Hepatoprotective Activity of Heptoplus on Isoniazid and Rifampicin Induced Liver Damage in Rats

Preclinical liver toxicity models: Advantages, limitations and recommendations

Experimental animal models are crucial for elucidating the pathophysiology of liver injuries and for assessing new hepatoprotective agents. Drugs and chemicals such as acetaminophen, isoniazid, valproic acid, ethanol, carbon tetrachloride (CCl4), dimethylnitrosamine (DMN), and thioacetamide (TAA) are metabolized by the CYP2E1 enzyme, producing hepatotoxic metabolites that lead to both acute and chronic liver injuries. In experimental settings, acetaminophen (centrilobular necrosis), carbamazepine (centrilobular necrosis and inflammation), sodium valproate (necrosis, hydropic degeneration and mild inflammation), methotrexate (sinusoidal congestion and inflammation), and TAA (centrilobular necrosis and inflammation) are commonly used to induce various types of acute liver injuries. Repeated and intermittent low-dose administration of CCl4, TAA, and DMN activates quiescent hepatic stellate cells, transdifferentiating them into myofibroblasts, which results in abnormal extracellular matrix production and fibrosis induction, more rapidly with DMN and CCL4 than TAA (DMN > CCl4 > TAA). Regarding toxicity and mortality, CCl4 is more toxic than DMN and TAA (CCl4 > DMN > TAA). Models used to induce metabolic dysfunction-associated liver disease (MAFLD) vary, but MAFLD's multifactorial nature driven by factors like obesity, fatty liver, dyslipidaemia, type II diabetes, hypertension, and cardiovascular disease makes it challenging to replicate human metabolic dysfunction-associated steatohepatitis accurately. From an experimental point of view, the degree and pattern of liver injury are influenced by various factors, including the type of hepatotoxic agent, exposure duration, route of exposure, dosage, frequency of administration, and the animal model utilized. Therefore, there is a pressing need for standardized protocols and regulatory guidelines to streamline the selection of animal models in preclinical studies.

Protective effect of hesperidin, ascorbic acid and their combination on oxidative stress, dyslipidemia, and histological changes in antitubercular drug-induced hepatotoxicity in rats

BACKGROUND

Hesperidin and ascorbic acid (AA) enhance cellular antioxidant defense systems by neutralizing the free radicals which formed during oxidative stress that could offer protective effects against drug-induced liver injury. Hence, this study aims to investigate the effect of hesperidin, AA and their combination against antitubercular drug (ATDs)- induced hepatotoxicity in Wistar albino rats.

MATERIALS AND METHODS

The rats were divided into six groups of 6 animals each. Isoniazid (H), Rifampicin (R), and pyrazinamide (Z) (27, 54, 135 mg/kg.b.wt) were co-administration for 50 days to induce hepatotoxicity. Hesperidin 200 mg/kg and AA 100 mg/kg p.o were administered 1 h before ATDs administration. At the end of the study, blood and liver tissues were collected and subjected to biochemical and histopathological examination. Biochemical parameters, serum marker enzymes (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, acid phosphatase, Gamma glutamyltransferase, and lactate dehydrogenase), lipid peroxidation (LPO), antioxidant enzymes (superoxide dismutase, catalase, GSH, glutathione peroxidase, GR, Vitamin C, and Vitamin E), lipid profile, membrane bound ATPase, and histological changes of liver were assessed.

RESULTS

Our results revealed that HRZ-induced hepatotoxicity was evident by significant (P < 0.001) elevation in level of urea, creatinine, bilirubin, liver marker enzymes, lipid profile (P < 0.01), and LPO (P < 0.001) along with significant decline in the level of total protein, albumin (P > 0.05), ATPase (P < 0.001), and antioxidant enzymes (P < 0.001). Treatment with HDN and AA significantly reduced the changes induced by HRZ. However, compared to individual treatment, combined treatment with HDN and AA significantly (P < 0.001) ameliorated all the changes induced by ATDs and improved the hepatic architecture to near normal.

CONCLUSION

The combination of HDN and AA demonstrated a synergistic therapeutic effect against HRZ-induced liver injury; hence, this combination represents a potential novel strategy for the management of anti-TB drug-induced liver damage.

