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Hepatoprotective properties of Dandelion: Recent update

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Taraxacum officinalis (Dandelion) have been used as folk medicines in China, India, and Russia for the treatment of chronic liver diseases. This review focuses exclusively on published literature pertaining to the potential use of Taraxacum officinalis or Dandelion for the treatment of various chronic liver diseases. Dandelion has been tested against various drugs and chemical induced chronic liver diseases in experimental animals and came out with promising results. In vitro studies also confirm the hepatoprotective, antioxidant and anti-inflammatory properties of dandelion. The extensive literature survey reveal the fact that Taraxacum officinalis or dandelion to be safe and the available evidence on the mechanisms of action appears promising, there are currently insufficient data from well-conducted clinical trials to recommend it use in patients with alcoholic liver chronic liver disease.
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Journal of Applied Pharmaceutical Science Vol. 6 (04), pp. 202-205, April, 2016
Available online at http://www.japsonline.com
DOI: 10.7324/JAPS.2016.60429
ISSN 2231-3354
Hepatoprotective properties of Dandelion: recent update
Ezhilarasan Devaraj
Department of Pharmacology, Saveetha Dental College and Hospitals Saveetha University, Chennai- 600 077, Tamil Nadu, India.
ARTICLE INFO
ABSTRACT
Article history:
Received on: 24/10/2015
Revised on: 20/12/2015
Accepted on: 10/02/2016
Available online: 30/04/2016
Taraxacum officinalis (Dandelion) have been used as folk medicines in China, India, and Russia for the treatment
of chronic liver diseases. This review focuses exclusively on published literature pertaining to the potential use of
Taraxacum officinalis or Dandelion for the treatment of various chronic liver diseases. Dandelion has been tested
against various drugs and chemical induced chronic liver diseases in experimental animals and came out with
promising results. In vitro studies also confirm the hepatoprotective, antioxidant and anti-inflammatory properties
of dandelion. The extensive literature survey reveal the fact that Taraxacum officinalis or dandelion to be safe
and the available evidence on the mechanisms of action appears promising, there are currently insufficient data
from well-conducted clinical trials to recommend it use in patients with alcoholic liver chronic liver disease.
Key words:
Taraxacum officinale,
oxidative stress, antioxidant,
hepatoprotective
INTRODUCTION
The liver is one of the vital organs of human body,
being involved in myriad vital functions and regulation of
physiological processes. Due to its unique anatomic location and
function, liver is vulnerable to many forms of injury. Fortunately,
it also has remarkable capacity to repair itself following many
types of injuries that it encounters in compensation for the
important, yet hazardous functions it undertakes. However, liver
disorders following chronic liver injury lead to various
pathological changes such as fatty liver, increase in ROS or
oxidative stress, necrosis of liver cells, hepatitis, steatosis,
cholestasis, vascular lesions, and granuloma and veno-occlusive
diseases, increase in the level of inflammatory markers, fibrosis,
cirrhosis, hepatocellular carcinoma which further produce portal
hypertension and organ failure (Singh et al., 2011).
The conventional treatments of chronic liver injuries
such as fibrosis, cirrhosis, steatosis and chronic hepatitis are
frequently inadequate due to side effects caused by various drugs
and chemicals. To overcome this problem, current research
focused on drugs derived from medicinal plants, due to their
richness in flavonoid and ployphenolic compounds have been
extensively studied against various drug and chemical induced
.
* Corresponding Author
Email: ezhild@gmail.com
hepatotoxicity in vivo and in vitro and it is need of the hour
(Pereira et al., 2015). There are several plant derived agents have
shown promising hepatoprotective properties i.e., dandelion,
silymarin, silibinin, curcumin, berberin, resveratrol (Ezhilarasan et
al., 2014; Ezhilarasan et al., 2012). Among these dandelion is one
of the promising agent obtained from the medicinal plant
Taraxacum officinalis. Hence, the present review aimed to gain
insight into the recent update on the hepatoprotective properties of
Taraxacum officinalis.
