months later when she restarted Centella asiatica for two weeks when she developed pain, weakness and jaundice again. Laboratory results were similar to those with the first episode but ANA, SMA and AMA were still negative. A repeat liver biopsy again showed acute hepatitis with granulomatous changes. She was treated with a course of prednisone and ursodiol and again improved.</p><div id="Centella.Key_Points"><h4>Key Points</h4><div id="Centella.Tc" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK603561/table/Centella.Tc/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__Centella.Tc_lrgtbl__"><table><tbody><tr><th id="hd_b_Centella.Tc_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Medication:</th><td headers="hd_b_Centella.Tc_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Centella asiatica</td></tr><tr><th id="hd_b_Centella.Tc_1_1_2_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pattern:</th><td headers="hd_b_Centella.Tc_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hepatocellular (R=17.6)</td></tr><tr><th id="hd_b_Centella.Tc_1_1_3_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Severity:</th><td headers="hd_b_Centella.Tc_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3+ (jaundice, hospitalized)</td></tr><tr><th id="hd_b_Centella.Tc_1_1_4_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><a class="def" href="/books/n/livertox/glossary/def-item/glossary.latency/">Latency</a>:</th><td headers="hd_b_Centella.Tc_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30 days initially, 14 days on re-exposure</td></tr><tr><th id="hd_b_Centella.Tc_1_1_5_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Recovery:</th><td headers="hd_b_Centella.Tc_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1-2 months</td></tr><tr><th id="hd_b_Centella.Tc_1_1_6_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Other medications:</th><td headers="hd_b_Centella.Tc_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None mentioned</td></tr></tbody></table></div></div></div><div id="Centella.Laboratory_Values"><h4>Laboratory Values</h4><div id="Centella.Td" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK603561/table/Centella.Td/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__Centella.Td_lrgtbl__"><table><thead><tr><th id="hd_h_Centella.Td_1_1_1_1" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Time After<br />Starting</th><th id="hd_h_Centella.Td_1_1_1_2" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Time After<br />Stopping</th><th id="hd_h_Centella.Td_1_1_1_3" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;"><a class="def" href="/books/n/livertox/glossary/def-item/glossary.alanine-aminotransferase-alt-/">ALT</a><br />(U/L)</th><th id="hd_h_Centella.Td_1_1_1_4" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Alk P<br />(U/L)</th><th id="hd_h_Centella.Td_1_1_1_5" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;"><a class="def" href="/books/n/livertox/glossary/def-item/glossary.bilirubin/">Bilirubin</a><br />(mg/dL)</th><th id="hd_h_Centella.Td_1_1_1_6" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_Centella.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1 month</td><td headers="hd_h_Centella.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0</td><td headers="hd_h_Centella.Td_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1193</td><td headers="hd_h_Centella.Td_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">503</td><td headers="hd_h_Centella.Td_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">4.2</td><td headers="hd_h_Centella.Td_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SMA 1:160, AMA 1:320</td></tr><tr><td headers="hd_h_Centella.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_Centella.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">< 1 week</td><td headers="hd_h_Centella.Td_1_1_1_3 hd_h_Centella.Td_1_1_1_4 hd_h_Centella.Td_1_1_1_5 hd_h_Centella.Td_1_1_1_6" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Liver biopsy: acute hepatitis with granulomatous changes</td></tr><tr><td headers="hd_h_Centella.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">3 months</td><td headers="hd_h_Centella.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1 month</td><td headers="hd_h_Centella.Td_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">18</td><td headers="hd_h_Centella.Td_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">191</td><td headers="hd_h_Centella.Td_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1.2</td><td headers="hd_h_Centella.Td_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SMA & AMA negative</td></tr><tr><td headers="hd_h_Centella.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0</td><td headers="hd_h_Centella.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0</td><td headers="hd_h_Centella.Td_1_1_1_3 hd_h_Centella.Td_1_1_1_4 hd_h_Centella.Td_1_1_1_5 hd_h_Centella.Td_1_1_1_6" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">
|
||
<b>Restarts Centella asiatica</b>
|
||
</td></tr><tr><td headers="hd_h_Centella.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">2 weeks</td><td headers="hd_h_Centella.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0</td><td headers="hd_h_Centella.Td_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">413</td><td headers="hd_h_Centella.Td_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">383</td><td headers="hd_h_Centella.Td_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">2.8</td><td headers="hd_h_Centella.Td_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ANA, SMA & AMA negative</td></tr><tr><td headers="hd_h_Centella.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_Centella.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">< 1 week</td><td headers="hd_h_Centella.Td_1_1_1_3 hd_h_Centella.Td_1_1_1_4 hd_h_Centella.Td_1_1_1_5 hd_h_Centella.Td_1_1_1_6" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Liver biopsy: acute hepatitis with granulomatous changes</td></tr><tr><td headers="hd_h_Centella.