
Pyrrolizidine alkaloids (PAs), sometimes referred to as necine bases, are a group of naturally occurring
alkaloid
Alkaloids are a broad class of natural product, naturally occurring organic compounds that contain at least one nitrogen atom. Some synthetic compounds of similar structure may also be termed alkaloids.
Alkaloids are produced by a large varie ...
s based on the structure of
pyrrolizidine. Their use dates back centuries and is intertwined with the discovery, understanding, and eventual recognition of their
toxicity
Toxicity is the degree to which a chemical substance or a particular mixture of substances can damage an organism. Toxicity can refer to the effect on a whole organism, such as an animal, bacteria, bacterium, or plant, as well as the effect o ...
on humans and animals.
History
PAs were first discovered in plants in the 19th century, but their toxic effects were not immediately recognized. Instead, many PA-containing plants were traditionally used for medicinal purposes in various cultures around the world. For example, herbs containing PAs were used in
traditional Chinese medicine
Traditional Chinese medicine (TCM) is an alternative medicine, alternative medical practice drawn from traditional medicine in China. A large share of its claims are pseudoscientific, with the majority of treatments having no robust evidence ...
and by Native American tribes for their purported therapeutic properties. It has been estimated that 3% of the world's flowering plants contain pyrrolizidine alkaloids. Honey can contain pyrrolizidine alkaloids, as can grains, milk, offal and eggs. To date (2011), there is no international regulation of PAs in food, unlike those for herbs and medicines.
In the early to mid-20th century, researchers began to observe and document cases of livestock poisoning linked to the consumption of PA-containing plants. These observations led to the recognition of PAs as potent
hepatotoxic and
genotoxic compounds.
In response to growing concerns about PA exposure, regulatory agencies around the world began to establish guidelines and regulations to limit PA levels in food, herbal products, and animal feed.
These regulations aim to protect human and animal health by minimizing PA exposure and mitigating the risk of toxicity.
Despite regulatory efforts, the issue of PA exposure remains relevant today. Ongoing research continues to explore various aspects of PA toxicity, including the identification of new PA-containing plants, the development of sensitive analytical methods, and the assessment of human health risks associated with PA exposure. Additionally, efforts to raise awareness among healthcare professionals, herbal product manufacturers, and the general public about the risks of PA exposure are ongoing.
Natural occurrence
PAs are a group of naturally occurring compounds found in a wide range of plant species. These alkaloids are secondary metabolites synthesized by plants primarily as a defense mechanism against herbivores, insects, and pathogens.
The biosynthesis of PAs was discovered to occur through the first pathway-specific enzyme
homospermidine synthase.

The
polyamine
A polyamine is an organic compound having two or more amino groups. Alkyl polyamines occur naturally, but some are synthetic. Alkylpolyamines are colorless, hygroscopic, and water soluble. Near neutral pH, they exist as the ammonium derivatives. ...
s
putrescine
Putrescine is an organic compound with the formula (CH2)4(NH2)2. It is a colorless solid that melts near room temperature. It is classified as a diamine. Together with cadaverine, it is largely responsible for the foul odor of Putrefaction, putref ...
and spermidine are derived from the basic amino acid arginine. Subsequently, homospermidine synthase exchanges the
1,3-diaminopropane
1,3-Diaminopropane, also known as , is a simple diamine with the formula H2N(CH2)3NH2. A colourless liquid with a fishy odor, it is soluble in water and many polar organic solvents. It is isomeric with 1,2-diaminopropane. Both are building blocks ...
by putrescine and forms symmetric
homospermidine. Oxidation of homospermidine by copper-dependent
diamine oxidases initiates cyclization to pyrrolizidine-1-carbaldehyde, which is reduced, to 1-hydroxymethylpyrrolizidine. Desaturation and hydroxylation ultimately form retronecine, which is acylated with an activated necic acid, for instance with senecyl-CoA2 as in the example shown below.
PAs are preferably found in the plant families
Asteraceae
Asteraceae () is a large family (biology), family of flowering plants that consists of over 32,000 known species in over 1,900 genera within the Order (biology), order Asterales. The number of species in Asteraceae is rivaled only by the Orchi ...
(tribes
Eupatorieae and
Senecioneae
Senecioneae is the largest tribe of the Asteraceae, or the sunflower family, comprising over 150 genera and over 3,500 species. Almost one-third of the species in this tribe are placed in the genus ''Senecio''. Its members exhibit probably the w ...
