Natural Products As Hepatoprotective Agents-A Comprehensive Review of Clinical Trials

Overview

Journal Plants (Basel)

Date 2024 Jul 27

PMID 39065511

Authors

Piotr Sluzaly

Pawel Pasko

Agnieszka Galanty

Affiliations

Soon will be listed here.

Abstract

The hepatoprotective effects of natural products have been a significant focus in recent decades due to the growing demand for the help in the treatment of hepatic impairments. This review specifically delves into the findings of clinical trials involving 13 selected natural products, namely plants and their derived compounds (e.g., artichoke, berberine, and turmeric), algae (e.g., spirulina), probiotics, and other products like phospholipids and vitamin D. A literature search was performed in the Scopus database, PubMed, and Google Scholar, covering all articles found up to June 2024. Artichoke, berberine, chlorella, chicory, green tea, probiotics, phospholipids, schisandra, silymarin, spirulina, and vitamin D caused a decrease in liver enzymes, while for cinnamon and turmeric such an effect was either not observed or not convincing. The presented results indicate that some natural products might satisfactorily improve hepatic outcomes in NAFLD, NASH, and other liver disorders; however, further studies and metanalyses are needed to clearly demonstrate their effectiveness.

Citing Articles

A comprehensive review of Schisandrin B's preclinical antitumor activity and mechanistic insights from network pharmacology.

Fang Y, Pan J, Wang P, Wang R, Liang S Front Pharmacol. 2025; 16:1528533.

PMID: 39995410 PMC: 11847788. DOI: 10.3389/fphar.2025.1528533.

Metabolic-Associated Fatty Liver Disease: The Influence of Oxidative Stress, Inflammation, Mitochondrial Dysfunctions, and the Role of Polyphenols.

Tauil R, Golono P, de Lima E, de Alvares Goulart R, Landgraf Guiguer E, Bechara M Pharmaceuticals (Basel). 2024; 17(10).

PMID: 39458995 PMC: 11510109. DOI: 10.3390/ph17101354.

Spirulina/Arthrospira/Limnospira-Three Names of the Single Organism.

Sinetova M, Kupriyanova E, Los D Foods. 2024; 13(17).

PMID: 39272527 PMC: 11395459. DOI: 10.3390/foods13172762.

References

Famouri F, Shariat Z, Hashemipour M, Keikha M, Kelishadi R . Effects of Probiotics on Nonalcoholic Fatty Liver Disease in Obese Children and Adolescents. J Pediatr Gastroenterol Nutr. 2017; 64(3):413-417. DOI: 10.1097/MPG.0000000000001422. View

Panahi Y, Kianpour P, Mohtashami R, Jafari R, Simental-Mendia L, Sahebkar A . Efficacy and Safety of Phytosomal Curcumin in Non-Alcoholic Fatty Liver Disease: A Randomized Controlled Trial. Drug Res (Stuttg). 2017; 67(4):244-251. DOI: 10.1055/s-0043-100019. View

Nejati L, Movahedi A, Salari G, Moeineddin R, Nejati P . The Effect of Berberine on Lipid Profile, Liver Enzymes, and Fasting Blood Glucose in Patients with Non-alcoholic Fatty Liver Disease (NAFLD): A Randomized Controlled Trial. Med J Islam Repub Iran. 2022; 36:39. PMC: 9448505. DOI: 10.47176/mjiri.36.39. View

Targher G, Tilg H, Byrne C . Non-alcoholic fatty liver disease: a multisystem disease requiring a multidisciplinary and holistic approach. Lancet Gastroenterol Hepatol. 2021; 6(7):578-588. DOI: 10.1016/S2468-1253(21)00020-0. View

Manzhalii E, Virchenko O, Falalyeyeva T, Beregova T, Stremmel W . Treatment efficacy of a probiotic preparation for non-alcoholic steatohepatitis: A pilot trial. J Dig Dis. 2017; 18(12):698-703. DOI: 10.1111/1751-2980.12561. View

Azocar J, Diaz A . Efficacy and safety of Chlorella supplementation in adults with chronic hepatitis C virus infection. World J Gastroenterol. 2013; 19(7):1085-90. PMC: 3581996. DOI: 10.3748/wjg.v19.i7.1085. View

Fried M, Navarro V, Afdhal N, Belle S, Wahed A, Hawke R . Effect of silymarin (milk thistle) on liver disease in patients with chronic hepatitis C unsuccessfully treated with interferon therapy: a randomized controlled trial. JAMA. 2012; 308(3):274-82. PMC: 3683986. DOI: 10.1001/jama.2012.8265. View

