PMID 23235664 Green tea for weight loss and weight maintenance in overweight or obese adults Cochrane review · Cochrane Database Syst Rev, 2012 RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.s of 12+ weeks - mean weight -0.04 kg across 6 non-Japan trials (532 people), not significant. Concluded the loss is too small to be clinically important.
Key summary
A CochraneAn international network that rigorously reviews and synthesizes evidence. systematic review of green tea preparations for weight loss and maintenance in overweight or obese adults (RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.s of at least 12 weeks). Because of heterogeneity, trials inside and outside Japan were analyzed separately; the mean weight change across 6 non-Japan trials (532 people) was -0.04 kg, not significant. The 8 Japan trials could not be pooled and scattered widely. BMI and waist circumference were also non-significant outside Japan, and there was no significant effect on maintaining weight after loss. Adverse events were mostly mild to moderate, with two hospitalisations reported as not associated with the intervention. The authors concluded the loss is too small to be clinically important.
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BACKGROUND: Preparations of green tea are used as aids in weight loss and weight maintenance. Catechins and caffeine, both contained in green tea, are each believed to have a role in increasing energy metabolism, which may lead to weight loss. A number of randomised controlled trials (RCTs) evaluating the role of green tea in weight loss have been published; however, the efficacy of green tea preparations in weight loss remains unclear. OBJECTIVES: To assess the efficacy and safety of green tea preparations for weight loss and weight maintenance in overweight or obese adults. SEARCH METHODS: We searched the following databases from inception to specified date as well as reference lists of relevant articles: The Cochrane Library (Issue 12, 2011), MEDLINE (December 2011), EMBASE (December 2011), CINAHL (January 2012), AMED (January 2012), Biological Abstracts (January 2012), IBIDS (August 2010), Obesity+ (January 2012), IPA (January 2012) and Web of Science (December 2011). Current Controlled Trials with links to other databases of ongoing trials was also searched. SELECTION CRITERIA: RCTs of at least 12 weeks' duration comparing green tea preparations to a control in overweight or obese adults. DATA COLLECTION AND ANALYSIS: Three authors independently extracted data, assessed studies for risk of bias and quality, with differences resolved by consensus. Heterogeneity of included studies was assessed visually using forest plots and quantified using the I(2) statistic. We synthesised data using meta-analysis and descriptive analysis as appropriate; subgroup and sensitivity analyses were conducted. Adverse effects reported in studies were recorded. MAIN RESULTS: Due to the level of heterogeneity among studies, studies were divided into two groups; those conducted in Japan and those conducted outside Japan. Study length ranged between 12 and 13 weeks. Meta-analysis of six studies conducted outside Japan showed a mean difference (MD) in weight loss of -0.04 kg (95% CI -0.5 to 0.4; P = 0.88; I(2) = 18%; 532 participants). The eight studies conducted in Japan were not similar enough to allow pooling of results and MD in weight loss ranged from -0.2 kg to -3.5 kg (1030 participants) in favour of green tea preparations. Meta-analysis of studies measuring change in body mass index (BMI) conducted outside Japan showed a MD in BMI of -0.2 kg/m(2) (95% CI -0.5 to 0.1; P = 0.21; I(2) = 38%; 222 participants). Differences among the eight studies conducted in Japan did not allow pooling of results and showed a reduction in BMI ranging from no effect to -1.3 kg/m(2) (1030 participants), in favour of green tea preparations over control. Meta-analysis of five studies conducted outside Japan and measuring waist circumference reported a MD of -0.2 cm (95% CI -1.4 to 0.9; P = 0.70; I(2) = 58%; 404 participants). Differences among the eight studies conducted in Japan did not allow pooling of results and showed effects on waist circumference ranging from a gain of 1 cm to a loss of 3.3 cm (1030 participants). Meta-analysis for three weight loss studies, conducted outside Japan, with waist-to-hip ratio data (144 participants) yielded no significant change (MD 0; 95% CI -0.02 to 0.01). Analysis of two studies conducted to determine if green tea could help to maintain weight after a period of weight loss (184 participants) showed a change in weight loss of 0.6 to -1.6 kg, a change in BMI from 0.2 to -0.5 kg/m(2) and a change in waist circumference from 0.3 to -1.7 cm. In the eight studies that recorded adverse events, four reported adverse events that were mild to moderate, with the exception of two (green tea preparations group) that required hospitalisation (reported as not associated with the intervention). Nine studies reported on compliance/adherence, one study assessed attitude towards eating as part of the health-related quality of life outcome. No studies reported on patient satisfaction, morbidity or cost. AUTHORS' CONCLUSIONS: Green tea preparations appear to induce a small, statistically non-significant weight loss in overweight or obese adults. Because the amount of weight loss is small, it is not likely to be clinically important. Green tea had no significant effect on the maintenance of weight loss. Of those studies recording information on adverse events, only two identified an adverse event requiring hospitalisation. The remaining adverse events were judged to be mild to moderate. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 21715508 Green tea intake lowers fasting serum total and LDL cholesterol in adults: a meta-analysis of 14 randomized controlled trials Meta-analysis · Am J Clin Nutr, 2011 14 RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.s, 1,136 people - total cholesterol -7.20 mg/dL, LDLLow-density lipoprotein cholesterol - the so-called "bad" cholesterol. -2.19 mg/dL. No change in HDL.
