title: Contemporary Pacific and Western perspectives on `awa (Piper methysticum) toxicology.
abstract: In 2010, a National Science Foundation project in Hawai`i assembled a collaboration of Pacific indigenous scientists, Hawaiian cultural practitioners and scientists trained in Western pharmacology. The objective of the collaborative project was to study Kava, a culturally significant Pacific beverage, and to address and ultimately transcend, long-standing barriers to communication and collaboration between these groups. Kava is a product of the `awa plant (Piper methysticum) that has been used ceremonially and medicinally throughout the history of Pacific Island cultures, and is now in widespread recreational and nutraceutical use in the US. This project, culminating in 2015, has enriched the participants, led to published work that integrates cultural and Western pharmacologic perspectives and established a paradigm for collaboration. This review paper integrates cultural and Western perspectives on efficacy, toxicity and the future cultural and commercial significance of `awa in the Pacific. Here we present a detailed review of traditional and non-traditional kava usage, medicinal efficacy and potential toxicological concerns. Recent mechanistic data on physiological action and potential pathological reactions are evaluated and interpreted.
authors.affiliation: Laboratory of Immunology and Signal Transduction, Division of Natural Sciences and Mathematics, Chaminade University, Honolulu, HI, United States; Graduate Program in Molecular Biosciences and Bioengineering, University of Hawai`i at Mānoa, United States.
authors.forename: Angelique F
authors.initials: AF
authors.lastname: Showman
authors.affiliation: Department of Anthropology, University of Hawai`i, Honolulu, HI, United States.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Baker
authors.affiliation: Laboratory of Immunology and Signal Transduction, Division of Natural Sciences and Mathematics, Chaminade University, Honolulu, HI, United States.
authors.forename: Christina
authors.initials: C
authors.lastname: Linares
authors.affiliation: Laboratory of Immunology and Signal Transduction, Division of Natural Sciences and Mathematics, Chaminade University, Honolulu, HI, United States.
authors.forename: Chrystie K
authors.initials: CK
authors.lastname: Naeole
authors.affiliation: Daniel K. Inouye College of Pharmacy, University of Hawai`i at Hilo, Hilo, HI, United States.
authors.forename: Robert
authors.initials: R
authors.lastname: Borris
authors.affiliation: Association for Hawaiian `Awa, Hilo, HI, United States.
authors.forename: Edward
authors.initials: E
authors.lastname: Johnston
authors.affiliation: Association for Hawaiian `Awa, Hilo, HI, United States.
authors.forename: Jerry
authors.initials: J
authors.lastname: Konanui
authors.affiliation: Laboratory of Immunology and Signal Transduction, Division of Natural Sciences and Mathematics, Chaminade University, Honolulu, HI, United States; Graduate Program in Molecular Biosciences and Bioengineering, University of Hawai`i at Mānoa, United States; Department of Cell and Molecular Biology, John A. Burns School of Medicine, University of Hawai`i, Honolulu, HI, United States. Electronic address: hturner@chaminade.edu.
authors.forename: Helen
authors.initials: H
authors.lastname: Turner
mesh_terms: D000818:Animals; D001628:Beverages / Q000633:toxicity; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism; D005260:Female; D006254:Hawaii; D006801:Humans; D020901:Kava / Q000737:chemistry* / Q000633:toxicity*; D007783:Lactones / Q000737:chemistry / Q000494:pharmacology; D008297:Male; D051379:Mice; D015394:Molecular Structure; D051381:Rats
chemical_list: D007783:Lactones; D003577:Cytochrome P-450 Enzyme System
keywords: Kava; Kavalactones; Piper methysticum