The Treatment of Liver Disease with Botanical Agents

Abstract

Traditional herbal medicine has gained increasing attention as alternative therapy for the treatment of liver disease, which has become a global health problem associated with the increased prevalence of harmful chemicals in the environment and the use of pharmaceuticals known to have detrimental effects on liver function as well as alcohol abuse. Herbal derived medicines such as Turmeric (Curcuma longa), Guduchi (Tinospora cordifolia), Amla (Emblica officinalis), Milk Thistle (Silybum marianum), Madder (Rubia tinctorum), Andrographis (Andrographis paniculata), Bupleurum and Azadirachta indica have shown hepatoprotective and regenerative effects mainly associated with their antioxidant and antiinflammatory properties, and they have been used as adjunctive or stand alone agents for the treatment of several conditions affecting liver function. Curcuma longa, a culinary spice known as Turmeric, and Bupleurum have been used in traditional medicine for the treatment of liver disease. The active component of Curcuma is the flavonoid curcumin, which has been researched extensively for its beneficial effects on several liver diseases. The active components of Bupleurum are the saikosaponins, which have hepatoprotective effects and have shown activity against the hepatitis B virus. The hepatoprotective effects of Silybum are thought to be mediated by its constituent flavonolignans, which are commercially available in a crude extract labeled silymarin and a semipurified flavonoid, Silibinin. The efficacy of these hepatoprotective herbs is determined by routine testing of liver enzymes including AST, ALT, ALP and bilirubin. Although some side effects have been reported, these have not been validated by clinical studies, and the safety of these supplements has been demonstrated when used at the appropriate doses.

Indian herb Tinospora cordifolia and Tinospora species: Phytochemical and therapeutic application

“…In cases of carbon tetrachloride-induced liver injury, T. cordifolia has been seen to preserve normal metabolism and lower levels of particular enzymes such aspartate, alanine aminotransferase (ALT), alkaline phosphatase (ALP), aminotransferase (AST) and total bilirubin. The powerful hepatoprotective activities of T. cordifolia extract can be related to its ability to stimulate liver regeneration, as well as its antioxidant and free radical-scavenging properties [ 124 , 126 ] [ [124] , [126] , [127] , [128] ] [ [124] , [126] , [127] , [128] ]. A standardised aqueous extract was used to study patients with hepatic disorders who showed signs of immunosuppression and/or fibrosis.…”