Key summary
A meta-analysisA statistical synthesis combining results of multiple studies into one conclusion. of how green tea and its extracts affect lipid profiles in adults (14 RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.s, 1,136 people). Green tea intake significantly lowered total cholesterol by 7.20 mg/dL (95% CI -8.19 to -6.21) and LDLLow-density lipoprotein cholesterol - the so-called "bad" cholesterol. cholesterol by 2.19 mg/dL (95% CI -3.16 to -1.21), with no significant change in HDL cholesterol. Subgroup analyses by intervention type, catechin dose, duration, health status, and study quality did not materially change the results. Still, the LDL reduction itself is small, about 2 mg/dL.
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BACKGROUND: The effect of green tea beverage and green tea extract on lipid changes is controversial. OBJECTIVE: We aimed to identify and quantify the effect of green tea and its extract on total cholesterol (TC), LDL cholesterol, and HDL cholesterol. DESIGN: We performed a comprehensive literature search to identify relevant trials of green tea beverages and extracts on lipid profiles in adults. Weighted mean differences were calculated for net changes in lipid concentrations by using fixed-effects or random-effects models. Study quality was assessed by using the Jadad score, and a meta-analysis was conducted. RESULTS: Fourteen eligible randomized controlled trials with 1136 subjects were enrolled in our current meta-analysis. Green tea consumption significantly lowered the TC concentration by 7.20 mg/dL (95% CI: -8.19, -6.21 mg/dL; P < 0.001) and significantly lowered the LDL-cholesterol concentration by 2.19 mg/dL (95% CI: -3.16, -1.21 mg/dL; P < 0.001). The mean change in blood HDL-cholesterol concentration was not significant. Subgroup and sensitivity analyses showed that these changes were not influenced by the type of intervention, treatment dose of green tea catechins, study duration, individual health status, or quality of the study. Overall, no significant heterogeneity was detected for TC, LDL cholesterol, and HDL cholesterol; and results were reported on the basis of fixed-effects models. CONCLUSION: The analysis of eligible studies showed that the administration of green tea beverages or extracts resulted in significant reductions in serum TC and LDL-cholesterol concentrations, but no effect on HDL cholesterol was observed. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 24861099 Green tea catechins and blood pressure: a systematic review and meta-analysis of randomised controlled trials Meta-analysis · Eur J Nutr, 2014 13 RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.s - systolic -2.08 mmHg, diastolic -1.71 mmHg. Larger reduction when baseline systolic was 130 mmHg or higher.
Key summary
A systematic review and meta-analysisA statistical synthesis combining results of multiple studies into one conclusion. of how green tea intake affects blood pressure (13 RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.s). The green tea group had systolic pressure -2.08 mmHg (95% CI -3.06 to -1.05) and diastolic pressure -1.71 mmHg (95% CI -2.86 to -0.56) lower than control. Total cholesterol (-0.15 mmol/L) and LDLLow-density lipoprotein cholesterol - the so-called "bad" cholesterol. (-0.16 mmol/L) also fell significantly. In subgroups, the reduction was larger when baseline systolic pressure was 130 mmHg or higher, or when green tea was taken as an extract. The authors said green tea and its catechins may improve blood pressure, with a possibly greater effect in those with higher pressure.
