Clinical application of pyrrole–hemoglobin adducts as a biomarker of pyrrolizidine alkaloid exposure in humans

Jiang Ma, Wei Zhang, Yisheng He, Lin Zhu*, Chunyuan Zhang, Jia Liu, Yang Ye, Yuzheng Zhuge*, Ge Lin*

*Corresponding author for this work

Research output: Contribution to journalJournal articlepeer-review

20 Citations (Scopus)


Pyrrolizidine alkaloids (PAs) are naturally occurring hepatotoxins widely present in hundreds of plant species and also known to contaminate many foodstuffs, such as grain, honey, and tea. The formation of pyrrole–protein adducts via metabolic activation of PAs has been suggested as a primary trigger initiating hepatotoxicity. The present study for the first time tested the suitability of pyrrole–hemoglobin adducts as a novel and specific biomarker of PA exposure in humans. The level and elimination kinetics of pyrrole–hemoglobin adducts were systematically investigated in the blood samples of 43 PA-induced liver injury (PA-ILI) patients. The results revealed significantly higher concentrations (84.50 ± 78.38 nM) and longer persistence (~ 4 months) of pyrrole–hemoglobin adducts than that (concentration: 9.53 ± 10.72 nM; persistence: ~ 2 months) of pyrrole–plasma protein adducts, our previously developed PA exposure biomarker. Our findings confirmed that pyrrole–hemoglobin adducts with higher level and longer persistence should serve as a more applicable PA exposure biomarker for future clinical diagnosis of PA-ILI in drug/herb-induced liver injury patients.

Original languageEnglish
Pages (from-to)759-765
Number of pages7
JournalArchives of Toxicology
Issue number2
Early online date18 Nov 2020
Publication statusPublished - Feb 2021

Scopus Subject Areas

  • Toxicology
  • Health, Toxicology and Mutagenesis

User-Defined Keywords

  • Diagnostic biomarkers
  • Liver injury
  • Pyrrole–hemoglobin adducts
  • Pyrrole–plasma protein adducts
  • Pyrrolizidine alkaloids


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