XueLi Ding
Beijing University of Chinese Medicine, China
Title: Pharmacovigilance study of rhubarb-induced colonic melanosis from bench to regulatory science practice
Biography
Biography: XueLi Ding
Abstract
Statement of the Problem: Rhubarb is a widely used medicinal plant worldwide, and its main chemical components are anthrone, rhubarbic acid, rhodopsin, rhodopsin methyl ether, rhubarb phenol, polysaccharides and so on. It has a variety of pharmacological effects such as gastrointestinal regulation, anticancer, antibacterial, hepatoprotective, anti-inflammatory and cardiovascular protection. FDA surveillance data as well as academic reports have shown that rhubarb has some adverse effects, with anthraquinone-based laxatives, which may lead to colon blackening, being the most common. The purpose of this study was to clarify the exact mechanism of rhubarb-induced colon blackening, to explore the risk factors, and to refine and summarize the risk warning measures for the clinical application of rhubarb.
METHODS AND THEORY: The results of public data mining, network computer simulation prediction, in vivo and in vitro experiments were biologically validated, and the early warning of the risk of rhubarb clinical application was proposed from the four perspectives of "discovery-assessment-understanding-prevention". It was found that rhubarb and rhubarb acid, rhubarb phenol, aloe barbadensis, and rhubarbol methyl ether increased the protein expression of TP53 and induced apoptosis of colon cells. It is suggested that rhubarb-induced colonic melanosis is related to apoptosis, and TP53 protein-induced apoptosis may be one of the mechanisms of rhubarb-induced colonic melanosis.
CONCLUSIONS AND SIGNIFICANCE: The content of free anthraquinone components, clinical use of rhubarb, dosage, duration of treatment, and changes in the expression of key proteins are all important factors of rhubarb-induced colorectal melioidosis, and pharmacovigilance of rhubarb should be carried out from the perspectives of monitoring of adverse reactions, analysis of components, optimization of dosage, duration of treatment, and communication of risks.