Description
The genus Taraxacum Wiggers, family Asteraceae,
subfamily Cichorioideae, tribe Lactuceae, commonly known as
dandelion, includes approximately 3057 varieties with many
microspecies, divided into nine sections (Vašut et al., 2015).
Dandelion (Taraxacum officinalis), a traditional herbal medicine is
used for treatment of jaundice and disorders of the liver,
gallbladder and other various hepatic ailments (You et al., 2010;
Ahmed et al., 2013,). The folk medicines of China, India, and
Russia have recognized dandelion’s effect as a liver tonic.
Traditional Chinese medicine combines dandelion with other herbs
to treat hepatitis (Modaresi, 2012). Conventionally, root and herb
from Taraxacum officinale (TO) have been reported to use for the
treatment of various ailments, including liver and gallbladder
disorders (Gulfraz et al., 2014).
Ezhilarasan Devaraj / Journal of Applied Pharmaceutical Science 6 (04); 2016: 202-205 203
Phytochemical constituents
The phytochemical investigation showed that TO has an
abundance of terpenoid and sterol (principally taraxacin and
taraxacerin), equally distributed in the roots, leaves, and flowers.
Other terpene/sterol compounds include beta-amyrin, taraxasterol,
and taraxerol, as well as free sterols (sitosterin, stigmasterin, and
phytosterin) structurally related to bile (Koo et al., 2004; Schütz et
al., 2006). Presence of these biologically active principles in the
TO extract have been attributed for its beneficial effects. The terms
Taraxacum officinale and dandelion are generally interchangeably
used in the literature.
SPECTRUM OF HEPATOPROTECTIVE EFFECTS
Antioxidant effect
Oxidative stress is a common feature observed in a wide
spectrum of chronic liver diseases including viral hepatitis,
alcoholic, and nonalcoholic steatohepatitis (Jiang and Török,
2015). Oxidative stress leads to deleterious processes in the liver
and produces liver diseases. Therefore, restoring antioxidants is
essential to maintain homeostasis. One method of restoring
antioxidants is suggested to consume natural compounds with
antioxidant capacity (Casas-Grajales and Muriel, 2015).
Dandelion, a natural antioxidant compound has been empirically
used due to its health-promoting properties as an anti-
carcinogenic, anti-inflammatory and anti-oxidant (You et al.,
2010). Ethanolic TO leaves and root extract significantly
attenuated marker enzymes of liver toxicity (AST and ALT), lipid
peroxidation and oxidative stress induced by acetaminophen in
mice. The TO extract shown to possess the free radical quenching
activities. This protective effects of TO have been suggested to the
presence of phenolic compounds in the extract (Colle et al., 2012).
In a recent study, ethanolic and n-hexane TO leaves extract
significantly decreased the liver marker enzymes, superoxide
dismutase (SOD), catalase, lipid peroxidation and glutathione
peroxidase (GPx) in rats intoxicated with CCl4. The efficacy of TO
ethanolic leaves extract found to be more effective as it compared
with n-hexane extract and silymarin against CCl4 induced
hepatotoxicity and oxidative stress in rats (Gulfraz et al., 2014).
In CCl4 induced oxidative stress model TO extract
reversed the glutathione (GSH) depletion, up-regulation of Nuclear
factor-kB (NF-kB) and increased expression of regulatory
inflammatory mediators, such as inducible nitric oxide synthase
(iNOS), cyclooxygenase (COX)-2, Tumor necrosis factor- α
(TNF-α) and interleukin (IL)-(Park et al., 2010). These results
suggest that TO have a hepatoprotective effect by modulating
inflammatory responses and ameliorating oxidative stress. Alcohol
is a leading cause of liver disease and is associated with significant
morbidity and mortality. Alcohol induced liver diseases represents
a spectrum of liver pathology ranging from fatty change to fibrosis
to cirrhosis (Dugum and McCullough, 2015). In vitro the
protective effects of TO root against alcoholic liver damage were
investigated in HepG2/2E1 cells. In this study, ROS was generated
by the administration of ethanol in vitro this was consequent to
decrease in cell viability by less than 40%. However, cells were
simultaneously treated with ethanol and TO hot water root extract
did not induce cytotoxicity as compare to ethanol alone treated
HepG2/2E1 cells (You et al., 2010).