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1.5 months</td><td headers="hd_h_Centella.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1 month</td><td headers="hd_h_Centella.Td_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">27</td><td headers="hd_h_Centella.Td_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">238</td><td headers="hd_h_Centella.Td_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0.6</td><td headers="hd_h_Centella.Td_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ursodiol & prednisone stopped</td></tr><tr><td headers="hd_h_Centella.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">8 years</td><td headers="hd_h_Centella.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">8 years</td><td headers="hd_h_Centella.Td_1_1_1_3 hd_h_Centella.Td_1_1_1_4 hd_h_Centella.Td_1_1_1_5 hd_h_Centella.Td_1_1_1_6" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Laboratory values remained normal during follow up</td></tr><tr><td headers="hd_h_Centella.Td_1_1_1_1 hd_h_Centella.Td_1_1_1_2" colspan="2" scope="row" rowspan="1" style="text-align:center;vertical-align:top;">
|
||
<b>Normal Values</b>
|
||
</td><td headers="hd_h_Centella.Td_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
||
<b><40</b>
|
||
</td><td headers="hd_h_Centella.Td_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
||
<b><301</b>
|
||
</td><td headers="hd_h_Centella.Td_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
||
<b><1.2</b>
|
||
</td><td headers="hd_h_Centella.Td_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></div><div id="Centella.Comment"><h4>Comment</h4><p>A dramatic case of an immunoallergic acute hepatitis arising in an otherwise healthy woman taking a commercial weight loss product said to be Centella asiatica. The clinical history, laboratory tests, liver biopsy, and recurrence on re-exposure provide convincing evidence of drug induced liver injury from the herbal product. At issue is whether the product consisted of Centella asiatica only. The history could also be consistent with other better known herbal causes of acute liver injury such as ephedra, chaparral, germander, garcinia, or green tea. The product name, concentration of centella, number of tablets taken daily, chemical analysis, and even product label were not provided. After these 3 cases from a single referral center in Mendoza, Argentina in 2005, there have been no published case series of injury from Centella asiatica and only a single case report from Switzerland in 2011. Furthermore, the large series of herbal and dietary supplement induced liver injury from around the world, there have been no further described cases.</p><p>Other Names: Gotu kola, Asian pennywort, spadeleaf, coinwort, tiger grass, Brahmi, Centella</p><p>Drug Class: <a href="/books/n/livertox/HerbalDietarySuppl/">Herbal and Dietary Supplements</a></p></div></div></div><div id="Centella.PRODUCT_INFORMATION"><h2 id="_Centella_PRODUCT_INFORMATION_">PRODUCT INFORMATION</h2><p>
|
||
<b>REPRESENTATIVE TRADE NAMES</b>
|
||
</p><p>Centella asiatica – Generic</p><p>
|
||
<b>DRUG CLASS</b>
|
||
</p><p>Herbal and <a class="def" href="/books/n/livertox/glossary/def-item/glossary.dietary-supplements/">Dietary Supplements</a></p></div><div id="Centella.CHEMICAL_FORMULA_AND_STRUCTURE"><h2 id="_Centella_CHEMICAL_FORMULA_AND_STRUCTURE_">CHEMICAL FORMULA AND STRUCTURE</h2><div id="Centella.Te" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK603561/table/Centella.Te/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__Centella.Te_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_Centella.Te_1_1_1_1" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">DRUG</th><th id="hd_h_Centella.Te_1_1_1_2" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CAS REGISTRY NUMBER</th><th id="hd_h_Centella.Te_1_1_1_3" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MOLECULAR FORMULA</th><th id="hd_h_Centella.Te_1_1_1_4" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">STRUCTURE</th></tr></thead><tbody><tr><td headers="hd_h_Centella.Te_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Asiaticoside</td><td headers="hd_h_Centella.Te_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<a href="https://pubchem.ncbi.nlm.nih.gov/substance/135065643" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem">16830-15-2</a>
|
||
</td><td headers="hd_h_Centella.Te_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">C48-H78-O</td><td headers="hd_h_Centella.Te_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<a href="https://pubchem.ncbi.nlm.nih.gov/substance/135065643" title="View this structure in PubChem" class="img_link" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&sid=135065643" alt="image 135065643 in the ncbi pubchem database" /></a>
|
||
</td></tr><tr><td headers="hd_h_Centella.Te_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Madecassoside</td><td headers="hd_h_Centella.Te_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<a href="https://pubchem.ncbi.nlm.nih.gov/substance/135117696" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem">34540-22-2</a>
|
||
</td><td headers="hd_h_Centella.Te_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">C48H78O20</td><td headers="hd_h_Centella.Te_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<a href="https://pubchem.ncbi.nlm.nih.gov/substance/135117696" title="View this structure in PubChem" class="img_link" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&sid=135117696" alt="image 135117696 in the ncbi pubchem database" /></a>
|
||
</td></tr></tbody></table></div><div><div><dl class="temp-labeled-list small"><dt>*</dt><dd><div id="Centella.TF.e.1"><p class="no_margin">Major pentacyclic triterpenoid glycosides found in Centella asiatica.</p></div></dd></dl></div></div></div></div><div id="Centella.CITED_REFERENCES"><h2 id="_Centella_CITED_REFERENCES_">CITED REFERENCES</h2><dl class="temp-labeled-list"><dt>1.</dt><dd><div class="bk_ref" id="Centella.REF.1">Jorge
|
||
OA, Jorge
|
||
AD. Hepatotoxicity associated with the ingestion of Centella asiatica.
