Polymers in Medicine
2023, vol. 53, nr 1, January-June, p. 81–89
doi: 10.17219/pim/165977
Publication type: review
Language: English
License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)
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Cite as:
Choudhary A, Noman M, Bano U, Akhtar J, Shaikh Y, Shahar Yar M. Global uses of traditional herbs for hepatic diseases and other pharmacological actions: A comprehensive review. Polim Med. 2023;53(1):81–89. doi:10.17219/pim/165977
Global uses of traditional herbs for hepatic diseases and other pharmacological actions: A comprehensive review
1 Department of Pharmaceutical Chemistry, School of Pharmaceutical Education and Research (SPER), Jamia Hamdard University, New Delhi, India
2 School of Unani Medical Education and Research (SUMER), Jamia Hamdard University, New Delhi, India
3 Central Council for Research in Unani Medicine, Ministry of Ayurveda, Yoga & Naturopathy, Unani, Siddha, Sowa Rigpa, and Homeopathy (AYUSH), Government of India, New Delhi, India
Abstract
Hepatocellular carcinoma (HCC) is the 7th most common cancer and the 3rd leading cause of cancer-related death worldwide. It is resistant to the majority of chemotherapeutics and has a dismal prognosis. Hepatocellular carcinoma is a prevalent complication of chronic liver disease (CLD) in India. Primary liver cancer is the 6th most common cancer worldwide and the 4th most prevalent cause of cancer-related death. In 2018, it affected 841,000 people and caused 782,000 deaths around the world. Thus, research into the tumor cycle and its prevention through suitable herbal (Unani/Ayurvedic) medication is critical for reducing the impact of primary liver cancer. Treatment options for end-stage liver cancer are limited, necessitating costly liver transplantation, which is unavailable in most countries. Here, we present the results of a comprehensive literature survey to determine the benefits of using various herbs with liver protective and antioxidant properties. This information will be useful to researchers working on liver carcinoma and free radical scavenging, both of which are important in curbing potential carcinogens.
Key words
HCC, anti-oxidant, Bauhinia variegata, Picrorhiza kurroa, traditional Unani medicine
Graphical abstract

References (69)
- Ribes J, Clèries R, Esteban L, Moreno V, Bosch FX. The influence of alcohol consumption and hepatitis B and C infections on the risk of liver cancer in Europe. J Hepatol. 2008;49(2):233–242. doi:10.1016/j.jhep.2008.04.016
- Parkin DM, Bray F, Ferlay J, Pisani P. Estimating the world cancer burden: GLOBOCAN 2000. Int J Cancer. 2001;94(2):153–156. doi:10.1002/ijc.1440
- Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. doi:10.3322/caac.21492
- Mokdad AA, Singal AG, Yopp AC. Liver cancer. JAMA. 2015;314(24):2701. doi:10.1001/jama.2015.15425
- D’Alessandro N. Multifactorial nature of hepatocellular carcinoma drug resistance: Could plant polyphenols be helpful? Word J Gastroenterol. 2007;13(14):2037. doi:10.3748/wjg.v13.i14.2037
- Hong M, Li S, Tan H, Wang N, Tsao SW, Feng Y. Current status of herbal medicines in chronic liver disease therapy: The biological effects, molecular targets and future prospects. Int J Mol Sci. 2015;16(12):28705–28745. doi:10.3390/ijms161226126
- Setiawan VW, Stram DO, Porcel J, Lu SC, Le Marchand L, Noureddin M. Prevalence of chronic liver disease and cirrhosis by underlying cause in understudied ethnic groups: The multiethnic cohort. Hepatology. 2016;64(6):1969–1977. doi:10.1002/hep.28677
- Carr BI. Understanding Liver Cancer: A Tale of Two Diseases. Tarporley, UK: Springer Healthcare Ltd.; 2014. doi:10.1007/978-1-910315-02-6
- Rashid B. Oral health in perspective of Unani literature: A review. Int J Unani Integr Med. 2018;2(2):10–13. https://www.unanijournal.com/articles/26/2-1-5-886.pdf. Accessed September 22, 2022.
- Sies H, Packer L, August J, Murad F, Anders M, Coyle J, eds. Antioxidants in Disease Mechanisms and Therapy. San Diego, USA: Academic Press; 1996. ISBN:978-0-08-058130-9.
