You are on page 1of 59

1. Role of free radicals in liver diseases and hepatic fibrosis.
An increased production of free radicals in the liver has been implicated in a variety of liver
diseases. Free radicals can damage cellular macromolecules and, therefore, may participate in
hepatocellular injury when produced in excess. Strong evidence exists for hepatic free radical
production in animal models of iron and copper overload, ethanol consumption, and ischemiareperfusion. Although less is known about the situation in humans with liver diseases, the
available evidence is consistent with the findings in animal experiments. Treatments that reduce
free radical production and/or levels have protective effects in hepatic ischemia-reperfusion.
Free radical-initiated lipid peroxidation may play a role in hepatic fibrogenesis, perhaps through
an effect of aldehydic peroxidation products on Kupffer cells and lipocytes. This hypothesis is
supported by the observation that dietary supplementation with vitamin E has a protective effect
on carbon tetrachloride-induced hepatic fibrosis. While cellular damage in human liver
diseases is probably multifactorial, free radicals may play important roles in initiating and/or
perpetuating this damage.
2.Immunogenetics of chronic liver diseases.
The genetic background of autoimmune diseases becomes more and more evident.
Immunogenetics comprises the analysis of genes and their products located at the region 6p21 on
the short arm ofchromosome 6, which is also known as the major histocompatibility complex
(MHC). MHC class I and II genes are highly polymorphic. The complement genes
C2, C4A, C4B, and BF, which are also polymorphic, became known as MHC class III genes.
In autoimmune hepatitis type 1, there is a dual association for white persons with either HLAA1-B8-DR3 or HLA-DR4. In patients from Japan,autoimmune hepatitis type 1 is predominantly
associated with HLA-DR4. This dual association is confirmed at the DNA level. Whereas only
limited data are available for autoimmune hepatitis type 2, the association of primary biliary
cirrhosis with HLA-DR8 is based on several studies. Primary sclerosing cholangitis is associated
with HLA-B8-DR3 and -DR52a. This association was confirmed at the DNA level because of a
significant increase of the DRB3*0101 allele. For DRB3*0101-negative individuals, a second
association with DRB5*0101 (= DR2) was described. Further analysis of the hypervariable
region of the HLA class II molecule indicates that lysine at position 71 is crucial forautoimmune
hepatitis type 1 in white persons, whereas position 13 is important for people from Japan. In
contrast, leucine at position 35 is important for patients with primary biliary cirrhosis, whereas
leucine at position 38 is an important risk factor for primary sclerosing cholangitis. The MHC
class III allele C4A-QO is significantly increased in autoimmune hepatitis type 1 and 2 and
in primary biliary cirrhosis. Advances in immunogenetics will certainly increase our knowledge
of the etiology andpathogenesis of immune-mediated liver diseases, which hopefully will lead to
more specific therapeutic interventions.
3.Relation between autoimmune liver diseases and viral hepatitis: clinical and serological
characteristics in 859 patients.
An etiopathological link between hepatitis virus infection and autoimmune liver disease, in
particularautoimmune hepatitis has been suggested. In some patients features of both viral

and autoimmune disease are present. We have studied 352 patients with autoimmune liver
disease and 507 patients with viral hepatitis for diagnostic characteristics as well as for evidence
of an etiological connection. 38 of the 201 patients with hepatitis C (19%) and 42 of the 306
patients with hepatitis B (14%) had significant titres of autoantibodies (ANA, SMA or
LKM). SLA autoantibodies were found exclusively in patients with autoimmune liver disease.
LKM auto-antibody was found in only one of the 201 HCVpatients. Evidence of past or
present hepatitis B virus and past hepatitis A virus infection was most common in the hepatitis C
virus patients and least common in autoimmune hepatitis. 28 of the 352 patients
with autoimmune liver diseases tested positive in the second generation anti-HCV ELISA, but
only five patients (two with autoimmune hepatitis, one with primary sclerosing cholangitis and
two withprimary biliary cirrhosis) were positive in confirmatory anti-HCV assays, and only in
these could HCV-RNA be isolated. Autoimmune hepatitis patients had significantly higher
transaminase, GLDH and IgG levels. HLA-B8, HLA-DR3 and HLA-DR4 were significantly
more common in autoimmune hepatitis. Distinction between autoimmune liver disease and
viral hepatitis C could be made reliably on clinical and laboratory grounds. Our data show that a
link between hepatitis A, B, or C virus infection andautoimmune liver diseases is highly
4.Fatty liver hepatitis and cirrhosis in obese patients
Liver function and liver biopsy findings were studied in a selected group of 29 overweight
patients. Fatty liver, fatty hepatitis, fatty fibrosis and fatty cirrhosis were seen with equal
frequency. Diabetes was also present with an equal incidence in each of these four pathologic
groups. Lipoprotein abnormalities, particularly type IV hyperlipoproteinemia, were found mostly
in the two groups with the lesions with less fibrosis (fatty liver and fatty hepatitis). The
pathologic picture resembled that of alcohol and postjejunoileal bypass-induced liver diseases
suggesting a common denominator in these three conditions.
5. Epidemiology of alcoholic liver disease.
Although there exists a relationship between alcohol consumption and alcoholic liver disease at
both the aggregate and individual levels, it is also well established that less than one-third of
alcoholics or heavy drinkers develop serious alcohol-related liver damage. A number of factors
have been proposed to account for this susceptibility. Evidence supporting the direct doseresponse relationship and the role of genetic and environmental factors in influencing
vulnerability are reviewed. To date, no consistent evidence attests to the significance of any one
factor in the susceptibility to developingalcoholic liver disease.
6.Oxidative damage and fibrogenesis
Various chronic disease processes are characterized by progressive accumulation of connective
tissue under-going fibrotic degeneration. Evidence of oxidative reactions is often associated with
fibrogenesis occurring in liver, lung, arteries, and nervous system. Moreover, an increasing bulk
of experimental and clinical data supports a contributory role of oxidative stress in
the pathogenesis of this kind of disease. Indeed, many etiological agents of fibrogenesis

stimulate free radical reactions either directly or through inflammatory stimuli. Free radicals, as
well as products of their reaction with biomolecules, appear to modulate the activity of the two
cellular types mainly involved in the process, namely phagocytes and extracellular matrixproducing cells. Lipid peroxidation and certain lipidperoxidation products induce genetic
overexpression of fibrogenic cytokines, the key molecules in the pathomechanisms of fibrosis, as
well as increased transcription and synthesis of collagen. Both these events can be
downregulated, at least in experimental models, by the use of antioxidants. The effect of
oxidative stress on cytokine gene expression appears to be an important mechanism by which it
promotes connective tissue deposition.
7.Pathogenesis of liver fibrosis: role of oxidative stress
In the liver, the progressive accumulation of connective tissue, a complex and dynamic process
termed fibrosis, represents a very frequent event following a repeated or chronic insult of
sufficient intensity to trigger a "wound healing"-like reaction. The fibrotic process recognises the
involvement of various cells and different factors in bringing about an excessive fibrogenesis
with disruption of intercellular contacts and interactions and of extracellular matrix composition.
However, Kupffer cells, together with recruited mononuclear cells, and hepatic stellate cells are
by far the key-players in liver fibrosis. Their cross-talk is triggered and favoured by a series of
chemical mediators, with a prominent role played by the transforming growth factor beta. Both
expression and synthesis of this inflammatory and pro-fibrogenic cytokine are mainly modulated
through redox-sensitive reactions. Further, involvement of reactive oxygen species
and lipid peroxidation products can be clearly demonstrated in other fundamental events of
hepatic fibrogenesis, like activation and effects of stellate cells, expression of metalloproteinases
and of their specific inhibitors. The important outcome of such findings as regards
the pathogenesis of liver fibrosis derives from the observation of a consistent and marked
oxidative stress condition in many if not all chronic disease processes affecting hepatic tissue.
Hence, reactive oxidant species likely contribute to both onset and progression of fibrosis as
induced by alcohol, viruses, iron or copper overload, cholestasis, hepatic blood congestion.
8.The herbal medicine Inchinko-to reduces hepatic fibrosis in cholestatic rats
PURPOSE: Several studies have reported the herbal medicine Inchinko-to (ICKT) to have an
antifibrotic effect which thus leads to an improvement of hepatic injury. However, there are still
few reports of its use in the treatment of cholestatic liver disorder. The aim of this study was to
clarify whether the administration of ICKT will ameliorate hepatic fibrosis and injury in
cholestatic rats.
MATERIALS AND METHODS: We performed bile duct ligation on 7-week-old male
cholestatic Wistar rats and assigned them to one of three groups according to the method of
treatment: (1) the SHAM group, (2) the NT-group (non-treatment group), and (3) the T-group
(treatment-group). Rats in the T-group were orally administered ICKT (TJ-135) at a dose of 1
g/kg/day and were killed on the 17th postoperative day. We subsequently investigated the levels
of fibrosis and various clinical markers through measurement of the following: serum levels
of AST and ALT; tissue transforming growth factor-beta 1 (TGF-beta1); tissue

inhibitor metalloprotease-1 mRNA (TIMP-1 mRNA) through real-timePCR analysis; and Azan
staining and immunohistochemical staining of alfa-smooth muscle actin (alfa-SMA) to evaluate
the degree of fibrosis.
RESULTS: The levels of serum AST, serum ALT, and TGF-bata1 in the T-Group were
significantly lower than those in the NT-Group. In addition, staining of Azan and alfa-SMA in
the T-Group was significantly lower than those in the NT-Group.
CONCLUSION: ICKT may help reduce hepatic fibrosis and injury by controlling stellate cell
9.Effect of weight reduction on hepatic abnormalities in overweight patients
Palmer M, Schaffner F
Samuel Bronfman Department of Medicine, Mount Sinai School of Medicine of the City
University of New York, New York.
Gastroenterology [1990, 99(5):1408-1413]
The effects of weight reduction on hepatic test results and physical findings related to the liver
were retrospectively evaluated in 39 overweight patients screened to exclude other factors
affecting the liver. An additional 11 overweight patients with primary liver disease were
retrospectively evaluated to compare the effect of weight reduction in patients with liver
disease with its effect in those without primary liver disease. This study showed that in
overweight adults without primary liver disease, a weight reduction of greater than or equal to
10% corrected abnormal hepatic test results, decreased hepatosplenomegaly, and resolved some
stigmata of liver disease. In similarly studied overweight patients with primary liver disease,
some findings improved, but the changes did not correlate with a greater than or equal to 10%
weight loss. Increased alanine aminotransferase activity was the most frequent hepatic enzyme
abnormality in this population. For every 1% reduction in body weight,alanine aminotransferase
activity improved by 8.1%. After other causes of liver disease are eliminated by clinical and
biochemical parameters, weight reduction should be tried for overweight patients with abnormal
hepatic test results in the absence of obvious primary liver disease as judged by clinical and
biochemical parameters before extensive and expensive studies are undertaken.
10.Criteria of drug-induced liver disorders. Report of an international consensus meeting.
Type: Consensus Development Conference, Journal Article, Review
DOI: 10.1016/0168-8278(90)90124-A

International reporting of adverse drug reactions by pharmaceutical manufacturers to national
drug regulatory authorities requires internationally accepted standard definitions of reactions
and criteria for assessment of causality. The Council for International Organizations of Medical
Sciences (CIOMS) undertook a pilot project to prepare such definitions and criteria, and
proposed to use as its model a series of expert consensus meetings organized in France by the
pharmaceutical company, Roussel Uclaf, with the participation of the official French network of
pharmacovigilance. Under CIOMS auspices, an international meeting was organized to test the
feasibility of adapting for international use the outcome of the French consensus meetings on
drug-induced liver disorders. The meeting resulted in a series of proposed standard designations
of drug-induced liver disorders and criteria of causality assessment.
11.Vulnerability to psychologic distress and depression in patients with end-stage liver disease
due to hepatitis C virus.
(PMID:9361931) Type: Journal Article, Comparative Study
Psychosocial sequelae and quality of life impairment in patients with end-stage liver disease due
tohepatitis C virus (HCV) are not known. Quality of life, psychological distress (Profile of
Mood State scale), depression (Beck Depression Inventory), and coping (Ways of Coping scale)
were prospectively assessed in 82 liver transplant candidates; comparisons were made between
patients with HCV hepatitis versus patients with other liver diseases. Patients with HCV were
significantly younger than all other patients (p = 0.002). Total mood disturbance (p = 0.038),
tension and anxiety (0.047), confusion and bewilderment (p = 0.035) and depression and
dejection (p = 0.035), as assessed by Profile of Mood States Scale were significantly higher in
patients with HCV than other patients. Patients with HCV were significantly more depressed as
assessed by Beck Inventory scores (p = 0.014). Karnofsky performance scores, Child-Pugh
score, and liver function tests were not significantly different for patients with HCV vs. all other
patients. However, somatic manifestations of the illness (e.g. pain) were greater in patients
with HCV and may have contributed towards greaterdepression in these patients. Our findings
warrant replication in other studies, since depression is a modifiable and treatable disorder.
12.Lethal hepatocellular necrosis associated with herbal polypharmacy in a patient with chronic
hepatitis B infection.
Gilbert JD, Musgrave IF, Hoban C, Byard RW
Forensic Science SA, Adelaide, SA 5000, Australia.
Forensic Science International [2014, 241:138-140]
Type: Journal Article
DOI: 10.1016/j.forsciint.2014.05.021

paul.arsenic.Abstract Following a short treatment for irritable bowel with the following herbs: Astragalus propinquus. University of Exeter. CONCLUSIONS: Collectively these data suggest that there are reasons for concerns with regards to the quality of HMPs. RESULTS: Twenty-six systematic reviews met our inclusion criteria.. Pueraria sp. rodents. Dioscorea opposita. malignancies or carcinomas. despite the popularity of herbal medicine use in the western world. METHODS: Five electronic databases were searched to identify all relevant systematic reviews. mould. Surgery was followed by multiorgan failure and death. Contamination and adulteration of herbal medicinal products (HMPs): an overview of systematic reviews. lead or mercury poisoning. Veysey Building. Poria cocos. While numerous studies have evaluated the effect of polypharmacy. hepatic encephalopathy. toxins.posadzki@pcmd. 69(3):295-307] Type: Journal Article. cerebral edema. intracerebral The most commonly HMPs were adulterated or contaminated with dust. Exeter EX2 4SG. Patriniae. Adulteration and contamination of HMPs were most commonly noted for traditional Indian and Chinese remedies. Salmon Pool Lane.1007/s00228-012-1353-z PURPOSE: The aim of this overview of systematic reviews is to summarise and critically evaluate the evidence from systematic reviews of the adulteration and contamination of herbal medicinal products (HMPs). renal or liver failure. Review DOI: 10. nephrotoxicity. insects. pesticides. Histopathological examination of the liver showed massive hepatic necrosis in keeping with drug/chemical toxicity. Psoralea corylifolia. pollens. parasites. Watson L.coma. rhabdomyolysis. the possibility of untoward effects from herbal polypharmacy must be increasingly considered in the evaluation of medicolegal cases. Ernst E Complementary Medicine. a 43-year-old woman developed acute severe liver failure requiring liver transplantation. Adulteration and contamination of HMPs can cause serious . The most severe adverse effects caused by these adulterations were agranulocytosis. perinatal stroke. fungi. toxic heavy metals and/or prescription drugs. Atractylodes macrocephala. multi-organ failure.Codonopsis pilosula. Paeonia sp. the study of multiple concurrent herb use is only just emerging. and death. Glycyrrhiza uralensis and Dolomiaeasouliei European Journal of Clinical Pharmacology [2013. Alpinia katsumadai. 13. microbes. metabolic acidosis. respectively. meningitis. Peninsula Medical School. As this case demonstrates that fulminant hepatic failure and death may be caused by the concomitant use of a number of herbal products. Posadzki P. hepatorenal syndrome. UK.

