Essay on Liver Diseases!

Chronic liver diseases represent a major health burden worldwide, with liver cirrhosis being the ninth leading cause of death in Western coun­tries. Chronic viral hepatitis B and C, alcoholic liver disease, non-alcoholic fat­ty liver disease and hepatocellular carcinoma are the major entities and many problems remain unresolved.

Treatment options for common liver diseases such as cirrhosis, fatty liver and chronic hepatitis are often limited in efficacy, carry the risk of adverse effects and are often too costly, especially for the developing world.

The effec­tiveness of treatments such as interferon, colchi­cine, penicillamine and corticosteroids are incon­sistent and the incidence of side-effects profound. Physicians and patients are in need of effective therapeutic agents with a low incidence of side-effects. Herbal medicines potentially constitute such a group.

In recent years many researchers have examined the effects of plants used tradi­tionally by indigenous healers to support liver function and treat diseases of the liver. In most cases, research has confirmed traditional experi­ence and wisdom by discovering the mechanisms and modes of action of these plants as well as reaffirming the therapeutic effectiveness of cer­tain plants or plant extracts in clinical studies.

Causative factors for liver toxicity mainly are alcohol, viral and induced by drugs. Alcoholic liver damage is differentiated by three main his­tological stages, that is, steatosis, acute alcoholic hepatitis and cirrhosis.

In alcoholic liver disease, oxidative stress is caused by pro-oxidant forma­tion, inadequate intake of antioxidants, antioxi­dant depletion, and alcohol-mediated inhibition of glutathione synthesis. Alcohol-induced liver diseases are mediated by cytokines, which are secreted by liver and other parts of the body.

The second is the viral hepatitis, mainly responsible for both acute and chronic liver diseases. So far hepatitis A, B, C, D, and E have been identified as causative in human. Drug induced hepatotoxicity is a dose limiting adverse effect for several drugs like paracetamol, isoniazid and rifampicin.

Therefore, treating liver diseases with plant-derived compounds which are accessible and do not require laborious pharmaceutical synthesis seems highly attractive. Furthermore, in spite of the advances in conventional medicine in the last decades, research professionals of developed countries are paying increasing attention to phytomedicine.

Several recent surveys from Europe and the United States have demonstrated a sharp rise in the use of phytomedicine within a few years, and up to 65% of patients with liver dis­ease take herbal preparations.

Many factors contribute to herb­al medicine’s appeal. It is claimed that herbal medicine may both treat and prevent diseases. This adds to a deep belief that these treatments are safe because they are “natural” and, there­fore, harmless alternative to conventional medi­cine.

In addition, herbal products are often ex­empt from rigorous regulations, such as in the U.S., and prescriptions are usually not required for these inexpensive products.

The following review describes the current scientific evidence regarding herbal drugs and the liver, especially in regards to their presumed beneficial effect, and delineates the issues that need to be addressed to incorporate herbal medicine into the arsenal of therapies in the treatment of liver diseases.