- Halliwell B, Gutteridge JMC. Free Radicals in Biology and Medicine. 5th ed. Oxford, UK: Oxford University Press; 2015. ISBN:978-0-19-871747-8.
- Neha K, Haider MR, Pathak A, Yar MS. Medicinal prospects of antioxidants: A review. Eur J Med Chem. 2019;178:687–704. doi:10.1016/j.ejmech.2019.06.010
- Xu LB. Role of liver stem cells in hepatocarcinogenesis. World J Stem Cells. 2014;6(5):579. doi:10.4252/wjsc.v6.i5.579
- Gonzalez SA, Keeffe EB. Risk assessment for hepatocellular carcinoma in chronic hepatitis B: Scores and surveillance. Perspective. Int J Clin Pract. 2012;66(1):7–10. doi:10.1111/j.1742-1241.2011.02808.x
- Mathew S, Faheem M, Archunan G, et al. In silico studies of medicinal compounds against hepatitis C capsid protein from north India. Bioinform Biol Insights. 2014;8:159–168. doi:10.4137/BBI.S15211
- Mathew S, Ali A, Abdel-Hafiz H, et al. Biomarkers for virus-induced hepatocellular carcinoma (HCC). Infect Genet Evol. 2014;26:327–339. doi:10.1016/j.meegid.2014.06.014
- Mailly L, Robinet E, Meuleman P, Baumert TF, Zeisel MB. Hepatitis C virus infection and related liver disease: The quest for the best animal model. Front Microbiol. 2013;4:213. doi:10.3389/fmicb.2013.00212
- Kumar S, Baniwal P, Kaur J, Kumar H. Kachnar (Bauhinia variegata). In: Nayik GA, Gull A, eds. Antioxidants in Fruits: Properties and Health Benefits. Singapore: Springer Singapore; 2020:365–377. doi:10.1007/978-981-15-7285-2_18
- Chatterjee A, Pakrashi SC; Council Of Scientific And Industrial Research–National Institute Of Science Communication and Policy Research (CSIR–NIScPR) (New Delhi, India); eds. The Treatise on Indian Medicinal Plants. New Delhi, India: Publications & Information Directorate; 1991. ISBN:978-81-7236-011-5, 978-81-7236-010-8.
- Manoj A, Kumar A, Yunus S. Screening of hepatoprotective activity of ethanolic extract of stem bark of Bauhinia variegata in rats. Int J Pharm Pharm Sci. 2013;5(2):624–628. https://innovareacademics.in/journal/ijpps/Vol5Suppl2/6808.pdf. Accessed March 23, 2023.
- Yadava RN, Reddy VMS. Anti-inflammatory activity of a novel flavonol glycoside from the Bauhinia variegata Linn. Nat Prod Res. 2003;17(3):165–169. doi:10.1080/1478641031000104127
- Azevedo CR, Maciel FM, Silva LB, et al. Isolation and intracellular localization of insulin-like proteins from leaves of Bauhinia variegata. Braz J Med Biol Res. 2006;39(11):1435–1444. doi:10.1590/S0100-879X2006001100007
- Rajkapoor B, Jayakar B, Anandan R, Kavimani S. Anti-ulcer effect of Bauhinia variegata Linn. in rats. J Nat Remedies. 2003;3(2):215–217. https://www.informaticsjournals.com/index.php/jnr/article/view/170. Accessed February 17, 2023.
- Rajkapoor B, Jayakar B, Murugesh N, Sakthisekaran D. Chemoprevention and cytotoxic effect of Bauhinia variegata against N-nitrosodiethylamine induced liver tumors and human cancer cell lines. J Ethnopharmacol. 2006;104(3):407–409. doi:10.1016/j.jep.2005.08.074
- Maldonado PD, Barrera D, Rivero I, et al. Antioxidant S-allylcysteine prevents gentamicin-induced oxidative stress and renal damage. Free Radic Biol Med. 2003;35(3):317–324. doi:10.1016/S0891-5849(03)00312-5
- Rajani G, Ashok P. In vitro antioxidant and antihyperlipidemic activities of Bauhinia variegata Linn. Indian J Pharmacol. 2009;41(5):227. doi:10.4103/0253-7613.58513
- Sharma N. Evaluation of Bauhinia variegata L. bark fractions for in vitro antioxidant potential and protective effect against H2O2-induced oxidative damage to pBR322 DNA. Afr J Pharm Pharmacol. 2011;5(12):1494–1500. doi:10.5897/AJPP11.457
- Parekh J, Karathia N, Chanda S. Evaluation of antibacterial activity and phytochemical analysis of Bauhinia variegata L. bark. Afr J Biomed Res. 2009;9(1):53–56. doi:10.4314/ajbr.v9i1.48773
- Kulshrestha P, Kumar P, Mishra A, et al. The antimicrobial activity of Bauhinia variegata Linn. flower extract (methanolic). Asian J Pharm Clin Res. 2011;4(1):46–47. https://innovareacademics.in/journal/ajpcr/Vol4Suppl1/382.pdf. Accessed February 11, 2023.