9(2):85-88] Type: Journal Article DOI: 10. 'gastrointestinal'. These discrepancies may increase the problems that exist in attempting to determine what role herbal medicines may play in the mechanism of death in certain forensic cases. Frome Road. 'stress' and 'premenstrual syndrome'.008 Abstract A survey of herbal medicines available for internet and over-the-counter purchase in South Australia. Journal of Forensic and Legal Medicine [2014. 33 in 'cold and flu'. More stringent quality control and its enforcement seem to be necessary to avoid health risks.Detecting organic toxins in possible fatal poisonings--a diagnostic problem. 23:19-21] Type: Journal Article DOI: 10. 15.0559 Abstract Highlight Terms Species(1) Chemicals(1) Two fatal cases are reported where there was strong circumstantial evidence of plant toxin ingestion. South Australia.1016/ These findings demonstrate that it may not be possible to determine what herbal substance an individual has been exposed to prior to death and in what concentration. 19 in 'gastrointestinal' 30 in 'stress' and 10 in 'premenstrual syndrome'. Of the registered products 59 (60%) of 99 had differing ingredient concentrations on the website compared to their ARTG Journal of Clinical Forensic Medicine [2002. James RA. Byard RW. The University of Adelaide.jflm. byard. Only three of the 15 purchased products had ingredient concentrations which were consistent between the website. SA 5005. based on packaging from medications seized at the scene.adverse effects. 'cold and flu'. 121 products consisted of 29 in the 'arthritis' category.1054/jcfm. ARTG listing and product packaging.roger@saugov. Australia. Forensic problems with the composition and content of herbal medicines Blacksell L. Adelaide. was conducted looking specifically at those used for 'arthritis'. despite this being a legal requirement for their sale.2014. (PMID:15274954) Byard RW. Musgrave IF School of Health Felgate P Forensic Science Centre. Adelaide. Australia. Twenty two (18%) of 121 products were not registered with the Australian Register of Therapeutic Goods (ARTG). 14. In only one case however was a low urine level of hyoscine detected (in keeping with . or from examination of website data and the ARTG listing. Australia.

a weight reduction of greater than or equal to 10% corrected abnormal hepatic test results. weight reduction should be tried for overweight patients with abnormal hepatic test results in the absence of obvious primary liver disease as judged by clinical and biochemical parameters before extensive and expensive studies are undertaken. (PMID:2210247) Palmer M. 17. but the changes did not correlate with a greater than or equal to 10% weight loss. Altunkaynak BZ. some findings improved. (PMID:22812507) Pişkin A. Yazıcı OB. Hökelek M Departments of Orthopedic and Trauma Surgery. Identification of plant materials at the scene of suspected poisoning may be crucial in directing toxicological investigations.Effect of weight reduction on hepatic abnormalities in overweight patients. and resolved some stigmata of liver disease.2012.The beneficial effects of Momordica charantia (bitter gourd) on wound healing of rabbit skin. The Journal of Dermatological Treatment [2014.713459 . In similarly studied overweight patients with primary liver disease. Gastroenterology [1990. This study showed that in overweight adults without primary liver disease. and the limitation of standard screening. Increased alanine aminotransferase activity was the most frequent hepatic enzyme abnormality in this population. Mount Sinai School of Medicine of the City University of New York. 25(4):350-357] Type: Journal Article DOI: 10. For every 1% reduction in body weight. Schaffner F Samuel Bronfman Department of Medicine. Tümentemur G.alanine aminotransferase activity improved by 8.a history ofDatura sp. 99(5):1408-1413] Type: Journal Article Abstract Highlight Terms Gene Ontology(1) Diseases(1) The effects of weight reduction on hepatic test results and physical findings related to the liver were retrospectively evaluated in 39 overweight patients screened to exclude other factors affecting the liver. Samsun . New York. Medical School of Ondokuz Mayıs University .1%. Turkey. An additional 11 overweight patients with primary liver disease were retrospectively evaluated to compare the effect of weight reduction in patients with liver disease with its effect in those without primary liver disease. 16. After other causes of liver disease are eliminated by clinical and biochemical parameters. Fatal cases of plant toxin ingestion may be a problem for the laboratory given the wide range and rarity of certain plant poisons. Kaplan S.3109/09546634. decreased hepatosplenomegaly. consumption).

the MC group displayed the highest fractions of epidermis to papillary dermis. 28 New Zealand rabbits were divided into four groups and excision wounds (7 cm²) were made on their backs. oleander leaf distillate on cholesterol metabolism is not disclosed sufficiently. they compare the healing potential with conventional creams used therapeutically. Pharmaceutical Biology [2014. The MC group also presented a high density of blood vessels. . contraceptive and antibacterial properties. areas of the skin with initial wound area were en bloc dissected and prepared for histopathological and stereological analysis. Baş AL Sarayönü Vocational High School.Implications from a pharmacogenomic analysis: Nerium oleander leaf distillate supplemented diet regulates cholesterol metabolism in rats Demirel Kars M. nitrofurazon (Furacin®.2013.antioxidant. Different cream supplements caused healthy and fast wound healing according to untreated controls and the results show that administration of the MC extract improves and accelerates the process of wound healing in rabbits in comparison with the BP and FR extracts.874535 Abstract Highlight Terms Gene Ontology(1) Species(4) Abstract Context: Despite the usage of Nerium oleander L. Towards this aim. Selçuk University . but the latter provided more effective reorganisation of the dermis. No application was made to the control group. Moreover. especially in the MC group. n = 7). fibroblasts to reticular dermis and collagen fibres to reticular dermis. The BP group showed better epithelialisation compared with the FR group. n = 7) and olive oil extract of MC (MC group. the authors aim to observe the topical effect of MC cream on the wound-healing process in rabbits. BP group. Turkey . Furthermore. Inflammatory cells were abundant in the control group and cream application led to a decrease in the number of these cells. (Apocynaceae) for anticancer studies and traditional remediation. n = 7). bitter gourd) is a traditional herbal commonly used for its antidiabetic. 18. 52(8):988-993] Type: Journal Article DOI: 10.Abstract Highlight Terms Gene Ontology(1) Species(4) Chemicals(2) Momordica charantia (MC. Bağcı Y. the regulatory effect of N. At the end of day 28. Uney K. Konya . FR group. Odabaşı BA. Kars G. In the current study. The highest number of fibroblasts was detected in the MC group. Open wound dressing was carried out daily for 28 days among the experimental groups with the application of dekspanthenol (Bepanthen®. moderate density of collagenfibres and mature fibroblasts.3109/13880209.

Histopathology of the livers from vasicinone and silymarin pre-treated animals showed normal hepatic cords and absence of necrotic changes suggesting pronounced recovery from CCl4 induced liver damage.5 mL distilled water applied by gavage). Pre-treatment with vasicinone and silymarin (25 mg/kg/day for 7 days) significantly decreased these enzyme levels. Vasicinone was isolated from leaves of J. The aim of this study was to investigate the regulation ofcholesterol metabolism in response to a high-fat diet (HFD) and the effects of N.Evaluation of hepatoprotective activity of vasicinone in mice Sarkar C. adhatoda. FT-IR and 1H NMR. oleander leaf distillate-supplemented diet (NOHFD) in rats. thus indicating recovery of liver function. Based on the above results it can be concluded that vasicinone may act as . The treatment period was 90 days. Its crude extract has been previously reported to have hepatoprotective activity. column purified and characterized using. The results showed that expression levels of 47 genes were altered related to cholesterol metabolism in HFD and NOHFD groups. Results of groups were statistically analyzed with the Partek 6. Rat liver tissues were used for microarray analysis using the Affymetrix GeneChip Rat Genome platform. ALP levels. CCl4 treatments lead to significant increase in SGOT.Objective: Cholesterol is an important biological molecule and the synthesis rate is regulated by the amount of cholesterol uptake from the diet. Banerjee S Indian Journal of Experimental Biology [2014.6 bioinformatic program. 19. Materials and methods: Microarray technology was used to clarify the regulation of cholesterol mechanism in HFD and NOHFD-fed rats (375 μg/0. Both vasicinone and silymarin significantly decrease the CCl4 mediated increase in pentobarbital indiced sleeping time in experimental animals. Results: The HFD group exhibited alterations in the expression levels of about 1945 genes with respect to the normal diet (ND) group. TLC UV. 52(7):705-711] Type: Evaluation Studies. The isolated vasicinone was evaluated for hepatoprotective activity using (CCl4)-induced acute hepatotoxicity model in mice. findings suggest that N. Journal Article Abstract Highlight Terms Diseases(1) Genes/Proteins(2) Species(5) Chemicals(3) Justicia adhatoda (vasaka) leaves have long been used in Indian Ayurvedic system of medicine asantitussive. The expression levels of seven genes in the NOHFD group were significantly closer to those in the ND group than those of the HFD group. oleander leaf distillatesupplemented food has considerable beneficial effects on cholesterol metabolism-related gene expression levels. Bose S. Discussion and conclusion: To conclude. SGPT.

Research Support.lfs. Wu C. Zhang G. Wenzhou 325000. has a wide range of clinical effects. anti-inflammation. AA induced an imbalance between MMP-2 and TIMP-2 and enhanced expression of TGF-β1 and its receptor. Life Sciences [2014. (PMID:24594217) . we determined whether S.Sedum sarmentosum Bunge extract exerts renal anti-fibrotic effects in vivo and in vitro. (PMID:24747135) Bai Y. as indicated by reduced serum creatinine levels. Protective effect of total alkaloids on lipopolysaccharide-induced acute lung injury. and alleviated renal interstitial fibrosis. a traditional Chinese herbal medicine. Gov't DOI: 10. In this study. sarmentosum Bunge Extract (SSBE) has anti-fibrotic effects on renal tissues. we examined the expression levels of TGF-β1 and its receptor.MAIN METHODS: We investigated the effects of SSBE on aristolochic acid (AA)induced injury to renal tubular epithelial cells (RTECs) in vitro and unilateral ureteral obstruction (UUO)-induced renal fibrosis in vivo by evaluating epithelial-to-mesenchymal transition (EMT) and the accumulation ofextracellular matrix (ECM) components. AA promoted renal EMT and ECM accumulation by up-regulating the expression of mesenchymal markers and ECM components and by down-regulating the expression of epithelial markers. Non-U. China. SIGNIFICANCE: These findings suggest that SSBE may have therapeutic potential for fibrotic kidney diseases 21. Liang Y.S.013 Abstrac t Highlight Terms Gene Ontology(2) Diseases(6) Genes/Proteins(5) Species(3) Chemicals(1) AIMS: Sedum sarmentosum Bunge.hepatoprotective in mice and warrants further investigation onhuman volunteers 20. Lin C. SSBE treatment significantly inhibited AA-induced TGF-β1 expression and prevented the induction of EMT and deposition of ECM. and anti-cancer properties. tubular injury and interstitial fibrosis were obviously increased. Chen B Wenzhou Key Laboratory of Surgery.2014. Wenzhou Medical University. Lu H. Furthermore. In addition.04. KEY FINDINGS: In cultured RTECs (NRK-52E). including anti-oxidation. The First Affiliated Hospital. In the UUOrats. These anti-fibrotic effects were associated with a reduction in TGF-β1 expression and inhibition ofEMT and ECM accumulation. SSBE administration protected renal function.1016/j. 105(1-2):22-30] Type: Journal Article.

and three different doses (50. Moreover. CONCLUSIONS: This study indicates that total alkaloids may have a protective effect against LPS-induced acute lung injury.jss.Niu X.2014.1016/j. pretreatment with total alkaloids significantly reduced LPS-induced death. Gov't DOI: 10. which validate the use of totalalkaloids of denticulato-bracteata Fedde in the literature.1016/S0378-8741(03)00184-3 . Xi'an Jiaotong University. P. Yao H. Mu Q. Santacruz East. 189(1):126-134] Type: Journal Article. which causes the reduction of inflammatory markers such as tumor necrosis factor α and inducible nitric oxide synthase. intraperitoneally). Li H School of Pharmacy. India. However. intragastric gavage) for total alkaloids-treated groups. University of Mumbai. Li Y. intragastric gavage). there is no scientific evidence. Li W. 100. Biyani MK Department of Life Science. The Journal of Surgical Research [2014. Total alkaloids pretreatment also reduced LPS-induced inducible nitric oxide synthase and p65nuclear factor kappa B protein expression in the lung.065 Abstrac t Highlight Terms Gene Ontology(1) Diseases(1) Genes/Proteins(3) Species(2) Chemicals(4) BACKGROUND: Corydalis denticulato-bracteata Fedde is used as a traditional herbal medicine for the treatment of pneumonia. Suthar AC. total alkaloids decreased the production of the tumor necrosis factor α and nitric oxide in the serum and bronchoalveolar lavage fluid. each): control group.R China. Hu H. Shahani S. Journal of Ethnopharmacology [2003. Comparative Study DOI: 10. (PMID:12902059) Virdi J. LPS group. and 200 mg/kg. Banavalikar MM. Sivakami S.S. intraperitoneally) group. RESULTS: As revealed by survival study. This protective effect of total alkaloids seems to result from inhibition of nuclear factor kappa B activation. Corresponding drugs or vehicles were given 24 and 1 h before lipopolysaccharide (LPS) administration (5 mg/kg. The severity of pulmonary injury was evaluated 6 h after LPS challenge. Xi'an. Non-U. Antihyperglycemic effects of three extracts from Momordica charantia. MATERIALS AND METHODS: Male Kunming mice were randomly divided into seven groups (n = 12. total alkaloidsalone (200 mg/kg.01. 88(1):107-111] Type: Journal Article. 22. Huang H. Dexamethasone (5 mg/kg. We also found that total alkaloids pretreatment markedly decreased the lung wet-to-dry weight ratios and significantly attenuated histopathologic changes. 400 098 Mumbai. Kalina. Research Support.

Turkey. ethanol extract of the fruits showed significant activity against HCl-EtOH induced ulcerogenesis in indomethacin-pretreated rats and diethyldithiocarbamate-induced ulcer models . 71(1-2):77-82] Type: Journal Article.Abstract Highlight Terms Diseases(2) Genes/Proteins(1) Species(4) Chemicals(3) Momordica charantia (L. Faculty of Pharmacy. Sener B Department of Pharmacognosy.S.1016/S0378-8741(99)00178-6 Abstract Highlight Terms Diseases(1) Species(3) Chemicals(4) The mature fruits of Momordica charantia L.Anti-ulcerogenic effect of Momordica charantia L.) (Cucurbitaceae) commonly known as bitter gourd or karela is a medicinal plant. Non-U. fruits on various ulcer models in rats. one of which is diabetes mellitus. Yeşilada E. Akyüz C. The aqueous extract powder of fresh unripe whole fruits at a dose of 20mg/kg body weight was found to reduce fasting blood glucoseby 48%. hepatotoxicity and biochemical parameters such as SGOT. 23. the material was first extracted with hexane and then by ethanol and both extracts were found active against the same ulcer model. Furthermore. Gazi University. various extract powders of the fresh and dried whole fruits were prepared and their blood glucoselowering effect compared by administrating them orally to diabetic rats. Journal of Ethnopharmacology [2000. Gov't DOI: 10. appears to be a safe alternative to reducing blood glucose. The extract did not show any signs of nephrotoxicity and hepatotoxicity as judged by histological and biochemical parameters. (PMID:10904148) Gürbüz I. Hipodrom 06330. For the evaluation of the latter activity. For the bioassay-guided fractionation. The olive oil extract of the material as well as dried-powdered fruits in filtered honey showed significant and dose-dependent anti-ulcerogenic activity against this model. an effect comparable to that of glibenclamide. SGPT and lipidprofile. In this study. This extract was tested for nephrotoxicity. used in Ayurveda for treating various diseases. a known synthetic drug. an edible vegetable. ethanol-induced ulcerogenesis model in rats was employed. Thus the aqueous extract powder of Momordica charantia. (Cucurbitaceae) are used externally for the rapid healing of wounds and internally for the treatment of peptic ulcers in Turkish folk medicine. A potent and dosedependent inhibitory activity was also observed by the administration of ethanol extract of the fruits. Ankara. Research Support.

Inflammopharmacology [2013.2013.044 Abstract Highlight Terms Genes/Proteins(1) Complementary and alternative medical (CAM) therapies are commonly used by patients for the treatment of medical conditions spanning the full spectrum of severity and chronicity.rochester. 21(6):413-419] . is on the increase. Etiler. Included within this categorization. 113(5):897-903] Type: Journal Article.1016/j. The American Journal of Cardiology [2014. Uludag arrhythmic disease-absent effective catheter-based therapy or with medical therapy limited by the toxicities of contemporary antiarrhythmic agents is frequently managed by patients with CAM therapies without their practitioner's knowledge and in the face of potential herb-drug toxicities. Greenville Health System. Gazi University.      (PMID:23794063) Abstract Citations BioEntities Related Articles External Links Ercan N. Demirel-Yilmaz E Department of Pharmacology. Review of complementary and alternative medical treatment of arrhythmias.24. for conditions lacking effective medical treatment. Agis ER. Aktas MK Department of Medicine. We stress persistent vigilance on the part of the provider in discussing the use of herbal or other CAM agents within the arrhythmia population. The anti-inflammatory effect of diclofenac is considerably augmented by topical capsaicinoids-containing patch in carrageenan-induced paw oedema of rat. The use of alternative remedies. Greenville. Faculty of Pharmacy. Electronic address: Andrew_Brenyo@urmc. South Carolina. This study reviews 9 CAM therapies: 7 individual herbal therapies along with acupuncture and yoga that have been studied and reported as having an antiarrhythmic effect. 06330. (PMID:24528618) Brenyo A. Turkey. The primary focuses are the proposed antiarrhythmic mechanism of each CAM agent along with interactions between the CAM therapies and commonly prescribed medical therapy for arrhythmia patients. Review DOI: 10. Ankara. 25. both herbal and others.amjcard.11.

