"Unlike the single active component-dominant mode observed to produce antioxidant and hypoglycemic effects, the antiarrhythmia action of aconite exhibits multi-target characteristics. Both its alcohol extract and water extract demonstrate significant inhibitory effects on ventricular fibrillation, primarily mediated by characteristic C18-and C19-type diterpenoid alkaloids. The specific mechanisms include C18-type diterpenoid alkaloids (e.g., lappaconitine), targeting the regulation of cardiomyocyte Na+ channels. At doses of 0.05-0.15 mg/kg, these diterpenoid alkaloids can suppress the occurrence of premature ventricular beats and ventricular tachycardia. C19-type diterpenoid alkaloids regulate the pathological process of arrhythmia by inhibiting myocardial oxidative stress, modulating mitochondrial energy metabolism homeostasis, and interacting with key biomolecules."The original version of this article has been updated.A correction has been made to the section Page 6, Section 5 Overview of toxicological studies, 5.1 Cardiotoxicity, paragraph 1, line 19, point (2):"(2) Calcium homeostasis mechanism: The sustained opening of Na channels leads to the persistent opening of L-type calcium channels, thereby further triggering intracellular Ca2+ homeostasis imbalance manifested as tachyarrhythmia. Animal experiments demonstrated that 1 μmol/L Aconitum carmichaeliialkaloid promoted Ca2+ influx in rats, while 5 and 10 μmol/L induced ventricular arrhythmia in rat cardiomyocytes (Zhou et al., 2013;Jiang et al., 2021)."The original version of this article has been updated.A correction has been made to the section Page 7, Section 5 Overview of toxicological studies, 5.4 Other toxicity, 5.4.1 Neurotoxicity, paragraph 1, line 13, point (2): "(2) Toxicity mechanisms: ① Aconitine was shown to persistently activate voltage-gated sodium channels and inhibit Na+-K+-ATPase activity, leading to abnormal intracellular Na+-ATPase activity, which triggers an imbalance in the homeostasis of intracellular ions, such as Na+, K+, and Ca2+. This process progresses to disrupt both the central and peripheral nervous systems, resulting in symptoms like numbness and tremors."The original version of this article has been updated.A correction has been made to the section Page 8, Section 6 Overview of detoxification research, 6.1 Processes reducing toxicity, paragraph 2, point (4):"Prepared aconite lateral root slices (with glycyrrhiza and black beans): Salt-processed aconite is soaked in clean water to remove salt, then boiled with Glycyrrhiza uralensis (common name: licorice root) and black beans until numbing sensations and bitterness disappear. Glycyrrhiza uralensis and the black beans are removed, then the aconite is sliced thinly and sun-dried. High-temperature steaming destroys the toxic components, while excipients help adsorb and promote the dissolution of toxic constituents."The original version of this article has been updated.A correction has been made to the section Page 9, Section 6 Overview of detoxification research, 6.2 Detoxification by compatibility, 6.2.1 Glycyrrhiza uralensis combined with aconite, paragraph 1,line 21:"The flavonoids in Glycyrrhiza uralensis(e.g., glycyrrhizin and liquiritin) can precipitate with the diesterditerpenoid alkaloids in aconite, reducing the leaching of toxic components and slowing the absorption of alkaloids in the intestines. After decocting Glycyrrhiza uralensiswith aconite, the dissolution rate of Glycyrrhiza uralensisflavonoids decreases, likely due to the binding of hydroxyl groups in the flavonoids with the diester-diterpenoid alkaloids."The original version of this article has been updated. "Histopathological observation: Mesaconine can cause histopathological changes in rat liver tissue at specific dose thresholds. After a single oral mesaconine gavage dose of 10 mL/kg to Sprague-Dawley (SD) rats, followed by 4 h of fasting and continuous observation for 2 weeks, the liver of rats in each administration group exhibited fatty vacuoles or degeneration, along with hepatocyte necrosis."The original version of this article has been updated.
Li et al. (Tue,) studied this question.