|
||
Rev Esp Enferm Dig.
|
||
2005;97:115-24.
|
||
[<a href="https://pubmed.ncbi.nlm.nih.gov/15801887" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15801887</span></a>]</div></dd></dl></div><div id="Centella.SELECTED_ANNOTATED_BIBLIOGRAPHY"><h2 id="_Centella_SELECTED_ANNOTATED_BIBLIOGRAPHY_">SELECTED ANNOTATED BIBLIOGRAPHY</h2><p>References updated: 24 April 2024</p><p>Abbreviation: HDS, herbal and dietary supplements.</p><ul class="first-line-outdent"><li><div class="bk_ref" id="Centella.REF.zimmerman.1999">Zimmerman HJ. Unconventional drugs. Miscellaneous drugs and diagnostic chemicals. In, Zimmerman, HJ. Hepatotoxicity: the adverse effects of drugs and other chemicals on the liver. 2nd ed. Philadelphia: Lippincott,1999: pp. 731-4.<div><i>(Expert review of hepatotoxicity published in 1999; several herbal medications linked to liver injury are discussed, but neither Centella asiatica or gotu kola are mentioned).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.seeff.2013">Seeff L, Stickel F, Navarro VJ. Hepatotoxicity of herbals and dietary supplements. In, Kaplowitz N, DeLeve LD, eds. Drug-induced liver disease. 3rd ed. Amsterdam: Elsevier, 2013, pp. 631-58.<div><i>(Review of hepatotoxicity of herbals does not mention gotu kola).</i></div></div></li><li><div class="bk_ref" id="Centella.REF4">Gotu kola <em>(Centella asiatica)</em>. PDR for Herbal Medicines. 4th ed. Montvale, New Jersey: Thomson Healthcare Inc. 2007: pp 400-404.<div><i>(Compilation of short monographs on herbal medications and dietary supplements mentions allergic contact dermatitis and infertility but not ALT elevations or hepatotoxicity).</i></div></div></li><li><div class="bk_ref" id="Centella.REF5">Electronic Code of Federal Regulations. Title 21. Part 182. Substances Generally Recognized As Safe. Available at: <a href="https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>.accessdata<wbr style="display:inline-block"></wbr>.fda.gov/scripts/cdrh<wbr style="display:inline-block"></wbr>/cfdocs/cfcfr/CFRSearch<wbr style="display:inline-block"></wbr>.cfm?CFRPart=182</a><div><i>(Listing of botanical and herbal products that are “generally recognized as safe” (GRAS) according to FDA criteria which permits them to be sold as over-the-counter supplements without prior proof of safety and efficacy).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.bradwejn.2000.680">Bradwejn
|
||
J, Zhou
|
||
Y, Koszycki
|
||
D, Shlik
|
||
J.
|
||
A double-blind, placebo-controlled study on the effects of Gotu Kola (Centella asiatica) on acoustic startle response in healthy subjects.
|
||
J Clin Psychopharmacol.
|
||
2000;20:680-4.
|
||
[<a href="https://pubmed.ncbi.nlm.nih.gov/11106141" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11106141</span></a>]<div><i>(Among 40 healthy adult volunteers given a single 12 gram oral dose of gotu kola or placebo in grape juice, the acute startle response decreased more in those given the herb [-68% vs -29%], while pulse, blood pressure and mood ratings [anxiety, depression] did not change; no mention of hepatotoxicity and laboratory tests were not done).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.russo.2004.1018">Russo
|
||
MW, Galanko
|
||
JA, Shrestha
|
||
R, Fried
|
||
MW, Watkins
|
||
P. Liver transplantation for acute liver failure from drug-induced liver injury in the United States.
|
||
Liver Transpl
|
||
2004; 10: 1018-23.
