A REVIEW OF MEDICINAL PLANTS WITH HEPATOPROTECTIVE ACTIVITY

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ABOUT AUTHORS:
Shristi Badhani*, Shivani Sharma, Amrita Kainth, Bharat Parashar
Department of Pharmacy,
Manav Bharti University, Solan, H.P.
*shristibadhani0104@gmail.com

ABSTRACT:
Hepatic diseases are a major worldwide health problem, with frequently found in developing countries. They are mainly caused by uses of high doses of chemicals and some drugs. There is no effective drug available that stimulates liver function, offer protection to the liver from damage or help to regenerate hepatic cells. Therefore there is urgent need, for effective drugs to replace/add those in current use. Medicinal herbs are significant source of pharmaceutical drugs. Latest trends have shown increasing demand of phytoconstituents from some medicinal herbs and those medicinal herbs have proven hepatotprotective potential.A number of herbal preparations are available in the market. The present review is aimed at compiling data on promising phytochemicals from medicinal plants that have been tested in hepatotoxicity models using modern scientific system. In this century clinicalresearch has confirmed the efficacy of  some herbs in the treatment of liver related disease. Hence, this review article contributes to the knowledge of reported indigenous plants, which are prevalent for prevention and treatment ofliver disorders.

REFERENCE ID: PHARMATUTOR-ART-1926

INTRODUCTION:
The liver has more functions than any other human organ and also is a largest part of the body. The blood supply passes through the liver several times a day. The Liver has a important role in human metabolism. Liver produces and secretes bile, it also produces prothrombin and fibrinogen, both blood clotting factors, and heparin. It converts sugar into glycogen. Liver diseases have become one of the major causes of morbidity and mortality in man and animals. Hepatotoxicity due to drugs appears to be the most common factor [1]. The most common disease that can affect the liver is 'viral hepatitis'. Hepatitis mainly caused by drugs, viruses, bacteria, parasites like amoebas or giardiasis. The use of natural remedies to treat the liver diseases has a long history. There are some medicinal plants and their derivatives which still used all over the world in one form or the other, have been tested and found to contain active principles with curative properties against a variety of diseases [2]. Hepatoprotective plants contain a variety of chemical constituents like phenols, coumarins, lignans, essential oil, monoterpenes, carotinoids, glycosides, flavanoids, organic acids, lipids, alkaloids and xanthenes [3]. Recent experience has shown that plant drugs are non-toxic, safe and even free from side effects [4].

There are many plants and traditional formulations available to treat the liver diseases [5, 6]. About 600 commercial herbal formulations with hepatoprotective activity are being sold all over the world. Around 170 phytoconstituents isolated from 110 plants belonging to 55 families have been reported to possess hepatoprotective activity. In India, more than 93 medicinal plants are used in different combinations in the preparations of 40 patented herbal formulations [7]. However, only a small proportion of hepatoprotective plants as well as formulations used in traditional medicine are pharmacologically evaluated for their safety and efficacy [8].

DRUG HEPATOTOXICITY:
Chemicals produce a wide variety of clinical and pathological hepatic injury. Biochemical markers (e.g. alanine transferase, alkaline phosphatase and bilirubin) are often used to indicate liver damage. Liver injury is defined as a rise in either
(a) ALT level more than three times of upper limit of normal (ULN),
(b) ALP level more than twice ULN, or
(c) total bilirubin level more than twice ULN when associated with increased ALT or ALP [32, 33].

Mechanism of liver damage:
Drugs continue to be taken off the market due to late discovery of hepatotoxicity. Due to its unique metabolism and close relationship with the gastrointestinal tract, the liver is susceptible to injury from drugs and other substances. 75% of blood coming to the liver arrives directly from gastrointestinal organs and then spleen via portal veins which bring drugs and xenobiotics in near-undiluted form. Several mechanisms are responsible for either inducing hepatic injury or worsening the damage process. Many chemicals damage mitochondria, an intracellular organelle that produce energy. Its dysfunction releases excessive amount of oxidants which, in turn, injure hepatic cells. Activation of some enzymes in the cytochrome P-450 system such as CYP2E1 also lead to oxidative stress [34]. Injury to hepatocyte and bile duct cells lead to accumulation of bile acid inside the liver. This promotes further liver damage. Non-parenchymal cells such as Kupffer cells, fat storing stellate cells, and leukocytes (i.e. neutrophil and monocyte) also have a role in the mechanism [35].

