Kava extract drug: what is the actual risk of hepatotoxicity in adult male albino rats?

Background:There is an increasing widespread use of complementary and alternative medicine in the treatment of psychiatric symptoms and disorders worldwide. Kava extract is a useful herbal medicine for treatment of insomnia and anxiety. However, a number of case reports have raised serious concerns about kava’s safety regarding liver toxicity. Aim of the work: To examine the putative hepatotoxic effect of prolonged administration of a commercial kava extract drug on albino rats. Materials and methods:Thirty adult male rats were randomly divided into three equal groups: 10 rats each. Group (negative control group) rats were kept in the same environment without handling. Group (vehicle group) rats were gavaged with 1.5 ml of corn oil. Group III (kava group) rats received 2 g/kg (600mg kavalactones) orally for 60 days. The anesthetized animals were sacrificed after blood collection (for liver function tests and statistical analysis) and dissected; livers were prepared for light and electron microscopic examinations. Results:The kava-treated rats showed a significant reduction in their final body weights accompanied with a significant increase in both the absolute and the relative liver weight. Analysis of sera from the kava group depicted significant elevations in γ-glutamyl transferase, aspartate transaminase, alanine transaminase, alkaline phosphatase, total bilirubin, and calculated globulin levels associated with a significant decrease in the total protein, albumin, and the albumin/globulin ratio in comparison with the control values. These biochemical alterations were confirmed by the presence of different morphological changes such as degeneration and necrosis of some hepatocytes, mononuclear inflammatory cell infiltration, increased collagen fibers in the liver interstitium, loss of microvilli of hepatocytes in Disse’s space, large activated Kupffer cell, and collagen fibrils in Disse’s space in the examined liver sections. Conclusion, These potentially hepatotoxic effects of kava should be taken into consideration, with close monitoring of liver function tests at frequent intervals during drug use for a long time.