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Hepatotoxicity Induced by "the 3Ks": Kava, Kratom and Khat.

Abstract

The 3Ks (kava, kratom and khat) are herbals that can potentially induce liver injuries. On the one hand, growing controversial data have been reported about the hepatotoxicity of kratom, while, on the other hand, even though kava and khat hepatotoxicity has been investigated, the hepatotoxic effects are still not clear. Chronic recreational use of kratom has been associated with rare instances of acute liver injury. Several studies and case reports have suggested that khat is hepatotoxic, leading to deranged liver enzymes and also histopathological evidence of acute hepatocellular degeneration. Numerous reports of severe hepatotoxicity potentially induced by kava have also been highlighted, both in the USA and Europe. The aim of this review is to focus on the different patterns and the mechanisms of hepatotoxicity induced by "the 3Ks", while trying to clarify the numerous aspects that still need to be addressed.

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  • Authors+Show Affiliations

    ,

    Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy. flaminia.pantano@uniroma1.it.

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    Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy. roberta.tittarelli@uniroma1.it.

    ,

    Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy. giulio.mannocchi@uniroma1.it.

    ,

    Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy. simona.zaami@uniroma1.it.

    ,

    Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy. serafino.ricci@uniroma1.it.

    ,

    Section of Legal Medicine, Università Politecnica delle Marche, 60121 Ancona, Italy. r.giorgetti@univpm.it.

    ,

    Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy. daniela.terranova@uniroma1.it.

    ,

    Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy. fra.busardo@libero.it.

    Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy. enrico.marinelli@uniroma1.it.

    Source

    MeSH

    Animals
    Catha
    Humans
    Liver
    Mitragyna
    Piper
    Plant Extracts
    Plants, Medicinal

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    27092496

    Citation

    Pantano, Flaminia, et al. "Hepatotoxicity Induced By "the 3Ks": Kava, Kratom and Khat." International Journal of Molecular Sciences, vol. 17, no. 4, 2016, p. 580.
    Pantano F, Tittarelli R, Mannocchi G, et al. Hepatotoxicity Induced by "the 3Ks": Kava, Kratom and Khat. Int J Mol Sci. 2016;17(4):580.
    Pantano, F., Tittarelli, R., Mannocchi, G., Zaami, S., Ricci, S., Giorgetti, R., ... Marinelli, E. (2016). Hepatotoxicity Induced by "the 3Ks": Kava, Kratom and Khat. International Journal of Molecular Sciences, 17(4), p. 580. doi:10.3390/ijms17040580.
    Pantano F, et al. Hepatotoxicity Induced By "the 3Ks": Kava, Kratom and Khat. Int J Mol Sci. 2016 Apr 16;17(4):580. PubMed PMID: 27092496.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Hepatotoxicity Induced by "the 3Ks": Kava, Kratom and Khat. AU - Pantano,Flaminia, AU - Tittarelli,Roberta, AU - Mannocchi,Giulio, AU - Zaami,Simona, AU - Ricci,Serafino, AU - Giorgetti,Raffaele, AU - Terranova,Daniela, AU - Busardò,Francesco P, AU - Marinelli,Enrico, Y1 - 2016/04/16/ PY - 2016/02/18/received PY - 2016/02/18/revised PY - 2016/04/11/accepted PY - 2016/4/20/entrez PY - 2016/4/20/pubmed PY - 2017/1/7/medline KW - hepatotoxicity KW - herb induced liver injury KW - herbals KW - kava KW - khat KW - kratom SP - 580 EP - 580 JF - International journal of molecular sciences JO - Int J Mol Sci VL - 17 IS - 4 N2 - The 3Ks (kava, kratom and khat) are herbals that can potentially induce liver injuries. On the one hand, growing controversial data have been reported about the hepatotoxicity of kratom, while, on the other hand, even though kava and khat hepatotoxicity has been investigated, the hepatotoxic effects are still not clear. Chronic recreational use of kratom has been associated with rare instances of acute liver injury. Several studies and case reports have suggested that khat is hepatotoxic, leading to deranged liver enzymes and also histopathological evidence of acute hepatocellular degeneration. Numerous reports of severe hepatotoxicity potentially induced by kava have also been highlighted, both in the USA and Europe. The aim of this review is to focus on the different patterns and the mechanisms of hepatotoxicity induced by "the 3Ks", while trying to clarify the numerous aspects that still need to be addressed. SN - 1422-0067 UR - https://www.unboundmedicine.com/medline/citation/27092496/full_citation L2 - http://www.mdpi.com/resolver?pii=ijms17040580 DB - PRIME DP - Unbound Medicine ER -