Drug-related hepatotoxicity cannot be viewed as a single disease. Many different mechanisms lead to hepatotoxicity, including disruption of the cell membrane and cell death resulting from covalent binding of the drug to cell proteins, which creates new adducts that serve as immune targets, thus inciting an immunologic reaction [36, 37]; inhibition of cellular pathways of drug metabolism [38, 39]; abnormal bile flow resulting from disruption of subcellular actin filaments or interruption of transport pumps, leading to cholestasis and jaundice, sometimes with minimal cell injury [40]; apoptosis occurring through tumor-necrosis-factor and fas pathways [41]; and inhibition of mitochondrial function, with accumulation of reactive oxygen species and lipid peroxidation, fat accumulation and cell death [42].

HEPATOPROTECTIVE PLANTS:

Sr. no.

Biological name

Common name

Extract

Dose

References

1.

Andrographis lineatanees (Acanthaceae)

Kirayat, K?lamegha

Methanol and aqueous extract

845 mg/kg/day

Sangameshwaran B. Reddy et al [9]

2.

Azadirachta indica(Meliaceae)

Neem

Methanolic extract


Chattopadhyay R R et al [10]

3.

Careya arborea(Myrtaceae)

Kumbhi, slow match tree

Methanolic extract

50, 100 & 200 mg/kg

Senthilkumar N et al [11]

4.

Cassia fistula(fabaceae)

Amaltas

Methanolic extract

400 mg/kg

Bhakta T et al [12]

5.

Cleome viscosalinn (Capparidaceae)

Tickweed

Ethanolic extract


Gupta N K et al [13]

6.

Eclipta alba(Asteraceae)

Bhringaraj

Ethanol:water 1:1 extract


Saxena A K et al [14]

7.

Fumaria indica(Fumariceae)

Hauskn

Petroleum ether extract against CCl4, methanolic extract against rifampicine, and aqueous extract against PCM.


Rao K S et al [15]

8.

Morinda citrifoliaLinn (Rubiaceae)

Noni



Wang M Y et al [16]

9.

Phyllanthus amarus(Euphorbiaceae)

Bhuiamala

Ethanolic extract

0.3 g/kg

Naaj F et al [17]

10.

Phyllanthus emblica(Euphorbiaceae)

Amla

Ethanolic extract


Pramyothin P et al [18]

11.

Phyllanthus polyphyllus(Euphorbiaceae)

Dalzell

Methanolic extract

200 & 300 mg/kg

B. R et al [19]

12.

Phyllanthus reticulates(Euphorbiaceae)

Potato bush

Ethanolic extract


Das B K et al [20]

13.

Picrorhiza kurroa(Scrophulariaceae)

Kutki

Alcoholic extract

3-12 mg/kg/day

Chander R et al and Ansari R A et al [21, 22]

14.

Polygala arvensis(Polygalaceae)

Field milkwort

Chloroform extract

200 & 400 mg/kg

Dhanabal S P et al [23]

15.

Pterocarpus santalinus (Fabaceae)

Kanak champa

Aqueous and ethanol extract

45(aqueous) & 30(etanol) mg/ml

Manjunatha B.K. et al [24]

16.

Ptrospermum acerifolium(Sterculiaceae)

Maple-leaved Bayur tree

Ethanol extract

25 mg/kg

Kharpate S et al [25]

17.

Solanum nigrum(Solanaceae)

Makoi



Sultana S et al [26]

18.

Cichorium intybus(Asteraceae)

Kasni



Sultana S et al [26]

19.

Swertia chirata(Gentianaceae)

Chirayata


20, 50 & 100 mg/kg

Karan M et al & Mukherjee S et al [27, 28]

20.

Wedelia calendulaceaLinn (Asteraceae)

Bhanra

Ethanolic extract


Murugaian P et al [29]

21.

Anoectochilus formosanus (Orchidaseae)

Jewel Orchid

Aqueous extract

130 mg/kg

Wu Jin Bin et al [30]

22.

Bacopa monniera(Scrophulariaceae)

Brahmi


10 mg/kg

Sumathi T et al [31]

23.

Ixora coccineaLinn (Rubiaceae)

Thetchi

Aqueous extract

100, 200 & 400 mg/kg

Mukharji PK et al & Awauters F et al [43, 44]

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