- Rajkapoor B, Jayakar B, Murugesh N. Antitumour activity of Bauhinia variegata on Dalton’s ascitic lymphoma. J Ethnopharmacol. 2003;89(1):107–109. doi:10.1016/S0378-8741(03)00264-2
- Prusty B, Kiran B, Bhargavi V, Subudhi S. Anti-ulcer investigation of the different extract of bark of Bauhinia variegata Linn (Caesalpiniaceae) by pyloric ligation & aspirin plus pyloric ligation model. Int J Pharm Biol Sci. 2012;2(1):248–262. https://ijpbs.com/ijpbsadmin/upload/ijpbs_50c866113ef30.pdf. Accessed December 13, 2022.
- Arain S, Memon N, Rajput M, Sherazi S, Bhanger M, Mahesar S. Physico-chemical characteristics of oil and seed residues of Bauhinia variegata and Bauhinia linnaei. Pakistan J Anal Environ Chem. 2012;13(1):6. http://pjaec.pk/index.php/pjaec/article/view/199. Accessed January 22, 2023.
- Pokhrel NR, Adhikari RP, Baral MP. In-vitro evaluation of the antimicrobial activity of Bauhinia variegata, locally known as koiralo. World J Microbiol Biotechnol. 2002;18(1):69–71. doi:10.1023/A:1013969628634
- Patil JK, Jalalpure SS, Sayyed HYH, Hiremath RD, Chouhan MK. Evaluation of antibacterial and antifungal potential of(linn.) stem Bauhinia variegata bark. Indian J Nat Prod. 2015;29(1):44–55.
- Mohamed MA, Mammoud MR, Hayen H. Evaluation of antinociceptive and anti-inflammatory activities of a new triterpene saponin from Bauhinia variegata leaves. Z Naturforsch C J Biosci. 2009;64(11–12):798–808. doi:10.1515/znc-2009-11-1208
- Mali RG, Dhake AS. Bauhinia variegata Linn. (mountain ebony): A review on ethnobotany, phytochemistry and pharmacology. Orient Pharm Exp Med. 2009;9(3):207–216. doi:10.3742/OPEM.2009.9.3.207
- Bansal V, Malviya R, Deeksha P, Malaviya T, Sharma P. Phytochemical, pharmacological profile and commercial utility of tropically distributed plant. Global J Pharmacol. 2014;8(2):196–205. https://idosi.org/gjp/8(2)14/12.pdf. Accessed November 5, 2022.
- Gunalan G, Vijayalakshmi K, Saraswathy A, Hoper W, Tamilvannan T. Anti-inflammatory activities of phytochemicals from Bauhinia variegata Linn. leaf: An in silico approach. J Chem Pharm Res. 2014;6(9):334–348. https://www.jocpr.com/articles/antiinflammatory-activities-of-phytochemicals-from-bauhinia-variegata-linn.pdf. Accessed March 21, 2023.
- Dewangan P, Verma A, Kesharwani D. Isolation of D-pinitol: A bioactive carbohydrate from the leaves of Bauhinia variegata L. Int J Pharm Sci Rev Res. 2014;24(1):43–45. https://globalresearchonline.net/journalcontents/v24-1/08.pdf. Accessed February 10, 2023.
- Shahana S, Nikalje A, Nikalje G. A brief review on Bauhinia variegata: Phytochemistry, antidiabetic and antioxidant potential. Am J Pharmtech Res. 2017;7:186–197. https://www.researchgate.net/publication/313674462_A_Brief_Review_on_Bauhinia_variegata_Phytochemistry_Antidiabetic_and_Antioxidant_potential. Accessed December 23, 2022.