),
Boraginaceae
Boraginaceae, the Borago, borage or forget-me-not family, includes about 2,000 species of shrubs, trees, and herbs in 146 to 154 genus, genera with a worldwide distribution.
The APG IV system from 2016 classifies the Boraginaceae as single famil ...
(many genera),
Fabaceae
Fabaceae () or Leguminosae,[International Code of Nomen ...](_blank)
(mainly the genus
Crotalaria
''Crotalaria'' is a genus of flowering plants in the family (biology), family Fabaceae (subfamily Faboideae) commonly known as rattlepods. The genus includes over 700 species of herbaceous plants and shrubs. Africa is the continent with the major ...
), and
Orchid
Orchids are plants that belong to the family Orchidaceae (), a diverse and widespread group of flowering plants with blooms that are often colourful and fragrant. Orchids are cosmopolitan plants that are found in almost every habitat on Eart ...
aceae (nine genera). More than 95% of the PA-containing species investigated thus far belong to these four families.
Structure and reactivity

PAs are compounds made up of a necine base, a double five-membered ring with a nitrogen atom in the middle, and one or two carboxylic
ester
In chemistry, an ester is a compound derived from an acid (either organic or inorganic) in which the hydrogen atom (H) of at least one acidic hydroxyl group () of that acid is replaced by an organyl group (R). These compounds contain a distin ...
s called necic acids. Four major necine bases are described, with
retronecine and its enantiomer Heliotridine being the largest group, and highly toxic. Another group is the platynecine, the difference between these groups is its saturated base, which makes it less toxic.
Most bases have a 1,2-unsaturated base. Another difference in the groups is with Otonecine, which cannot form
''N''-oxides, due to the
methylation
Methylation, in the chemistry, chemical sciences, is the addition of a methyl group on a substrate (chemistry), substrate, or the substitution of an atom (or group) by a methyl group. Methylation is a form of alkylation, with a methyl group replac ...
of the nitrogen atom.
The alcohol groups on the necine bases can make esters in a wide variety of forms. Among the possibilities are mono-esters, like Floridine and Heliotrine, and di-esters either with an open or closed ring structure, like Usaramine and Lasiocarpine. In total more than 660 PAs and PA ''N''-oxides have been identified in over 6000 plants.
Synthesis
There are multiple ways to synthesize PAs and their derivatives. A flexible strategy would be to start with a
Boc (tert-Butoxycarbonyl) protected
pyrrole
Pyrrole is a heterocyclic, aromatic, organic compound, a five-membered ring with the formula . It is a colorless volatile liquid that darkens readily upon exposure to air. Substituted derivatives are also called pyrroles, e.g., ''N''-methylpyrrol ...
molecule and use specific reaction for synthesis into the desired compound.
Mechanisms of actions and metabolism
PAs are commonly introduced into the body via oral ingestion through contaminated food or traditional medicine, notably
borage
Borage ( or ; ''Borago officinalis''), also known as starflower, is an annual herb in the flowering plant family Boraginaceae native to the Mediterranean region. Although the plant contains small amounts of pyrrolizidine alkaloids, some parts ar ...
leaf,
comfrey
''Symphytum'' is a genus of flowering plants in the borage family, Boraginaceae, known by the common name comfrey (pronounced , from the Latin confervere to 'heal' or literally to 'boil together', referring to uses in ancient traditional medicin ...
and
coltsfoot.
It can readily form salts with nitrates, chlorides and sulphates, which facilitate the uptake in the
gastrointestinal tract
The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the Digestion, digestive system that leads from the mouth to the anus. The tract is the largest of the body's systems, after the cardiovascula ...
. After which they travel to the
liver
The liver is a major metabolic organ (anatomy), organ exclusively found in vertebrates, which performs many essential biological Function (biology), functions such as detoxification of the organism, and the Protein biosynthesis, synthesis of var ...
via the
portal vein
The portal vein or hepatic portal vein (HPV) is a blood vessel that carries blood from the gastrointestinal tract, gallbladder, pancreas and spleen to the liver. This blood contains nutrients and toxins extracted from digested contents. Approxima ...
.