Aller R, Izaola O, Gomez S, Tafur C, Gonzalez G, Berroa E . Effect of silymarin plus vitamin E in patients with non-alcoholic fatty liver disease. A randomized clinical pilot study. Eur Rev Med Pharmacol Sci. 2015; 19(16):3118-24. View

Saadati S, Hatami B, Yari Z, Shahrbaf M, Eghtesad S, Mansour A . The effects of curcumin supplementation on liver enzymes, lipid profile, glucose homeostasis, and hepatic steatosis and fibrosis in patients with non-alcoholic fatty liver disease. Eur J Clin Nutr. 2019; 73(3):441-449. DOI: 10.1038/s41430-018-0382-9. View

10.

Panahi Y, Hosseini M, Khalili N, Naimi E, Simental-Mendia L, Majeed M . Effects of curcumin on serum cytokine concentrations in subjects with metabolic syndrome: A post-hoc analysis of a randomized controlled trial. Biomed Pharmacother. 2016; 82:578-82. DOI: 10.1016/j.biopha.2016.05.037. View

11.

Rahmani S, Asgary S, Askari G, Keshvari M, Hatamipour M, Feizi A . Treatment of Non-alcoholic Fatty Liver Disease with Curcumin: A Randomized Placebo-controlled Trial. Phytother Res. 2016; 30(9):1540-8. DOI: 10.1002/ptr.5659. View

12.

Sakata R, Nakamura T, Torimura T, Ueno T, Sata M . Green tea with high-density catechins improves liver function and fat infiltration in non-alcoholic fatty liver disease (NAFLD) patients: a double-blind placebo-controlled study. Int J Mol Med. 2013; 32(5):989-94. DOI: 10.3892/ijmm.2013.1503. View

13.

Ferreira-Hermosillo A, Torres-Duran P, Juarez-Oropeza M . Hepatoprotective effects of Spirulina maxima in patients with non-alcoholic fatty liver disease: a case series. J Med Case Rep. 2010; 4:103. PMC: 2861069. DOI: 10.1186/1752-1947-4-103. View

14.

Nabavi S, Rafraf M, Somi M, Homayouni-Rad A, Asghari-Jafarabadi M . Effects of probiotic yogurt consumption on metabolic factors in individuals with nonalcoholic fatty liver disease. J Dairy Sci. 2014; 97(12):7386-93. DOI: 10.3168/jds.2014-8500. View

15.

SALMI H, Sarna S . Effect of silymarin on chemical, functional, and morphological alterations of the liver. A double-blind controlled study. Scand J Gastroenterol. 1982; 17(4):517-21. DOI: 10.3109/00365528209182242. View

16.

Fogacci F, Rizzoli E, Giovannini M, Bove M, DAddato S, Borghi C . Effect of Dietary Supplementation with Eufortyn Colesterolo Plus on Serum Lipids, Endothelial Reactivity, Indexes of Non-Alcoholic Fatty Liver Disease and Systemic Inflammation in Healthy Subjects with Polygenic Hypercholesterolemia: The ANEMONE.... Nutrients. 2022; 14(10). PMC: 9145013. DOI: 10.3390/nu14102099. View

17.

Mohamed A, Halim A, Mohamed S, Mahmoud S, Bahgat Eldemiry E, Sobh Mohamed R . The effect of high oral loading dose of cholecalciferol in non-alcoholic fatty liver disease patients. A randomized placebo controlled trial. Front Pharmacol. 2023; 14:1149967. PMC: 10043211. DOI: 10.3389/fphar.2023.1149967. View

18.

Sakpal M, Satsangi S, Mehta M, Duseja A, Bhadada S, Das A . Vitamin D supplementation in patients with nonalcoholic fatty liver disease: A randomized controlled trial. JGH Open. 2018; 1(2):62-67. PMC: 6207029. DOI: 10.1002/jgh3.12010. View

19.

Cicero A, Fogacci F, Bove M, Giovannini M, Veronesi M, Borghi C . Short-Term Effects of Dry Extracts of Artichokeand Berberis in Hypercholesterolemic Patients Without Cardiovascular Disease. Am J Cardiol. 2018; 123(4):588-591. DOI: 10.1016/j.amjcard.2018.11.018. View

20.

Aller R, de Luis D, Izaola O, Conde R, Gonzalez Sagrado M, Primo D . Effect of a probiotic on liver aminotransferases in nonalcoholic fatty liver disease patients: a double blind randomized clinical trial. Eur Rev Med Pharmacol Sci. 2011; 15(9):1090-5. View