|
||
[<a href="https://pubmed.ncbi.nlm.nih.gov/15390328" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15390328</span></a>]<div><i>(Among ~50,000 liver transplants reported to UNOS between 1990 and 2002, 270 [0.5%] were done for drug induced acute liver failure, including 7 [5%] for herbal medications, none were specifically attributed to a product containing gotu kola).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.jorge.2005.115">Jorge
|
||
OA, Jorge
|
||
AD. Hepatotoxicity associated with the ingestion of Centella asiatica.
|
||
Rev Esp Enferm Dig.
|
||
2005;97:115-24.
|
||
[<a href="https://pubmed.ncbi.nlm.nih.gov/15801887" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15801887</span></a>]<div><i>(3 Argentinian women developed jaundice 30, 20, and 60 days after starting Centella asiatica for weight loss [bilirubin 4.3, 19.9, and 3.9 mg/dL, ALT 1193, 1694, and 324 U/L, Alk P 503, 472, and 484 U/L], biopsies showing hepatitis with granulomas and zone 3 necrosis, high titers of autoantibodies found in one case [Case 1 above], all resolving completely with 1-2 months of stopping).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.chitturi.2008.366">Chitturi
|
||
S, Farrell
|
||
GC. Hepatotoxic slimming aids and other herbal hepatotoxins.
|
||
J Gastroenterol Hepatol.
|
||
2008;23:366-73.
|
||
[<a href="https://pubmed.ncbi.nlm.nih.gov/18318821" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18318821</span></a>]<div><i>(Review of liver injury from herbal agents taken for weight loss mentions the 3 cases due to Centella asiatica as reported by Jorge [2005]).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.garc_acort_s.2008.688">García-Cortés
|
||
M, Borraz
|
||
Y, Lucena
|
||
MI, Peláez
|
||
G, Salmerón
|
||
J, Diago
|
||
M, Martínez-Sierra
|
||
MC, et al.
|
||
[Liver injury induced by "natural remedies": an analysis of cases submitted to the Spanish Liver Toxicity Registry]. Rev Esp Enferm Dig
|
||
2008; 100: 688-95. Spanish.
|
||
[<a href="https://pubmed.ncbi.nlm.nih.gov/19159172" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19159172</span></a>]<div><i>(Among 521 cases of drug induced liver injury submitted to Spanish registry, 13 [2%] were due to herbals, but none were attributed to gotu kola).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.navarro.2009.373">Navarro
|
||
VJ. Herbal and dietary supplement hepatotoxicity.
|
||
Semin Liver Dis
|
||
2009; 29: 373-82.
|
||
[<a href="https://pubmed.ncbi.nlm.nih.gov/19826971" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19826971</span></a>]<div><i>(Review of the problems of causality assessment in herbal and dietary supplement [HDS] associated liver disease, including the variable clinical presentations, the complexity and lack of information on their components, absence of controlled trials demonstrating safety and efficacy, the possibility of contamination or incorrect labeling, and the frequent underreporting of herbal use by patients. Regulation of HDS is under DSHEA, which requires manufacturers to determine safety and prohibits claims of efficacy in treating specific diseases. The US Pharmacopeia sets standards for food and drugs and includes HDS; HDS induced liver injury is a growing problem and currently accounts for at least 10% of cases of acute liver injury due to medications).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.jacobsson.2009.1039">Jacobsson
|
||
I, Jönsson
|
||
AK, Gerdén
|
||
B, Hägg
|
||
S. Spontaneously reported adverse reactions in association with complementary and alternative medicine substances in Sweden.
|
||
Pharmacoepidemiol Drug Saf
|
||
2009; 18: 1039-47.
|
||
[<a href="https://pubmed.ncbi.nlm.nih.gov/19650152" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19650152</span></a>]<div><i>(Review of 778 spontaneous reports of adverse reactions to herbals to Swedish Registry; no mention of gotu kola or Centella asiatica).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.reuben.2010.2065">Reuben
|
||
A, Koch
|
||
DG, Lee
|
||
WM; Acute Liver Failure Study Group. Drug-induced acute liver failure: results of a U.S. multicenter, prospective study.
|
||
Hepatology
|
||
2010; 52: 2065-76.
|
||
[<a href="/pmc/articles/PMC3992250/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3992250</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/20949552" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20949552</span></a>]<div><i>(Among 1198 patients with acute liver failure enrolled in a US prospective study between 1998 and 2007, 133 [11%] were attributed to drug induced liver injury of which 12 [9%] were due to herbals, but none were attributed to gotu kola).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.gohil.2010.546">Gohil
|
||
KJ, Patel
|
||
JA, Gajjar
|
||
AK. Pharmacological Review on Centella asiatica: A potential herbal cure-all.
|
||
Indian J Pharm Sci.
|
||
2010;72:546-56.