Non-U.x Abstract Highlight Terms Gene Ontology(1) Diseases(1) BACKGROUND: Large proportions of patients use herbal medicinal products. the combination of NSAID with topicalcapsaicinoids-containing patch could increase the anti-inflammatory efficiency of drug without systemic side effects.S. (PMID:12950418) Pittler MH. UK. Exeter. The systemic application of diclofenac (3 mg/kg).Pittler@exeter. Peninsula Medical School. In this study. Review. M.H. Research Support. The results of this study indicate that topical application of capsaicinoids-containing patch enhances the anti-inflammatory effect of diclofenac and its beneficial effect may not purely relate to its capsaicincontent. the combination of diclofenac with topical capsaicinoids-containing patch significantly increased the effectiveness of diclofenac on inflammation. Topical capsaicinoids-containing patch application or local capsaicin injection (2. 20 μg/paw) alone did not cause any effect on oedema volume and weight.2003.Type: Journal Article DOI: Alimentary Pharmacology & Therapeutics [2003. 26. significantly decreased the volume and weight of the paw oedema. On the other hand. the effects of both topical capsaicinoidscontaining patch and local subcutaneous capsaicin application on the anti-inflammatory action of NSAID were examined. 10.1007/s10787-013-0175-7 Abstract Highlight Terms Diseases(2) Species(1) Chemicals(6) Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most used drugs in musculoskeletal disorders. Evans blue content of the paws that represents plasma extravasation was decreased by capsaicinoids-containing patch with and without diclofenac and diclofenac combination with the lowest dose of capsaicin injection. and encouraging . 18(5):451-471] Type: Journal Article.Systematic review: hepatotoxic events associated with herbal medicinal products.1365-2036. which is an NSAID. In the treatment of local inflammatory disorders. Universities of Exeter and Plymouth. topical preparations of capsaicinoids are widely used for musculoskeletal disorders as a complementary therapy. The volume and weight of the paw oedema and plasma extravasation in the paw were determined after carrageenaninjection.Carrageenan-induced paw oedema of rats was used as the inflammation model.1046/j. However.01689. Ernst E Complementary Medicine. Gov't DOI: 10. but their systemic adverse effects limit their therapeutic benefit in local inflammation.

The Cochrane Library. To identify additional data. Gajbhiye A Department of Pharmaceutical Sciences. Drug Development and Industrial Pharmacy [2013. contamination and/or adulteration. Comparative Study. In order to be included articles were required to report data on hepatotoxic events associated with the therapeutic use of herbal medicinal products. In most instances hepatotoxic herbal constituents are believed to be the cause. Research Support.S.3109/03639045. Owing to which there is a need to develop MF herbosomes to resolve the . Madhya Pradesh . which is still largely under-investigated is the question of potential harm. MF shows hepatoprotection against various liver disorders but due to rapid clearance and limited solubility in lipoid environment. there is problem of its poor absorption from intestine hence poor bioavailability.738685 Abstract Highlight Terms Diseases(4) Genes/Proteins(6) Species(1) Chemicals(9) CONTEXT: Fatty liver is the first stage of alcoholic damage which is reversible with abstinence from alcohol. educate all parties involved. The challenge for the future is to systematically research this area. Amed and Ciscom. the spectrum ranges from transient elevations of liver enzyme levels to fulminant liver failure and death. One aspect.Pharmacological evaluation of mangiferin herbosomes for antioxidant and hepatoprotection potential against ethanol induced hepatic damage. In Vitro DOI: 10. Clinically. CONCLUSIONS: A number of herbal medicinal products are associated with serious hepatotoxic events. India. Non-U. 39(11):1840-1850] Type: Journal Article. Sagar. 27. while others may be due to herb-drug interactions. (PMID:23167243) Jain PK. Incidence figures are largely unknown. however. Mangiferin (MF) showed potent scavenging activity on diphenyl-1-picrylhydrazyl radicals which stimulate liver regeneration in various liver injuries. There were no restrictions regarding the language of publication. OBJECTIVE: Although. Embase. RESULTS: Single medicinal herbs and combination preparations are associated with hepatotoxic in terms of effectiveness exist for some of these. searches were conducted by hand in relevant medical journals and in our own files. METHODS: Systematic literature searches were performed on Medline. and in most cases a causal attribution is not established. Kharya M. Dr Hari Singh Gour Central University . The screening and selection of articles and the extraction of data were performed independently by the two authors. and minimize patient risk.2012. AIM: To review the recent evidence on hepatotoxic events associated with the use of herbal medicinal products. Gov't.

4103/0975-9476.problem of poor bioavailability to enhance the therapeutic potential. chromatography. India. silymarin (SL). 3(1):38-44] Type: Journal Article DOI: 10. infrared (IR). 28. and nuclear magnetic resonance (NMR)). ex vivo absorption using everted small intestine sac technique and in vivo studies using ethanol inducing hepatotoxicity in albino rats and comparing the results against plain MF.      (PMID:22529679) Abstract Citations BioEntities Related Articles External Links Chopra A. Evaluating higher doses of Shunthi . Tillu G. CONCLUSION: The above mentioned results showed that hepatoprotective and antioxidant potency of MF enhanced due to the preparation of its herbosomes. METHODS: Successfully prepared MF herbosomes through complexation with phospholipids were characterized by physicochemical. MF herbosomes also showed significantly decreased level of malonyl dehydrogenase along with increased levels of reduced glutathione. serum glutamate pyruvate transminase (SGPT).93948 Abstrac t Highlight Terms Gene Ontology(2) Diseases(3) Genes/Proteins(1) Species(5) Chemicals(1) BACKGROUND: Results of an exploratory trial suggested activity trends of Zingiber .Guduchi formulations for safety in treatment of osteoarthritis knees: A Government of India NMITLI arthritis project. Maharashtra. Venugopalan A. Patwardhan B Centre for Rheumatic Diseases. Saluja M. Narsimulu G. Journal of Ayurveda and Integrative Medicine [2012. and alkaline phosphatase(ALP) in MF herbosomes as compared to plain MF. Pune. total bilirubin. RESULTS: Ex vivo study showed significant increased absorption of MF from prepared MF herbosomes as compared to plain MF. Sarmukaddam S.superoxide dismutase (SOD) and catalase as compared to plain MF which was also comparable to the standard drug. The hepatoprotective potential of MF herbosomes evaluated by in vivo study revealed significantly decreased levels of serum glutamate oxaloacetate transminase (SGOT). spectroscopy (differential scanning calorimetry (DSC).

4(4):236-241] Type: Journal Article. CI 0.S. These formulations were "platform combination+Withania somnifera+Tribulus terrestris" (formulation B) and "platform combination+Emblica officinale" (formulation C).co. (PMID:22196506) Suriyavathana Vedanarayanan M.52 times) along with Sallaki Guggul and Bhallataka Parpati (a Semecarpus anacardium preparation).22-2. The 4 arms were (I) formulation B. 2 t.37. Non-U. Standard statistical program (SPSS version 12.5-2.5) was used for analysis. Gov't DOI: 10. CI 0.i. randomized parallel efficacy 4-arm multicenter drug trial. The mean improvement in active pain visual analog scale (1.. An improved efficacy and likely chondroprotective effect was shown by group IV intervention. 29. Patients were examined at baseline. and on completion. (III) platform combination+Sallaki Guggul. (II) formulation B.014 Abstrac t Highlight Terms . and urinary C-TAX (cartilagecollagen breakdown product) assay was maximum (NS) in group IV.jams. (IV) Bhallataka Parpati+formulation C. WOMAC (functional activity questionnaire) pain score (1. suriyaveda@yahoo.d. Research Support.09. 2 q. India. MATERIALS AND METHODS: Ninety-two patients with symptomatic OA knees were enrolled in a 6 weeks investigator blind.d.2011. Mild gut-related (mostly epigastric burning) AE was reported.22). standardized Ayurvedic formulations demonstrated a good safety profile.5). first and fourth weeks.officinale-Tinopsora cordifolia (platform combination)-based formulations in the treatment of Osteoarthritis (OA) Knees. serum glutamic oxaloacetic transaminase (SGOT)] without any other hepatic abnormality was reported in 2 patients (group IV). Ayurvedic formulation of Liv-Pro-08 reduces nonalcoholic fatty liver disease in rats fed with high-fat diet. RESULTS: None of the patients reported serious AE or withdrew due to any drug-related toxicity. CONCLUSION: The results suggested that despite higher doses. Other laboratory parameters remained normal.1016/j. Laboratory evaluation included detailed hematology and metabolic parameters.4. A detailed enquiry was carried out for adverse events (AE) and drug toxicity as per a priori check list and volunteered information. Periyar University. This paper reports safety of these formulations when used in higher doses (1. A mild increase in liver enzymes [serum glutamic pyruvate transaminase (SGPT). Krishnan N Department of Biochemistry. Tamilnadu. Lower dose group I showed numerically superior improvement compared with higher dose group Journal of Acupuncture and Meridian Studies [2011. A confirmatory drug trial with adequate power and sample size was planned based on the learning from this trial..i.

alanine aminotransferase. alkaline phosphatase. and alkaline phosphatase enzymes. (PMID:19459733) Reddy VD. Entada pursaetha. and it will continue to be a major liver health issue worldwide in the coming decades. superoxide dismutase. 12(2):327-333] Type: Journal Article DOI: 10. viz. This experimental study suggests that Liv-Pro-08 can act as a therapeutic tool in preventing NAFLD progression (i. Chronic alcohol feeding also . Sri Krishnadevaraya University. was investigated for its effects on liver mitochondria of ethanol-administered rats. and gammaglutamyl transferase compared to control rats. Rats were given a high-fat diet for a period of 7 days. activities of hepatic mitochondrial antioxidant enzymes. However. Although further investigations and large randomized trials should be conducted. Liv-Pro-08 (250. a slight reduction was observed in serum aspartate aminotransferase. Journal of Medicinal Food [2009. were significantly lower.body weight was given orally for 7 days. reducing hepatic lipid accumulation). 30. and Ficus glomerata) an oral ayurvedic formulation on rats fed with high-fat diet..2007. Moreover. Varadacharyulu NCh Department of Biochemistry..e. India.0694 Abstract Highlight Terms Gene Ontology(1) Genes/Proteins(7) Species(2) Chemicals(10) The protective effect of Emblica officinalis. Also. glutathione peroxidase. their lipoprotein profiles were significantly improved compared with those that are not receiving the extract. Emblica officinalis protects against alcohol-induced liver mitochondrial dysfunction in rats. Padmavathi P. and 750 mg/kg. Liv-Pro-08 significantly decreased their fasting serum glucose and fasting insulin levels. We examined the effect of the high-fat diet on various parameters related to obesity and insulinresistance. a commonly used botanical in many Ayurvedic preparations. In the experimental rats who received the extract of Liv-Pro-08. We aimed to determine the effect of Liv-Pro-08 (Nigella sativa. Alcohol-administered rats showed a significant elevation of plasma transaminases (aspartate and alanine aminotransferases). Oxidative stress and reactive oxygen species-mediated toxicity are considered two of the key underlying mechanisms responsible for alcohol-induced liver injury and mitochondrial dysfunction. Anantapur. ayurvedic Liv-Pro-08 oral formulation may be a potential natural drug for NAFLD in the future. 500.Gene Ontology(1) Diseases(2) Genes/Proteins(3) Species(4) Chemicals(3) Nonalcoholic fatty liver disease (NAFLD) has emerged as a serious obesity-related disorder. and reduced glutathione.1089/jmf. After this period.

2007. Journal of Ethnopharmacology [2007.S. on aflatoxin B1-induced liver damage in mice. SDH. et Thonn.increased lipid peroxide levels. Ethanolic extract ofPhyllanthus amarus (0. It is an ayurvedic herb and has a wide range of traditional uses in different diseases. Euphorbiacae) is a herb common to central and southern India.07. I and gp. glutathione-Stransferase (GST). Aflatoxin was administered orally (66.1016/j. protein carbonyl content.3g kg(-1)BW 0.NADH dehydrogenase.jep. Jamia Hamdard. V) after 30 min of aflatoxin administration. (Bhuia amla.2 ml(-1)day(-1)) was given to all groups except control groups (gp. Our data indicate that EFE administration to chronically alcohol-fed rats offers protection against alcohol-induced alterations. Non-U. Research Support. Gov't DOI: 10. and cytochrome c oxidase activities.2 ml(-1)day(-1)) were given. officinalis fruit extract (EFE) at a dose of 250 mg/kg of body weight/day to alcoholic rats offers protection by simultaneously lowering the carbonyl content and lipid peroxidation and elevating antioxidant enzyme activities. Department of Biotechnology.superoxide dismutase (SOD) and catalase (CAT).2 ml(-1)day(-1)) to the mice of each group except control to which normal saline andascorbic acid (0. 31. and overproduction of nitricoxide followed by lowered activities of NADH dehydrogenase. Abdin MZ Centre for Transgenic Plant Development.017 Abstract Highlight Terms Gene Ontology(2) Genes/Proteins(7) Species(4) Chemicals(5) Phyllanthus amarus Schum. Histopathological analyses . India. 113(3):503-509] Type: Journal Article. The aim of this work was to evaluate the hepatoprotective effect of ethanolic extract of Phyllanthus amarus (Phyllanthus amarus) on aflatoxin B(1)-induced liver damage in mice using different biochemical parameters and histopathological studies. Faculty of Science. et Thonn. andcytochrome c oxidase and content of cytochromes. Hepatoprotective effect of ethanolic extract of Phyllanthus amarus Schum. and content of cytochromes in hepatic mitochondria. Phyllanthus amarus extract was found to show hepatoprotective effect by lowering down the content ofthiobarbituric acid reactive substances (TBARS) and enhancing the reduced glutathione level and the activities of antioxidant enzymes. The active tannoid principles and nitric oxide scavenging compounds present in EFE may have contributed to the protection observed. respectively. glutathione peroxidase (GPx). Administration of E.6 microg kg(-1)BW 0. succinate dehydrogenase (SDH). (PMID:17720339) Naaz F. New Delhi 110062. The entire study was carried out for 3 months and animals were sacrificed after an interval of 30 days till the completion of study.1g kg(-1)BW 0. Javed S.

A number of products are reported to be useful in patients with acute viral hepatitis. CONCLUSIONS: Evidence-based studies on the efficacy and safety of traditional Indian . In another multicentric trial. ascorbic acid. Traditional Indian systems of medicine. which was comparable to the standard antioxidant.of liver samples also confirmed the hepatoprotective value and antioxidant activity of the ethanolic extract of the herb. (PMID:10748962) Lodha R. RESULTS: Ayurvedic preparations have been successfully used for the treatment of bronchial asthma. Single case reports were excluded. 32. Annals of the Academy of Medicine. A multicentric study by the Indian Council of Medical Research showed that a preparation fromPterocarpus marsupium was effective in reducing levels of blood glucose and glycosylatedhaemoglobin in patients with non-insulin-dependent diabetes mellitus. 29(1):37-41] Type: Journal Article. All India Institute of Medical Sciences. was reported to significantly improve short-term and long-term memory. ischaemic heart disease and hyperlipidaemia. and the main mechanism involved in the protection could be associated with its strong capability to reduce the intracellular level of reactive oxygen species by enhancing the level of both enzymatic and nonenzymatic antioxidants. India. METHODS: We reviewed the MEDLINE database to identify clinical trials conducted using traditional Indian medicines. Surgical treatment led to a faster cure but recurrence rates were lower with medicated seton. The overall data indicated thatPhyllanthus amarus possesses a potent protective effect against aflatoxin B(1)-induced hepatic damage. few properly designed trials have scientifically examined the clinical potential of Ayurvedic and other medications. New Delhi. to children with mental retardation. Review Abstrac t Highlight Terms Gene Ontology(1) Diseases(7) Genes/Proteins(1) Species(2) Chemicals(3) INTRODUCTION: A number of traditional systems of medicine exist in India of which Ayurveda is the most popular. Despite being in use for more than 3000 years. patients with fistula-in-ano were randomised to surgery or application of medicated seton (Ksharsootra). Administration of extract from Bacopa monnieri. Bagga A Department of Pediatrics. Formulations containing curcumin were reported to reduce inflammation and disability in double-blind clinical trials on patients with rheumatoid arthritis. Singapore [2000.

