AHPA offers fixes for NIH LiverTox database

The American Herbal Products Association (AHPA) has provided formal recommendations to address misinformation that was found in the National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases' (NIDDK) LiverTox database concerning its references to herbals and dietary supplements.

The database, which was launched in October 2012, was designed to be a resource for health care professionals and researchers studying liver injury that is associated with prescription and over-the-counter drugs, herbals and dietary supplements. However, after review of the information, AHPA found that significant improvements could be made and that the database was in need of additional expert review by individuals with significant expertise in dietary supplements, natural products chemistry and pharmacognosy.

In a letter to NIDDK, and an accompanying 11-page document, AHPA Chief Science Officer Steven Dentali, Ph.D., offered specific suggestions for the herbs and dietary supplement (HDS) section of the website, including modifying the text to make clear that not all entries have been implicated in causing liver injury. AHPA's inquiry also asked if the goal of the database is to expand the HDS section to include many more such entries and, if so, what criteria will be used to prioritize materials for inclusion.

"Many of the references in individual HDS entries are quite general in nature and make it difficult to determine which are germane to the entry where they are found," said Dentali, widely recognized as an authority on botanical product quality issues. "This may be helped by moving them from the individual entries to the HDS introduction so that the citations relevant to individual entries will be more apparent."

Dentali further noted that the current structure of the HDS entries is well suited for drugs, but not well suited for HDS materials. He suggested that consideration be given to revamping the structure of that section of the website, since drug-oriented fields, such as Chemical Abstracts Service numbers and chemical structures are often not appropriate to describe botanical products.

"The current treatment of HDS botanical entries fails to distinguish between botanical starting material, ingredients, and finished products," said Dentali. "Greater clarity should be brought to bear in these cases."