Rani Jyoti, Dhull Sanju Bala, Rose Pawan Kumar, Kidwai Mohd Kashif
Department of Botany, Chaudhary Devi Lal University, Sirsa 125055, Haryana, India.
Department of Food Science and Technology, Chaudhary Devi Lal University, Sirsa 125055, Haryana, India.
Phytomedicine. 2024 Jan;122:155142. doi: 10.1016/j.phymed.2023.155142. Epub 2023 Oct 11.
Drug-induced liver injury (DILI) is the most challenging and thought-provoking liver problem for hepatologists owing to unregulated medication usage in medical practices, nutritional supplements, and botanicals. Due to underreporting, analysis, and identification issues, clinically evaluated medication hepatotoxicity is prevalent yet hard to quantify.
This review's primary objective is to thoroughly compare pharmaceutical drugs and herbal compounds that have undergone clinical trials, focusing on their metabolic mechanisms contributing to the onset of liver illnesses and their hepatoprotective effects.
The data was gathered from several online sources, such as PubMed, Scopus, Google Scholar, and Web of Science, using appropriate keywords.
The prevalence of conventional and herbal medicine is rising. A comprehensive understanding of the metabolic mechanism is necessary to mitigate the hepatotoxicity induced by drugs and facilitate the incorporation or substitution of herbal medicine instead of pharmaceuticals. Moreover, pre-clinical pharmacological research has the potential to facilitate the development of natural products as therapeutic agents, displaying promising possibilities for their eventual clinical implementation.
Acetaminophen, isoniazid, rifampicin, diclofenac, and pyrogallol have been identified as the most often reported synthetic drugs that produce hepatotoxicity by oxidative stress, inflammation, apoptosis, and fibrosis during the last several decades. Due to their ability to downregulate many factors (such as cytokines) and activate several enzyme/enzyme systems, herbal substances (such as Gingko biloba extract, curcumin, resveratrol, and silymarin) provide superior protection against harmful mechanisms which induce hepatotoxicity with fewer adverse effects than their synthetic counterparts.
由于医疗实践、营养补充剂和植物药中药物使用的不规范，药物性肝损伤（DILI）是肝病学家面临的最具挑战性和发人深省的肝脏问题。由于报告不足、分析和识别问题，临床评估的药物肝毒性很普遍，但难以量化。
本综述的主要目的是全面比较经过临床试验的药物和草药化合物，重点关注它们导致肝病发生的代谢机制及其肝保护作用。
使用适当的关键词从多个在线来源收集数据，如PubMed、Scopus、谷歌学术和科学网。
传统药物和草药的使用率正在上升。全面了解代谢机制对于减轻药物引起的肝毒性以及促进草药替代药物的应用或替代是必要的。此外，临床前药理学研究有可能促进天然产物作为治疗剂的开发，显示出其最终临床应用的广阔前景。
在过去几十年中，对乙酰氨基酚、异烟肼、利福平、双氯芬酸和邻苯三酚已被确定为最常报告的通过氧化应激、炎症、细胞凋亡和纤维化产生肝毒性的合成药物。由于草药物质（如银杏叶提取物、姜黄素、白藜芦醇和水飞蓟素）能够下调多种因子（如细胞因子）并激活多种酶/酶系统，因此它们对诱导肝毒性的有害机制具有更好的保护作用，且副作用比合成药物少。