- Gyawali R, Hengaju A, Thapa P, et al. Antioxidant and wound healing property of polyherbal ointment of Nepalese medicinal plants. Int J Allied Med Sci Clin Res. 2016;4(2):275–283. https://www.academia.edu/34156708/Antioxidant_and_Wound_Healing_Property_of_Polyherbal_Ointment_of_Nepalese_Medicinal_Plants. Accessed January 19, 2023.
- Sharma RK, Rajni GP, Nathiya D, Sharma AK. Assessment of wound healing activity of roots of Bauhinia variegata Linn. by excision and incision model in albino rats. Asian J Res Pharm Sci. 2015;5(3):145–152. doi:10.5958/2231-5659.2015.00023.5
- Kumar A, Kavimani S, Jayaveera K. A review on medicinal plants with potential antidiabetic activity. Int J Phytopharmacol. 2011;2(2):53–60. https://www.researchgate.net/publication/270814387_International_Journal_of_Phytopharmacology_A_REVIEW_ON_MEDICINAL_PLANTS_WITH_POTENTIAL_ANTIDIABETIC_ACTIVITY. Accessed February 12, 2023.
- Goel R, Bhatia D, Gilani S, Katiyar D. Medicinal plants as antidiabetics: A review. Int Bull Drug Res. 2012;1(2):100–107. https://www.researchgate.net/publication/292349915_MEDICINAL_PLANTS_AS_ANTI-DIABETICS_A_REVIEW. Accessed February 5, 2023.
- He LJ, Liang M, Hou FF, Guo ZJ, Xie D, Zhang X. Ethanol extraction of Picrorhiza scrophulariiflora prevents renal injury in experimental diabetes via anti-inflammation action. J Endocrinol. 2009;200(3):347–355. doi:10.1677/JOE-08-0481
- Husain GM, Singh PN, Kumar V. Antidiabetic activity of standardized extract of Picrorhiza kurroa in rat model of NIDDM. Drug Discov Ther. 2009;3(3):88–92. PMID:22495535.
- Husain GM, Rai R, Rai G, Singh HB, Thakur AK, Kumar V. Potential mechanism of anti-diabetic activity of Picrorhiza kurroa. Tang (Humanitas Medicine). 2014;4(4):27.1–27.5. doi:10.5667/TANG.2014.0013
- Navarro VJ, Senior JR. Drug-related hepatotoxicity. N Engl J Med. 2006;354(7):731–739. doi:10.1056/NEJMra052270
- Jia D, Barwal I, Thakur S, Yadav SC. Methodology to nanoencapsulate hepatoprotective components from Picrorhiza kurroa as food supplement. Food Biosci. 2015;9:28–35. doi:10.1016/j.fbio.2014.10.005
- Visen P, Binduja S, Patnaik G, Dhawan B, Agarwal D. Protective activity of picroliv isolated from Picrorhiza kurrooa against ethanol toxicity in isolated rat hepatocytes. Indian J Pharmacol. 1996;28(2):98–101. https://www.ijp-online.com/article.asp?issn=0253-7613;year=1996;volume=28;issue=2;spage=98;epage=101;aulast=Visen;type=0. Ac-cessed September 22, 2022.
- Saraswat B, Visen PKS, Patnaik GK, Dhawan BN. Ex vivo and in vivo investigations of picroliv from Picrorhiza kurroa in an alcohol intoxication model in rats. J Ethnopharmacol. 1999;66(3):263–269. doi:10.1016/S0378-8741(99)00007-0
- Jeyakumar R, Rajesh R, Meena B, et al. Antihepatotoxic effect of Picrorhiza kurroa on mitochondrial defense system in antitubercular drugs (isoniazid and rifampicin)-induced hepatitis in rats. J Med Plants Res. 2008;2(1):17–19. https://www.internationalscholarsjournals.com/articles/antihepatotoxic-effect-of-picrorhiza-kurroa-on-mitochondrial-defense-system-in-antitubercular-drugs-isoniazid-and-rifamp.pdf. Accessed December 7, 2022.