Abhrak bhasma treatment along with CCl4 enhanced alkaline lipaseactivity at 10 and 20 mg dose and later it was reduced at 30 and 40 mg doses and came to normal levels. 30 and 40 mg/kg body wt) were tested to decide the dose related hepatoprotective efficacy. 34. It is tested in albino rats using a model of hepatitis induced by a single dose of CCl4 (3 ml/kg body wt). while alkaline and lipoprotein lipase activities were elevated due to treatment of single dose of CCl4. 42(4):105-108] . Perissond D. Kolhapur. Ramesh V. an ayurvedic drug in albino rats against hepatitis induced by CCl4. The essential ingredient in most formulations is not precisely defined. Indian Journal of Experimental Biology [2001. Goregaon. Acid lipase activity was raised by administration of different doses of abhrak bhasma concurrent with CCl4. Baxi AJ. Bhatt AD. 39(10):1022-1027] Type: Journal Article Abstract Highlight Terms Diseases(2) Genes/Proteins(2) Species(1) Chemicals(2) Abhrak bhasma is a commonly used ayurvedic drug against many diseases including hepatitis. Kulkarni PH. Abhrak bhasma counteracted the action of CCl4 on liver lipolytic enzymes. Kanase A Department of Zoology. CCl4 did not alter the kidney histologically. Activities of three lipases of rat kidney (acid. The centrolobular necrosis induced by single dose of CCl4 was reduced significantly by abhrak bhasma (10 mg) and liver histology was also protected by 20 mg dose. Bombay. 33. Liver acid lipase activity was lowered. alkaline and lipoprotein lipases) were reduced by CCl4 treatment and were reversed by administration of abhrak bhasma. Shivaji University. lipoprotein and hormone sensitive lipases were enhanced after 24 hr of administration of CCl4. Doshi JC.medicines are limited. Hepatoprotective action of abhrak bhasma. Journal of Postgraduate Medicine [1996. Antarkar DS. (PMID:11883510) Buwa S. High quality studies are necessary to evaluate and compare the value of traditional Indian drugs to modern medicine. Lipoprotein and hormone sensitive lipases were reduced by the counteraction of increasing doses of abhrak bhasma. Patil S. 20. On the contrary alkaline. Vora PV. Acid lipase activity of rat adipose tissue was reduced by CCl4 treatment. Picrorhiza kurroa (Kutaki) Royle ex Benth as a hepatoprotective agent--experimental & clinical studies. (PMID:9715310) Vaidya AB. Kale PM Ciba Research Centre. Different doses of abhrak bhasma (10. India.

kidney and adipose tissue and hormone sensitive lipase of adipose tissue of albino rat. 35. double-blind placebo controlled trial in patients diagnosed to have acute viral hepatitis(HBsAg negative). Kanase A. The standardization of active principles--Picroside 1 and 2 was done with High Performance Liquid Chromatography.lipoprotein lipase of liver. India.88 mg/capsule and picroside 2 from 5. Indian Journal of Experimental Biology [1993. Journal Article.05) in liver lipid content. Effect of hepatoprotective ayurvedic drugs on lipolytic activities during CCl4 induced acute hepatic injury in albino rats.o.Type: Clinical Trial. was studied in experimental and clinical situtations. The possible physiological significance of alterations in lipolytic enzymes during hepatic necrosis induced by CCl4 and hepatoprotection by the above ayurvedic drugs is discussed.44 days in Pk group. 31(3):265-269] Type: Journal Article. Picroside 1 ranged from 2. The time in days required for total serum bilirubin to drop to average value of 2. Varute AT Zoology Department. The present study has shown a biological plausability of efficacy of Pk as supported by clinical trial in viral hepatitis. showed a significant reduction (p < 0. Non-U. Pk at a dose of 200 mg/kg p.72 to 2. Research Support. Pk root powder 375 mg three times a day was given for 2 weeks (n = 15) or a matching placebo (n = 18) was given.50 to 6. . Randomized Controlled Trial Abstrac t Highlight Terms Gene Ontology(1) Diseases(2) Genes/Proteins(2) Species(2) Chemicals(3) Picrorhiza kurroa (Pk). In the galactosamine-induced liver injury in rats. In a randomised. Treatment of CCl4 caused significant alterations in the activities of acid lipase.5 mg% was 75.9 days in placebo as against 27. Shivaji University. Administration of hepatoprotective ayurvedic drugs (kumari asav. Difference in values of bilirubin. kumari kalp. hepatoprotection in animal model and an approach for standardizing extracts based on picroside content. Kolhapur. Gov't Abstract Highlight Terms Diseases(1) Genes/Proteins(2) Species(1) Chemicals(2) Daily treatment of CCl4(3 ml/kg body wt) for 7 days induced acute hepatic necrosis in albino rats.S. alkaline lipase. arogyavardhini and tamra bhasma) concomitant with CCl4 counteracted the action of CCl4 on lipolytic enzymes exhibiting hepatoprotection. SGOT and SGPT was significant between placebo and Pk groups.00 mg/capsule. a known hepatoprotective plant. (PMID:8500840) Patil S. GOT and GPT.

Shukla AC. Since the practice of ethnomedicine is based on the age-long indigenous knowledge which has been orally transmitted through generations and sustained in traditions there is an urgent need to document such knowledge. AZ 85282. Tempe. this system is rooted in folk or ethnomedicine and in practice it shows further refinement and developmentin accordance with local traditions. (PMID:24689312) Mukherjee A. Isolation of active principles from crude drugs. 9(2):287-290] Type: Journal Article Abstract Highlight Terms Gene Ontology(1) Species(2) Ayurveda has been the main guiding force in drug discovery from traditional medicine. Mandal SC Natural Product Communications [ Alternative Medicine Review : a Journal of Clinical Therapeutic [1998. India with her rich plant wealth and traditional knowledge about the medicinal use of plants has tremendous scope to provide leadership in ensuring human health and longevity. Review Abstract Highlight Terms Diseases(5) Species(5) Chemicals(1) Botanicals have been used traditionally by herbalists and indigenous healers worldwide for the prevention and treatment of liver disease. To keep the opportunity alive for further development in traditional as well as modem medicines. Modernization of Ayurveda: a brief overview of Indian initiatives. The ongoing strategies adopted in India to document the precious traditional knowledge and conserve medicinal plants are discussed in this communication. USA. 3(6):410-421] Type: Journal Article.36. their pharmacological evaluation. Basic scientific research has uncovered the mechanisms by which some plants afford their therapeutic effects. it is necessary to have an uninterrupted connection with ethnomedicine. therapeutic proving and clinical application resulted in the genesis of modem or so called allopathic medicine. Clinical research in this century has confirmed the efficacy of several plants in the treatment of liver disease. Mandal V. A review of plants used in the treatment of liver disease: part 1. (PMID:9855566) Luper S Southwest College of Naturopathic Medicine: 2140 East Broadway Rd. 37. Banerjee M. In concept. lupers@cwix. Silybum .

The efficacy of these herbal preparations need to be evaluated in .1007/s10620-005-2942-9 Abstract Highlight Terms Gene Ontology(1) Diseases(7) Genes/Proteins(1) Species(5) Herbal medicines have been used in the treatment of liver diseases for a long time. 50(10):1807-1812] Type: Journal Article. or in many cases. Chawla YK Department of Hepatology. radiation toxicity. Herbal medicines for liver diseases. (3) glycyrrhizin (licorice root extract). it appears to be safe and well tolerated. fatty liver. When compared with Silybum. It improves mortality in patients with subacute liver failure and improves liver functions in patients with subacute hepatic failure. This article reviews four commonly used herbal preparations: (1) Phyllanthus. (2) Silybum marianum (milk thistle). however. superior to the effect of Silybum.1% cysteine. and cirrhosis with activity. (PMID:16187178) Dhiman RK. it primarily acts as an anti-inflammatory or cytoprotective drug. placebo-controlled clinical trials are lacking to support their efficacy. A number of herbal preparations are available in the market. though less well researched than Silybum. cirrhosis. prospective data are lacking. ischemic injury. SNMC does not have antiviral properties. SNMC does not reduce mortality among patients with cirrhosis with activity. Standardization of herbal medicines has been a problem and prospective.2% glycyrrhizin. chronic hepatitis. randomized. immunomodulating. and 2% glyceine. Liv 52. and liver regenerating effects. and on survival. The methodological qualities of clinical trials of treatment with herbal preparations are poor. such as progression of chronic hepatitis to cirrhosis and/or liver cancer. anti-lipid peroxidative. Silymarin does not reduce mortality and does not improve biochemistry and histology among patients with chronic liver disease. Postgraduate Institute of Medical Education and Research. is not useful in the management of alcohol-induced liver disease. anti-inflammatory. there are no data from randomized controlled trials on clinically relevant outcomes.marianum (milk thistle) has been shown to have clinical applications in the treatment of toxic hepatitis. however. Stronger neominophagen C (SNMC) is a Japanese preparation that contains 0. rkpsdhiman@hotmail. appears to have similar applications and mechanisms of action. an Ayurvedic hepatoprotective agent. and viral hepatitis via its antioxidative. 0. Phyllanthus has a positive effect on clearance of HBVmarkers and there are no major adverse effects. India. and (4) Liv 52 (mixture of herbs). 160012. the hepatoprotective effect of Picrorhiza was found to be similar. Chandigarh. 38. antifibrotic. Review DOI: 10. Picrorhiza kurroa. SNMC may prevent thedevelopment of hepatocellular carcinoma in patients with chronic hepatitis Digestive Diseases and Sciences [2005.

D. The future is to carry out controlled prospective double-blind multicenter studies with the newly discovered drugs with proven beneficial effects on animals.F. the number of drugs actually used successfully in humans is very small. alphabetically: colchicine. clinical studies are lacking. In this review some of the most promising/studied drugs utilized for liver diseases were chosen and analysed critically from the basic to the clinical point of view. nitric oxide. resveratrol. (PMID:17966118) Muriel P. glycyrrhizin. corticosteroids. Postal 14-740. The compounds/preparations described herein are. larger randomized. double-blind. Fundamental hepatobiology should also be encouraged. placebo-controlled multicenter trials. Beneficial drugs for liver diseases. Colchicine and corticosteroids have been studied extensively in animals and humans. and thalidomide. Sulfoadenosylmethionine and silymarin are also promising drugs utilized mainly incholestasis but the benefits can be expanded if more controlled trials are performed.1310 Abstract Highlight Terms Diseases(3) Species(2) Chemicals(6) Liver diseases are a major problem of worldwide proportions. Rivera-Espinoza Y Departamento de Farmacología. 39. México. most clinical studies suggest that these compounds are not useful in the treatment of liver diseases. (PMID:19638451)  Abstract . Unfortunately. Antiviral agents are not discussed because excellent reviews have appeared on this topic. Silibinin suppresses growth and induces apoptotic death of human colorectal carcinoma LoVo cells in culture and tumor xenograft. Their mechanism of action is associated with the ability to down-regulate NF-kappaB and to decrease pronecrotic and profibrotic cytokines. Review DOI: 10. México 07000. However. Interferon has shown interesting antifibrotic properties in animalsand humans. pamuriel@cinvestav. Liv 52. 40. Apdo. 28(2):93-103] Type: Journal Journal of Applied Toxicology : JAT [2008. Curcumin. sulfoadenosylmethionine.resveratrol and thalidomide are very attractive newly discovered protective and curative compounds on experimental hepatic diseases.rigorously designed. prospective studies on their antifibrotic/fibrolytic activity are required. Glycyrrhizin is an herbal medicine with several components that has interesting hepatoprotective properties in patients with subacute liver failure but deserves more prospective controlled trials. interferons (for their antifibrotic properties). silymarin. Cinvestav-IPN.1002/jat. curcumin.

05-0.001) in athymic nude mice without any apparent toxicity. Colorado 80045. silibinin treatment also decreased thephosphorylation of retinoblastoma protein at Ser(780).001). which was associated with increased levels of cleaved caspases (3 and 9) and cleaved poly(ADP-ribose) polymerase. Here we assessed the anticancer efficacy of silibinin against advanced colorectal cancer LoVo cells both in vitro and in vivo. The use of nontoxic phytochemicals in the prevention and intervention of colorectal cancer has been suggested as an alternative to chemotherapy. Analyses of xenograft tissue showed that silibinin treatment inhibits proliferation and increases apoptosis along with a strong increase in p27 levels but a decrease in retinoblastoma phosphorylation. N.01-0. In animal studies.H. Together. silibinin caused a strong cell cycle arrest at G(1) phase and a slight but significant G(2)-M-phase arrest at highest concentration (P < 0.001). Deep G. Additionally. (PMID:18955291) Bianchi N. A and B1) and cyclin-dependent kinases (1. Zuccato C. School of Pharmacy. USA. Molecular Cancer Therapeutics [2009.MCT-09-0304 Abstrac t Highlight Terms Gene Ontology(6) Diseases(3) Genes/Proteins(5) Species(2) Chemicals(1) Colorectal cancer is one of the leading causes of cancer-related morbidity and mortality.001) and induces apoptotic death (P < 0. 8(8):2366-2374] Type: Journal Article.01-0.I. D3. Agarwal C. Tyagi A. Extramural DOI: 10. Ser(795). University of Colorado-Denver. Lampronti I. Katiyar S..1158/1535-7163. 41. and 6) and increases the level of cyclin-dependent kinase inhibitors (p21 and p27). Borgatti M. Molecular analyses for cell cycle regulators showed that silibinin decreases the level of cyclins (D1. Gambari R . 2. these results suggest the potential use of silibinin against advanced human colorectal cancer. oral administration of silibinin for 6 weeks (at 100 and 200 mg/kg/d for 5 days/wk) significantly inhibited the growth of LoVo xenograft (P < 0. Aurora.    Citations BioEntities Related Articles External Links Kaur M. and Ser(807)/Ser(811) sites without significantly affecting its total level. Fetal Hemoglobin Inducers from the Natural World: A Novel Approach for Identification of Drugs for the Treatment of {beta}-Thalassemia and Sickle-Cell Anemia. Agarwal R Department of Pharmaceutical Sciences. Velmurugan B. Consistent with these results. 4. Our results showed that silibinin treatment strongly inhibits the growth of LoVo cells (P < 0. Research Support.

6(2):141-151] Type: Journal Article DOI: 10.558515 Abstrac t Highlight Terms Gene Ontology(2) Diseases(3) Genes/Proteins(3) Species(1) Chemicals(4) CONTEXT: Liver disease is a serious ailment and the scenario is worsened by the lack of . (iii) good correlation of in vivo and in vitro results of HbF synthesis and gamma-globin mRNA accumulation indicates that in vitro testing might be predictive of in vivo responses and (iv) combined use of different inducers might be useful to maximize HbF. both in vitro and in vivo. Biotechnology Centre. (ii) resveratrol. the following conclusions can be reached: (i) this therapeutic approach is reasonable. (PMID:21595500) Ghosh N. Recent advances in herbal medicine for treatment of liver Pharmaceutical Biology [2011. Ferrara. Mandal V. Concerning the employment of HbF inducers as potential drugs for pharmacological treatment of beta-thalassemia.GenTech-for-Thal.3109/13880209. apolyphenol found in grapes and several plant extracts and (iii) rapamycin. In this review. nilanjanghosh81@yahoo. contained in plant extracts from Angelica arcangelica and Aegle marmelos. plant extracts and agro-industry material) and of possible interest in the field of a pharmacological approach to the therapy of beta-thalassemia using molecules able to stimulate production of fetal hemoglobin (HbF) in adults. India. (ii) clinical trials (even if still limited) employing HbF inducers were effective in ameliorating the symptoms of betathalassemia patients. 42. on the basis of the clinical parameters exhibited by hereditary persistence of fetal hemoglobin patients. Laboratory for the Development of Pharmacological and Pharmacogenomic Therapy of Thalassaemia. Evidence-based Complementary and Alternative Medicine : ECAM [2009. Italy. BC Roy College of Pharmacy and Allied Health Sciences. Review DOI: 10.2011. Mandal SC Dr. gam@unife.1093/ecam/nem139 Abstract Highlight Terms Diseases(1) Genes/Proteins(2) Species(4) Chemicals(7) The objective of this review is to present examples of lead compounds identified from biological material (fungi. Durgapur. isolated from Streptomyces hygroscopicus. Ghosh R. we present three examples of HbF inducers from the natural world: (i) angelicin and linear psoralens. 49(9):970-988] Type: Journal Article.

x Abstract Highlight Terms Diseases(2) Genes/Proteins(1) OBJECTIVES: Complementary and alternative medicine (CAM) is used by 42% of the U. 44. . Hepatology and Nutrition. Currently available therapies for liver ailments are not apposite and systemic toxicity inhibits their long term use. The scenario calls for extensive investigations which can lead to development of lead molecules for hepatoprotective molecules of future. La Brecque DR. mode of action and toxicity and forthcoming application of some of these leads. This review deals with the biological activity. Toward that end.S.2002. METHODS: These generally have strong antioxidative potential and cause induction of antioxidantenzymes like superoxide dismutase. Veterans Affairs Medical Center. population. reduced glutathione and catalase. Significant efficacy has been seen with silymarin.1572-0241.precise therapeutic regimens. Khokar MF.05993.Seeff LB Division of Gastroenterology. RESULTS AND CONCLUSION: Out of the several leads obtained from plant sources as potential hepatoprotective agents. The American Journal of Gastroenterology [2002. curcumin. OBJECTIVE: Several phytochemials have been identified which have significant hepatoprotective activity with minimal systemic adverse effects which could limit their long term use. neoandrographolide. USA. hepatocyte apoptosis and nuclear factor-κB activation. glycyrrhizin and Liv-52 in treatment of hepatitis. Bacon BR. 97(9):2391-2397] Type: Journal Article DOI: 10. kutkoside. Hoofnagle JH. andrographolide. Washington. Medicinal plants have been traditionally used for treating liver diseases since centuries as the toxicity factor appears to be on the lower side. The hepatoprotective potential of several herbal medicines has been clinically evaluated. (PMID:12358262) Strader DB. Its use among patients with chronic liver disease has not been well defined. silymarin. picroside. se of complementary and alternative medicine in patients with liver disease. DC 20422. alcoholic liver disease and liver cirrhosis. Lindsay KL. phyllanthin. Additional mechanisms of hepatoprotection include stimulation of heme oxygenase-1 activity. Morgan T. inhibition of nitric oxide production. and glycyrrhizin have been established as potent hepatoprotective agents. Allen J.1111/j. we surveyed patients in six geographically diverse liver disease clinics in the United States for use of CAM. Wright EC. hypophyllanthin.

