Abstract
Purpose: Non-alcoholic steatohepatitis (NASH) is a disease that depends on various causes and its progression is not properly elucidated, hence one treatment may not be effective. It has remained undiagnosed due to the absence of any prominent symptoms and the only way to diagnose NASH is by liver biopsy. At present, the treatments that are available act indirectly by either targeting liver functions or obesity. Many drugs like selonsertib, elafibranor are being explored and are still in clinical trials. In this article, we are focusing on the treatment of NASH through the herbal approach as they have no known adverse effects and contain several components that may be helpful to treat the disease. Methods: This paper summarizes the methods to separate the chemical components of flaxseed, its application in the treatment of NASH, and the challenges in designing an herbal product. Results/Outcome: On reviewing few published articles, it was shown to possess health benefits like decreasing blood pressure, preventing the risk of cardiovascular diseases, reducing cholesterol, hepatoprotective, antidiabetic, antisteatotic, and antioxidant activities. After separation of the chemical constituents, they are further used to formulate edible film, microcapsules, and so on. Conclusion: Some current researches on Herbal medicines have shown the potential to make the currently existing conventional medicine more efficient when these two systems of medicine are merged together. On evaluating the pharmacological activities possessed by herbal components, they can be either used alone or in combination with other classes of drugs like antioxidant, antiobesity, and insulin sensitizers for effective treatment of NASH.
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Key Points
Non-alcoholic steatohepatitis (NASH) features include liver steatosis, inflammation. are insulin resistance, metabolic syndromes (obesity, type 2 diabetes, and high blood pressure), hormonal disorders (polycystic ovarian disorder, hypogonadism, and hypothyroidism), dysbiosis (a microbial imbalance that is caused by increased blood ethanol and choline depletion due to increased choline metabolism) and overnutrition. With an increased interest in herbal medicines, researchers have started to explore the plant products to screen their active components which can treat NASH. Among them, flaxseed with lipid-lowering property can be employed in the treatment of risk factors associated with NAFLD and NASH. Future prospects include 1) Differentiation of therapies and positioning them at different stages to reduce symptoms and prevent the progression of the disease; 2) Development of 3 distinct biomarkers; functional biomarkers to assess liver functions, blood-borne biomarkers to assess metabolism, inflammation and fibrosis, and imaging biomarkers and 3) Combination therapies using different categories of drugs like antiobesity (orlistat), antioxidants (vitamin E), cytoprotective agents (ursodeoxycholic acid), and insulin sensitizers (metformin). Since NASH is a multifactorial disease, combination therapy may prove to be more promising. The future approach may include a combination of these drugs with traditional herbal medicines.