The Diagnosis and Management of Allergic Reactions Caused by Chinese Materia Medica

Abstract

Traditional Chinese medicines (TCM) have been used in China for thousands of years. Although TCM has been generally perceived to be safe, adverse reactions to Chinese materia medica (CMM) have been reported. Most of the adverse reactions are allergic in nature, but other mechanisms may play a role. This review focuses on the mechanism and clinical presentation of these allergic reactions. Allergic reactions can occur as a result of the active and inactive ingredients of CMM. Impurities and chemicals generated during the production process can also lead to allergic or adverse reactions. Environmental factors such as temperature, humidity, and light can cause changes in the allergenicity of drugs. Human error in formulating CMM drugs also contributes to adverse drug reactions. The management of allergic reactions to CMM includes taking a good history, avoidance of medications in the same class as those which caused prior reactions, the proper training of staff, adherence to manufacturer guidelines and expiration dates, evaluation of benefit and risk balance, and the formulation of a risk management strategy for the use of CMM. A small test dose of a considered drug before using, improvements in drug purification technology, and proper storage and clinical administration help reduce allergic reactions due to CMM.

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Data Availability

All data generated or analyzed during this study are included in this published article.

Abbreviations

ACD:

Allergic contact dermatitis

ADR:

Adverse drug reactions

BC:

Blood circulation

CMM:

Chinese materia medica

CMMI:

Chinese materia medica injection

HMs:

Herbal medicines

RC:

Rheumatic condition

SHLI:

Shuanghuanglian injection

sIgE:

Specific IgE

TCHM:

Topical Chinese herbal medicine

TCM:

Traditional Chinese medicines

UTI:

Urinary tract infection

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Funding

This project was sponsored by the grants from National Natural Science Foundation of China (No.81703908, No. 81771725 and No. 81873291) and CAMS Innovation Fund for Medical Sciences (CIFMS:2016-I2M-1003).

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Correspondence to Yuanlin Piao or Christopher Chang or Jin-Lyu Sun or Thomas A. E. Platts-Mills.

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Shi, Y., Tang, R., Luo, F. et al. The Diagnosis and Management of Allergic Reactions Caused by Chinese Materia Medica. Clinic Rev Allerg Immunol (2021). https://doi.org/10.1007/s12016-020-08812-7

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Keywords

  • Allergens
  • Drug allergy
  • Chinese materia medica (CMM)
  • Traditional Chinese medicine (TCM)
  • Integrative medicine
  • Complementary and alternative medicine