Demographic information was obtained to identify predictors of CAM use. In all. The study.lipid storage and energy usage in liver cells . Circadian rhythms of 24 hours govern fundamental physiological functions in virtually all organisms. annual income. Statistical analysis included univariate and multivariate analysis using logistic regression. 389 (39%) admitted to using some form of CAM at least once during the preceding month. but 26% did not inform their physician of their CAM young age.php Much of the liver's metabolic function is governed by circadian rhythms . and 13% used herbs to treat their liver disease.12am PST http://www.our own body clock . level of education. 74% of patients reported using CAM in addition to the medications prescribed by their physician.separately and distinctly from each other. reveals how strictly regulated circadian control of metabolism can be. What's remarkable is that the circadian clock is intimately involved in this dialogue. UCI's Donald Bren Professor of Biological Chemistry. Changes to these rhythms can profoundly influence human health. 21% admitted to using herbal preparations. Masri noted. published online in Cell. and postdoctoral scholar Selma Masri report that two of these circadian-linked proteins.New leads for liver disease treatments Tuesday 5 August 2014 . Up to 15 percent of people's genes are regulated by the day-night pattern of circadian . Of these. "The ability of the genome and epigenome to cross-talk with metabolic pathways is critical for cellular and organismal functions. SIRT1 and SIRT6.medicalnewstoday. The circadian clocks are intrinsic time-tracking systems in our bodies that anticipate environmental changes and adapt themselves to the appropriate time of day.METHODS: Patients attending six liver disease clinics were polled via a common questionnaire regarding their use of CAM. Paolo Sassone-Corsi. This surprising discovery of genomic partitioning. and geographic location. CONCLUSIONS: CAM use is as common among patients visiting liver disease clinics in the United States as in the general population (39% vs 42%). manage important liver processes . Five variables were found to be predictive of alternative therapy use: female sex." she said. reveals new information about the body clock's sway over metabolism and points the way to more focused drug treatments for liver disease and such metabolic disorders as obesity and diabetes.and UC Irvine researchers have now found two independent mechanisms by which this occurs. RESULTS: A total of 989 patients completed the questionnaire. Many patients are using herbs to treat their liver disease but are declining to discuss this use with their physician. 45.

including those affecting endocrine.or SIRT6-specific metabolic functions and pathologies. "Mutations or altered regulation of human CDFs modify the concentrations of metal ions critical to cell function and are associated with key human Case Western Reserve scientists sought to understand the intricate details of CDF molecular function and mechanisms of transport. the Charles W. PhD. to human health.cation diffusion facilitators (CDFs) . "CDF is a major protein family type found in all forms of life. The two sirtuins. The finding has the potential to inform future research aimed at identifying ways to ensure the process works as designed and.php Case Western Reserve University scientists have discovered how a family of proteins . Mathias Professor of Cancer Research.1am PST http://www. if successful. the scientists learned.rhythms. and in turn. This resulted in a distinct partition of metabolic pathways and physiological functions." said senior author Mark R. To discover how SIRT1 and SIRT6 work independently of each other. They're widely studied for their effect on metabolism and longevity. neurologic. . Scientists pinpoint channeling of cell's energy flow in moving metal ions Tuesday 24 June 2014 . could lead to significant breakthroughs in the treatment of Parkinson's. 46. hepatic and cardiovascular systems. Chance. and Iona A." To understand how the cell cycle works. SIRT1 and SIRT6 belong to a group of proteins called sirtuins that participate in epigenetic control of the genome and help regulate important biological processes ranging from cell health maintenance to lipid storage and energy expenditure in cells.regulates an important cellular cycle where a cell's energy generated is converted to necessary cellular with SIRT1 in the liver knocked out and the other with SIRT6 nullified. Masri and Sassone-Corsi conducted tests with two sets of mice . envision a gate to human cells that controls the flow of substances necessary to maintain cell survival. with hundreds of genes being SIRT1-dependent and hundreds of others relying on SIRT6. chronic liver disease and heart disease. In this investigation. The results of this research were posted online by the journal Nature and will be published in the print edition at a later date. are committed to the control of distinct genomic domains. Sassone-Corsi said. When and how that gate opens and closes is critical to fundamental cellular functions. Case Western Reserve University School of Medicine. He added that these findings pave the way to further investigations that may facilitate the design of pharmacological strategies targeting SIRT1.medicalnewstoday. CDFs ensure the gate's seamless operation by controlling the flow of metal ions as energy is cycled. nearly 50 percent of those involved with metabolic pathways in the liver are influenced by these rhythms.

com/releases/275473. to carry out cellular functions. but explainable. Those changes. The scientists also used mass spectrometry. It is a complex. a powerful atom-andmolecule recognition technology.Significant potential in treating hepatitis C with new Chinese herbal medicine Tuesday 15 April 2014 . in turn.Chance and his colleagues studied a form of CDF found in bacteria where the protein YiiP functions like a motor. then." Chance said. especially in the context of drug effects on the biochemical mechanisms of action.that recognizes water molecules in transmembrane proteins. Case Western Reserve scientists used sophisticated dynamic imaging technology . send zinc out of the cell. a range of diseases can result. "Our work in CDFs is a visible example of the power of these new technologies to solve important problems in the membrane protein field. While zinc is pushed successfully out of the cell. the proton gradient.12am PST http://www." Chance said. that has the ability to inhibit hepatitis C virus (HCV) activity in cells at several points in the virus' lifecycle.[i] . Dynamic imaging involved a labeling system . If the CDF-regulated gate controlling the zinc-proton cycle malfunctions. We must continue to examine CDFs to understand their mechanisms of action. In this more recent work on CDFs." 47. a flow of protons is pulled into it. using energy in the form of a gradient of protons (hydrogen atoms) to pump zinc ions out of cells. SBEL1.medicalnewstoday.php Data from a late-breaking abstract presented at the International Liver Congres 2014 identifies a new TM compound. which the YiiP protein converts into conformational changes in the protein structure. brings in protons. machine that uses a widely available form of energy. Chance and his colleagues have studied GPCR structure and dynamics using innovative mass spectrometry-based technology. "We have now produced high-resolution pictures of signal transmission and ion transport mechanisms for a range of ion channels and GPCRs. A perfectly functioning zinc-proton flow cycle. a dynamic picture of the membrane protein has emerged.the cellular cycle operates on time scales comparable to the blink of the eye. "Membrane proteins (including CDF) are some of the most important cellular drug targets. to study the labeled proteins. including Gprotein coupled receptors (GPCR). which represent 50 percent of the non-antibiotic drug market. GPCRs are protein molecules that sense chemical signals outside the cell and then activate cellular responses to these signals. These technologies allowed investigators to watch the YiiP protein in real time as it took up zinc atoms and rearranged its structure cycle through a pumping sequence. To visualize the zinc-proton cycle.x-ray-mediated hydroxyl radical footprinting .

Secretary-General of the European Association for the Study of the Liver and Associate Professor of Medicine. This process enables the virus to take advantage of the host cell's protein translation machinery for its own purposes. allowing the virus to spread to other sites of the body. Austria. less than 20 percent of all HCV patients were treated because the available treatments were unsuitable due to poor efficacy and high toxicity." Professor Peck-Radosavljevic continued: "SBEL1 has demonstrated significant inhibition of HCV at multiple stages of the viral lifecycle. which is an exciting discovery because it allows us to gain a deeper understanding of the virus and its interactions with other compounds." HCV invades cells in the body by binding to specific receptors on the cell.2 Once inside.SBEL1 is a compound isolated from Chinese herbal medicines that was found to inhibit HCV activity by approximately 90%. Scientists pre-treated human liver cells in vitro with SBEL1 prior to HCV infection and found that SBEL1 pre-treated cells contained 23 percent less HCV protein than the control.2 When HCV enters the host cell. which enables HCV to make copies of its viral genome and proteins. Ultimately this adds to our library of knowledge that may bring us closer to improving future treatment outcomes. it is used to treat sore throats and inflammations. the HCV ribonucleic acid (RNA) levels were significantly reduced by 78 percent in HCV infected cells treated with SBEL1 compared to the control group. it releases viral (+)RNA that is transcribed by viral RNA replicase into viral (-)RNA. HCV initiates a process known as IRES-mediated translation. which can be used as a template for viral genome replication to produce more (+) RNA or for viral protein synthesis. The function of SBEL1 within the plant is unknown and its role and origins are currently being investigated. enabling the virus to enter it. In addition. Once the viral RNA is transcribed. a critical process for viral protein production.[iii] Viral RNA is the genetic material that gives HCV its particular characteristics. This demonstrates that SBEL1 may also affect the viral RNA replication process. translation and replication. commented: "People infected with hepatitis C are at risk of developing severe liver damage including liver cancer and cirrhosis. However. the different virus genotypes coupled with the complexity of the disease means there is still a major unmet need to improve options for all populations. which allows the viral RNA to be translated into proteins by bypassing certain protein translation checkpoints that would normally be required by the host cell to start protein translation. Prof. In the past. This suggests that that SBEL1 inhibits IRES-mediated translation. [ii]. suggesting that SBEL1 blocks virus entry. In Chinese medicine.[iv] HCV is transmitted through blood contact between an . University of Vienna. The liver cells transfected with an HCV internal ribosome entry site (IRES)-driven luciferase reporter that were treated with SBEL1 reduced reporter activity by 50% compared to control.000 people die annually from HCV-related diseases. Recent advances means that we can now virtually cure HCV without unpleasant side effects. There are an estimated 150 million to 200 million people living with chronic HCV and more than 350. HCV hijacks functions of the cell known as transcription. SBEL1 is extracted from a herb found in certain regions of Taiwan and Southern China. Markus Peck-Radosavljevic.

[1] The criterion for consideration of liver biopsy in these patients was not identified. 140 of the patients with HCV underwent endoscopic evaluation during the study period.8 incoming or outgoing calls during the 5-year study period. 9% having genotype 3. The presence of hepatic fibrosis correlated with body mass index (BMI).2] Over a 5-year span. and treatment.infected individual and someone who is not infected.[2]Patients undergoing combination interferon plus ribavirin therapy had an average of 8. race. A second abstract from the same group looked at utilization of practice resources in the care of HCV patients. [1. 11% having genotype 2. Patients were largely white (80%) or black (15%). and this year's ACG meeting was no different.medscape. including surveillance for varices and colorectal cancer. but not with age. with emphasis on topics in epidemiology. and 2% having genotype-4 infection. Disease Burden. 670 patients with hepatitis C were referred to the practice. In addition.9 office visits compared with 2. patients with HCV accounted for 8% of all patient referrals to the practice. Office phone calls were also monitored in the practice. with 74% having genotype 1 disease. sex. . This can occur through needlestick injuries or sharing of equipment used to inject Introduction This year's meeting of the American College of Gastroenterology (ACG) offered a dynamic venue for the presentation of the latest information regarding issues in liver disease.[v] 48. pathophysiology. diagnosis. Clinical Advances in Liver Disease -. In 2002 alone. The distribution of patient genotypes was typical of North American patients.3 phone calls for untreated HCV patients. 99% had some degree of chronic inflammation and 72% had concomitant fibrosis. identifying that a typical patient in this office logged a mean of 7. This report discusses the key concepts highlighted during these meeting proceedings.What's New and Where Are We Going? http://www. compared with 13 calls for treated HCV patients and 5. with a focus toward implications for clinical practice. Clinical Presentation. Of the 327 patients who underwent liver biopsy.8 visits for those individuals not treated. Hepatitis C Presentations concerning hepatitis C virus (HCV) continue to dominate the sessions on liver disease at national conferences. and Resource Utilization Two reports from a single gastroenterology practice in Michigan focused on the distribution of HCV disease and its evaluation in an office setting. or viral load. and most had abnormal liver function tests (LFTs) (81%).

When the degree of hepatic fibrosis was compared with the APRI by multivariate regression. They found that treatment with pegylated interferon plus ribavirin for 1 year was superior to treatment with conventional interferon plus ribavirin. The study authors also noted that the majority of patients referred for HCV care lacked much HCV-specific assessment by the primary physician beyond more than the patient's anti-HCV and LFTs. quantitative HCV level. confirmed the correlation of APRI with the simultaneous presence of fibrosis on liver biopsy. Additional testing of an anti-HCV-positive patient by the primary care physician. it is not yet clear that all patients who have mild fibrosis progress to end-stage liver disease. Although fibrosis appears to be an indicator or risk factor for cirrhosis. and HCV genotype analysis. an APRI < 0. We must also continue to assess predictive factors for the development of cirrhosis. In a prospective study of the aspartate aminotransferase (AST)-to-platelet ratio index (APRI). HCV Genotype-4 Disease Khuroo and colleagues[5] performed a meta-analysis of 6 treatment trials of HCV genotype-4 disease involving therapy with either combination pegylated interferon plus ribavirin or conventional interferon plus ribavirin. and then divided by the total platelet count) was calculated in 113 patients undergoing liver biopsy to assess correlation with fibrosis and inflammation.This evaluation of patients with HCV in a private gastroenterology practice serves to identify the increasing burden of patients with hepatitis C presenting for care in an urban gastroenterology practice. the presence of underlying fibrosis is thought to identify the patient who is at risk for continued progression of liver disease. Using the Ludwig-Batts criteria. Subgroup analysis found that pegylated interferon plus full-dose ribavirin was important to improve sustained response -. . Does this mean that liver biopsy is no longer needed to assess patients for treatment with combination pegylated interferon plus ribavirin therapy? Although many hepatologists will likely continue to rely on histologic evidence of fibrosis to recommend treatment. [4] APRI (the product of the serum AST/the upper limit of normal x 100. This study confirms that genotype-4 patients should receive 1 year of therapy and that full-dose ribavirin based on weight is also needed.[3] from the University of Texas Medical Branch at Galveston. Currently. this requires that a percutaneous liver biopsy be obtained and graded for fibrosis and inflammation. including a liver enzyme profile.a 72% response was achieved in patients receiving 1000-1200 mg ribavirin daily as compared with a 49% response in patients receiving 800 mg ribavirin daily.42 had a negative predictive value of 93% (25 of 27 patients correctly identified as having no fibrosis) and an APRI > 1. as reported earlier in a retrospective analysis of patients by Wai and colleagues. could help reduce the total costs of care when referral to a consulting gastroenterologist is needed. and its use in this setting is encouraged. Snyder and colleagues. 63 patients had significant fibrosis on histology.0 had a positive predictive value for hepatic fibrosis of 96% (44 of 46 patients correctly predicted). Noninvasive Method for Estimating Hepatic Fibrosis In assessing patients for HCV treatment. the APRI may be a useful index for the patient who refuses liver biopsy.

It has also been suggested that HCV infection may further increase the risk of chronic allograft rejection in patients with recurrent HCV infection post transplantation. there has been concern that treatment of post-liver transplant patients with interferon-based regimens might increase the risk of allograft rejection. This retrospective analysis reminds us that patients often use other medications and/or herbal supplements during conventional medical treatments and that patients may or may not tell their physicians about their use of such complementary substances. Lyons and colleagues[7] confirmed that percutaneous liver biopsy after coagulation factor infusion is safe. Hemophiliac Patients With HCV Infection HCV and HIV are common infections in patients with hemophilia.[6] Although those patients who used supplements were slightly more likely to have symptoms associated with treatment than those who did not. whereas some will develop acute or chronic allograft rejection. This study suggests that approximately 25% of patients with recurrent HCV infection post liver transplantation can achieve clearance of HCV. some of whom will require liver transplantation. and attempts by the patient or the physician to control symptoms may have potential effects on response to therapy. In a retrospective review[8] of 49 patients at the Duke University Medical Center who received combination pegylated interferon plus ribavirin treatment for recurrent HCV post liver transplantation. Because of the increased risk for bleeding in hemophiliacs. Unfortunately. Although this study . 7 developed acute or chronic rejection while 12 achieved sustained viral clearance. there are few data available regarding the risk of percutaneous liver biopsy in this population In a retrospective review of patients with hemophilia who underwent liver biopsy. patients using herbal supplements were also more likely to complete treatment (91%) when compared with patients who did not use them (78%). In a retrospective survey of patients who had been treated with interferon with or without ribavirin over a 5-year period. and that those patients with concomitant HIV infection are more likely to have significant fibrosis than hemophiliac patients with HCV infection alone. It is incumbent upon those providing care to carefully ask each patient about alternative and conventional therapies during treatment for any disorder. and many patients will require posttransplant therapy with combination pegylated interferon and ribavirin. Because interferon is an immunomodulator. it was observed that 64% of patients admitted to using herbal supplements during therapy.Herbal Supplements Side effects associated with treatment of HCV can be severe. the recurrence of hepatitis C infection in the new graft is nearly universal. Clinical Course in Patients Receiving Antiviral Therapy for Recurrent HCV-Related Liver Disease Twenty-five percent to 40% of patients with chronic hepatitis C will develop end-stage liver disease.