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PURPOSE: Although previous literature has reported that regular green tea consumption may improve blood pressure, the evidence from these studies is not consistent. The present study systematically reviewed randomised controlled trials and examined the effect of green tea consumption on blood pressure using meta-analysis. METHODS: Search of ProQuest, PubMed, Scopus and Cochrane Library (CENTERAL) was conducted, to identify eligible articles. Articles from 1995 to 2013 were included. A random-effect model was chosen to calculate the effect of combined trials. RESULT: Thirteen studies were included in the meta-analysis. Green tea consumption significantly changed systolic blood pressure, by -2.08 mm Hg (95% CI -3.06, -1.05), and diastolic blood pressure, by -1.71 mm Hg (95% CI -2.86, -0.56), compared to the control. Changes in lipid profile, blood glucose and body mass index were also assessed in the meta-analysis. A significant reduction was found in total cholesterol (-0.15 mmol/L [95% CI -0.27, -0.02]) and low-density lipoprotein cholesterol (-0.16 mmol/L [95% CI -0.22, -0.09]). Changes in other parameters did not reach statistical significance. Subgroup analysis suggested a greater reduction in both systolic and diastolic blood pressure in studies that included participants with a baseline mean systolic blood pressure of ≥ 130 mm Hg, and studies involving consuming green tea as an extract. CONCLUSION: The present meta-analysis suggests that green tea and its catechins may improve blood pressure, and the effect may be greater in those with systolic blood pressure ≥ 130 mm Hg. The meta-analysis also suggests that green tea catechins may improve total and low-density lipoprotein cholesterol. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 38034724 Effects of green tea catechin on the blood pressure and lipids in overweight and obese population-a meta-analysis Meta-analysis · Heliyon, 2023 11 RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.s, 613 people (overweight/obese) - reduced waist circumference and triglycerideA type of fat in the blood; high levels raise cardiovascular risk.s, higher HDL. No significant effect on blood pressure.
Key summary
A meta-analysisA statistical synthesis combining results of multiple studies into one conclusion. of green tea catechins on blood pressure and lipids limited to an overweight and obese population (11 RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.s, 613 people). Catechin supplementation reduced waist circumference (-1.37 cm) and triglycerideA type of fat in the blood; high levels raise cardiovascular risk.s (-0.18 mmol/L) and raised HDL cholesterol (+0.07 mmol/L). However, there was no significant effect on blood pressure. The authors concluded that catechins showed a moderate benefit on lipid profiles in overweight and obese people but no significant effect on blood pressure. Unlike the 13-RCT analysis above, it shows that blood-pressure results diverge by population.
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BACKGROUND: Overweight and obesity as main health problems harm human beings worldwide. The number of people diagnosed with overweight and obese is gradually increasing. Green tea catechin has been reported to effectively help control body weight in overweight and obese population, and is protectively against the blood pressure and lipids in people with type 2 diabetes and metabolic syndrome. METHODS: We retrieved 4 English databases (PubMed, Web of science, Cochrane, Scoups) from inception to April 20, 2023. Two reviewers independently determined eligibility, assessed the reporting quality of included studies, and extracted the data. Data were extracted from eleven studies. The results were presented with the weighted mean differences (WMDs), and the confidence intervals (CIs) was 95 %. The random-effects or fixed-effects model was applied according to the heterogeneity. The subgroup analysis was used to identify the source of heterogeneity. Publication bias was evaluated using funnel plots, Egger's test, and Begg's test. RESULTS: Eleven randomized controlled trials (RCTs) inclusion studies were screened from 3072 literature articles, involving 613 overweight and obese patients. After combining all studies, it was found that in overweight and obese people green tea catechin could reduce waist circumference (WC) (pooled WMD = -1.37 cm, 95 % CI: -2.52 to -0.22 cm, p = 0.019), and triglyceride (TG) (pooled WMD = -0.18 mmol/L, 95 % CI: -0.35 to -0.02 mmol/L, p = 0.032), and increase high density lipoprotein cholesterol (HDL-c) (pooled WMD = 0.07 mmol/L, 95 % CI: 0.01-0.14 mmol/L, p = 0.031). CONCLUSION: Green tea catechin supplement effectively reduced WC and TG levels and improved HDL-c levels. However, it did not show the significant effect on the blood pressure in overweight and obese people. The present meta-analysis showed a moderate benefit of green tea catechin supplementation on lipid profiles in overweight and obese people. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 32118296 Green tea (Camellia sinensis) for the prevention of cancer Cochrane review · Cochrane Database Syst Rev, 2020 142 studies - green tea and cancer risk gave conflicting results by design. Evidence of benefit is limited. High intakes reported adverse effects including elevated liver enzymes.