Hu and Kitts (2004) reported that dandelion flower
extracts has also the capability to scavenge ROS and prevent DNA
from ROS-induced damage in vitro. Suppression of oxidative
stress by dandelion has been attributed to presence of luteolin and
luteolin-7-Oglucoside. Generally, Taraxacum species are found
effective against oxidative stress. Recently, it has been reported
that T. marginellum was the most efficient extract reducing
intracellular ROS levels although in vitro assays, T. obovatum was
observed as the best free radical scavenger (Mingarro et al., 2015).
Undoubtedly the above studies suggest the promising efficacy of
TO against various drugs induced oxidative stress.
Fig. 1: Hepatoprotective effects of Taraxacum officinale.
204
Ezhilarasan Devaraj / Journal of Applied Pharmaceutical Science 6 (04); 2016: 202-205
Antifibrotic effects
Hepatic fibrosis is common sequel following chronic
liver injury and reversal of fibrosis prior it attains the cirrhotic
stage would be a clear therapeutic strategy (Lee et al., 2015). TO
extract has been evaluated against the drug and chemical induced
hepatic fibrosis in experimental animals and came out with
promising results. For instance, it has been reported that dandelion
root water-ethanolic extract (DWE) ameliorated the CCl4 induced
hepatic fibrosis in mice. Administration of 600 mg/kg of DWE for
10 days in mice shows significant replenishment of liver aspartate
and alanine transaminases (AST and ALT) marker enzymes of
hepatotoxicity, superoxide dismutase, hydroxyproline and α-
smooth muscle actin -SMA) protein expression in CCl4 induced
hepatic fibrotic mice (Domitrovi´c et al., 2010). Further, this study
suggests that administration TO promote the complete regression
of fibrosis and the enchantment of hepatic regenerative
capabilities.
Antisteatotic effect
Steatosis or alcoholic fatty liver disease has a widespread
incidence and is the first step in the progression to more severe
stages of alcoholic liver disease, with concomitant increases in
morbidity and mortality rates (Lívero and Acco, 2015). CCl4
induced lipid changes in liver is one of the classical model for the
evaluation of lipid lowering activity of drug and herbal extract.
Ethanol and n-hexane leaves extract of TO significantly lower the
lipid profile in CCl4 administered rats. Interestingly, TO
significantly reduces the increase in triglyceride (TG), cholesterol
(CHO), high and low density lipoproteins (HDL and LDL)
(Gulfraz et al., 2014). It is reported that dandelion leaves extract
has the ability to reduce the murine model of methionine- and
choline-deficient diet-induced nonalcoholic steatohepatitis
(NASH). In light of these studies it has been suggested that TO
could also be a promising agent and has to be tested against
hepatic steatosis condition (Davaatseren et al., 2013). In a recent
study TO leaves extract found effective against CCl4 induced
hepatic steatosis in rats. It was shown that steatosis grade was
significantly reduced upon administration of TO leave extract (Al-
Malki et al., 2013)
Anticancer activity
Hepatocellular carcinoma (HCC) is one of the most
common malignancies, which accounts for 90% of primary liver
cancer. HCC usually presents with poor outcomes due to the high
rates of tumor recurrence and widespread metastasis (Mao and
Wang, 2015). Recent results pointed out that natural products, in
particular those present in Taraxacum root extract, have great
potential as non-toxic and effective alternatives to conventional
modes of chemotherapy available today (Ovadje et al., 2012).
Dandelion has been said to induce cytotoxicity in Hep G2 cells
and decreases its viability below 40% (You et al., 2010). TO
extract significantly induced the secretion of TNF-α and IL-1 α
and apoptosis of Hep G2 cells (Koo et al., 2004). These strategies
are clearly implicated in anticancer efficacy of dandelion. In a very
recent study it was found that relevant cytotoxic effect in T.
lacistrum extract over HeLa and HepG2 cell lines (Mingarro et al.,
2015). However, studies regarding the usefulness of TO against
liver carcinoma experimental models are scanty or not available in
literature. Hence, further studies are warranted in animal models to
prove the promising anti-cancer efficacies of TO observed in vitro
cancer cell line models i.e., Hep G2 and HeLa.
