HERBAL MEDICINE IN VIRAL HEPATITIS: EVIDENCE- BASED THERAPEUTIC POTENTIAL, MOLECULAR MECHANISMS, AND CLINICAL PERSPECTIVES.

Abstract

Viral hepatitis is a serious worldwide health problem as it leads to high morbidity due to chronic liver inflammation, cirrhosis, and other complications. Fortunately, there is a wide range of traditional medicinal herbs that can help in the treatment of the disease. Bioactive compounds isolated from medicinal plants, such as silymarin, glycyrrhizin, phyllanthin, curcumin, and andrographolide, have shown good antiviral activity against various hepatitis viruses. Mechanistically, these compounds are able to inhibit various stages of the viral replication cycle, including viral entry, DNA and RNA polymerization, and viral protein processing. They also possess potent antioxidant (by upregulating Nrf2-mediated SOD, catalase, glutathione, and downregulating reactive oxygen species and lipid peroxidation) and anti-inflammatory activities (by inhibiting NF-κB, COX-2, TNF-α, IL-1β, IL-6, and TGF-β/Smad pathways) and prevent hepatic stellate cell activation. Thus, herbal extracts are promising therapeutics for the treatment of viral hepatitis, as they effectively reduce serum ALT and AST levels, decrease the viral load, and improve general well-being with minimal side effects. However, there is a need for clinical trials to comprehensively evaluate the effectiveness and safety of herbal extracts in patients with viral hepatitis. Therefore, the combination of standard antiviral drugs with herbal extracts could be an optimal solution to fight the disease.