- Shukla S, Kumar K. Hepatoprotective efficacy of Picrorhiza kurroa in experimentally induced hepatotoxicity in cockerels. Int J Curr Microbiol Appl Sci. 2017;6(4):2614–2622. doi:10.20546/ijcmas.2017.604.304
- Floersheim GL, Bieri A, Koenig R, Pletscher A. Protection against Amanita phalloides by the iridoid glycoside mixture of Picrorhiza kurroa (kutkin). Agents Actions. 1990;29(3–4):386–387. doi:10.1007/BF01966472
- Sindhu N, Pratima T, Ashwini W. Isolation of a cucurbitacin from Picrorhiza kurroa by column chromatography and its characterization. Res J Pharm Biol Chem Sci. 2011;2(3):149–156. https://www.rjpbcs.com/pdf/2011_2(3)/19.pdf. Accessed August 13, 2022.
- Mallick MdN, Singh M, Parveen R, et al. HPTLC analysis of bioactivity guided anticancer enriched fraction of hydroalcoholic extract of Picrorhiza kurroa. Biomed Res Int. 2015;2015:513875. doi:10.1155/2015/513875
- Jeena KJ, Joy KL, Kuttan R. Effect of Emblica officinalis, Phyllanthus amarus and Picrorrhiza kurroa on N-nitrosodiethylamine induced hepatocarcinogenesis. Cancer Lett. 1999;136(1):11–16. doi:10.1016/S0304-3835(98)00294-8
- Joy KL, Rajeshkumar NV, Kuttan G, Kuttan R. Effect of Picrorrhiza kurroa extract on transplanted tumours and chemical carcinogenesis in mice. J Ethnopharmacol. 2000;71(1–2):261–266. doi:10.1016/S0378-8741(00)00168-9
- Kalaivani T, Mathew L. Free radical scavenging activity from leaves of Acacia nilotica (L.) Wild. ex Delile, an Indian medicinal tree. Food Chem Toxicol. 2010;48(1):298–305. doi:10.1016/j.fct.2009.10.013
- Deshpande N, Das R, Manohar M, Das V, Kandi S, Ramana K. Antioxidant effects of Picrorhiza kurrooa rhizome extracts in alcoholic cirrhosis of liver. Am J Pharmacol Sci. 2015;3(2):49–51. http://pubs.sciepub.com/ajps/3/2/4/index.html. Accessed January 27, 2023.
- Rajkumar V, Guha G, Ashok Kumar R. Antioxidant and anti-neoplastic activities of Picrorhiza kurroa extracts. Food Chem Toxicol. 2011;49(2):363–369. doi:10.1016/j.fct.2010.11.009
- Krupashree K, Hemanth Kumar K, Rachitha P, Jayashree GV, Khanum F. Chemical composition, antioxidant and macromolecule damage protective effects of Picrorhiza kurroa Royle ex Benth. S Afr J Botany. 2014;94:249–254. doi:10.1016/j.sajb.2014.07.001
- Singh GB, Bani S, Singh S, et al. Antiinflammatory activity of the iridoids kutkin, picroside-1 and kutkoside from Picrorhiza kurroa. Phytother Res. 1993;7(6):402–407. doi:10.1002/ptr.2650070604
- Kantibiswas T, Marjit B, Maity LN. Effect of Picrorhiza kurroa Benth. in acute inflammation. Anc Sci Life. 1996;16(1):11–14. PMID:22556764. PMCID:PMC3331136.
- Kumar R, Gupta YK, Singh S, Arunraja S. Picrorhiza kurroa inhibits experimental arthritis through inhibition of pro-inflammatory cytokines, angiogenesis and MMPs. Phytother Res. 2016;30(1):112–119. doi:10.1002/ptr.5509
- Gupta A, Khajuria A, Singh J, et al. Immunomodulatory activity of biopolymeric fraction RLJ-NE-205 from Picrorhiza kurroa. Int Immunopharmacol. 2006;6(10):1543–1549. doi:10.1016/j.intimp.2006.05.002
- Sharma ML, Rao CS, Duda PL. Immunostimulatory activity of Picrorhiza kurroa leaf extract. J Ethnopharmacol. 1994;41(3):185–192. doi:10.1016/0378-8741(94)90031-0
- Hussain A, Shadma W, Maksood A, Ansari S. Protective effects of Picrorhiza kurroa on cyclophosphamide-induced immunosuppression in mice. Phcog Res. 2013;5(1):30. doi:10.4103/0974-8490.105646
- Nandave M, Ojha SK, Kumari S, et al. Cardioprotective effect of root extract of Picrorhiza kurroa (Royle Ex Benth) against isoproterenol-induced cardiotoxicity in rats. Indian J Exp Biol. 2013;51(9):694–701. PMID:24377128.