CONCLUSION
Overwhelming evidence clearly suggest that dandelion is
widely used in traditional and natural medicine systems
worldwide. Thus far it has received little research attention
towards its beneficial effects against various hepatic ailments. In
light of the studies reviewed here it has been evident that TO has
the ability to intervene various pathophysiological functions
related to liver. The extensive literature survey reveal the fact that
Taraxacum officinalis or dandelion appear to be safe and the
available evidence on the mechanisms of action appears
promising, there are currently insufficient data from well-
conducted clinical trials to recommend their use in patients with
chronic liver diseases.
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How to cite this article:
Ezhilarasan Devaraj. Hepatoprotective properties of Dandelion:
recent update. J App Pharm Sci, 2016; 6 (04): 202-205.
... It is a perennial weed, containing terpenoid and sterol (principally taraxacin and taraxacerin) compounds, equally distributed in the roots, leaves, and flowers. Other terpene/sterol molecules are represented by β-amirin, taraxasterol, and taraxerol, but also free sterols (sitosterin, stigmasterin, and phytosterin) similar to bile [45]. Rubber, resins, tannins, fatty acids, levulose, a galactose polyholoside, arabinose, caffeic acid, p-hydroxyphenylacetic acid, asparagine, tyrosine, carotenoids, phytosterol, flavonoids, amino acids, saponins, and inulin could be also extracted [46]. ...
... Moreover, T. officinale is rich in minerals such as iron, copper, and potassium, as well as vitamins B1, PP, and D, and it contains high concentrations of vitamins A and C than other vegetables [46]. In addition to analgesic, anti-allergic, anticarcinogenic, anti-inflammatory, antithrombotic, diuretic, hypoglycemic, and prebiotic activities, also hepatoprotective, antifibrotic, antioxidant, antisteatotic, and choleretic effects have been attributed to T. officinale [44,45]. After the consumption of Taraxacum, no toxicity has been reported. ...
... Attention must be paid in case of administration of roots in presence of obstruction of the bile ducts, as it is contraindicated, and it can only be used under medical supervision in cases of gallstones [46]. Furthermore, although as reported in the paper published by Devaraj in 2016, extensive literature on dandelion indicated the ability of the several extracts to influence the liver function, and most of them have been performed in vitro and in vivo (laboratory animals) models; therefore, attention must be made in transferring results to humans [44,45]. 4 Veterinary Medicine International ...
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Numerous complementary feeds to support liver function are commercially available for small animals. Aiming to furnish a scientific support for clinicians/nutritionists that necessitate a complementary feed to support liver function in dogs and cats, with the present paper, we analyzed scientific evidences supporting the use, for this purpose, of ingredients/additives such as artichoke (Cynara scolymus), curcumin, dandelion (Taraxacum officinale), milk thistle (Silybum marianum), phosphatidylcholine, and S-adenosylmethionine. Although sustained by significant results, our review found only few scientific papers, and albeit we believe that they represent a significant aid in handling hepatopathies, in the authors’ opinion, this topic probably deserves, and would benefit of, further studies.
... As dandelion is an edible plant, it has been used as traditional herbal medicine in the Arabian zones for the treatment of liver and spleen ailments (Schutz et al., 2006). It has been used as folk medicines in China, India, Russia, Pakistan, and Italy for the treatment of chronic liver diseases (Devaraj, 2016;Martinez et al., 2015). Several health-promoting properties, including diuretic, anti-inflammatory, anti-carcinogenic, and anti-oxidative activities, have been attributed to the use different parts of dandelion (Devaraj, 2016;Martinez et al., 2015). ...