Ameliorative effects of Liv-52 on doxorubicin-induced oxidative damage in rat liver

Hepatotoxicity is a common side effect of doxorubicin (Dox) treatment of cancer. Liv-52 is an ayurvedic medicine that is reported to ameliorate liver injury due to oxidative stress. We investigated the effects of Liv-52 on Dox induced oxidative damage to liver tissues of rats using biochemical and histopathological techniques. Thirty male rats were assigned randomly into three equal groups: control (CG), Dox group (DG) Liv-52 + Dox group (LD). Rats in the LD group received 50 mg/kg Liv-52 in distilled water via gastric gavage. Distilled water was given via the same route to the rats in the DG and CG groups. Rats in the LD and DG groups were injected intraperitoneally with 5 mg/kg Dox 1 h after administration of Liv-52 or distilled water. The procedure was repeated daily for 7 days. On day 8, the animals were sacrificed, and serum and tissue biochemical and histopathological assays were performed. The malondialdehyde level was increased significantly in the DG group, while glutathione and superoxide dismutase levels were significantly lower in the DG group compared to the LD and CG groups. The highest levels of alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase were found in the DG group, while the lowest levels were found in the CG group, which exhibited levels similar to those of the LD group. Treatment with Liv-52 prior to Dox treatment reduced the histopathologic changes in the Dox group. Therefore, pre-treatment with Liv-52 protected against Dox induced oxidative stress and hepatotoxicity.

The Activity of Purple Sweet Potato Extract on Antituberculosis-Induced Liver Toxicity

BACKGROUND: The proportion of antituberculosis-induced liver injury on tuberculosis patients showed a relatively high incidence in many countries. Hepatic damage induced by antituberculosis drugs might potentially fatal. Isoniazid (INH) and rifampicin (RIF) are two main components of antituberculosis with crucial role for the incidence of liver injury. One of the herbal remedies that pose hepatoprotective action is purple sweet potato. Hepatoprotective action of purple sweet potato extract has been proved to pose antioxidant and anti-inflammatory activity. AIM: This study was designed to analyze the effect of purple sweet potato extract on rat interleukin-6 (IL-6) and tumor necrosis factor-α _(TNF-α) level, as well as liver histopathology feature in hepatic injury induced by INH-RIF. METHODS: This study was a randomized posttest-only control group design. Male Wistar rats (Rattus norvegicus), age 8–12 weeks, weight 180–220 g were included in this research (divided into three groups). Purple sweet potato extract was produced by maceration technique. IL-6 and TNF-α _level was measured by enzyme-linked immunosorbent assay, whereas liver histopathology examination was performed with hematoxylin and eosin staining. Statistical analysis was performed using one-way ANOVA and post hoc test. RESULTS: Liver IL-6 level in the normal, control, and treatment groups was 2.272±0.473, 3.315 ± 0.536, and 2.548 ± 0.304, respectively (p < 0.001). Liver TNF-α _level in the normal, control, and treatment groups was 26.476 ± 1.681, 48.584 ± 1.359, and 32.547 ± 1.528, respectively (p < 0.05). Histopathology feature of the liver in the control group showed significant liver congestion, liver degeneration, liver necrosis, and infiltration of inflammatory cell. Otherwise, histopathology feature of the liver in the treatment group showed minimal lesion. CONCLUSIONS: Purple sweet potato ethanol extract lowered the liver concentration of IL-6 and TNF-α, as well as improving liver damage in Wistar rats induced with isoniazid and rifampicin.

Antibacterial activity of medicinal plants against ESKAPE: An update

Antibiotic resistance has emerged as a threat to global health, food security, and development today. Antibiotic resistance can occur naturally but mainly due to misuse or overuse of antibiotics, which results in recalcitrant infections and Antimicrobial Resistance (AMR) among bacterial pathogens.