Key summary
A CochraneAn international network that rigorously reviews and synthesizes evidence. review of green tea intake and cancer risk (2020 update, 142 studies including 11 RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.s and over 1.1 million observational participants). Findings from experimental and non-experimental studies were inconsistent; a tendency toward lower risk appeared at some sites, but cohort and case-control results conflicted. The authors concluded that the evidence for a cancer-related benefit of green tea is limited and that well-conducted, adequately powered RCTs are needed. They also reported adverse effects with high intakes of green tea extract, including gastrointestinal disorders, elevated liver enzymes, and more rarely insomnia, raised blood pressure, and skin reactions.
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BACKGROUND: This review is an update of a previously published review in the Cochrane Database of Systematic Reviews (2009, Issue 3).Tea is one of the most commonly consumed beverages worldwide. Teas from the plant Camellia sinensis can be grouped into green, black and oolong tea, and drinking habits vary cross-culturally. C sinensis contains polyphenols, one subgroup being catechins. Catechins are powerful antioxidants, and laboratory studies have suggested that these compounds may inhibit cancer cell proliferation. Some experimental and nonexperimental epidemiological studies have suggested that green tea may have cancer-preventative effects. OBJECTIVES: To assess possible associations between green tea consumption and the risk of cancer incidence and mortality as primary outcomes, and safety data and quality of life as secondary outcomes. SEARCH METHODS: We searched eligible studies up to January 2019 in CENTRAL, MEDLINE, Embase, ClinicalTrials.gov, and reference lists of previous reviews and included studies. SELECTION CRITERIA: We included all epidemiological studies, experimental (i.e. randomised controlled trials (RCTs)) and nonexperimental (non-randomised studies, i.e. observational studies with both cohort and case-control design) that investigated the association of green tea consumption with cancer risk or quality of life, or both. DATA COLLECTION AND ANALYSIS: Two or more review authors independently applied the study criteria, extracted data and assessed methodological quality of studies. We summarised the results according to diagnosis of cancer type. MAIN RESULTS: In this review update, we included in total 142 completed studies (11 experimental and 131 nonexperimental) and two ongoing studies. This is an additional 10 experimental and 85 nonexperimental studies from those included in the previous version of the review. Eleven experimental studies allocated a total of 1795 participants to either green tea extract or placebo, all demonstrating an overall high methodological quality based on 'Risk of bias' assessment. For incident prostate cancer, the summary risk ratio (RR) in the green tea-supplemented participants was 0.50 (95% confidence interval (CI) 0.18 to 1.36), based on three studies and involving 201 participants (low-certainty evidence). The summary RR for gynaecological cancer was 1.50 (95% CI 0.41 to 5.48; 2 studies, 1157 participants; low-certainty evidence). No evidence of effect of non-melanoma skin cancer emerged (summary RR 1.00, 95% CI 0.06 to 15.92; 1 study, 1075 participants; low-certainty evidence). In addition, adverse effects of green tea extract intake were reported, including gastrointestinal disorders, elevation of liver enzymes, and, more rarely, insomnia, raised blood pressure and skin/subcutaneous reactions. Consumption of green tea extracts induced a slight improvement in quality of life, compared with placebo, based on three experimental studies. In nonexperimental studies, we included over 1,100,000 participants from 46 cohort studies and 85 case-control studies, which were on average of intermediate to high methodological quality based on Newcastle-Ottawa Scale 'Risk of bias' assessment. When comparing the highest intake of green tea with the lowest, we found a lower overall cancer incidence (summary RR 0.83, 95% CI 0.65 to 1.07), based on three studies, involving 52,479 participants (low-certainty evidence). Conversely, we found no association between green tea consumption and cancer-related mortality (summary RR 0.99, 95% CI 0.91 to 1.07), based on eight studies and 504,366 participants (low-certainty evidence). For most of the site-specific cancers we observed a decreased RR in the highest category of green tea consumption compared with the lowest one. After stratifying the analysis according to study design, we found strongly conflicting results for some cancer sites: oesophageal, prostate and urinary tract cancer, and leukaemia showed an