Metabolites form mostly in the liver. Here
esterase
In biochemistry, an esterase is a class of enzyme that splits esters into an acid and an alcohol in a chemical reaction with water called hydrolysis (and as such, it is a type of hydrolase).
A wide range of different esterases exist that differ ...
s can hydrolyze the PAs to reduce the compound into its necine acids and bases, both forms are non-toxic for humans and do not damage the body. However,
cytochrome P450
Cytochromes P450 (P450s or CYPs) are a Protein superfamily, superfamily of enzymes containing heme as a cofactor (biochemistry), cofactor that mostly, but not exclusively, function as monooxygenases. However, they are not omnipresent; for examp ...
(CYP450) also metabolizes PAs, this enzyme can form pyrrolic esters (EPy), these are hepatotoxic due to their high reactivity. The EPy can also be hydrolyzed into alcoholic pyrroles, which are mutagenic and carcinogenic.
Since this mostly happens in the liver, this is the most affected organ. Other affected organs are the lungs and kidneys. The EPy can escape the liver, and travel through the
Disse space into the bloodstream.
The electrophilic nature of pyrroles makes it an easy target for nucleophilic attack from nucleic acids and protein. If bound by
glutathione
Glutathione (GSH, ) is an organic compound with the chemical formula . It is an antioxidant in plants, animals, fungi, and some bacteria and archaea. Glutathione is capable of preventing damage to important cellular components caused by sources ...
it can become a non-toxic conjugate and be excreted via the kidneys.
A second detoxifying pathway is the formation of the ''N''-oxide In the liver and lungs of certain mammal species enzymes called
monooxygenase
Monooxygenases are enzymes that incorporate one hydroxyl group (−OH) into substrates in many metabolic pathways. In this reaction, the two atoms of dioxygen are reduced to one hydroxyl group and one H2O molecule by the concomitant oxidation of ...
can prevent aromatization of the double 5-ring and in turn prevent the formation of the pyrrole-protein adduct.
Toxicological effects
The toxicity consequences resulting from the
metabolism
Metabolism (, from ''metabolē'', "change") is the set of life-sustaining chemical reactions in organisms. The three main functions of metabolism are: the conversion of the energy in food to energy available to run cellular processes; the co ...
of PAs in humans primarily revolve around hepatotoxicity and genotoxicity.

PAs are metabolized in the liver through CYP450-mediated pathways. This metabolic process leads to the formation of reactive intermediates, such as pyrrolic metabolites, which can covalently bind to proteins in the liver, forming pyrrole-protein adducts. These adducts impair the function of essential liver proteins, leading to hepatotoxicity. The severity of liver damage correlates with the level of pyrrole-protein adduct formation. Hepatotoxicity induced by PAs can manifest as
liver injury,
inflammation
Inflammation (from ) is part of the biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. The five cardinal signs are heat, pain, redness, swelling, and loss of function (Latin ''calor'', '' ...
,
necrosis
Necrosis () is a form of cell injury which results in the premature death of cells in living tissue by autolysis. The term "necrosis" came about in the mid-19th century and is commonly attributed to German pathologist Rudolf Virchow, who i ...
,
HSOS (Hepatic Sinusoidal Obstruction Syndrome) and even liver failure in severe cases.
The pathogenesis of PAs-induces HSOS is shown by Xu.
Genotoxicity is another consequence of PA metabolism. The reactive metabolites formed during PA metabolism can also bind to
DNA
Deoxyribonucleic acid (; DNA) is a polymer composed of two polynucleotide chains that coil around each other to form a double helix. The polymer carries genetic instructions for the development, functioning, growth and reproduction of al ...
, leading to the formation of DNA adducts. These adducts can induce
mutation
In biology, a mutation is an alteration in the nucleic acid sequence of the genome of an organism, virus, or extrachromosomal DNA. Viral genomes contain either DNA or RNA. Mutations result from errors during DNA or viral replication, ...
s and DNA damage, increasing the risk of
cancer
Cancer is a group of diseases involving Cell growth#Disorders, abnormal cell growth with the potential to Invasion (cancer), invade or Metastasis, spread to other parts of the body. These contrast with benign tumors, which do not spread. Po ...
development and other adverse health effects. Genotoxicity is particularly concerning as it can lead to long-term health consequences, including
carcinogenesis
Carcinogenesis, also called oncogenesis or tumorigenesis, is the formation of a cancer, whereby normal cell (biology), cells are malignant transformation, transformed into cancer cells. The process is characterized by changes at the cellular, G ...