NASH continues to be described in patients who may not have the typical associations of obesity and type 2 diabetes mellitus. Shaheen and colleagues [10] performed a randomized.[9] Ninety-five patients had histologic evidence of NASH. and physical findings (such as waist circumference and BMI) could identify patients with NASH. Despite these known relationships. Nonalcoholic Steatohepatitis Nonalcoholic steatohepatitis (NASH) is the progressive form of nonalcoholic fatty liver disease that can lead to cirrhosis and hepatocellular carcinoma. hepatic ultrasound data. double-blinded trial of pantoprazole vs placebo given after elective endoscopic variceal ligation.[10] What is the effect of the transjugular intrahepatic portosystemic shunt (TIPS) on thrombocytopenia associated with liver cirrhosis? Sixty consecutive patients with a TIPS had platelet counts assessed before and after undergoing procedure. The only significant difference with respect to these markers as a predictor of NASH was the observation of a lower mean glucose-toinsulin ratio in patients with NASH compared with patients with steatosis alone. identifying the patient with NASH can be difficult. In an effort to determine whether LFTs. [11] Supported by an independent educational grant from Novartis. 4 of whom had abnormal LFTs only. 45 had an abnormal ultrasound. and hyperlipidemia. 365 consecutive patients who underwent gastric bypass surgery at the Geisinger Clinic. Thus. Results showed that a significant increase in platelet count (at least 20% higher) occurred in all patients. Most important. There was no significant correlation with insulin or glucose levels. clinicians need to continue to assess the epidemiology of this disease in order to identify those associations that do lead to progressive liver disease and cirrhosis. had these measurements compared with liver histology obtained during liver biopsy at surgery. An index of suspicion plus histologic findings at liver biopsy may be the best combination of tests available to the clinician at this time. obesity. Their findings confirmed that this proton-pump inhibitor reduced the size of ulceration postbanding. although the total number of postbanding ulcers or of patient symptoms were not different between the 2 study arms. including those with severe thrombocytopenia. 26 had both an abnormal ultrasound and elevated LFTs. Danville. none of these factors could easily separate patients with NASH from those with only fatty liver. Pennsylvania. . or with physical findings observed. and 16 had a normal ultrasound and LFTs. insulin and glucose levels.does not clarify the relationship between use of interferon and allograft rejection. and it is often associated with coexistent type 2 diabetes mellitus. Potpourri The use of proton-pump inhibitor therapy after endoscopic variceal ligation is commonplace in clinical practice to reduce ulcerations at the banding site. a measure of insulin resistance. it does identify the need to carefully monitor the patient's liver studies and immunosuppression during therapy with combination pegylated interferon and ribavirin.

and may be enhanced by the insulin resistance index (HOMA-IR). [Abstract #736] 3.99:S85. Shehab TM. et al.99:S68. [Abstract #216] 8. Dahab ST. et al. Greenson JK. [Abstract #219] 11. 2004.[Abstract #304] Article Recent advances in herbal medicine for treatment of liver diseases. Am J Gastroenterol. Office based resource utilization and endoscopic resource utilization in the care of hepatitis C patients in a private practice gastroenterology group.99:S99. [Abstract #305] 10. et al. http://www.References 1. Gunaratnam NT. Am J Gastroenterol. Stravitz Nilanjan Ghosh Rituparna Ghosh Vivekananda Mandal Subhash C Mandal .ncbi. et al.nih. Finlay D. Fontana RJ. Naram S. 2004. A prospective study. [Abstract #259] 9. 2004.99:S238. 2004.38:518-526. Massoud OI. Snyder N. Schmitz SM. Am J Gastroenterol. Clinical presentation and disease burden in hepatitis C patients referred to a private practice gastroenterology group: a five year experience (1997-2002) with 670 patients. Khuroo MS. Lyons CD. 2004. Peginterferon plus ribavirin for the initial treatment of chronic hepatitis C genotype 4: a meta-analysis of randomized trials. Smith AD. spectrum of liver disease. Shaheen NJ. Sterling RK. The APRI is a good predictor of fibrosis in HCV. 2004. Muir AJ. 2004. 2004. Am J Gastroenterol. Prasad S.99:S72. Zein N. Shehab TM. [Abstract #225] 2.99:S100.nlm. Heneghan MA. Pantoprazole reduces the size of post-banding ulcers after elective endoscopic variceal band ligation: a randomized controlled trial. Stuart E. Am J Gastroenterol. Beneficial effects of herbal supplements in the treatment of hepatitis C. et al. and impact of human immunodeficiency virus (HIV) coinfection. Am J Gastroenterol. What is the course of patients undergoing anti-viral therapy for recurrent hepatitis C liver disease? Am J Gastroenterol. et al. Kancherla VK. [Abstract #310] 4. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C.99:S100. Wai CT. 2004. [Abstract #308] 6. Randawa R. Am J Gastroenterol. Inverso N.99:S74. Effect of transjugular intrahepatic portosystemic shunt on thrombocytopenia associated with liver cirrhosis. Komar M. Am J Gastroenterol. Noninvasive measures are not predictive of nonalcoholic steatohepatitis.99:S71. 5. Mitchell S. Gajula L. Hepatology. Am J Gastroenterol. Hepatitis C virus (HCV) in patients with hemophilia: safety of outpatient percutaneous liver biopsy. [Abstract #208] 7.99:S98. Khuroo MS. 2004. 2003. et al. et al.

India. Shenzhen Institute of Advanced Technology. The hepatoprotective potential of several herbal medicines has been clinically evaluated. Out of the several leads obtained from plant sources as potential hepatoprotective agents. China 2 Department of Anatomy. phyllanthin.asp?issn=2225-4110. Li Ka Shing Faculty of Medicine. Hong Kong SAR.year=2013. Hong Kong SAR. Brain Hormone Healthy Aging Centre. Department of Anatomy. glycyrrhizin and Liv-52 in treatment of hepatitis. reduced glutathione and catalase. hypophyllanthin. Several phytochemials have been identified which have significant hepatoprotective activity with minimal systemic adverse effects which could limit their long term use. Emily Liong3. Hong Kong SAR. andrographolide.jtcm. Significant efficacy has been seen with silymarin.spage=88. neoandrographolide. The scenario calls for extensive investigations which can lead to development of lead molecules for hepatoprotective molecules of future.epage=94. This review deals with the biological activity. The University of Hong Kong. Pharmaceutical Biology (Impact Factor: 1. Li Ka Shing Faculty of Medicine. Currently available therapies for liver ailments are not apposite and systemic toxicity inhibits their long term use. Li Ka Shing Faculty of Medicine. Shenzhen. Li Ka Shing Faculty of Medicine. The University of Hong Kong. and glycyrrhizin have been established as potent hepatoprotective agents. mode of action and toxicity and forthcoming application of some of these leads. picroside. Brain Hormone Healthy Aging Centre. George C Tipoe4 L Center for Gene and Cell Engineering. inhibition of nitric oxide production. Hong Kong SAR.issue=2.Dr. curcumin. These generally have strong antioxidative potential and cause induction of antioxidant enzymes like superoxide dismutase.21). Li Ka Shing Faculty of Medicine. Additional mechanisms of hepatoprotection include stimulation of heme oxygenase-1 activity.2011.volume=3. China 3 Department of Anatomy. The University of Hong Kong. kutkoside. Medicinal plants have been traditionally used for treating liver diseases since centuries as the toxicity factor appears to be on the lower side. 05/2011. China Date of Web Publication 10-Apr-2013 . Durgapur. 49(9):970-88.aulast=Xiao REVIEW ARTICLE Year : 2013 | Volume : 3 | Issue : 2 | Page : 88-94 Recent Advances in the Herbal Treatment of Non-Alcoholic Fatty Liver Disease Jia 1 Xiao1. Li Ka Shing Faculty of Medicine. hepatocyte apoptosis and nuclear factor-κB http://www. BC Roy College of Pharmacy and Allied Health Sciences. alcoholic liver disease and liver cirrhosis. Chinese Academy of Sciences. silymarin. The University of Hong Kong.558515 Source: PubMed ABSTRACT Liver disease is a serious ailment and the scenario is worsened by the lack of precise therapeutic regimens. China 4 Department of Anatomy. State Key Laboratory of Brain and Cognitive Science. DOI: 10. Kwok Fai So2.

Li Ka Shing Faculty of Medicine. Pathogenesis. Oregon http://www.D. and symptoms of metabolic syndrome. we selected several herbal derivatives under intense basic and/or clinical investigations by carrying out a PubMed search of English language articles relevant to herbal derivatives and NAFLD. The University of Hong Kong. In the present review. Keywords: Garlic-derived monomers. Over the past decades. Although more detailed mechanistic researches and long-term clinical evaluations are needed for their future applications. Ph. It is also strongly related to other pathological conditions. inflammation. Pathogenesis of NAFLD remains not fully characterized but is generally attributed to the occurrence of insulin resistance. Li Ka Shing Faculty of Medicine. diabetes. Resveratrol. they offer unanticipated and great health benefits without obvious adverse effects in NAFLD therapy. Wolfberry CHINESE HERBAL MEDICINE FOR THE TREATMENT OF HEPATITIS B INFECTION by Subhuti Dharmananda. lipid metabolism dysfunction. some monomers and certain functional mixtures of herbs have been extensively examined for their potential uses in NAFLD treatment. cardiovascular diseases..htm INTRODUCTION . such as polysaccharide portion of wolfberry.Correspondence Address: George L Tipoe Department of Anatomy. Portland. and milk thistle-derived substances. Milk thistle-derived substances. including obesity.itmonline. application of herbal treatment for NAFLD has received increasing attention due to its wide availability. In recent years. China DOI: 10. They have been shown to target the pathological events during NAFLD initiation and progression both in pre-clinical studies and clinical trials. garlic-derived monomers. low side effects.0 oxidative stress. Every potential therapeutic strategy should target one or some of these pathological events in the liver.110411 PMID: 24716162 Abstract Non-alcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver injury across the Nonalcoholic fatty liver disease. Brain Hormone Healthy Aging Centre. Hong Kong SAR . Institute for Traditional Medicine.4103/2225-4110. and proven therapeutic mechanisms and benefits. red grape-derived resveratrol. Director. and necro-apoptosis. Herbal treatment.

with nearly as high infection rates in other major urban areas of China. China. figures of 20% infection rates are reasonable estimates of the situation in 1997. and cinnamon-have been a matter of record kept for all subsequent generations. Statistics compiled at the Third Teaching Hospital of Zhongshan Medical College (Guangzhou). Further. Therefore. The ingredients used in making such decoctions-which include some herbs well-known in the West. individual herbs. and viral DNA.S. Nonetheless. though often severe in symptoms. today it has become common practice in the U. indicated about 15% of the local population in 1983 were hepatitis B carriers. the appearance of jaundice was a primary indication of the disease. Hepatitis B. viral antigens. the primary therapeutic measure was to prescribe a combination of Chinese herbs. other measures of the disease are relied upon to monitor its progress and cure. is usually self-limiting. to inoculate newborns against hepatitis B due to the high lifetime risk of infection. jaundice is most frequently associated with hepatitis A. testing of crude herb extracts and purified components in laboratory animals. such as the crowded subtropical city of Guangdong (Canton)." Hepatitis B is also a major concern in other parts of the world. At that time. usually in the form of a decoction. Historical records indicate that a disease corresponding to hepatitis B was known to Chinese doctors at least 1. and because the epidemic has been spreading. estimated to infect up to 20% of the population in some areas. In ancient times. such as serum levels of liver enzymes. it was found that 10% of the local population are hepatitis B virus carriers. the main cause of death in this area: 95% of liver cancer patients in Southeast China test positive for hepatitis B virus. especially in the chronic cases and in well-nourished individuals. Beginning around 1950. the Chinese government has announced tentative plans to enforce strict birth prevention measures for those who test positive for viral hepatitis. and clinical studies of complex formulas. Of the . and synthetically-modified ingredients. an acute disease which. isolated components.Hepatitis B is endemic in Southeast Asia. including isolation of active constituents. so that today it is quite easy to study the traditional Chinese medical theory and specific treatments for infectious hepatitis. as part of a larger program to reduce the number of births of children with various kinds of "defects. scientific evaluation of herb materials used for treatment of viral hepatitis was undertaken in China and Japan. with its spread increasing to epidemic proportions during the past two decades. contributing to the incidence of liver cancer. and relief of jaundice would indicate that the therapeutic measures were effective. Hepatitis B is responsible for considerable morbidity and mortality. rarely produces obvious jaundice. licorice. In a 1983 survey by the Hong Kong Medical and Health Department. The vaccine that is used to prevent infection has not been well-accepted even by Western medical professionals who are at substantial risk of infection from their patients. Today. such as rhubarb. which specializes in the treatment of liver diseases. Infection by hepatitis B is a reason for denial of exit visas from China.800 years ago. antibodies to viral antigens. Since techniques used at the time could not detect many cases.

such tests have been used to demonstrate that a wide range of Chinese herbal compounds are highly effective in the treatment of viral hepatitis. though it appears that by using compounds with this property. Liver protection can reduce the impact of viral hepatitis without necessarily reducing the viral load or the immune response to the virus. about 150 crude materials have been identified as having measurable activity against viral hepatitis. reduction of serum liver enzyme levels (ALT. This might occur by making it more difficult for chemical and biochemical activators of the virus to affect cell surface receptors or to enter the infected liver cells. the ability of the virus to infect new cells may also be impeded by these compounds. and by inhibiting inflammation and fibrinogenesis. a liver poison that is frequently used to assay the ability of a substance to alleviate inflammation. An objection that may be raised by Western researchers regarding the published Chinese studies is that the clinical reports may lack sufficient detail to reveal the true impact of the treatments. specific results vary because of differing treatments and because of selection of differing populations for study. Results comparable to previously-published Chinese . medical doctors who prescribe Chinese herbs (up to 40% of all Western-trained medical doctors in that country) report that a diagnosis of hepatitis is one of the principal reasons for starting a patient on a course of Chinese herb therapy and that the Chinese herbs are more effective than Western medicine for treating this disease. The actions of anti-hepatitis herbs may be subdivided.000 species of plants and animals used as sources of Chinese medicine. along with various measures of symptom reduction. The other category is "antiviral. plus PCR evaluation of hepatitis viral DNA. stimulating bile production and release. such as reverse transcriptase. for purposes of discussion. AP) and seroconversion from HBsAG+ or HBeAG+ to negative are usually used as modern standards of effectiveness. into two categories. In Japan. up to 2/3 of patients show seroconversion. perhaps because of budgetary limitations. As revealed in this article. Antigen tests for both HBsAg and HBeAg.more than 6. Liver protection appears to be conferred by several processes including antioxidant activity. The formula described in this article was administered in China to patients who were hospitalized for 12 weeks while taking the herb materials. the activity of the virus is often reduced. One category is "hepatoprotective. In some clinical trials. or by blocking some step in viral replication. In clinical trials conducted in China during the past twenty years. The number of tests available for analyzing the results of therapeutic interventions has grown in recent years." including herbs and isolated compounds demonstrated to protect laboratory animals from the toxic effects of carbon tetrachloride. and clinical improvement to "normal" may be attained for about 80% of the patients. were utilized to confirm the status of the hepatitis infection before and after treatment." indicating the ability to inhibit viral activity by promoting the production of interferon or other immune responses to viruses (including both cell-mediated and antibody responses to infected cells). but not all such tests have been used in the Chinese research.