|
||
[<a href="/pmc/articles/PMC3116297/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3116297</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/21694984" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21694984</span></a>]<div><i>(Review of the botany and possible mechanisms of action of Centella asiatica extracts based upon laboratory studies in rodents and clinical trials in humans states that it “has no know toxicity in recommended doses” and that side effects are rare but may include skin allergy, headache, stomach upset, nausea, dizziness, and drowsiness particularly at high doses, and that it should not be used for more than 6 weeks).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.dantuluri.2011.500">Dantuluri
|
||
S, North-Lewis
|
||
P, Karthik
|
||
SV. Gotu Kola induced hepatotoxicity in a child - need for caution with alternative remedies.
|
||
Dig Liver Dis.
|
||
2011;43:500.
|
||
[<a href="https://pubmed.ncbi.nlm.nih.gov/21334992" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21334992</span></a>]<div><i>(15 year old female developed abdominal pain 6 weeks after starting gotu kola for acne [bilirubin 1.8 mg/dL, ALT 319 rising to 3222 U/L, GGT 39 U/L, INR 2.7], improving rapidly upon stopping).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.teschke.2012.1543">Teschke
|
||
R, Wolff
|
||
A, Frenzel
|
||
C, Schulze
|
||
J, Eickhoff
|
||
A.
|
||
Herbal hepatotoxicity: a tabular compilation of reported cases.
|
||
Liver Int
|
||
2012; 32: 1543-56.
|
||
[<a href="https://pubmed.ncbi.nlm.nih.gov/22928722" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22928722</span></a>]<div><i>(A systematic compilation of all publications on the hepatotoxicity of specific herbals identified 185 publications on 60 different herbs, herbal drugs and supplements, mentions 3 cases attributed to gotu kola as reported by Jorge [2005]).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.navarro.2014.1399">Navarro
|
||
VJ, Barnhart
|
||
H, Bonkovsky
|
||
HL, Davern
|
||
T, Fontana
|
||
RJ, Grant
|
||
L, Reddy
|
||
KR, et al.
|
||
Liver injury from herbals and dietary supplements in the U.S. Drug-Induced Liver Injury Network.
|
||
Hepatology
|
||
2014; 60: 1399-408.
|
||
[<a href="/pmc/articles/PMC4293199/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4293199</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25043597" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25043597</span></a>]<div><i>(Among 85 cases of HDS associated liver injury [not due to anabolic steroids] enrolled in a US prospective study between 2004 and 2013, none were attributed to a product containing Centella asiatica).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.chalasani.2015.1340">Chalasani
|
||
N, Bonkovsky
|
||
HL, Fontana
|
||
R, Lee
|
||
W, Stolz
|
||
A, Talwalkar
|
||
J, Reddy
|
||
KR, et al.; United States Drug Induced Liver Injury Network. Features and outcomes of 899 patients with drug-induced liver injury: The DILIN Prospective Study.
|
||
Gastroenterology
|
||
2015; 148: 1340-52.e7.
|
||
[<a href="/pmc/articles/PMC4446235/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4446235</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25754159" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25754159</span></a>]<div><i>(Among 899 cases of drug induced liver injury enrolled in a prospective database between 2004 and 2012, HDS were implicated in 145 [16%], the single major herbal cause being green tea, and none were attributed to Centella asiatica or gotu kola [see also Navarro et al Hepatology 2014]).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.garc_acort_s.2016.537">García-Cortés
|
||
M, Robles-Díaz
|
||
M, Ortega-Alonso
|
||
A, Medina-Caliz
|
||
I, Andrade
|
||
RJ. Hepatotoxicity by dietary supplements: A tabular listing and clinical characteristics.
|
||
Int J Mol Sci
|
||
2016; 17. pii: 537.
|
||
[<a href="/pmc/articles/PMC4848993/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4848993</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27070596" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27070596</span></a>]<div><i>(Listing of published cases of liver injury from HDS products does not mention or list gotu kola or Centella asiatica).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.brown.2017.449">Brown
|
||
AC. An overview of herb and dietary supplement efficacy, safety and government regulations in the United States with suggested improvements. Part 1 of 5 series.
|
||
Food Chem Toxicol
|
||
2017; 107: 449-71.
|
||
[<a href="https://pubmed.ncbi.nlm.nih.gov/27818322" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27818322</span></a>]<div><i>(Summary of the US regulations on safety and efficacy of herbal and dietary supplements).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.brown.2017.472">Brown
|
||
AC. Liver toxicity related to herbs and dietary supplements: Online table of case reports. Part 2 of 5 series.
|
||
Food Chem Toxicol
|
||
2017; 107: 472-501.