.
The toxicity of PA metabolites can vary depending on the specific PA compound and its chemical structure. Different PAs may undergo metabolic activation to varying degrees, resulting in differences in toxicity. For example, retronecine-type PAs like
monocrotaline are known to be highly hepatotoxic, while other types may exhibit lower toxicity or different toxicological profiles.
Pharmacological effects
Next to its toxicological effects, PAs have long been researched for their potential beneficial effects.
Traditional medicinal plants have long been known to contain PAs, the exact effect of the PAs regarding beneficial effect of the plants is debated. Among these traditional medicines is the root of ''
Ligularia achyrotricha'' of Tibet. Several pharmacological effects have been found. Among these effects are antimicrobial activity,
antiviral activity
and
antineoplastic activity,
acetylcholinesterase
Acetylcholinesterase (HUGO Gene Nomenclature Committee, HGNC symbol ACHE; EC 3.1.1.7; systematic name acetylcholine acetylhydrolase), also known as AChE, AChase or acetylhydrolase, is the primary cholinesterase in the body. It is an enzyme th ...
inhibition,
and
gastric ulcers treatment.
Antimicrobial activity of several PAs have been identified as having mild to strong effect against bacteria: ''
E. coli'' and ''
P. chrysogenum''.
In particular Lasiocarpine and 7-angeloyl heliotrine were found to have significant activity against these microbes. Derivatives of PAs have been found to induce cell death in these bacteria by attacking bacterial cell membranes. Retronecine derivatives have been found slow the growth rate of several strains of the fungus ''
Fusarium oxysporum
''Fusarium oxysporum'' (Schlecht as emended by Snyder and Hansen), an ascomycete fungus, comprises all the species, varieties and forms recognized by Wollenweber and Reinking within an infrageneric grouping called section Elegans. It is part of ...
''.
Antiviral activity has been found in haliotridine derivates.
However, effects are not consistent across PA compounds, derivates significantly differ in activity between different viral pathogens. As a result, it is difficult to determine an exact PA with an effect on a specific virus. Several PAs have been found with significant inhibition of growth in the following viruses:
coxsackie,
polio
Poliomyelitis ( ), commonly shortened to polio, is an infectious disease caused by the poliovirus. Approximately 75% of cases are asymptomatic; mild symptoms which can occur include sore throat and fever; in a proportion of cases more severe ...
myelitis,
measles
Measles (probably from Middle Dutch or Middle High German ''masel(e)'', meaning "blemish, blood blister") is a highly contagious, Vaccine-preventable diseases, vaccine-preventable infectious disease caused by Measles morbillivirus, measles v ...
, and
vesicular stomatitis.
Antineoplastic activity, specifically against
leukemia
Leukemia ( also spelled leukaemia; pronounced ) is a group of blood cancers that usually begin in the bone marrow and produce high numbers of abnormal blood cells. These blood cells are not fully developed and are called ''blasts'' or '' ...
, has been found in retronecine derivatives such as indicine.
A 1984 study by L. Letendre treated 22 leukaemia patients with indicine, this resulted in a significant observed antineoplastic response with four complete remissions and five partial remissions. An observed adverse side effect of the treatment was observed in 5 patients who died of hepatic toxicity likely caused by the medication. Two different dose levels were tested on children: 2 g/m2/ day for 5 consecutive days (14 patients) and 2,5 g/m2/ day for 5 consecutive days (17 patients).
Therapeutic effect was determined based on these doses and deemed to have a limited antileukemic effect below a dose of 3 g/m2/ day. However, this study also found severe hepatotoxic responses to be common at these doses.
Four known PAs, 7-''O''-angeloyllycopsamine ''N''-oxide, echimidine ''N''-oxide, echimidine, and 7-''O''-angeloylretronecine have been clinically shown to inhibit
acetylcholinesterase
Acetylcholinesterase (HUGO Gene Nomenclature Committee, HGNC symbol ACHE; EC 3.1.1.7; systematic name acetylcholine acetylhydrolase), also known as AChE, AChase or acetylhydrolase, is the primary cholinesterase in the body. It is an enzyme th ...
(AChE) .