... It has been used as folk medicines in China, India, Russia, Pakistan, and Italy for the treatment of chronic liver diseases (Devaraj, 2016;Martinez et al., 2015). Several health-promoting properties, including diuretic, anti-inflammatory, anti-carcinogenic, and anti-oxidative activities, have been attributed to the use different parts of dandelion (Devaraj, 2016;Martinez et al., 2015). Dandelion contains a wide array of phytochemicals whose biological activities are explored in various human health care areas (Devaraj, 2016;Martinez et al., 2015). ...
... Several health-promoting properties, including diuretic, anti-inflammatory, anti-carcinogenic, and anti-oxidative activities, have been attributed to the use different parts of dandelion (Devaraj, 2016;Martinez et al., 2015). Dandelion contains a wide array of phytochemicals whose biological activities are explored in various human health care areas (Devaraj, 2016;Martinez et al., 2015). These include sesquiterpene lactones, terpenoids, polysaccharides, and phenolic compounds (Gonzalez-Castejon, Visioli, & Rodriguez-Casado, 2012;Schutz et al., 2006;Williams, Goldstone, & Greenham, 1996). ...
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Background Liver fibrosis is the main contributor to the chronic liver-associated morbidity and mortality. Purpose The study was conducted to evaluate the effects of whole plant powder of dandelion ( Taraxacum officinale ) on liver fibrosis. Methods Liver fibrosis was induced by the oral administration of 20% carbon tetrachloride (CCL4), twice a week for 8 weeks. Simultaneously, dandelion root extract (500 mg/kg) was daily administered via the same route. Results Dandelion remarkably improved the liver histology as evidenced by histopathological scoring with hematoxylin-eosin staining. Masson staining and hydroxyproline content similarly showed that dandelion decreased collagen deposition. Both mRNA and protein levels of α-smooth muscle actin and collagens 1 and 3 have been decreased after dandelion treatment compared to CCL4 group. Dandelion also downregulated the mRNA expressions of inflammatory factors interleukin-IL-1β, tumor necrosis factor-α, remodeling growth factor-β1, cyclooxygenase-2, and nuclear factor kappa-B and decreased the myeloperoxidase activity. Additionally, the effects of dandelion were associated with the decreased levels of the hepatic oxidative stress markers (malondialdehyde and P. carbonyl) and elevation of the activity of superoxide dismutase activity. Dandelion’s effect to alleviate the fibrosis and inflammation induced by CCL4 treatment in the livers and was more pronounced than with silymarin. The total antioxidant study of dandelion extract revealed that dandelion has notable ferric reducing antioxidant power and high total phenolic content. Conclusion Finally, these results suggest that dandelion prevents the progression of hepatic fibrosis induced by CCL4. The dandelion’s antifibrotic effects could be attributed to its ability to scavenge free radicals and to attenuate inflammatory cells activations.
... Furthermore, drugs, air pollution, inflammation, triglyceride accumulation, obesity, insulin resistance and microorganisms play essential roles in liver functions and related disorders. Medicinal plants are traditionally used for their hepatoprotective effects [2] and Taraxacum officinale, also known as "common dandelion", is one important medicinal plant as a hepatoprotective agent, which is used for treatment of hepatobiliary problems [3]. Dandelion is a popular hepatoprotective medicinal plant in different traditional medicines. ...
... Dandelion roots are used in different cuisines of at least 54 countries. Dandelion is used in folk medicine of China, India and Russia as liver tonic [3]. Different traditional systems including Ayurveda [6], Siddha and Unani recommended using the dandelion for management of liver disorders such as jaundice, liver and gallbladder's disorders [7][8][9]. ...
... Different traditional systems including Ayurveda [6], Siddha and Unani recommended using the dandelion for management of liver disorders such as jaundice, liver and gallbladder's disorders [7][8][9]. Dandelion roots in combination with other plants are used in the powder form as a sedative agent and for regulating the urine discharge and urine burning sensation in India [10], and this combination is applied as blood purifier and for treatment of hepatitis, jaundice, and Asian Pacific Journal of Tropical Biomedicine 2020; 10(1): [1][2][3][4][5][6][7][8][9][10] Asian Pacific Journal of Tropical Biomedicine journal homepage: www.apjtb.org fever [4]. ...