These mainly include the MDR strains (multi-drug resistant) of ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species). These bacterial pathogens have the potential to “escape” antibiotics and other traditional therapies. These bacterial pathogens are responsible for the major cases of Hospital-Acquired Infections (HAI) globally. ESKAPE Pathogens have been placed in the list of 12 bacteria by World Health Organisation (WHO), against which development of new antibiotics is vital. It not only results in prolonged hospital stays but also higher medical costs and higher mortality. Therefore, new antimicrobials need to be developed to battle the rapidly evolving pathogens. Plants are known to synthesize an array of secondary metabolites referred as phytochemicals that have disease prevention properties. Potential efficacy and minimum to no side effects are the key advantages of plant-derived products, making them suitable choices for medical treatments. Hence, this review attempts to highlight and discuss the application of plant-derived compounds and extracts against ESKAPE Pathogens.

The effect of Liv-52 on liver ischemia reperfusion damage in rats

Background

Liver ischemia reperfusion (I/R) damage which is frequently seen in clinical hepatobiliary surgeries has no effective treatment for it. Liv-52, known to have hepatoprotective effects, is a natural antioxidant drug licensed by the Ministry of Health of India. The aim of our study is to investigate the effect of Liv-52 on liver damage induced by I/R in rats.

Methods

Albino Wistar male rats were divided into three groups; liver I/R (IR), 20 mg/kg Liv-52 + liver ischemia reperfusion (LIR) and sham operation applied to control group (HG). Liv-52 was administered to the LIR group (n = 6) 1 h prior to I/R application and distilled water was given orally to IR (n = 6) and HG (n = 6) groups as a solvent. Ischemia was determined as 1 h, and reperfusion was identified as 6 h in animals.

Results

Increased levels of alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase, malondialdehyde, myeloperoxidase, and decreased levels of superoxide dismutase, and glutathione related enzymes caused by I/R application have been converged to healthy group level with Liv-52 treatment and the damage in liver tissue has been improved histopathologically.

Conclusions

Liv-52 may be beneficial for preventing liver I/R damage in pre-surgery application.

Medicinal plants: Adjunct treatment to tuberculosis chemotherapy to prevent hepatic damage

The effectiveness of herbs for the management of chemically induced hepatotoxicity has been discussed by many researchers. However, there is a paucity of compressive literature on the significance of hepatoprotective plants for the management of anti-TB drug induced toxicity. Anti-TB drugs have been reported to causes hepatic damage, due to which, many patients across the globe discontinued the treatment. Medicinal plants have multiple therapeutic effects. The assessment of biological activity of plants against Mycobacterium and its use for hepatic recovery provides an effective treatment approach. Traditionally used medicinal plants are the rich source of phytochemicals and secondary metabolites. These compounds can restore normal function, enzymatic activity and structure of hepatic cells against anti-TB drug induced hepatotoxicity. The present review covers comprehensive details on different hepatoprotective and antimycobacterial plants studied during past few decades so that potential adjuvants can be studied for Tuberculosis chemotherapy.

The ameliorating effect of Centella asiatica ethanolic extract on albino rats treated with isoniazid

BACKGROUND

Isoniazid, also called isonicotinyl hydrazine (INH), is a commonly used drug for treating tuberculosis. The main drawback is its toxic side effects. Centella asiatica has long been used in the Ayurvedic system of medicine owing to its wide medicinal properties. This study was designed to examine the effectiveness of C. asiatica ethanolic leaf extract (CA) on INH-treated albino rats.

METHODS

The adverse effects induced by INH (50 mg/kg bw) administration on haematological parameters, oxidative status (thiobarbituric acid-reactive substances, superoxide dismutase, catalase, and reduced glutathione), liver and kidney function markers, and their amelioration by various concentrations of CA (20, 40, 60, and 100 mg/kg bw) or silymarin (SIL) (50 mg/kg bw, administered before 1 h of INH treatment for 30 days to rats) were studied. Moreover, histological studies were carried out in liver and kidney tissues of rats treated with the most effective concentration to further support the possible effectiveness of CA on INH-intoxicated rats.

RESULTS

All the affected parameters returned to near-normal levels, and the effective concentration of extract was found to be 100 mg/kg bw. The histology of both the liver and the kidneys subsequently supported the effectiveness of CA (100 mg/kg bw).

CONCLUSIONS

Altogether, the results suggest that CA at 100 mg/kg bw can substantially reduce the toxic effects of INH.