AChE inhibitors have been used as one of the treatments for
Alzheimer's disease
Alzheimer's disease (AD) is a neurodegenerative disease and the cause of 60–70% of cases of dementia. The most common early symptom is difficulty in remembering recent events. As the disease advances, symptoms can include problems wit ...
.
The effect of these compounds was significant in the reduction of AChE production and thus a potential alternative in the fight against Alzheimer's.
PAs like senecionine, integerrimine, retrorsine, usaramine and seneciphylline have been shown to cause an increase in both the levels of
gastrin
Gastrin is a peptide hormone that stimulates secretion of gastric acid (HCl) by the parietal cells of the stomach and aids in gastric motility. It is released by G cells in the pyloric antrum of the stomach, duodenum, and the pancreas.
...
and the expression of
epidermal growth factor (EGF).
These two compounds aid in the repair of the stomach after gastric ulcers. A high concentration of said compounds can reduce lesions in the stomach. This may aid in treatment after operation to the stomach.
Effects on animals
The toxicological effects of PAs have been studied on animals. Retronecine derivatives are known to cause a toxic response in the livers of livestock like cows. Symptoms tend to start with a change in rough hair coat and depression. When Pregnant livestock is exposed to PAs an effect can be seen on the foetus, mainly
stillbirth
Stillbirth is typically defined as fetus, fetal death at or after 20 or 28 weeks of pregnancy, depending on the source. It results in a baby born without vital signs, signs of life. A stillbirth can often result in the feeling of guilt (emotio ...
and accumulation in the foetus. The main lethal responses in adult livestock exhibit necrosis, HSOS and
megalacytosis. Additional to the short-term effect PAs have been found to lead to carcinogenic growths on the long term. The carcinogenic effect is caused by formation of DNA adducts,
because of metabolic reactions. No minimum dosage for the carcinogenic effect is currently known. However, there have been studies to determine the lowest dose for an adverse effect, also known as
LOAEL.
LOAEL and (oral) for 40 PAs have been experimentally found out. These values can be seen in the Table below. The found low LD
50 values clearly show the relatively high toxicity of PAs, however no significant relation was found between the LD
50 and LOAEL.
PAs are also used as a defense mechanism by some organisms such as ''
Utetheisa ornatrix''. ''Utetheisa ornatrix'' caterpillars obtain these toxins from their food plants and use them as a deterrent for predators. PAs protect them from most of their natural enemies. The toxins stay in these organisms even when they metamorphose into adult moths, continuing to protect them throughout their adult stage.
Plants species containing pyrrolizidine alkaloids
This is a
dynamic list and may never be able to satisfy particular standards for completeness. You can help by
adding missing items with
reliable sources
* ''
Adenostyles alliariae''
* ''
Adenostyles glabra
''Adenostyles alpina'' is herbaceous perennial plant belonging to the genus ''Adenostyles'' of the family Asteraceae. It is native to the Alps and southern Europe.
Description
This plant grows to a height of about . The inflorescence consists of ...
''
* ''
Ageratum conyzoides''
* ''
Ageratum houstonianum
''Ageratum houstonianum'', commonly known as flossflower, bluemink, goatweed, blueweed, pussy foot or Mexican paintbrush, is a cool-season annual plant often grown as bedding (horticulture), bedding in gardens.
Description
This herbaceous plant, ...
''
* ''
Anchusa officinalis
''Anchusa officinalis'', also knowns as common bugloss or common alkanet, is a species of flowering plant in the borage family. It is native to Europe and small parts of western Asia, but has been escaped from cultivation to grow in additional lo ...
''
* ''
Arnebia euchroma''
* ''
Borago officinalis
Borage ( or ; ''Borago officinalis''), also known as starflower, is an annual herb in the flowering plant family Boraginaceae native to the Mediterranean region. Although the plant contains small amounts of pyrrolizidine alkaloids, some parts ar ...
''
* ''
Cacalia hastata''
* ''
Cacalia hupehensis''
* ''
Chromolaena odorata
''Chromolaena odorata'' is also known as Jack in the Bush. It is a tropical and subtropical species of Flowering plant, flowering shrub in the family Asteraceae. It is native to the Americas, from Florida and Texas in the United States so ...
