ArticleHepatology (Baltimore, Md.)2021
HLA-B*35:01 and Green Tea-Induced Liver Injury.
Article in Hepatology (Baltimore, Md.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers.
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Who cites it
51 citing papers in PubMed.
- Enhanced bioavailability and short-term safety of a micellar green tea extract formulation co-delivered with N-acetylcysteine: a randomized crossover study in healthy adults.Frontiers in nutrition · 2026Trial
- Hepatotoxicity with High-Dose Green Tea Extract: Effect ofJournal of dietary supplements · 2023Trial
- The contemporary epidemiology, causes, and management of drug-induced liver injury.Hepatology communications · 2026Review
- Common Causes of Drug-Induced Liver Injury in 2025.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2026Review
- Evaluation of in vitro toxicity of common phytochemicals included in weight loss supplements usingFEBS open bio · 2026Article
- Human Leukocyte Antigen (International journal of molecular sciences · 2026Review
- Article
- Challenges in herbal-induced liver injury identification and prevention.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Liver Injury due to Intravenous Methylprednisolone in the Drug-Induced Liver Injury Network.Liver international : official journal of the International Association for the Study of the Liver · 2025Article
- Genetic and Genomic Approaches to the Study of Drug-Induced Liver Injury.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Identification of Genetic Risk Factors Associated With Herbal and Dietary Supplement-Induced Acute Liver Failure Using Whole Exome Sequencing Analysis.Gastro hep advances · 2025Article
- Association of HLA-DQA1*06:01 and DPB1*05:01:01G alleles with susceptibility to end-stage liver disease with HBV infection in liver transplant recipients from the Zhejiang Han population, China.Frontiers in immunology · 2025Article
- Nurses' use of 'wellness' supplements during the COVID-19 pandemic in the United States.Journal of advanced nursing · 2024Article
- Characterisation of an outbreak of acute liver injury after ingestion of plant-based food supplement.Alimentary pharmacology & therapeutics · 2024Article
- Estimated Exposure to 6 Potentially Hepatotoxic Botanicals in US Adults.JAMA network open · 2024Article
- Drug-induced liver injury (DILI) ascribed to non-steroidal anti-inflammatory drugs (NSAIDs) in the USA-Update with genetic correlations.Liver international : official journal of the International Association for the Study of the Liver · 2024Article
- The Epidemiology of Newly Recognized Causes of Drug-Induced Liver Injury: An Update.Pharmaceuticals (Basel, Switzerland) · 2024Review
- Drug-Induced Liver Injury in the Elderly: Consensus Statements and Recommendations from the IQ-DILI Initiative.Drug safety · 2024Article
- Complementary and alternative medicines and liver disease.Hepatology communications · 2024Review
- Recent advances in the diagnosis of drug-induced liver injury.World journal of hepatology · 2024Review
Corrections and comments
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Authors and funding
20 authors.
Funding
Abstract
BACKGROUND AND
aimsHerbal supplements, and particularly multi-ingredient products, have become increasingly common causes of acute liver injury. Green tea is a frequent component in implicated products, but its role in liver injury is controversial. The aim of this study was to better characterize the clinical features, outcomes, and pathogenesis of green tea-associated liver injury. APPROACH AND
resultsAmong 1,414 patients enrolled in the U.S. Drug-Induced Liver Injury Network who underwent formal causality assessment, 40 cases (3%) were attributed to green tea, 202 to dietary supplements without green tea, and 1,142 to conventional drugs. The clinical features of green tea cases and representation of human leukocyte antigen (HLA) class I and II alleles in cases and control were analyzed in detail. Patients with green tea-associated liver injury ranged in age from 17 to 69 years (median = 40) and developed symptoms 15-448 days (median = 72) after starting the implicated agent. The liver injury was typically hepatocellular (95%) with marked serum aminotransferase elevations and only modest increases in alkaline phosphatase. Most patients were jaundiced (83%) and symptomatic (88%). The course was judged as severe in 14 patients (35%), necessitating liver transplantation in 3 (8%), but rarely resulting in chronic injury (3%). In three instances, injury recurred upon re-exposure to green tea with similar clinical features, but shorter time to onset. HLA typing revealed a high prevalence of HLA-B*35:01, found in 72% (95% confidence interval [CI], 58-87) of green tea cases, but only 15% (95% CI, 10-20) caused by other supplements and 12% (95% CI, 10-14) attributed to drugs, the latter rate being similar to population controls (11%; 95% CI, 10.5-11.5).
conclusionsGreen tea-related liver injury has distinctive clinical features and close association with HLA-B*35:01, suggesting that it is idiosyncratic and immune mediated.
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