increased RR in cohort studies and a decreased RR or no difference in case-control studies. AUTHORS' CONCLUSIONS: Overall, findings from experimental and nonexperimental epidemiological studies yielded inconsistent results, thus providing limited evidence for the beneficial effect of green tea consumption on the overall risk of cancer or on specific cancer sites. Some evidence of a beneficial effect of green tea at some cancer sites emerged from the RCTs and from case-control studies, but their methodological limitations, such as the low number and size of the studies, and the inconsistencies with the results of cohort studies, limit the interpretability of the RR estimates. The studies also indicated the occurrence of several side effects associated with high intakes of green tea. In addition, the majority of included studies were carried out in Asian populations characterised by a high intake of green tea, thus limiting the generalisability of the findings to other populations. Well conducted and adequately powered RCTs would be needed to draw conclusions on the possible beneficial effects of green tea consumption on cancer risk. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 27677775 Liver injury from herbal and dietary supplements Review · Hepatology, 2017 AASLD/NIH symposium report - HDS liver injury is 20% of US hepatotoxicity. Green tea extract among major agents, causing acute hepatitis-like injury.
Key summary
A joint AASLD and NIH symposium report on liver injury from herbal and dietary supplements (HDS). Based on research data, HDS liver injury accounts for 20% of hepatotoxicity cases in the United States, and the major implicated agents include anabolic steroids, green tea extract, and multi-ingredient nutritional supplements. Anabolic steroids cause a cholestaticA type of liver injury in which bile flow is blocked, causing jaundice and itching. but ultimately self-limiting injury, whereas green tea extract and many products tend to cause an acute hepatitis-like injury. The authors stressed the need to identify responsible constituents and to strengthen regulatory oversight.
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Herbal and dietary supplements (HDS) are used increasingly both in the United States and worldwide, and HDS-induced liver injury in the United States has increased proportionally. Current challenges in the diagnosis and management of HDS-induced liver injury were the focus of a 2-day research symposium sponsored by the American Association for the Study of Liver Disease and the National Institutes of Health. HDS-induced liver injury now accounts for 20% of cases of hepatotoxicity in the United States based on research data. The major implicated agents include anabolic steroids, green tea extract, and multi-ingredient nutritional supplements. Anabolic steroids marketed as bodybuilding supplements typically induce a prolonged cholestatic but ultimately self-limiting liver injury that has a distinctive serum biochemical as well as histological phenotype. Green tea extract and many other products, in contrast, tend to cause an acute hepatitis-like injury. Currently, however, the majority of cases of HDS-associated liver injury are due to multi-ingredient nutritional supplements, and the component responsible for the toxicity is usually unknown or can only be suspected. HDS-induced liver injury presents many clinical and research challenges in diagnosis, identification of the responsible constituents, treatment, and prevention. Also important are improvements in regulatory oversight of nonprescription products to guarantee their constituents and ensure purity and safety. The confident identification of injurious ingredients within HDS will require strategic alignments among clinicians, chemists, and toxicologists. The ultimate goal should be to prohibit or more closely regulate potentially injurious ingredients and thus promote public safety. (Hepatology 2017;65:363-373). ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 34307603 Herb-induced liver injury: Systematic review and meta-analysis Systematic review · World J Clin Cases, 2021 936 cases - green tea extract among the most common of 79 herbs. Most recover (82.8%), but some led to transplant (6.6%) or death (10.4%).
Key summary
A systematic review cataloguing herbs linked to herb-induced liver injury (HILI) (446 references, 936 reported cases). Seventy-nine herbs or herbal compounds were associated with HILI, and He-Shou-Wu, green tea extract, Herbalife, and kava kava were among the most commonly reported. Most patients (82.8%) recovered fully, but across all cases liver transplant occurred in 6.6%, chronic liver disease in 1.5%, and death in 10.4%. The authors stressed the need to raise awareness of the risks of indiscriminate use of herbal products.