|
||
[<a href="https://pubmed.ncbi.nlm.nih.gov/27402097" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27402097</span></a>]<div><i>(Description of an online compendium of cases of liver toxicity attributed to HDS products, mentions 4 cases attributed to gotu kola, 3 as reported by Jorge [2005] and 1 by Dantuluri [2011]) .</i></div></div></li><li><div class="bk_ref" id="Centella.REF.navarro.2017.363">Navarro
|
||
VJ, Khan
|
||
I, Björnsson
|
||
E, Seeff
|
||
LB, Serrano
|
||
J, Hoofnagle
|
||
JH. Liver injury from herbal and dietary supplements.
|
||
Hepatology
|
||
2017; 65: 363-73.
|
||
[<a href="/pmc/articles/PMC5502701/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5502701</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27677775" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27677775</span></a>]<div><i>(Review of the problems of liver injury and HDS products, mentions that multiingredient dietary supplements account for the major of cases but does not mention a product with gotu kola as a component).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.haslan.2015.1779">Haslan
|
||
H, Suhaimi
|
||
FH, Das
|
||
S. Herbal supplements and hepatotoxicity: a short review.
|
||
Nat Prod Commun.
|
||
2015;10:1779-84.
|
||
[<a href="https://pubmed.ncbi.nlm.nih.gov/26669124" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26669124</span></a>]<div><i>(Review of liver injury due to herbal supplements mentions the 3 cases of jaundice caused by Centella asiatica as reported by Jorge [2005]).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.santos.2021.6">Santos
|
||
G, Gasca
|
||
J, Parana
|
||
R, Nunes
|
||
V, Schinnoni
|
||
M, Medina-Caliz
|
||
I, Cabello
|
||
MR, Lucena
|
||
MI, et al.
|
||
Profile of herbal and dietary supplements induced liver injury in Latin America: A systematic review of published reports.
|
||
Phytother Res.
|
||
2021;35:6-19.
|
||
[<a href="https://pubmed.ncbi.nlm.nih.gov/32525269" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32525269</span></a>]<div><i>(Review of reports of liver injury due to herbal supplements reported from Latin America lists the 3 cases of hepatitis attributed to Centella asiatica reported by Jorge from Argentina [2005]).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.torbati.2021.451">Torbati
|
||
FA, Ramezani
|
||
M, Dehghan
|
||
R, Amiri
|
||
MS, Moghadam
|
||
AT, Shakour
|
||
N, Elyasi
|
||
S, et al.
|
||
Ethnobotany, phytochemistry and pharmacological features of Centella asiatica: a comprehensive review.
|
||
Adv Exp Med Biol.
|
||
2021;1308:451-499.
|
||
[<a href="https://pubmed.ncbi.nlm.nih.gov/33861456" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33861456</span></a>]<div><i>(Review of the chemistry, possible mechanisms of action, and clinical uses of Centella asiatica; mentions the cases of hepatotoxicity published by Jorge [2005] but cites studies in rats showing no abnormalities in ALT or AST even with the highest doses used).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.biswas.2021.6624">Biswas
|
||
D, Mandal
|
||
S, Chatterjee Saha
|
||
S, Tudu
|
||
CK, Nandy
|
||
S, Batiha
|
||
GE, et al.
|
||
Ethnobotany, phytochemistry, pharmacology, and toxicity of Centella asiatica (L.) Urban: A comprehensive review.
|
||
Phytother Res.
|
||
2021;35:6624-6654.
|
||
[<a href="https://pubmed.ncbi.nlm.nih.gov/34463404" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34463404</span></a>]<div><i>(Review of the phytochemistry, pharmacology and toxicity of Centella asiatica mentions that it is cultivated is semi-aquatic environments and is used as a food as well as medicinal herb to treat minor wounds, eczema, ulcers, diarrhea, measles, jaundice, asthma, diabetes, toothache, smallpox, leprosy, syphilis, dementia, and digestive disorders, and that it is well tolerated in human subjects with no major undesirable effects, but also mentions the 3 cases of jaundice reported by Jorge [2005]).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.bessone.2022.e548">Bessone
|
||
F, García-Cortés
|
||
M, Medina-Caliz
|
||
I, Hernandez
|
||
N, Parana
|
||
R, Mendizabal
|
||
M, Schinoni
|
||
MI, et al.
|
||
Herbal and dietary supplements-induced liver injury in Latin America: experience from the LATINDILI Network.
|
||
Clin Gastroenterol Hepatol.
|
||
2022;20:e548-e563.
|
||
[<a href="https://pubmed.ncbi.nlm.nih.gov/33434654" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33434654</span></a>]<div><i>(Among 367 cases of hepatotoxicity enrolled in the Latin American DILI Network between 2011 and 2019, 29 [8%] were attributed to herbal products, the most frequent being green tea [n=7], Herbalife products [n=5] and garcinia [n=3]; Centella asiatica and gotu kola are not mentioned).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.ballotin.2021.5490">Ballotin
|
||
VR, Bigarella
|
||
LG, Brandão
|
||
ABM, Balbinot
|
||
RA, Balbinot
|
||
SS, Soldera
|
||
J. Herb-induced liver injury: Systematic review and meta-analysis.
|
||
World J Clin Cases.