In Japan. a component of licorice root (Glycyrrhiza uralensis is the species used in China). is an active component of schizandra. Screening of various analogues led to the production of a new drug for hepatitis known as DDB (dimethyl 1-4. and synthetic derivatives of the active components are used in modern pharmacies for the treatment of gastric ulcer. so the recognition that glycyrrhizin is safe makes it attractive. Schizandra and Its Component Schizandrin Schizandrin. and reducing liver lesions. dried licorice. Studies conducted in the 1970's in China revealed that schizandra and its component schizandrin could strongly lower ALT and AP in animal models of hepatitis and in human patients. Glycyrrhizin sulfate appears more active than ammoniate or other forms. 2'dicarboxylate). a lignan. certain active components.S. Glycyrrhizin ammoniate is a common flavoring agent used in the U. there was a rebound in these enzyme levels.trials were attained. 6'dimethylene dioxybiphenyl 1-2. Glycyrrhizin zinc is useful topically as a treatment for skin inflammation and ulceration. a typical dosage of glycyrrhizin corresponds to 15 grams per day of crude. Licorice was an ingredient in many of the prescriptions used in ancient times to treat hepatitis. but isolated glycyrrhizin is more readily absorbed than the glycyrrhizin in the total herbal extract.5'. lowering ALS and AP. the fruit from Schizandra sinensis. . its crude extract. low cost. lead to increased aldosterone production (by the adrenals) and imbalance of serum sodium and potassium levels (both by affecting NaK-ATPase directly and via the action of aldosterone) in susceptible individuals.. This confirmation may help alleviate some of the concerns about results reported in other trials. Licorice and its active components can be used in the treatment of Addison's disease (characterized by reduced production of aldosterone and other corticosteroids). reducing alphafetal protein levels and bilirubin. however. Large doses of licorice or glycyrrhizin can. Glycyrrhizin is an antioxidant and it promotes production of interleukin-2 (IL-2). and a combination of several valuable active components. the root.6. two actions that help inhibit viral diseases. This compound is strongly hepatoprotective. making it possible to further utilize the vast experience of Chinese researchers in order to develop a satisfactory treatment for hepatitis B that is both economical and easily applied. The root is well-known for its anti-inflammatory activity. as indicated by biopsy. it tended to have the problem that when administration of the compound ceased. Crude licorice extract has the advantage of easy access. recent in vitro studies indicate that glycyrrhizin sulfate may be a useful compound for inhibiting HIV infection of cells. based on antiretroviral activity. This response is not common when glycyrrhizin is used in standard therapeutic amounts for treatment of hepatitis. PRINCIPAL HERBS/ACTIVE COMPONENTS FOR TREATING HEPATITIS B Licorice and Its Component Glycyrrhizin One of the substances frequently mentioned in the Chinese literature regarding hepatitis B is glycyrrhizin. However. 4'-dimethoxy-5.

The herb. Patients treated with salvia who show clinical improvements also show normalization of the microcirculation. Salvia is used in China as a health food product. as a new drug. have been used in the treatment of chronic hepatitis. or in combination with other herbs. has undergone numerous trials in China. has a quick action and high rate of effectiveness for reducing plasma liver enzyme levels. Salvia has been known to Chinese doctors for centuries. a type of naphthaquinone. In China. regular ingestion is thought to prevent cardiovascular diseases and other problems of aging. Hu-chang is one of the broad-spectrum antiviral agents under investigation in China and Japan. as an energy tonic and immune enhancing agent. poor memory. it is used in the treatment of many ailments. it has been learned that in cases of severe or chronic liver disease. Usual oral dosages of salvia for treating severe diseases are 15-20 grams in decoction. a stilbene. and diabetes. up to 15 grams per day. Higher doses. salvia inhibits fibrinogen and aids in the resorption of fibrous plaques in the liver. like its isolated lignans. has been reported to cure both acute and chronic hepatitis. while today it is applied in the treatment of a wide range of diseases and symptoms. severe fatigue. but had been used in only a few applications. Second. it is given intravenously to quickly improve the condition of patients suffering from liver or kidney diseases. as well as for viral hepatitis. Huchang prevents lipid peroxidation. the crude herb extract is often used rather than an isolated component. Schizandra extract has the advantage of being a safe food product of China that is also widely used in the U. The main active constituents are the tanshinones. including asthma. Salvia and Its Components the Tanshinones Salvia is perhaps the most frequently used herb in the modern practice of Chinese herbal medicine. and as a result. It has been reported that schizandra. Salvia is provided as a single herb or in complex formulas in the treatment of both acute and chronic hepatitis. In clinical tests of anicteric infective hepatitis. but that relapse occurs relatively easily. It enhances adrenal cortical function. Salvia plays two major roles in the treatment of liver disease. and thus prevents hepatic degeneration. As a single herb. but is not an accepted drug in the West. enteritis. It is thus widely used in the treatment of liver cirrhosis.S. it also promotes liver cell regeneration through RNA synthesis. just 3 grams per day of powdered schizandra fruit for one to three months led to a clinical cure in 65% of cases. It has been suggested that schizandra be used with other herbs to increase the therapeutic effect and prevent relapse. Hu-Chang and Its Anthraquinone Components Hu-chang (Polygonum cuspidatum) refers to one of the many species of Polygonum used by Chinese doctors. there are alterations in microcirculation (capillary bed circulation) that appear to be part of the disease process.DDB. Salvia has a complex chemistry. The herb has been used in China to rescue patients with severe . though it has been suggested to have greater impact on acute hepatitis. as well as resveratrol. First. used alone. It contains anthraquinones as main active components.

It is reported to be efficacious in treating both acute and chronic hepatitis. and the isolate has been sold as a drug in Europe ("Legalon") for the treatment of liver disease for the past 15 years. for example. acting mainly as a liver-protective agent. three times daily). It contains a complex essential oil that regulates blood lipids and treats infectious hepatitis. it appears to block a long terminal repeat (LTR) during reproduction of the virus. A PROTOCOL FOR TREATMENT . is sold as a health product in the U. to enhance immune functions.S. In addition. Curcuma and Its Essential Oil Components Curcuma (yujin) refers to one of three major species of curcuma used in Chinese medicine. in the early stage of liver destruction due to ingestion of poisonous mushrooms. huchang influences microcirculation in a manner similar to salvia. Curcumin is also a powerful anti-inflammatory agent. It is rich in oleanolic acid. It is not clear that silymarin can cure viral hepatitis. Curcuma stimulates bile secretion. a bright yellow complex ketone found in both turmeric and curcuma. the other two are turmeric (huangjiang) and zedoaria (ezhu). Silybum extracts are widely sold as health foods in the United States. In a study of acute and chronic hepatitis involving 33 patients. a compound that appears to be effective in treatment of liver diseases. A concentrated extract of silybum. Silybum and Its Component Silymarin Silymarin is a complex flavonoid from Silybum marianum. an herb that was initially introduced as a therapeutic agent by European researchers.viral hepatitis who do not seem to recover when given standard Western therapies. Curcumin. A dosage of 140 mg/day is reported to be liver protective and a dosage of 420 mg/day is reported to help repair liver damage. Ligustrum has been identified as one of the herbs that strongly enhances immune responses. Ligustrum is used as a health food in the U. Its main action is to protect the liver from damage. all but one responded to the daily ingestion of a powder of curcuma (5 grams each time. rich in silymarin. but soon taken up by their counterparts in China as a treatment for liver diseases.S. and it is used. with 2/3 of the patients having subjective symptoms completely relieved. Ligustrum and Its Component Oleanolic Acid Ligustrum refers to the seed of Ligustrum lucidum. is currently under investigation as an anti-HIV agent. reversing leukopenia from cancer therapeutic agents. This action may apply to other viruses and to preventing activation of cancer genes. to save the lives of victims. with a cure rate of 70% for acute hepatitis and it was markedly effective in treating 44% of cases of chronic hepatitis.

root of Glycyrrhiza uralensis): 16% Hu-chang: (huzhang.The following formula is recommended for treatment of hepatitis B and was the subject of a clinical trial conducted in China during 1994-1996. though its use can also be justified on the basis of laboratory studies showing that it protects mice from liver injury induced by carbon tetrachloride and promotes liver cell regeneration. dried. to 94 grams of crude herb materials used to prepare a decoction. California]. after which the decoction is dried [the herb extract was manufactured by Sun Ten Laboratories. and formed into tablets of 800 mg each (880 mg in the Chinese clinical trial). Each tablet contained: . A vitamin tablet was used simultaneously. The daily dosage of licorice. Irvine. tuber of Curcuma longa): 11% Schizandra (wuweizi. is 15 grams. for a total dose of 27 tablets or about 23 grams of herb extracts. This corresponds. and later produced as a tablet for use in Western countries (Seven Forests Salvia/Ligustrum Tablets): Salvia (danshen. it is also used as an ingredient in several complex formulas for treatment of viral hepatitis. which is the marker compound for determining dosage of the mixture to administer. rhizome of Polygonum cuspidatum): 16% Curcuma (yujin. rhizome of Atractylodes macrocephala): 11% [total is 101% due to rounding] Atractylodes is included in this formulation as a digestive aid. The dosage schedule for the herb materials is 9 tablets each time. three times daily in the Chinese trial. fruit of Ligustrum lucidium): 16% Atractylodes (baizhu. three times daily. The herb ingredients are made as a decoction. root of Salvia miltiorrhiza): 21% Licorice (gancao. one tablet each time. fruit of Schizandra sinensis): 10% Ligustrum (nüzhenzi. approximately.

a 12-week treatment period is satisfactory as a standard course of treatment for chronic hepatitis B. which can be repeated once more if necessary. which is defined for the purpose of the Chinese study as the ability to attain 50% of patients experiencing both seroconversion (of HBsAg and/or HBeAg). DURATION OF TREATMENT Based on clinical experience in China. White Tiger label): Quercenol. and Calmagnium. a second course of treatment is recommended. an antioxidant mixture that includes silybum. A certain number of non-responders is to be expected.. these supplements provide a larger amount and wider range of nutrients and antioxidants that were applied in the Chinese trial. On the other hand. The basis for recommending this treatment period is a compromise between maximizing compliance and assuring measurable activity of the prescribed compounds. At standard recommended dosage. the treatment duration should be as short as possible.Silybum extract (8:1): 135 mg Vitamin C (as calcium ascorbate): 250 mg Beta carotene: 6 mg (10. The minimum duration of treatment depends on the amount of time that is reasonable to obtain a satisfactory therapeutic effect.5 times the maximal level of the normal range. some protocols include Alpha-Curcumone (a source of alpha-lipoic acid. it is possible that the primed immune . and a decline of ALT and AP to within 1. For the purpose of assuring maximum compliance.000 IU) Vitamin E: 133 IU Zinc (acetate): 5 mg Selenium (amino acid chelate): 40 mcg Quercetin: 100 mg l-Cysteine: 40 mg Vitamin B1: 5 mg Vitamin B2: 3 mg Vitamin B3: 10 mg Vitamin B5: 10 mg Vitamin B6: 12 mg Vitamin B12: 50 mcg Folic acid: 200 mcg In the U. especially since the disease can be sexually transmitted and the individual's partner may not have been treated at the same time. In addition. a mineral/vitamin mixture. A problem with long-term follow-up in the case of hepatitis B is that reinfection is always possible. even with two courses of treatment. an antioxidant used in the treatment of hepatitis). For the other 50% (or fewer) of the patients.S. this tablet is replaced by two formulas (produced by ITM.

The numbers in brackets after the study summary are the reference codes for the report abstract as found in the journal Abstracts of Chinese Medicine. SAMPLE STUDIES Following are brief reviews of eight clinical trials in which a treatment time of three months or less was sufficient to obtain results such as those suggested above. Study reported in 1989 of asymptomatic carriers with positive HBsAg treated with a decoction given twice daily for one month as a treatment course. a three month treatment time was adequate to obtain a 50% seroconversion rate. a tableted herb component. 128 of the patients. 63%. The control group used biphenyldicarboxylate (in place of herb decoction). The treatment protocol included a decoction. an additional herb was added and the treatment continued daily. the decoction was administered only every other day for one or more additional months. while that for the control was just 7%. In a one year follow-up of 20 cases from each group. 58 of 80 cases (73%) were cured within three courses of therapy and 17 others had reduced HBsAg titers. the rates were 53% and 13% respectively. According to this study. [891152] 3. for HBeAg. This study shows that a three month treatment period is adequate for at least 50% seroconversion. When the test was negative twice consecutively. the treatment was discontinued. [930249] . [891191] 2. with HBsAg and HBeAg becoming negative. Study reported in 1991 included 304 patients with chronic hepatitis B. 1.system of the successfully treated patient can prevent reinfection. but if it remained positive. plus the herb tablet and vitamin E. used daily for three months. the relapse rates were 10% and 60% respectively. reversion to positive antigen test response occurs in only about 10% of patients successfully treated with Chinese herbs if followed-up during the first year after conclusion of herb therapy. This apparent conversion to positive hepatitis test is probably the result of activation of remaining latent virus in most cases. This study shows that three months of therapy is adequate to obtain at least 50% seroconversion. According to Chinese reports. Only 32 patients failed to respond. were rated cured. and vitamin E. They were treated with herbs in pill form for 2 to 3 months. The seroconversion rate of HBsAg for those taking the herb decoction was 67%. Study reported in 1989 of treatment of chronic active hepatitis B. If the HBsAg test became negative.

Other cases were given just 2 doses per day for 30 days as a therapeutic course. Of those who were positive. average duration of treatment was 16 days. The effect of this therapy. [880251] . but seroconversion occurred in about 50% of the glycyrrhizin treated group. there was no seroconversion in the control group. but it was reported that it took "at least two months" to attain seroconversion. were treated with a decoction plus vitamin B complex. In some other studies of acute hepatitis. Clinical cure was claimed for 85% of the acute hepatitis group and 75% of the chronic hepatitis group treated with herbs. 47 cases in the treatment group (67%) seroconverted. Most of the seropositives at the beginning of the trial were in the chronic hepatitis group. Seroconversion information was not provided. It was claimed that 158 cases (90%) were cured in 6 to 24 days. Study reported in 1982 involving 80 patients with chronic or acute hepatitis. [880291] 6. [Reported in the English language Journal of Traditional Chinese Medicine 1982. a treatment for hepatitis B in decoction form was given to 31 patients. In a study reported in 1987. if SGPT was elevated. A three month trial with a more effective therapy would therefore appear adequate. The exact number of therapeutic courses was not reported in the abstract. as standard practice. A control group received Western drugs and. A study reported in 1987 with 104 patients having hepatitis A and 72 having hepatitis B. the treatment was reduced to once every other day for one month. were treated with a decoction of herbs. vitamin C. This is consistent with the practice of treating acute hepatitis (A or B) for only about one month. This study indicates that 50% seroconversion can be achieved in a three month period of treatment. a course of treatment was 15 days and might be repeated once. based on tonic herbs. with 71 cases of hepatitis B with positive HBsAg. was not especially great. an herb syrup known to control that condition was given. Only a few of the patients treated here were positive for HBsAg and HBeAg. [880263] 7. When HBsAg became negative. all acute cases. Acute cases were given 3-4 doses per day for 20 days as a therapeutic course. Glycyrrhizin was administered along with vitamins to the treatment group and the vitamins were given with injection of inosine in the control group. 4(2): 127-132] 5. but presumably was one to three courses. A study reported in 1987. Treatment time was one month for acute hepatitis and three months for chronic hepatitis.4. and diisoproplylamine ascorbate.

as follows: a) gastro-intestinal reactions including nausea. the duration of symptom persistence could be longer). the problem might persist. adverse reactions to the herb/nutrient treatment have not been observed. including hepatic reaction. it may be necessary to have the individual experiencing the reaction discontinue the treatment. which contains anthraquinones. In the event that the disease becomes chronic. In most individuals. The above reactions are idiosyncratic. There are some possible specific reactions to the therapies. or diarrhea. to determine whether or not the observed problems are due to the ingestion of the herbs (for liver hypersensitivity reaction. b) allergy type reaction. Hu-chang. flatulence. Allergy-type reactions are not expected to resolve with longer use of the herbs. loose stool. In the event that such responses are noted and believed to be due to the herb therapy (as opposed to due to the hepatitis). vomiting. constipation. POSSIBLE ADVERSE REACTIONS There are some potential adverse reactions to any herb therapy. fatigue. diarrhea. which increases bile flow. there is blood stasis (mainly affecting the . that is. it is believed that the yin becomes deficient.According to this information. The gastro-intestinal reactions usually subside within three to five days and thus they should be tolerated for that long before discontinuing unless they are severe. in rare instances. may induce intestinal peristalsis. and arrhythmia. If such reactions occur. As the disease develops. which is described in Chinese medical terminology as a toxic heat syndrome. However. with the same preparation. it is said to manifest symptoms of accumulated dampness and liver qi stagnation. the herb therapy should be discontinued for two consecutive days. Licorice may cause excessive aldosterone production. None of the herbs are inherently toxic in the dosage range recommended.S. ligustrum. among the participants who respond to the therapy. those with acute hepatitis should be cured (or improved) within about two months and those with chronic hepatitis should be cured (or improved) within three months. they cannot be predicted in advance and do not represent inherent properties of the selected herbs. The dosage of licorice in this protocol is set at a level for which this reaction is rare. with symptoms of edema. bloating. TRADITIONAL CHINESE MEDICAL DESCRIPTION OF THE HERB THERAPY Hepatitis begins as an acute disease (with manifestations of heat). In the Chinese clinical trial of the herb formulation described here and in three years experience in the U. and curcuma. which contains oils. this response will resolve with continued use of the herbs.

