ArticleJournal of gastroenterology2019
Adverse events in patients with ulcerative colitis treated with indigo naturalis: a Japanese nationwide survey.
Article in Journal of gastroenterology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed, 52 citations in OpenAlex.
- Indigo naturalis is effective even in treatment-refractory patients with ulcerative colitis: a post hoc analysis from the INDIGO study.Journal of gastroenterology · 2020Trial
- Trial
- Adult Colocolonic Intussusception Temporally Associated With Curcumin Qingdai Use in a Patient With Ulcerative Proctitis.ACG case reports journal · 2026Article
- Pharmacokinetics and Acute Safety Evaluation of Tryptanthrin, A Bioactive Constituent of Indigo naturalis, Following Intravenous Administration in Mice.Journal of applied toxicology : JAT · 2026Article
- Defined Natural Products as Adjunctive Therapies: Evidence-Gated Polypharmacology Across Molecular Targets, Human Exposure, Clinical Signals, and Safety Boundaries.International journal of molecular sciences · 2026Review
- Adult Intussusception and Ischemic Bowel Potentially Associated with CurQD Supplementation: A Case Report of A Diagnosis Driven by Point-of-care Ultrasound.Clinical practice and cases in emergency medicine · 2026Article
- Long-term outcomes of Qing-Dai-induced pulmonary arterial hypertension.ERJ open research · 2025Article
- Drugs and toxins associated with pulmonary arterial hypertension: from established culprits to novel threats.ERJ open research · 2025Review
- Macrophage-Mediated Transport of Insoluble Indirubin Induces Hepatic Injury During Intestinal Inflammation.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- Indigo naturalis‑associated ischemic injury of colorectal mucosa: A case series study.Experimental and therapeutic medicine · 2025Article
- Selected Use of Complementary and Alternative Medicine (CAM) Agents in IBD.Current gastroenterology reports · 2025Review
- Exploring the Causal Link Between Autoimmune Diseases and Pulmonary Arterial Hypertension: A Bidirectional Mendelian Randomization Study.Global heart · 2025Article
- Curcumin-QingDai combination for patients with active Crohn's disease: a retrospective, real-world multicenter cohort study.Frontiers in gastroenterology (Lausanne, Switzerland) · 2025Article
- Review
- Clinical outcomes of patients with remitting ulcerative colitis after discontinuation of indigo naturalis.Scientific reports · 2024Article
- Long-term Follow-up of Qing-Dai-Induced Pulmonary Arterial Hypertension: A Case Series.CJC open · 2023Article
- Ferroptosis in the colon epithelial cells as a therapeutic target for ulcerative colitis.Journal of gastroenterology · 2023Article
- Activation of the aryl hydrocarbon receptor inhibits the development of experimental autoimmune pancreatitis through IL-22-mediated signaling pathways.Clinical and experimental immunology · 2023Article
- Development of pulmonary arterial hypertension following long-term Qing-Dai use for ulcerative colitis.Journal of cardiology cases · 2023Article
- Reviewing not Homer's Iliad, but "Kai Bao Ben Cao": indigo dye-the past, present, and future.Intestinal research · 2023Article
Corrections and comments
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Authors and funding
18 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough indigo naturalis (IN) is effective for patients with active ulcerative colitis (UC), IN was associated with adverse events (AEs), including pulmonary arterial hypertension (PAH). Our aim was to evaluate the occurrence of IN-associated AEs and to evaluate any IN dose-effect on AEs.
methodsA nationwide survey, using questionnaires, was conducted by conducted by the research group funded by the Ministry of Health, Labour and Welfare of Japan, between June 2017 and September 2018. A first questionnaire determined the occurrence of AEs associated with the therapeutic use of IN or herbal medicines containing IN in patients with UC. A second survey identified the clinical characteristics of patients who developed IN-associated critical AEs, namely, liver dysfunction, PAH, and intussusception.
resultsAcross 337 participating institutions, 49,320 patients with UC were identified, with IN used in 877 (1.8%). AEs were reported in 91 patients (107 events), including liver dysfunction (n = 40), gastrointestinal symptoms (n = 21), headache (n = 13), and PAH (n = 11). No dose-effect relationship between IN and AEs was identified. Liver dysfunction tended to be mild and reversible. Ten cases of intussusception were reported, with 40% of these patients requiring surgical resection. IN-induced PAH was recovered in patients who discontinued to use IN. No IN-associated deaths were reported.
conclusionsIN-associated AEs were identified among patients with UC, with liver dysfunction often being reversible, while surgical resection was required in a high proportion of patients who developed intussusception. Both healthcare workers and patients should adequately recognize the potential for AEs with the use of IN.
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