''
* ''
Cordia myxa''
* ''
Crassocephalum crepidioides''
* ''
Crotalaria albida''
* ''
Crotalaria assamica''
* ''
Crotalaria crispat''
* ''
Crotalaria dura''
* ''
Crotalaria globifera''
* ''
Crotalaria mucronata''
* ''
Crotalaria sesseliflora''
* ''
Crotalaria spectabilis
''Crotalaria spectabilis'', the showy rattlebox or showy rattlepod, is a species of flowering plant in the pea family Fabaceae. It is native to the Indian Subcontinent, southern China, and Southeast Asia. It is a perennial herb that grows up to ...
''
* ''
Crotalaria tetragona''
* ''
Crotalaria retusa''
* ''
Cynoglossum amabile''
* ''
Cynoglossum lanceolatum''
* ''
Cynoglossum officinale''
* ''
Cynoglossum zeylanicum''
* ''
Echium plantagineum''
* ''
Echium vulgare
''Echium vulgare'', known as viper's bugloss and blueweed,Dickinson, T.; Metsger, D.; Bull, J.; & Dickinson, R. (2004) ROM Field Guide to Wildflowers of Ontario. Toronto:Royal Ontario Museum, p. 203. is a species of flowering plant in the borag ...
''
* ''
Emilia sonchifolia''
* ''
Eupatorium cannabinum
''Eupatorium cannabinum'', commonly known as hemp-agrimony, or holy rope, is a herbaceous plant in the family Asteraceae. It is a robust Perennial plant, perennial native to Europe, NW. Africa, Turkey, Syria, Iran, Iraq, Jordan, the Caucasus and ...
''
* ''
Eupatorium chinense''
* ''
Eupatorium fortunei''
* ''
Eupatorium japonicum''
* ''
Eupatorium perfoliatum''
* ''
Eupatorium purpureum''
* ''
Farfugium japonicum''
* ''
Gynura bicolor''
* ''
Gynura divaricata''
* ''
Gynura segetum''
* ''
Heliotropium amplexicaule''
* ''
Heliotropium europaeum''
* ''
Heliotropium indicum''
* ''
Heliotropium popovii''
* ''
Lappula intermedia''
* ''
Ligularia cymbulifera''
* ''
Ligularia dentata''
* ''
Ligularia duiformis''
* ''
Ligularia heterophylla''
* ''
Ligularia hodgsonii''
* ''
Ligularia intermedia''
* ''
Ligularia lapathifolia''
* ''
Ligularia lidjiangensis''
* ''
Ligularia platyglossa''
* ''
Ligularia tongolensis''
* ''
Ligularia tsanchanensis''
* ''
Ligularia vellerea''
* ''
Liparis nervosa''
* ''
Lithospermum erythrorhizon
''Lithospermum erythrorhizon'', commonly called purple gromwell, red stoneroot, red gromwell, red-root gromwell and redroot lithospermum, is a plant species in the family Boraginaceae. It is called ''zǐcǎo'' () in Chinese, ''jichi'' () in Kor ...
''
* ''
Neurolaena lobata''
* ''
Petasites japonicus''
* ''
Senecio alpinus''
* ''
Senecio argunensis''
* ''
Senecio brasiliensis''
* ''
Senecio chrysanthemoides''
* ''
Senecio cineraria''
* ''
Senecio glabellus''
* ''
Senecio integrifolius var. fauriri
''Senecio'' is a genus of flowering plants in the daisy family (Asteraceae) that includes ragworts and groundsels.
Variously circumscription (taxonomy), circumscribed taxonomically, the genus ''Senecio'' is one of the largest genera of floweri ...
''
* ''
Senecio interggerrimus''
* ''
Senecio jacobaea''
* ''
Senecio lautus''
* ''
Senecio linearifolius''
* ''
Senecio madagascariensis''
* ''
Senecio nemorensis''
* ''
Senecio quadridentatus''
* ''
Senecio riddelli''
* ''
Senecio scandens''
* ''
Senecio vulgaris
''Senecio vulgaris'', often known by the common names groundsel and old-man-in-the-spring, is a flowering plant in the family Asteraceae. It is an annual plant, annual herbaceous plant, herb, native to the Palaearctic and widely naturalised as a ...
''
* ''
Syneilesis aconitifolia''
* ''
Symphytum officinale''
* ''
Tussilago farfara''
References
{{Reflist
Plant toxins
Hepatotoxins