Use of herbal supplements in chronic liver disease
Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, Minnesota 55905, USA. Clinical Gastroenterology and Hepatology
(Impact Factor: 7.9).
11/2004; 2(11):947-56. DOI: 10.1016/S1542-3565(04)00455-0
Complementary and alternative medicine (CAM) is becoming popular among patients with liver disease. Although there is a growing body of evidence regarding potential mechanisms of action of these and other herbs, caution must be used to interpret the results of the few clinical trials available. Our goal was to discuss the biologic rationale for the use of specific herbs (silymarin, glycyrrhizin, sho-saiko-to, Phyllanthus amarus , Picrorrhiza kurroa , Compound 861, CH-100, and LIV.52) in the treatment of chronic liver diseases, as well as the evidence for their efficacy and adverse effects according to clinical trials.
Because of the relative paucity of clinical studies using herbs, every trial published in English was reviewed.
Although many trials suggest that these herbs can decrease serum transaminase levels, the effects on hepatic histopathology and long-term survival are either poorly studied or conflicting. LIV.52 has been withdrawn from the market because of deleterious effects in patients with liver disease.
Based on current evidence, we cannot recommend the use of herbal supplements for the routine treatment of any chronic liver disease and further well-designed clinical trials are necessary.
Available from: Alessandro Federico
- "Clinical research in this century has confirmed the efficacy of several plants in the treatment of liver disease, so the fact that the patients with chronic liver disease seek primary or adjunctive herbal treatment is not surprising. Particularly, silymarin (an extract of milk thistle) is the most popular product taken by subjects with liver disease and especially by those with hepatitis C virus infection . Seeff et al.  found that 41% of outpatients with diagnosis of liver disease had used some form of CAM. "
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ABSTRACT: Complementary and alternative medicine soughts and encompasses a wide range of approaches; its use begun in ancient China at the time of Xia dynasty and in India during the Vedic period, but thanks to its long-lasting curative effect, easy availability, natural way of healing, and poor side-effects it is gaining importance throughout the world in clinical practice. We conducted a review describing the effects and the limits of using herbal products in chronic liver disease, focusing our attention on those most known, such as quercetin or curcumin. We tried to describe their pharmacokinetics, biological properties, and their beneficial effects (as antioxidant role) in metabolic, alcoholic, and viral hepatitis (considering that oxidative stress is the common pathway of chronic liver diseases of different etiology). The main limit of applicability of CAM comes from the lacking of randomized, placebo-controlled clinical trials giving a real proof of efficacy of those products, so that anecdotal success and personal experience are frequently the driving force for acceptance of CAM in the population.
Available from: Yao Tong
- "While ample evidence supports Chinese medicines in treating liver fibrosis, some recent reviews on clinical trials did not find significant effects. Levy et al.  review the use of silymarin, glycyrrhizin, Xiao Chaihu Tang, Phyllanthus amarus, Picrorrhiza kurroa, Compound 861, CH-100 and LIV.52 used to treat chronic liver diseases. Dhiman et al.  review Phyllanthus, Silybum marianum (milk thistle), glycyrrhizin and LIV.52 used to treat liver diseases. "
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ABSTRACT: Liver fibrosis is a condition of abnormal proliferation of connective tissue due to various types of chronic liver injury often caused by viral infection and chemicals. Effective therapies against liver fibrosis are still limited. In this review, we focus on research on Chinese medicines against liver fibrosis in three categories, namely pure compounds, composite formulae and combination treatment using single compounds with composite formulae or conventional medicines. Action mechanisms of the anti-fibrosis Chinese medicines, clinical application, herbal adverse events and quality control are also reviewed. Evidence indicates that some Chinese medicines are clinically effective on liver fibrosis. Strict quality control such as research to identify and monitor the manufacturing of Chinese medicines enables reliable pharmacological, clinical and in-depth mechanism studies. Further experiments and clinical trials should be carried out on the platforms that conform to international standards.
Available from: Masataka Yoshino
- "Licorice is a lipophilic extract obtained from the roots of Glycyrrhiza, and glycyrrhizin a triterpenoid saponin, is the main constituent of licorice. Licorice and glycyrrhizin are useful as a sweetener in functional foods and a cosmetic ingredient, and further have been used for treating hepatitis (Takahara et al. 1994; Levy et al. 2004). "
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ABSTRACT: The prooxidant and apoptosis-inducing effects of Sho-saiko-to, a traditional Sino-Japanese herbal medicine and its active ingredients were analyzed. Among the components of Sho-saiko-to, wogon, the extract of Scutellaria and licorice root extract induced apoptosis of HL60 cells and increased the intracellular levels of reactive oxygen species. Lower concentrations (5 to 20 muM) of baicalein, the principal flavonoid in the Scutellaria root extract, showed induction of cell apoptosis and elevated the intracellular reactive oxygen species. However, the increase in the concentrations of baicalein rather inhibited the induction of apoptosis and the elevated levels of reactive oxygen species in cells. Induction of baicalein-mediated apoptosis was inhibited by addition of Tempol, the scavenger of reactive oxygen species. Glycyrrhetinic acid, an ingredient of licorice root extract, also induced apoptosis followed by increase in the intracellular reactive oxygen species. The effect of Sho-saiko-to on cell differentiation can be explained by the action of two ingredients, baicalein and glycyrrhetinic acid, which cause apoptosis and increase in reactive oxygen species in cells.
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