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BACKGROUND: The use of herbal supplements and alternative medicines has been increasing in the last decades. Despite popular belief that the consumption of natural products is harmless, herbs might cause injury to various organs, particularly to the liver, which is responsible for their metabolism in the form of herb-induced liver injury (HILI). AIM: To identify herbal products associated with HILI and describe the type of lesion associated with each product. METHODS: Studies were retrieved using Medical Subject Headings Descriptors combined with Boolean operators. Searches were run on the electronic databases Scopus, Web of Science, MEDLINE, BIREME, LILACS, Cochrane Library for Systematic Reviews, SciELO, Embase, and Opengray.eu. Languages were restricted to English, Spanish, and Portuguese. There was no date of publication restrictions. The reference lists of the studies retrieved were searched manually. To access causality, the Maria and Victorino System of Causality Assessment in Drug Induced Liver Injury was used. Simple descriptive analysis were used to summarize the results. RESULTS: The search strategy retrieved 5918 references. In the final analysis, 446 references were included, with a total of 936 cases reported. We found 79 types of herbs or herbal compounds related to HILI. He-Shou-Wu, Green tea extract, Herbalife, kava kava, Greater celandine, multiple herbs, germander, hydroxycut, skullcap, kratom, Gynura segetum, garcinia cambogia, ma huang, chaparral, senna, and aloe vera were the most common supplements with HILI reported. Most of these patients had complete clinical recovery (82.8%). However, liver transplantation was necessary for 6.6% of these cases. Also, chronic liver disease and death were observed in 1.5% and 10.4% of the cases, respectively. CONCLUSION: HILI is normally associated with a good prognosis, once the implied product is withdrawn. Nevertheless, it is paramount to raise awareness in the medical and non-medical community of the risks of the indiscriminate use of herbal products. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 25316200 Green tea extract and the risk of drug-induced liver injury Review · Expert Opin Drug Metab Toxicol, 2014 Review - green tea extract catechins are linked to a rare hepatotoxicity in a few individuals. No clinical evidence that it raises the DILI risk of co-taken drugs.
Key summary
A review of the relationship between green tea extract (GTE) and drug-induced liver injuryLiver damage caused by a drug or supplement (DILI), showing as jaundice or raised liver enzymes. (DILI). GTE catechins have been associated with a rare hepatotoxicity in a few individuals, and because GTE was co-administered with synthetic drugs in some cases, it was unclear whether GTE is a DILI risk factor. The authors concluded that the published case reports provide no clinical evidence that GTE increases the DILI risk of co-medicated drugs. GTE catechins partially inhibited several CYP enzymes in vitro, but a clinical bioavailabilityThe fraction of an ingested substance that actually reaches the blood and tissues to act. study found only a small risk for CYP3A4 substrates, lacking clinical relevance.
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INTRODUCTION: Catechins of green tea extract (GTE) have been associated with the rare risk of hepatotoxicity in a few individuals. As GTE were coadministered with synthetic drugs in some hepatotoxicity cases, uncertainty emerged whether GTE are a risk factor of drug-induced liver injury (DILI). AREAS COVERED: Case reports of liver injury by GTE and related review articles to assess the drugs that were coadministered with GTE were reviewed. The analysis included the question whether a formal causality of liver injury had confidently been attributed to GTE, the comedicated drug(s) or both. To elucidate possible metabolic interactions, GTE and their catechins were analyzed regarding their affinity to various CYP isoforms. EXPERT OPINION: The authors conclude that the published hepatotoxicity case reports in connection with the use of GTE provide no clinical evidence that GTE may increase the risk of DILI by drugs that had been comedicated in only few cases. Although partial inhibition of human hepatic and intestinal microsomal CYP2C8, CYP2B6, CYP3A4, CYP2D6 and CYP2C19 by GTE catechins was observed in vitro, a clinical study of drug bioavailability attributed a small risk of increased plasma drug levels only for substrates metabolized by CYP3A4, lacking clinical relevance. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
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