Protection by Indigenous Drugs Against Hepatotoxic Effects of Carbon Tetrachloride - a Long Term Study

Clinical and Safety Evaluation of Liv.52 in Alcoholic Liver Disease: A Review

Alcoholic liver disease (ALD) has been a growing concern in developed and developing nations. Oxidative stress and lipid peroxidation are the most common cause of the development and progression of ALD. Due to paucity in the number and efficacy of hepatoprotective drugs currently available, and with the easy availability of natural therapy and herbal medicines, ALD is managed using a combination of pharmaceutical interventions and herbal medications. However, the effectiveness of these hepatoprotectives is controversial. Preclinical and clinical studies have demonstrated that Liv.52 modulates the lipotropic activity of hepatocytes, reduces inflammation, enhances alcohol and acetaldehyde metabolism, and protects the hepatic parenchyma by restoring the antioxidant levels of hepatocytes. Clinical studies further support that there is improvement in the subjective symptoms of patients as well as improvements in liver function test parameters. Studies suggest that Liv.52 is well tolerated and has no reported side effects.

Hepatroprotective action of potentized lycopodium clavatum L

A high potency of Lycopodium clavatum Linn. (200th centesimal potency) is tested for its hepatoprotective action against carbon tetrachloride-induced hepatic damage in rat. It has been established from biochemical and histopathological studies that at least 4 doses of Lycopodium 200 can control the CCl4-induced alteration of plasma levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, acetylcholinesterase, lactate deyhydrogenase, bilirubin and urea. Protective action of the drug has also been confirmed by microanatomical studies on hepatic tissues.

Protective effect of Livactine against CCl(4) and paracetamol induced hepatotoxicity in adult Wistar rats

Background:

Liver disease has become one of the serious health problems as it is exposed to many kinds of xenobiotics and therapeutic agents. Moreover the rapidly growing morbidity and mortality from liver disease are attributable to the increasing number of chemical compounds and environmental pollution. Unfortunately, so far, in the modern era of medicine there is no specific treatment to counter the menacing impact of these dreaded diseases. Many polyherbal formulations are used widely to treat these disorders. Livactine is a polyherbal formulation and is claimed to be useful in jaundice and biliary dysfunctions. Most of these formulations do not have standard and approved reports stating their pharmacological action or therapeutic efficacy. Therefore, there is a need for experimental confirmation of the pharmacological effects of this formulation. The rationale behind the selection of carbon tetrachloride is due to its free radical mechanism based liver injury, and paracetamol is consumed widely by the human population and it is also a potential liver hazard.

Aim:

To evaluate the anti-hepatotoxic activity of Livactine against carbon tetrachloride & paracetamol induced toxicity in rats.

Material and Methods:

Albino rats of Wistar strain were used to evaluate the hepatoprotective activity of Livactine against carbon tetrachloride & paracetamol induced toxicity. Liver damage was assessed by estimating various biochemical parameters such as serum glutamate oxaloacetate transaminase, serum glutamate pyruvate transaminase, lactate dehydrogenase, alkaline phosphatase, acid phosphatase, total bilirubin, and total protein. The results of the rats treated with Livactine were compared with that of Liv-52.

Results:

Livactine showed significant dose dependent hepatoprotective effect by reducing elevated serum enzyme levels when compared to that of Liv-52.

Conclusion:

Our findings confirm that the formulation was found to be effective pharmacologically at higher dose against carbon tetrachloride and paracetamol induced hepatotoxic models and were comparable to that of Liv-52. The resultant hepatoprotective activity of Livactine could be due to its free radical scavenging property of the ingredients.

Liv.52 in alcoholic liver disease: a prospective, controlled trial

Liv.52, a hepatoprotective agent of herbal origin, is used empirically for the treatment of alcoholic liver disease in Sri Lanka. We conducted a controlled trial to assess the efficacy of Liv.52 in patients with alcoholic liver disease. Patients with evidence of alcoholic liver disease attending outpatient clinics were included in a prospective, double blind, randomized, placebo controlled trial. During the trial period, 80 patients who fulfilled inclusion criteria were randomly assigned Liv.52 (cases; n = 40) or placebo (controls) the recommended dose of three capsules twice daily for 6 months. All patients underwent clinical examination (for which a clinical score was computed), and laboratory investigations for routine blood chemistry and liver function before commencement of therapy (baseline). Thereafter, clinical assessments were done monthly for 6 months, while laboratory investigations were done after 1 and 6 months of therapy. There was no significant difference in the age composition, alcohol intake and baseline liver function between the two groups. The two-sample t-test was used to analyze data obtained after 1 and 6 months of therapy against baseline values. There was no significant difference in clinical outcome and liver chemistry between the two groups at any time point. There were no reports of adverse effects attributable to the drug. Our results suggest that Liv.52 may not be useful in the management of patients with alcohol induced liver disease.

