Modern Chinese Medicine Anti-Liver-Fibrosis Treatments (2)

Most MCM anti-fibrosis studies were done in chronic hepatitis B and schistosomiasis. In MCM's terminology, the main pathogenesis of liver fibrosis is termed as  "blood stasis" and the main treatment method for it is called "blood activating and stasis expelling".

The interpretation of this treatment principle is to improve the liquidity of the blood, to reduce its viscosity, to reduce the clustering of red blood cells and platelets, and to promote the phagocytosis of the macrophage and removal of circulatory immune complex.  The main traditional formula used is called "Xue Fu Zhu Yu Tang."  Chinese studies found that in taking "Xue Fu Zhu Yu Tang" formula for three months, patients' fibrosis markers, such as HA (hyaluronic acid), LN (Laminin), CIV(collagen IV), PCIII (procollagen type III) levels reduce significantly (p<0.05).

Recent studies on the active ingredients of herbal anti-fibrosis remedies have found many effective compounds. Some of these active anti-fibrosis ingredients are listed in following:

 
1. Cordyceps sinensis (Cs), observed in rat CCl₄ fibrostic model, the Cs treated group have a lighter inflammation, fatty degeneration and less liver cell damage. From the observation of ALT, HA, LN in liver tissue, found Cs has strong effects on improving regeneration of hepatocytes and suppression of fibroblasts and collagen fibers.

2. Glycyrrhizin, an active ingredient of Glycyrrhiza uralensis Fisch (Licorice root).

It can reduce the level of ALT, AST, fatty deposit (steatosis), and fibrosis. Shown in rats models, it can obviously suppress type I and III pro-collagen synthesis.  Reduce the over active fibrosis-related cytokines in the liver cell. It has definite liver cell protective effects. T

3. Danshensuan A, is a water soluble ingredient of Salvia miltiorrhiza Bge.

 It has excellent anti-oxidant effects. Animal experiments found that it has obvious effects to suppress the proliferation of fibroblastic cells and the synthesis of intracellular collagen.

4. Extract IH764-3 of Salvia miltiorrhiza,

It can obviously reduce the fibrosis in rat fibrostic models. Obviously reduce the content of    hydrooxyproline (Hyp), type I and III collagen, and HA, LN. Improve the liver function, and improve the liver histology.

5. Chuanxionyzine, its chemical name is Pyrazine. It is an active ingredient of Ligusticum chuanziong Hort. In rat CCl₄ fibrostic model, it can reduce ALT, HA, type III pro-collagen, and obviously reduce the fibrosis. It is also an anti-oxidant and can increase SOD activities and reduce the level of MDA (methylenedioxyamphetamine).

6. Oxymatrine, it is the extract of Sophorae Subprostratae Radix. It has anti-viral, anti-inflammatory, and immune regulatory effects. Recent studies found, it has obvious anti-fibrostic effects. An obvious fibrosis suppressive effect shown at a concentration of 62.5 ng/ml. It suppresses the fibroblastic cell activities and expression of mRNA of type III pro-collagen. The potency of these effects is concentration dependent. Clinical studies found that the treated group have lower levels of ALT, CIV, HA, and TNF-b, and less inflammatory activities and fibrosis than that of the control group.

7. Extracts of Persicae Semen, Studies done at Shanghai TCM University found that it can promote the action of collagen enzyme, reduce type III pre-collagen and increase the metabolite of collagen, hydroxyproline level in the blood. This substance has been successfully used to treat cirrhosis caused by viral hepatitis and parasitic hepatitis.

8. Taurine, it is an active ingredient of nature calculus Bovis. In TCM, the gallstone of Bos Taurus demesticus, used to remove heat from the heart, induce resuscitation, eliminate phlegm, relieve convulsion and remove heat and toxic substance. Recent studies found that it can suppress HA and the expression of mRNA of type I and III Pro-collagens.  It can also increase the content of cAMP in the plasma of the cells. In rats fibrostic model made by continuous injection of bovine albumin, found that treated with this substance, the collagen deposit in the liver tissue greatly reduced and the content of Hyp in the liver obviously reduced. In rat CCl₄ fibrostic model, it can obviously reduce the contents of Hyp, type I and III pro-collagen, HA, LN and improve the liver function and improve the liver histology.

9. Fustin, an active ingredient of Gleditsia sinensis Lam. It can obviously suppress the activities of PDGF PDGF (platelet delivered growth factor) and TGF-b(transforming growth factor-beta 1). PDGF induces the proliferation of the HSC (Hepatic Stellate Cells) and promote the activities of TGF-b which increases collagen and EMC (Extra Cellular Matrix) synthesis. This substance suppresses PDGF, so it can suppress fibrosis in two phases.