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The protection of the liver as an essential organ in the body against oxidative stress and deleterious compounds has been the subject of recent investigations. Among different compounds, medicinal plants play an important role due to their hepatoprotective effects. Taraxacum officinale or “common dandelion” is a popular plant that has been traditionally used for its hepatoprotective effects. Currently, there are limited clinical studies on its hepatoprotective effects. The aim of this review article is to evaluate the hepatoprotective effects of dandelion and its mechanism of action. We reviewed literature up to July 2019 on “Taraxacum officinale” or “dandelion” and hepatoprotection. Currently available pharmacological studies indicate that dandelion extracts have hepatoprotective effects against chemical agents due to its antioxidant and anti-inflammatory activities. The anti-inflammatory effects of dandelion, the prebiotic effects of its oligofructans, inhibitory effects against the release of lipopolysaccharides and fasting induced adipose factor, digestive enzymes, and enhancing effects of lipogenesis, reduce lipid accumulation and liver inflammation, which directly or indirectly improve the liver functions. Given emerging evidence on hepatoprotective effects of dandelion, designing large human clinical studies is essential.
... The root of dandelion contains many bioactive components such as carbohydrates, fatty acids, carotenoids, minerals, mucilage and vitamins [15]. These beneficial components have many health-promoting activities such as hepatoprotective, diuretic, anti-inflammatory and antioxidative properties [16,17]. ...
... Phenols are widely distributed in Asteraceae, and some have the efficiency to inhibit parasites [32]. Dandelion (Taraxacum officinale) is a member of the Asteraceae (Compositae) family that has a wide range of pharmacological applications and is a promising natural medicine in the treatment of chronic liver diseases such as hepatitis and hepatic steatosis [16]. ...
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Purpose: Although praziquantel (PZQ) has a wide use as an anti-schistosome agent, many of its imperfections and side effects have been reported in many studies. The current study aims to evaluate the curative effect of a natural dandelion extract (Taraxacum officinale) on schistosomiasis either alone or in combination with PZQ based on parasitological, immunological, histopathological and molecular investigations. Methods: Mice were experimentally infected with Schistosoma mansoni cercariae and then divided into four groups, Schistosoma spp.-infected untreated group (IC group), Schistosoma spp.-infected group of mice treated with dandelion (I-Dn group), Schistosoma spp.-infected group of mice treated with PZQ (I-PZQ group), and Schistosoma spp.-infected group of mice treated with both PZQ and dandelion (I-PZQ + Dn group). Treatment started 45 days' post-infection. Besides, non-infected, non-treated mice served as the negative healthy control group (HC group). Results: The present results indicated that dandelion administration significantly reduced the worm burden, ova number, and the number and diameter of hepatic granulomas as compared to the untreated infected group. The results also showed that the levels of IL-6 and TNF-α were significantly decreased in the combined treatment group (I-PZQ + Dn) as compared to the I-PZQ group. Administration of dandelion-only remarkably reduced AST and ALT activities associated with schistosomiasis. Moreover, hepatic DNA damage assessed by comet assay was significantly inhibited in the combined treated group compared to the infected untreated and PZQ treated groups. Conclusion: The results concluded that combined treatment of PZQ and dandelion extract improved immune response, decreased the number and diameter of granulomas, and inhibited DNA damage, indicating a reduction in liver fibrosis associated with schistosomiasis. The present study focused on the potential effect of dandelion as an adjunct medication for therapeutic properties of PZQ.
... Additionally, dandelion considered a natural source of minerals as iron, potassium, zinc and calcium besides to fibers and vitamins as B complex and C (Arafa et al., 2010). Dandelion gained a marked interest because of its impacted effects as antioxidant, antiinflammatory and anti-fibrotic agent (Ouarda et al., 2014;Devaraj, 2016). In folk medicines of India and China dandelion was used to treat respiratory system infections, inflammation, anemia and blood purification (Modaresi and Resalatpour, 2012). ...