Effects of the ethanol extract of Cichorium intybus on the immunotoxicity by ethanol in mice

Effects of the ethanol extract of Cichorium intybus (CIEE) on the immunotoxicity of ethanol (EtOH) were investigated in ICR mice. Mice were divided into four groups, and CIEE at dose of 300 mg/kg was orally administered to mice daily for 28 consecutive days, and normal mice were given vehicle. Mice treated with EtOH were given freely with 20% w/v EtOH solution. The results of this study are summarized as follows: The combination of CIEE and EtOH showed significant increases in the circulating leukocytes and the relative weights of liver, spleen and thymus, as compared with those in mice treated with EtOH alone. However, the body weight gain was not affected. Splenic plaque forming cells (PFC) and hemagglutination (HA) titers to sheep red blood cells (SRBC), and the secondary IgG antibody response to bovine serum albumin (BSA) were markedly enhanced by CIEE plus EtOH treatment as compared with the treatment of EtOH alone. In mice receiving the combination of CIEE and EtOH when compared with EtOH alone-treated mice, there were also significant increases in delayed-type hypersensitivity (DTH) reaction, phagocytic activity, natural killer (NK) cell activity and cell proliferation as well as interferony (IFN-gamma) secretion. In the case of interleukin-4 (IL-4) content, however, an insignificant induction observed by CIEE plus EtOH treatment. These findings indicate that the immunotoxicity induced by EtOH is significantly restored or prevented by CIEE treatment.

Crude extracts of hepatoprotective plants, Solanum nigrum and Cichorium intybus inhibit free radical-mediated DNA damage

The presence of plant extracts of Solanum nigrum and Cichorium intybus in the reaction mixture containing calf thymus DNA and free radical generating system protect DNA against oxidative damage to its deoxyribose sugar moiety. The effect was dependent on the concentration of plant extracts. However, the effect of Cichorium intybus was much pronounced as compared to the effect of Solanum nigrum. These studies suggest that the observed hepatoprotective effect of these crude plant extracts may be due to their ability to suppress the oxidative degradation of DNA in the tissue debris.

Hepatoprotective effects of Liv-52 and its indirect influence on the regulation of thyroid hormones in rat liver toxicity induced by carbon tetrachloride

This study was undertaken to investigate the protective effect of Liv-52, a herbal formulation, on various serum and liver marker enzymes, lipid peroxidation and histological changes in the liver of male albino rats suffering long-term carbon tetrachloride (CCl4) poisoning. It was observed that the activities of serum marker enzymes, hepatic enzymes and NADPH-dependent lipid peroxidation were significantly elevated after treatment with CCl4. However, in rats given Liv-52 at the same time as CCl4, the levels of all the marker enzymes were closer to those found in control animals. A similar trend was seen in the case of lipid peroxidation after Liv-52 treatment. CCl4 alone caused severe liver damage, but when Liv-52 was simultaneously given, there was much less effect on the structure of the organ. Circulating T3 and T4 concentrations were also determined after 6 weeks of simultaneous treatment with Liv-52 and CCl4. Concentrations of T3 were significantly lowered after CCl4 treatment alone, but Liv-52 administration together with CCl4 resulted in maintenance of the T3 activity within normal limits, thus suggesting indirect beneficial effects of Liv-52 on the regulation of thyroid hormone concentrations.

Role of Liv-52 in protection against beryllium intoxication

An ayurvedic medicine, Liv-52, was studied as a prophylactic agent against beryllium-induced toxicity in rats. Administration of beryllium per se caused severe degenerative and necrotic changes in kidneys, liver, and uterus. Beryllium exposure also reduced glycogen content, activities of alkaline phosphatase, succinate-dehydrogenase, and adenosine-triphosphatase in these organs. On the contrary, activities of acid phosphatase and glucose-6-phosphatase showed marginal increase. Liv-52-primed rats exhibited comparatively less marked toxic effects.

Evaluation of zinc in the regulation of serum T3 and T4 levels and hepatic functions in carbontetrachloride-intoxicated rats

Circulating tri-iodothyronine (T3) and thyroxine (T4) concentrations were determined after 6 wk of zinc treatment to carbontetrachloride (CCl4) intoxicated male albino rats. Concentrations of T3 were observed to be significantly depressed following CCl4 treatment alone. On the contrary, no significant change was noticed in the concentrations of T4 when compared to controls. However, zinc administration to hepatotoxic animals resulted in restoring the T3 activity to within normal limits, thus indicating the indirect effects of zinc on the regulation of thyroid hormone concentrations. The activities of all the serum and hepatic marker enzymes were found to be significantly elevated following CCl4 treatment. However, following zinc supplementation to these intoxicated animals, the levels of the marker enzymes decreased significantly when compared to the CCl4-treated animals. A similar trend was seen in the case of lipid peroxidation following zinc treatment.

Effect of Liv.52, a herbal preparation, on absorption and metabolism of ethanol in humans

In 8 social drinkers, the effect of a single dose of Liv.52 or placebo on ethanol absorption has been studied after ingestion of 30 ml whisky in 5 min. The t1/2 absorption with Liv.52 was 3.62 min, significantly less than after placebo, 6.29 min. The peak concentration after Liv.52 (49.9 mg.100 ml-1) was significantly higher than with placebo (40.5 mg.100 ml-1). Whisky 120 ml consumed by regular alcohol users in 1 h, before and following 15 days of Liv.52 treatment produced significantly higher ethanol levels at 2, 3 and 4 h and significantly lower acetaldehyde levels at 3 and 4 h after Liv.52 treatment. Liv.52 enhanced the rate of absorption of ethanol and rapidly reduced acetaldehyde levels, which may explain its hepatoprotective effect on ethanol-induced liver damage.