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Kava as a Clinical Nutrient: Promises and Challenges.
Nutrients. 2020 Oct 05; 12(10)N

Abstract

Kava beverages are typically prepared from the root of Piper methysticum. They have been consumed among Pacific Islanders for centuries. Kava extract preparations were once used as herbal drugs to treat anxiety in Europe. Kava is also marketed as a dietary supplement in the U.S. and is gaining popularity as a recreational drink in Western countries. Recent studies suggest that kava and its key phytochemicals have anti-inflammatory and anticancer effects, in addition to the well-documented neurological benefits. While its beneficial effects are widely recognized, rare hepatotoxicity had been associated with use of certain kava preparations, but there are no validations nor consistent mechanisms. Major challenges lie in the diversity of kava products and the lack of standardization, which has produced an unmet need for quality initiatives. This review aims to provide the scientific community and consumers, as well as regulatory agencies, with a broad overview on kava use and its related research. We first provide a historical background for its different uses and then discuss the current state of the research, including its chemical composition, possible mechanisms of action, and its therapeutic potential in treating inflammatory and neurological conditions, as well as cancer. We then discuss the challenges associated with kava use and research, focusing on the need for the detailed characterization of kava components and associated risks such as its reported hepatotoxicity. Lastly, given its growing popularity in clinical and recreational use, we emphasize the urgent need for quality control and quality assurance of kava products, pharmacokinetics, absorption, distribution, metabolism, excretion, and foundational pharmacology. These are essential in order to inform research into the molecular targets, cellular mechanisms, and creative use of early stage human clinical trials for designer kava modalities to inform and guide the design and execution of future randomized placebo controlled trials to maximize kava's clinical efficacy and to minimize its risks.

Authors+Show Affiliations

Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA.Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA.Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA.Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA.College of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA.Thorne Research Inc. Industrial Road, 620 Omni Dr, Summerville, SC 29483, USA.Department of Health Outcome & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA.The Association for Hawaiian 'Awa (kava), Pepe'ekeo, HI 96783, USA.Department of Biostatistics, College of Public Health & Health Professions, College of Medicine, University of Florida, Gainesville, FL 32610, USA.Department of Pharmacology, Penn State University College of Medicine, Hershey, PA 17033, USA.Department of Physiology and Functional Genomics, College of Medicine, University of Florida, Gainesville, FL 32610, USA.Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

33027883

Citation

Bian, Tengfei, et al. "Kava as a Clinical Nutrient: Promises and Challenges." Nutrients, vol. 12, no. 10, 2020.
Bian T, Corral P, Wang Y, et al. Kava as a Clinical Nutrient: Promises and Challenges. Nutrients. 2020;12(10).
Bian, T., Corral, P., Wang, Y., Botello, J., Kingston, R., Daniels, T., Salloum, R. G., Johnston, E., Huo, Z., Lu, J., Liu, A. C., & Xing, C. (2020). Kava as a Clinical Nutrient: Promises and Challenges. Nutrients, 12(10). https://doi.org/10.3390/nu12103044
Bian T, et al. Kava as a Clinical Nutrient: Promises and Challenges. Nutrients. 2020 Oct 5;12(10) PubMed PMID: 33027883.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Kava as a Clinical Nutrient: Promises and Challenges. AU - Bian,Tengfei, AU - Corral,Pedro, AU - Wang,Yuzhi, AU - Botello,Jordy, AU - Kingston,Rick, AU - Daniels,Tyler, AU - Salloum,Ramzi G, AU - Johnston,Edward, AU - Huo,Zhiguang, AU - Lu,Junxuan, AU - Liu,Andrew C, AU - Xing,Chengguo, Y1 - 2020/10/05/ PY - 2020/08/29/received PY - 2020/09/21/revised PY - 2020/09/25/accepted PY - 2020/10/8/entrez PY - 2020/10/9/pubmed PY - 2021/3/26/medline KW - anxiety KW - cancer KW - cultivars KW - hepatotoxicity KW - inflammation KW - kava KW - kavalactone KW - quality assurance KW - quality control KW - stress JF - Nutrients JO - Nutrients VL - 12 IS - 10 N2 - Kava beverages are typically prepared from the root of Piper methysticum. They have been consumed among Pacific Islanders for centuries. Kava extract preparations were once used as herbal drugs to treat anxiety in Europe. Kava is also marketed as a dietary supplement in the U.S. and is gaining popularity as a recreational drink in Western countries. Recent studies suggest that kava and its key phytochemicals have anti-inflammatory and anticancer effects, in addition to the well-documented neurological benefits. While its beneficial effects are widely recognized, rare hepatotoxicity had been associated with use of certain kava preparations, but there are no validations nor consistent mechanisms. Major challenges lie in the diversity of kava products and the lack of standardization, which has produced an unmet need for quality initiatives. This review aims to provide the scientific community and consumers, as well as regulatory agencies, with a broad overview on kava use and its related research. We first provide a historical background for its different uses and then discuss the current state of the research, including its chemical composition, possible mechanisms of action, and its therapeutic potential in treating inflammatory and neurological conditions, as well as cancer. We then discuss the challenges associated with kava use and research, focusing on the need for the detailed characterization of kava components and associated risks such as its reported hepatotoxicity. Lastly, given its growing popularity in clinical and recreational use, we emphasize the urgent need for quality control and quality assurance of kava products, pharmacokinetics, absorption, distribution, metabolism, excretion, and foundational pharmacology. These are essential in order to inform research into the molecular targets, cellular mechanisms, and creative use of early stage human clinical trials for designer kava modalities to inform and guide the design and execution of future randomized placebo controlled trials to maximize kava's clinical efficacy and to minimize its risks. SN - 2072-6643 UR - https://www.unboundmedicine.com/medline/citation/33027883/Kava_as_a_Clinical_Nutrient:_Promises_and_Challenges_ L2 - https://www.mdpi.com/resolver?pii=nu12103044 DB - PRIME DP - Unbound Medicine ER -