Worldwide Occurrence and Investigations of Contamination of Herbal Medicines by Tropane Alkaloids
Abstract
:1. Introduction
2. Methodology
3. Results
4. Discussion
5. Conclusions
Acknowledgments
Conflicts of Interest
References
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Species | Place, Year a [ref] | Details |
---|---|---|
Burdock root tea | USA, 1978 [11] | F/26 had mild symptoms after the first dose and needed ED attendance after the second (bigger) dose; her husband had mild symptoms after the first dose; commercial preparation obtained from the patient contained atropine >30 mg per g |
Burdock root tea | USA, 1984 [12] | F/59 needed ED attendance; commercial preparation provided by the patient contained 0.76 mg atropine per g |
Comfrey tea | UK, 1983 [13] | An elderly man needed hospital admission; his wife was cared for at home; their batch was known to be contaminated with A. belladonna |
Comfrey tea | UK, 1989 [14] | M/30 needed hospital admission; tea leaves estimated by in vitro study were shown to contain ≥4 mg per 28 g; likely to be contaminated with A. belladonna, as noted in a batch from a different supplier |
Common mallow tea | Canada, 1981–1984 [15] | Two hospitalised cases in 1981 and 1984; packages recovered from patients contained berries of A. Belladonna |
Marshmallow root tea | Netherlands, 2013 [16,17] | M/27 and his partner (F/28) needed hospital admission; within one week, four other cases (two needed hospital admission) reported to the Dutch National Poisons Information Centre; atropine content 1–10 mg per g; contamination by A. belladonna; probably occurred during harvest |
Marshmallow root tea | France, 2013 [17] | One case related to the marshmallow root tea purchased in The Netherlands identified via the European Association of Poisons Centres and Clinical Toxicologists network |
Lungwort tea | Spain, 2006 [18] | M/76 (two episodes), daughter (F/42, one episode) and granddaughter (F/14, one episode) with anticholinergic toxicity and ED attendance (at least one hospital admission); presence by tropane alkaloids was strongly suspected |
Paraguay tea | USA, 1994 [19] | A couple (M/39, F/38), F/20 and a family of four (M/40, F/35, M/18, M/10) presented within three days, requiring ED attendance (n = 6) or hospital admission (n = 1); contamination with leaves from a plant containing belladonna alkaloids was the most likely explanation, since the samples provided by patients tested positive for atropine, scolopamine, and hyoscyamine |
Stinging nettle tea | Austria, 1980 [20] | F/57 needed hospital admission; sample obtained fom patient contained impurities (insects and A. belladonna leaves) |
Place, Year [ref] | Details |
---|---|
Italy, 2005 [21] | F/34 was hospitalised after taking galenic product (C. forskohlii, green tea, rhodiola, dandelion, hawkweeds) |
Italy, 2005 [21] | F/44 was not reported to require hospitalisation or not after taking galenic product (C. forskohlii) |
Italy, 2005 [21] | F/46, after taking galenic product (C. forskohlii) |
Species | Place, Year b [ref] | Details |
---|---|---|
Unknown c | Hong Kong, 1985–1987 [23] | Nine cases (5M, 4F, aged 30–81 years), including one cluster of four cases and one cluster of two cases, admitted to two hospitals; herbal residues available from one case tested positive for atropine; the contaminated herbs were not identified |
Unknown c | Hong Kong, 2008–2012 [24] | Five hospitalised cases reported to the Department of Health; herbal samples or herbal residues tested positive for tropane alkaloids; the contaminated herbs were not identified |
Rhizoma Atractylodis | Hong Kong, 2000–2004 d [25] | Three hospitalised cases reported to the Department of Health; impurities tested positive for scopolamine and atropine in two; seed-like herb tested positive for scopolamine and atropine in one |
Rhizoma Atractylodis | Hong Kong, 2002–2011 d [26] | 11 hospitalised cases (3M, 8F, aged 9–52 years, median 45 years) reported to the Department of Health; tropane alkaloids found in four of the suppliers’ samples which came from imports |
Rhizoma Atractylodis | Ningbo, China, 1999 [27] | Numerous cases reported by several hospitals all related to one batch; found to contain rhizomes of Scopolia japonica, which tested positive for atropine and scopolamine |
Rhizoma Atractylodis | Taizhou, China, 2011 [28] | A cluster of >10 cases (9% of all treated subjects) reported by a health centre; no more new cases after the implicated batch was withdrawn; no impurities found on inspection of samples |
Rhizoma Atractylodis | Changsha, China, 2011–2012 [29] | Two cases (F/41, F/66) reported by a herbal medicine research centre; found to contain rhizomes of Solanaceae plants |
Rhizoma Atractylodis | Jingmen, China, 2014 [30] | A cluster of cases presented to one hospital; samples obtained from the retailer tested positive for atropine type of alkaloids and contained rhizomes of H. Niger |
Radix Aucklandiae | Hong Kong, 2008–2012 [24] | Two hospitalised cases reported to the Department of Health; sample from the same batch tested positive for tropane alkaloids |
Radix Strobilanthis Forrestii | Hong Kong, 2010 [31] | One hospitalised case (F/79) reported to the Department of Health; pre-packed sample imported from a herb processing factory tested positive for atropine; atropine, scopolamine, anisodamine detected in patient’s urine |
Rhizoma et Radix Notopterygii | Hong Kong, 2012 [32] | One hospitalised case (F/63) reported to the Department of Health; herbal residues and sample from herbal shop tested positive for tropane alkaloids |
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Chan, T.Y.K. Worldwide Occurrence and Investigations of Contamination of Herbal Medicines by Tropane Alkaloids. Toxins 2017, 9, 284. https://doi.org/10.3390/toxins9090284
Chan TYK. Worldwide Occurrence and Investigations of Contamination of Herbal Medicines by Tropane Alkaloids. Toxins. 2017; 9(9):284. https://doi.org/10.3390/toxins9090284
Chicago/Turabian StyleChan, Thomas Y. K. 2017. "Worldwide Occurrence and Investigations of Contamination of Herbal Medicines by Tropane Alkaloids" Toxins 9, no. 9: 284. https://doi.org/10.3390/toxins9090284