|
||
2021;9:5490-5513.
|
||
[<a href="/pmc/articles/PMC8281430/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8281430</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/34307603" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34307603</span></a>]<div><i>(Systematic review of the literature on herb induced liver injury identified 446 references describing 936 cases due to 79 different herbal products, the most common being He Shou Wu [91], green tea [90] Herbalife products [64], kava kava [62] and greater celandine [48]; Centella asiatica is listed as implicated in 3 cases as described by Jorge [2005]).</i></div></div></li><li><div class="bk_ref" id="Centella.REF.bandopadhyay.2023.593">Bandopadhyay
|
||
S, Mandal
|
||
S, Ghorai
|
||
M, Jha
|
||
NK, Kumar
|
||
M, Ghosh
|
||
A, et al.
|
||
Therapeutic properties and pharmacological activities of asiaticoside and madecassoside: A review.
|
||
J Cell Mol Med.
|
||
2023;27:593-608.
|
||
[<a href="/pmc/articles/PMC9983323/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9983323</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36756687" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36756687</span></a>]<div><i>(Review of the phytochemistry and the biologic and clinical effects of asiaticoside and madecassoside, major triterpenoid glycosides of Centella asiatica, including neuroprotection, dermatologic healing, UV protection, pulmonary, renal, and liver protection, immunomodulatory, antiinflammatory, and antiallergic activities; no discussion of toxicity).</i></div></div></li></ul></div><div id="bk_toc_contnr"></div></div></div>
|
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK603561/?report=reader">PubReader</a></li><li><a href="/books/NBK603561/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK603561" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK603561" style="display:none" title="Cite this Page"><div class="bk_tt">LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Centella asiatica. [Updated 2024 Apr 24].<span class="bk_cite_avail"></span></div></div></li><li><a href="/books/NBK603561/pdf/Bookshelf_NBK603561.pdf">PDF version of this page</a> (138K)</li><li><a href="#" class="toggle-glossary-link" title="Enable/disable links to the glossary">Disable Glossary Links</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>New and Updated</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="source-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="https://pubmed.ncbi.nlm.nih.gov/?term=%22LiverTox%22+AND+pmcbook&sort=date&size=200" ref="pagearea=source-links&targetsite=external&targetcat=link&targettype=uri">In PubMed</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Bulk Download</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="source-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="https://ftp.ncbi.nlm.nih.gov/pub/litarch/29/31/" ref="pagearea=source-links&targetsite=external&targetcat=link&targettype=uri">Bulk download LiverTox data from FTP</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Overviews</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="source-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/n/livertox/intro/">Introduction</a></li><li><a href="/books/n/livertox/ClinicalCourse/">Clinical Course</a></li><li><a href="/books/n/livertox/ClinicalOutcome/">Clinical Outcomes</a></li><li><a href="/books/n/livertox/ImmuneFeatures/">Immune Features</a></li><li><a href="/books/n/livertox/Phenotypes_intro/">Phenotypes</a></li><li><a href="/books/n/livertox/Causality/">Causality</a></li><li><a href="/books/n/livertox/DrugCategory/">Likelihood Scale</a></li><li><a href="/books/n/livertox/Severity/">Severity Grading</a></li><li><a href="/books/n/livertox/CaseReport/">Writing a Case Report</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Support Links</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="source-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/n/livertox/">LiverTox Homepage</a></li><li><a href="/books/n/livertox/masterlistintro/">Master List of LiverTox Drugs [with Metadata]</a></li><li><a href="/books/n/livertox/drugliverinjury/">LiverTox Drugs by Drug Class</a></li><li><a href="/books/n/livertox/aboutus/">About LiverTox</a></li><li><a href="/books/n/livertox/editorsandreviewers/">Editors and Review Committee</a></li><li><a href="/books/n/livertox/alert/">Meetings and News</a></li><li><a href="/books/n/livertox/abbreviation/">Abbreviations Used</a></li><li><a href="/books/n/livertox/glossary/">Glossary</a></li><li><a href="/books/n/livertox/resource/">Information Resources</a></li><li><a href="/books/n/livertox/disclaimer/">User/Medical Advice Disclaimer</a></li><li><a href="/books/n/livertox/Contactus/">Contact Us</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>OTHER REFERENCE LINKS</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="document-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li>