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... Indeed, these fibers are known to enhance the growth of intestinal microbiota and to positively affect lipid metabolism [125]. Dandelion has been used in traditional medicine as well, as a hepatoprotective (liver tonic in Chinese, Indian, and Russian traditional medicine) [126]. Moreover, dandelion roots contain inulin with prebiotic potential, i.e., numerous beneficial effects such as curbing the growth of pathogenic bacteria in the GIT and repressing cancer, obesity, and osteoporosis [127]. ...
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Taraxacum officinale L is a medicinal plant, which has enormous medicinal values against various types of liver disorders and it has traditionally been used for the treatment of liver problems by people from the South East Asia. Previously we have screened the crude methanolic extract of T. officinale against cytotoxicity induced by CCl 4 .Present study was designed to compare the protective effect of ethanolic and n-hexane extract of leaves in carbon tetrachloride (CCl 4) induced liver toxicity in rats. The extract (200 mg/kg and 400mg/kg body weight) along with silymarin (100 mg/kg) a standard drug was administered to experimental animals. It was observed that ethanolic plant extract has significantly reduced the negative effect of CCl 4 as compared to n-hexane extract and effect of extract was increased with increasing dose level. Although both leaf extracts decreased the concentration of TBARS, H 2 O 2 and nitrite contents which enhance due to CCl 4 toxicity but effect was higher in ethanolic extract. The results clearly indicated that Taraxacum officinale ethanolic leaves extract has better protective effect against CCl 4 induced liver tissues toxicity. This claim was also supported by histopathological results obtained during this study and this might be due to presence of various polar phytochemicals that might be more prevent in this extract.
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Hepatocellular carcinoma (HCC) is one of the most common malignancies, which accounts for 90% of primary liver cancer. HCC usually presents with poor outcomes due to the high rates of tumor recurrence and widespread metastasis. However, the underlying mechanism of HCC initiation and progression, which significantly hindered the development of valid approaches for early detection and treatment remain to be elucidated. As a group of small non-coding RNAs, microRNAs (miRNAs) have been demonstrated to be involved in many types of diseases especially human malignancies. Numerous miRNAs are deregulated in HCC, which may shed some light on current investigations. Since miRNAs are stable and detected easily, their ectopic expression has been reported in HCC tissues, serum/plasma and cell lines. As previously described, miRNAs serve as tumor suppressors or oncogenes, indicating that miRNAs may be useful as diagnostic, therapeutic and prognostic markers of HCC. In the present review, we assessed the latest data regarding dysregulated miRNAs in HCC and reviewed the reported functions of these miRNAs as they apply to the diagnosis and prognosis of HCC.
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Reversibility of hepatic fibrosis and cirrhosis following antiviral therapy for hepatitis B or C has advanced the prospect of developing antifibrotic therapies for patients with chronic liver diseases, especially non-alcoholic steatohepatitis. Mechanisms of fibrosis have focused on hepatic stellate cells, which become fibrogenic myofibroblasts during injury through 'activation', and are at the nexus of efforts to define novel drug targets. Recent studies have clarified pathways of stellate cell gene regulation and epigenetics, emerging pathways of fibrosis regression through the recruitment and amplification of fibrolytic macrophages, nuanced responses of discrete inflammatory cell subsets and the identification of the 'ductular reaction' as a marker of severe injury and repair. Based on our expanded knowledge of fibrosis pathogenesis, attention is now directed towards strategies for antifibrotic therapies and regulatory challenges for conducting clinical trials with these agents. New therapies are attempting to: 1) Control or cure the primary disease or reduce tissue injury; 2) Target receptor-ligand interactions and intracellular signaling; 3) Inhibit fibrogenesis; and 4) Promote resolution of fibrosis. Progress is urgently needed in validating non-invasive markers of fibrosis progression and regression that can supplant biopsy and shorten the duration of clinical trials. Both scientific and clinical challenges remain, however the past three decades of steady progress in understanding liver fibrosis have contributed to an emerging translational success story, with realistic hopes for antifibrotic therapies to treat patients with chronic liver disease in the near future. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.