Herbal products as potential drugs for non-alcoholic fatty liver disease (CROSBI ID 645663)
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Podaci o odgovornosti
Turčić, Petra ; Maleš, Željan
engleski
Herbal products as potential drugs for non-alcoholic fatty liver disease
Non-alcoholic fatty liver disease (NAFLD) represents the most common chronic liver disease that can progress to liver cirrhosis and hepatocellular carcinoma, and may lead to the end-stage liver disease. NAFLD is a multifactorial disease, and currently, there is no satisfying therapeutic strategy except lifestyle modification by diet and exercise. Several pharmacological treatments such as insulin sensitizers, antioxidants, lipid-lowering drugs, angiotensin receptor blockers and others have been proposed but none has shown significant efficacy or long-term safety. Over the past decades, herbal medicines have received increasing attention as potential therapeutic agents for NAFLD due to its wide availability, low side effects, variety mechanisms of action and consequential benefits. Evidence from in vitro and in vivo studies suggests that herbal medicines may prevent cellular damage in hepatocytes associated with NAFLD through different mechanisms of action, including: (1) depressing lipogenesis ; (2) increasing β-fatty acid oxidation ; (3) increasing insulin sensitivity ; (4) depressing oxidative stress and (5) inhibiting activation of inflammatory pathways. Herbal medicines can be used as plant extract (licorice, green tee, milk Thistle, red grapes, coffee…), polyherbal formulations (Kampo and Chinese medical) and phytochemicals (flavonoids, polyphenols, terpenoids, saponins, alkaloids…). Among them, red grape, milk thistle, licorice and green tee are the most promising agentsthat can target most of the pathological changes during NAFLD. Silymarin is a lipophilic extract from the milk thistle seeds that contains flavonolignans and flavonoids. It is the most studied herb in the field of hepatology. Two small-randomized clinical trials reported that silibinin, main component of silymarin may improve insulin resistance and liver histology as well as liver enzymes and lipid profile. Resveratrol belongs to stilbene family from red grape that improves insulin sensitivity and glucose tolerance, and reduce plasma lipids, inflammation and oxidative stress in animal studies, but there is conflicting results in clinical trials, and further studies are needed. Camellia sinensis, also popularly referred as green tea is rich with catechins that regulate lipid accumulation at multiple levels and prevent inflammation and oxidative stress in non-alcoholic steato-hepatitis patients. Licorice is widely used to treat various diseases including liver diseases. Glycycoumarin is active component from licorice that shows protective effect on hepatocyte lipoapoptosis in vitro and in vivo. Besides aforementioned therapeutic approaches have been observed with Lycii fructus, Garlic, Siberian Ginseng, Curcuma longa, Olive etc. From in vitro studies and in vivo animal models, we can conclude that herbal medicines may be promising therapeutic agents, but the findings are inconclusive, and rigorously conducted randomised clinical trials are required to establish the efficacy and safety of herbal medicines for NAFLD.
NAFLD, sylimarin, green tea, polyherbal formulation
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Podaci o prilogu
2017.
objavljeno
Podaci o matičnoj publikaciji
Podaci o skupu
3rd Seminaria hepatologica - Adriatic Liver Forum: Non-alcoholic fatty liver disease
predavanje
03.03.2017-03.03.2017
Zagreb, Hrvatska