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Urban: From Traditional Medicine to Modern Medicine with Neuroprotective Potential.</a><span class="source">[Evid Based Complement Alternat...]</span><div class="brieflinkpop offscreen_noflow">Centella asiatica (L.) Urban: From Traditional Medicine to Modern Medicine with Neuroprotective Potential.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Orhan IE. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Evid Based Complement Alternat Med. 2012; 2012:946259. Epub 2012 May 14.</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/27748812" ref="ordinalpos=1&linkpos=2&log$=relatedarticles&logdbfrom=pubmed">Protective effects of Centella asiatica leaf extract on dimethylnitrosamine‑induced liver injury in rats.</a><span class="source">[Mol Med Rep. 2016]</span><div class="brieflinkpop offscreen_noflow">Protective effects of Centella asiatica leaf extract on dimethylnitrosamine‑induced liver injury in rats.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Choi MJ, Zheng HM, Kim JM, Lee KW, Park YH, Lee DH. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Mol Med Rep. 2016 Nov; 14(5):4521-4528. Epub 2016 Oct 5.</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/36589020" ref="ordinalpos=1&linkpos=3&log$=relatedarticles&logdbfrom=pubmed">The Ameliorative Impact of Centella asiatica on the Working Memory Deficit in Streptozotocin-induced Rat Model of Alzheimer Disease.</a><span class="source">[Basic Clin Neurosci. 2022]</span><div class="brieflinkpop offscreen_noflow">The Ameliorative Impact of Centella asiatica on the Working Memory Deficit in Streptozotocin-induced Rat Model of Alzheimer Disease.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Sahraei R, Aminyavari S, Hosseini M, Hassanzadeh-Taheri M, Foadoddini M, Saebipour MR. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Basic Clin Neurosci. 2022 Jan-Feb; 13(1):25-34. Epub 2022 Jan 1.</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/36365380" ref="ordinalpos=1&linkpos=4&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Biotechnological Intervention and Secondary Metabolite Production in Centella asiatica L.</a><span class="source">[Plants (Basel). 2022]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Biotechnological Intervention and Secondary Metabolite Production in Centella asiatica L.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Ganie IB, Ahmad Z, Shahzad A, Zaushintsena A, Neverova O, Ivanova S, Wasi A, Tahseen S. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Plants (Basel). 2022 Oct 30; 11(21). Epub 2022 Oct 30.</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26602573" ref="ordinalpos=1&linkpos=5&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Gotu Kola (Centella asiatica): Nutritional Properties and Plausible Health Benefits.</a><span class="source">[Adv Food Nutr Res. 2015]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Gotu Kola (Centella asiatica): Nutritional Properties and Plausible Health Benefits.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Chandrika UG, Prasad Kumarab PA. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Adv Food Nutr Res. 2015; 76:125-57. Epub 2015 Oct 1.</em></div></div></li></ul><a class="seemore" href="/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed_reviews&uid=38718155" ref="ordinalpos=1&log$=relatedreviews_seeall&logdbfrom=pubmed">See reviews...</a><a class="seemore" href="/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed&uid=38718155" ref="ordinalpos=1&log$=relatedarticles_seeall&logdbfrom=pubmed">See all...</a></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Recent Activity</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="recent_activity" id="Shutter"></a></div><div class="portlet_content"><div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" id="HTDisplay" class=""><div class="action"><a href="javascript:historyDisplayState('ClearHT')">Clear</a><a href="javascript:historyDisplayState('HTOff')" class="HTOn">Turn Off</a><a href="javascript:historyDisplayState('HTOn')" class="HTOff">Turn On</a></div><ul id="activity"><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=1" href="/portal/utils/pageresolver.fcgi?recordid=67c809c6b70fbb19601c0eca">Centella asiatica - LiverTox</a><div class="ralinkpop offscreen_noflow">Centella asiatica - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=2" href="/portal/utils/pageresolver.fcgi?recordid=67c809c5d5edb449bf5a4989">Resmetirom - LiverTox</a><div class="ralinkpop offscreen_noflow">Resmetirom - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=3" href="/portal/utils/pageresolver.fcgi?recordid=67c809c4b70fbb19601c0369">Ritlecitinib - LiverTox</a><div class="ralinkpop offscreen_noflow">Ritlecitinib - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=4" href="/portal/utils/pageresolver.fcgi?recordid=67c809c3b70fbb19601bfe08">Afamelanotide - LiverTox</a><div class="ralinkpop offscreen_noflow">Afamelanotide - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=5" href="/portal/utils/pageresolver.fcgi?recordid=67c809c2feee5b00ac16f634">Bismuth - LiverTox</a><div class="ralinkpop offscreen_noflow">Bismuth - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li></ul><p class="HTOn">Your browsing activity is empty.</p><p class="HTOff">Activity recording is turned off.</p><p id="turnOn" class="HTOff"><a href="javascript:historyDisplayState('HTOn')">Turn recording back on</a></p><a class="seemore" href="/sites/myncbi/recentactivity">See more...</a></div></div></div>
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