. Modern research shows that it rectifies abnormal patterns of capillary bed circulation and successfully treats viral hepatitis when used in relatively large dosage. and calm mental irritability. edema. diarrhea. It is traditionally used for yin deficiency. and the qi is weakened (weakness of qi may be the cause of the acute disease becoming a chronic disease). loss of appetite. with a bitter and pungent flavor. cool the blood. spontaneous sweating. and disperses swelling. Atractylodes has been selected as the herb to remove dampness. deliver water. bitter. It is described as having a neutral property and sweet flavor.g. Recent studies show that it has anti-inflammatory action similar to that of the corticosteroids. dry dampness. to improve appetite and improve digestion. Modern research shows that it stimulates gastric secretion and bile secretion. It is traditionally used to regulate the flow of qi. It is described as having a neutral property and bitter taste. and promote secretion of fluids (e. vomiting. internal heat. tonify qi. and insomnia. detoxifies. disperse stagnant blood. and harmonize the stomach. mildly bitter and aromatic flavor. harmonize the stomach and spleen. It has been used for treatment of fatigue. It has been applied in the treatment of toxic swellings. it is used to supplement the spleen. It is described as a cold. astringe the lungs.liver). protects the liver from chemical injury. control diarrhea. and sour agent that clears up heat. diarrhea. Recent studies indicate that it enhances immune functions and protects liver cells from damage. Antibacterial and antiviral effects have been demonstrated in pharmacology experiments with this herb. It is traditionally used to invigorate blood circulation. It is applied to treatment of liver pain and jaundice. Hu-chang is the herb that has been selected to treat the toxic heat syndrome. remove toxin. It is described as having a warm property. and control pain. The herb is said to have a cool property. Schizandra has been selected as an aid to the qi tonic (licorice) and the yin nourishing herb (ligustrum). weakness of the lower back and legs. Traditionally. Modern research shows that it promotes immune system functions. Curcuma is the herb that has been selected to treat the stagnant qi that develops. Ligustrum is the herb that has been selected to treat yin deficiency. It is also a qi tonic herb. and dizziness. sweet. Salvia is the herb that has been selected to treat blood stasis. nourish the blood. cough. It is used to nourish the kidneys. Licorice has been selected as the qi tonic herb. and has anticoagulant properties. resolve qi stagnation. and palpitation. invigorates blood. clear heat. It is described as having a mild cold property and bitter flavor. thirst. It is traditionally described as having a warm property and sour flavor. It is traditionally used to supplement the spleen. mildly pungent. . replenish qi.

and thirst. and diarrhea. but 15-30 grams to treat severe diseases. this herb may cause abdominal aching and diarrhea. Higher dosage may cause dry mouth. Because of the relatively short duration of treatment in this study. A daily dosage of 15 grams has been selected for this treatment. in a published trial for treatment of hepatitis. In higher dosage. It has been applied to the treatment of fatigue. However. Curcuma is usually recommended in the dosage range 4. with some sour and acrid (pungent) properties. bitter after taste. numb sensation of limbs. Hu-chang is recommended to be used in the dosage range 9-30 grams/day. A daily dosage of 15 grams has been selected for this treatment.5 grams or higher (raw material equivalent) for treatment of hepatitis. spontaneous sweating. The extract has been used intravenously in doses of 22. it is said to reinforce the qi and nourish the yin. it was used in a dosage (as powder) of 15 grams/day. and gastrointestinal disturbance. these responses tend to subside of themselves without suspending treatment. of vitalizing blood. thirst. HERB DOSAGES Chinese doctors recommend herbal dosages that have been recorded in the classical and modern Materia Medica publications. clearing heat and toxin. the herb can cause dry mouth. Modern research shows that schizandra enhances adrenocortical function. Higher dosage may cause bloating and diarrhea. cough. promotes bile secretion. its taste is mainly sweet and bitter. Doses of up to 50 grams per day (made as fluid extract) have been used successfully to treat bronchitis. amnesia.saliva). and up to 30-60 grams for severe blood stasis syndrome. and reduces liver enzyme levels. In higher dosage. The complex formula has the properties of tonifying and regulating qi. the dosage of each item has been selected at a relatively high level within the range that is usually recommended. dizziness. Modern clinical trials confirm the validity of these dosage suggestions. Its quality is cooling. Ligustrum is recommended in dosages of 6-15 grams per day. the dosage of most ingredients is lower than would be utilized if the herb was selected as a sole ingredient. and drying dampness. Salvia is recommended in the dosage of 6-15 grams for typical uses. due to the expectation of synergistic action (attaining the same goal through complementary pathways). A daily dosage of 10 grams per day has been selected for this treatment. nausea. nausea. vomiting. of nourishing and astringing yin.5-9 grams/day. . shortness of breath. Generally speaking. abdominal pain. when making a complex formula. lassitude. insomnia. At higher dosage. A daily dosage of 20 gramshas been selected for this treatment. vomiting.

Quercenol. atractylodes. The relatively lower total dosage was deemed likely to be effective as the higher dosage treatments because of the careful selection of ingredients (focused formula design). A daily dosage of 9 grams has been selected for this treatment. used in Japanese treatment of hepatitis B). weak limbs. the control patients also took the vitamin . This reduction in number of ingredients-compared to that used in several recent trials with complex formulas-has been purposefully chosen to simplify the treatment protocol. Excessive dosage or long-term use of moderate dosage can cause an adverse reaction in up to 20% of patients. and schizandra. The additional vitamins and minerals may provide an action in the current protocol that would otherwise have been obtained from herb ingredients. the formula size and dosage range is reasonably consistent at 9-12 herbs and 100-140 grams. 7. spastic numbness. It should be noted that there is an additional herb extract present in the "vitamin tablet." namely silybum. about 13 grams each). A daily dose of 15 grams has been selected for this treatment. and the total dosage is just 94 grams (average. formulation characteristics were as follows: except for the one formula used temporarily at very high dosage. Doses up to 18 grams per day have been used in treatment of tuberculosis. hypokalamia. and grape seed). Higher dosage may cause heartburn. with 6-9 grams per day recommended to reinforce qi and nourish yin. headache. A few clinical trials rely on one to three herbs. Up to 15 grams per day (powdered herb) have been used in the treatment of hepatitis. hypertension. acid indigestion. Schizandra is recommended in the dosage range of 1. thus raising the total number of herbs to 8 (the substitute item. including possible symptoms of edema. Adverse reactions to large dosage have not been described. The primary control therapy was a tablet of the same size and same dosage made with lentinus extract (shiitake mushroom. stomach ache and anorexia. the number of herbs is only 7. In the formulation described in this article. RESULTS OF ONE CHINESE CLINICAL TRIAL In a clinical trial carried out at three test sites in China. typically 11-14 grams of each herb. A daily dose of10 grams has been selected for this treatment. The total dosage of the seven herbs is 94 grams.5-15 grams per day have been used to treat gastric and duodenal ulcers. the dosage of herbs is therefore slightly increased by the inclusion of the vitamin tablet. there were 94 inpatients treated and evaluated. contains other herb extracts. but gastro-intestinal responses might be expected. including those from green tea. utilizing three therapies (at each site). Doses up to 60 grams per day have been used for short-term applications. dizziness.5-9 grams per day.Licorice is recommended to be used in doses of 3-6 grams per day. In a review of hepatitis formulas listed in modern Chinese books (at the ITM library). taken with the vitamin tablet. sophora. The main test therapy was the formula now called Salvia/Ligustrum Tablets. Atractylodes is recommended in the dosage range of 3-12 grams.

Nearly half (9/20) of those tested showed viral DNA conversion from positive to negative in those receiving Salvia/Ligustrum. in the Salvia/Ligustrum group and the Lentinus group there was marked improvement in symptoms and liver enzymes. though less dramatic. edited by Chang and But. The study was conducted at the Hepo Medical Technical Research Institute in Beijing. The third control group took a patent medicine made in China that was understood. to be the most effective one available. the Haixia Hospital in Quanzhou (Fujian Province). These treatments were superior to one that had been deemed the best available in China by the researchers. edited by Chang.. the Salvia/Ligustrum formula (used with a nutritional supplement) produced excellent results in treating hepatitis B patients. schizandra. HBsAg conversion occurred only in a few patients. This regulation halted (perhaps temporarily) continuation of the trial despite the fact that no significant adverse events were noted for any of the participants enrolled thus far. Testing equipment and reagents were provided by the Tumor Virology Department of the Centers for Disease Control. Antigen conversion from positive to negative occurred for HBeAg in 2/3 of patients treated by Salvia/Ligustrum or Lentinus Tablets. et al. atractylodes. by the Chinese researchers. copyright 1985. but in only 1/3 of those receiving the Chinese patent. In sum. There were also obvious benefits. more so than with the Chinese patent remedy. New government regulations in China require data on safety (such as laboratory animal tests) in order to carry out clinical trials. The original study design called for treatment of 200 patients. and clinical trials used in this article:  The two volume book Pharmacology and Application of Chinese Materia Medica. and the nutritional supplement. and the Henan Medical Science Institute. The .supplement. 2 receiving Salvia/Ligustrum. and none receiving the Chinese patent.  The proceedings of a meeting that took place in 1983. Atlanta. pharmacology. unless the herbs are in the form of decoction. Advances in Chinese Medicinal Materials Research. 1 receiving Lentinus. copyright 1986. and in one-third (7/21) of those receiving Lentinus. published by World Scientific (Singapore). REFERENCE SOURCES The Chinese Medicinal Materials Research Centre at the Chinese University of Hong Kong (in Shatin) produced three resources which provided most of the background information about active constituents. but only in about one-fourth (6/26) of those receiving the Chinese patent. for treatment with lentinus. As a result of 12 weeks treatment. published by World Scientific (Singapore).

by Werbach.jtcm. Oriental Healing Arts Institute. 1993. provides background information on herbs mentioned in early Chinese literature. Oriental Materia Medica by Hsu and Hsu. and reported again in New York Times. 239. Modern Study and Application of Materia Medica by Dong and Yu. (4(3).asp DrSDTyagi Tradi&comple7 Editor-In-Chief Lee-Yan Sheen National Taiwan University . described plans for eugenics policies in China that included hepatitis B infection. 1976). SMC Publishing. 2. #1) included the review by Han Dewu. A news article in Beijing Xinhua [English version].meeting had a section on liver diseases for which seven papers were presented in the proceedings.academia." Additional information was obtained from the following English language sources: Recent Advances in Chinese Herbal Drugs. Abstracts of Chinese Medicine." by Saburo Miyasita in American Journal of Chinese Medicine. China Ocean Press. Beijing. CA 1980. 1992. the 1988 issue (vol. Formulation of the vitamin supplement was based. Journal of Traditional Chinese Medicine [English]. on information obtained from: Nutritional Influences on Illness. in part. Long Beach. 27.: "Chinese medicines for the prevention and treatment of viral hepatitis. published continuously since 1981. Science Press. 1990. An article. 1991. https://www. December 20. Los Angeles. Feb. "A historical study of Chinese drugs for the treatment of jaundice. Beijing. published continuously since 1986.  The quarterly journal of English language abstracts of Chinese medical journal articles. Third Line Press. The Illustrated Chinese Materia Medica. et al. 1993. DrSD academia7edu satyadevpr Journal of Traditional and Complementary Medicine http://www. by Yen. 1994.

Ghatkopar (East) City: Mumbai .C.400075 State: Maharashtra Country: INDIA Phone: 91-22-66491818 / 66491816 Fax: 91-22-66491817 Website: www. Sec.) Tel:+886-2-8590-6666 Web site : http://www. The Chief Editor/Editor may be guided by the policies of the journal's editorial board and constrained by such legal requirements as shall then be in force regarding libel. Roosevelt Publication Ethics and Publication Malpractice Statement The Chief Editor/Editor of the Journal of Traditional and Complementary Medicine is responsible for deciding which of the research papers/articles submitted to the journal should be published. Taipei 10617. Kanara Business Centre. org Fax number: +886-2-33669676 Published by Medknow Publications And Media Pvt. Sec. Tacheng St. Department of Chinese Medicine and Pharmacy. Datong District. The publishing decision is based on the recommendation of the journal's reviewers. . tw Managing Editor Chia-Chi Huang National Taiwan University No. Roosevelt Road. Taiwan E-mail: lysheen @ ntu . Taiwan E-mail: me @ jtcm . copyright infringement and plagiarism.. edu .No.mohw. Taiwan (R. 4. Taipei City 10341. 1. Taipei 10617. 1. Ministry of Health and Welfare Address: No. The Chief Editor/Editor may confer with other editors or reviewers in making this decision. part of Wolters Kluwer Health B9. Off Link Road.

Confidentiality The Chief Editor/Editor. as appropriate. Reviews should be conducted objectively. The Chief Editor/Editor communicates with authors. sexual orientation. The reviewers don't know the author's identity and Reviewers' comments to the editors are confidential and before passing on to the author will be made anonymous. Reviewers and any Editorial Staff must not disclose any information about a submitted manuscript to anyone other than the corresponding author. They must not be shown to or discussed with others except as authorized by the editor. Referees should express their views clearly with supporting arguments. A reviewer should also call to the Chief Editor/Editor’s attention any substantial similarity . as required. religious belief. potential reviewers. Promptness The journal Chief Editor/Editor are committed to provide timely review to the authors and if any selected referee who feels unqualified to review the research reported in a manuscript or knows that its prompt review will be impossible should notify the Chief Editor/Editor and excuse him/her from the review process. ethnic origin. or political philosophy of the authors. Duties of Reviewers Contribution to Editorial Decisions Technical papers will be published in the Journal after peer reviewing. and helps them in improving quality of their research paper. Acknowledgement of Sources Reviewers should identify relevant published work that has not been cited by the authors.Fair play Manuscripts shall be evaluated solely on their intellectual content without regard to race. under the “Blind Review” process. derivation. The reviewers advise the Chief Editor/Editor in making the editorial decision. Personal criticism of the author is inappropriate. and the publisher. Standards of Objectivity The editors and reviewers are required to evaluate papers based on the content. or argument had been previously reported should be accompanied by the relevant citation. Any statement that an observation. Disclosure and conflicts of interest Unpublished materials disclosed in a submitted manuscript must not be used in a Chief Editor/Editor’s own research without the express written consent of the author. The names of the reviewers remain strictly confidential. Confidentiality Any manuscripts received for review must be treated as confidential documents. with their identities known only to the Chief Editor/Editor. gender. other editorial advisers. citizenship. reviewers.

Originality and Plagiarism Authors should ensure that submitted work is original and has not been published elsewhere in any language. A paper should contain sufficient detail and references to permit others to replicate the work. Multiple. copying or paraphrasing substantial parts of another’s paper (without attribution). companies. Fraudulent or knowingly inaccurate statements constitute unethical behavior and are unacceptable. and claiming results from research conducted by others are among the numerous forms of plagiarism. Duties of Authors Reporting standards Authors of reports of original research should present an accurate account of the work performed as well as an objective discussion of its significance. or other relationships or connections with any of the authors. Redundant or Concurrent Publication An author should not in general publish manuscripts describing essentially the same research in more than one journal or primary publication. . Data Access and Retention Authors are asked to provide the raw data in connection with a paper for editorial review. collaborative. and should unfailingly cite the work on which they are based. Underlying data should be represented accurately in the paper. or institutions connected to the papers. Plagiarism in any form. In all its forms plagiarism constitutes unethical publishing behavior and is unacceptable. and if the authors have used the work and/or words of others that this has been appropriately cited or quoted. Privileged information or ideas obtained through peer review must be kept confidential and not used for personal advantage. Submitting the same manuscript to more than one journal concurrently constitutes unethical publishing behaviour and is unacceptable. and should be prepared to provide public access to such data. without the written consent of the two journals involved. including the touting of material contained in another paper (of the same authors or some other author) with cosmetic changes as a new paper. an author should not submit for consideration to another journal a previously published paper. and should in any event be prepared to retain such data for a reasonable time after publication. or the one under consideration with another journal. Applicable copyright laws and conventions should be followed. Disclosure and Conflict of Interest Reviewers should not consider manuscripts in which they have conflicts of interest resulting from competitive. if practicable.or overlap between the manuscript under consideration and any other published paper of which they have personal knowledge. Reviews and other articles should also be accurate and objective. In general.

written. procedures or equipment that have any unusual hazards inherent in their use. or discussion with third parties. they should be acknowledged or listed as contributors. Disclosure and Conflicts of Interest All authors should disclose in their manuscript any financial or other substantive conflict of interest that might be construed to influence the results or interpretation of their manuscript. and that all co-authors have seen and approved the final version of the paper and have agreed to its submission for publication. If the Chief Editor/Editor or the publisher learns from a third party that a published work contains a significant error. must not be used or reported without explicit. Information obtained privately. Where there are others who have participated in certain substantive aspects of the research project. or interpretation of the reported study.Acknowledgement of Sources Proper acknowledgment of the work of others must always be given. as in conversation. All sources of financial support for the project should be disclosed. execution. The corresponding author should ensure that all appropriate co-authors and no inappropriate co-authors are included on the paper. it is the author’s obligation to promptly notify the journal Chief Editor/Editor or publisher and cooperate to retract or correct the paper. Fundamental errors in published works When an author discovers a significant error or inaccuracy in his/her own published work. the author must clearly identify these in the manuscript. . Authors should cite publications that have been influential in determining the nature of the reported work. If the work involves chemicals. design. correspondence. All those who have made significant contributions should be listed as co-authors. permission from the source. Authorship of the Paper Authorship should be limited to those who have made a significant contribution to the conception. it is the obligation of the author to promptly retract or correct the paper or provide evidence to the Chief Editor/Editor of the correctness of the original paper.