• Tuberculosis and Respiratory Diseases
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• v.80 no.3
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• pp.265-269
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• 2017

Background: The first line of anti-tuberculosis (TB) drugs are the most effective standard of drugs for TB. However, the use of these drugs is associated with hepatotoxicity. Silymarin has protective effects against hepatotoxicity of anti-TB drugs in animal models. This study aims to investigate the protective effect of silymarin on hepatotoxicity caused by anti-TB drugs. Methods: This is a prospective, randomized, double-blind and placebo-controlled study. Patients were eligible if they were 20 years of age or order and started the first-line anti-tuberculosis drugs. Eligible patients were randomized for receiving silymarin or a placebo for the first 4 weeks. The primary outcome was the proportion of patients who showed elevated serum liver enzymes more than 3 times the upper normal limit (UNL) or total bilirubin (TBil) > $2{\times}UNL$ within the first 8 weeks of anti-TB treatment. Results: We enrolled a total of 121 patients who silymarin or a placebo to start their anti-TB treatment, for the first 8 weeks. The proportions of elevated serum liver enzymes more than 3 times of UNL at week 2, week 4, and week 8 did not show any significant difference between the silymarin and placebo groups, at 0% versus 3.6% (p>0.999); 4.4% versus 3.6% (p>0.999); and 8.7% versus 10.8% (p=0.630), respectively. However, patients with TBil >$2{\times}UNL$ at week 8 were significantly low in the silymarin group (0% versus 8.7%, p=0.043). Conclusion: Our findings did not show silymarin had any significant preventive effect on the hepatotoxicity of anti-TB drugs.

• Journal of Environmental Health Sciences
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• v.32 no.3
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• pp.235-239
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• 2006

Cichorium intybus (Compositae) has been used for fevers, dyspepsia, headache and jaundice, as a demulcent. Also, it has relaxation effects and relief effects against coffee and teas, and is widely used as food. We investigated anti-lipid peroxidative effects and liver protective activity on $CCl_4$ induced lipid peroxidation and hepatotoxicity in rats. MeOH Ex. enhanced the inhibition of anti-lipid peroxidative effects in liver lipid. In chemical parameters obtained from serum analysis, MeOH Ex. revealed significant decrease on hepatotoxicity. The results were as follows; 1. The inhibitory effects of lipid peroxidation were shown in accordance with the increase of samples' concentration level. 2. In chemical parameters obtained from serum analysis, the activities of GOT, GPT, AlP were restored to near the normal level. The contents of cholesterol and BUN showed inhibitory effects with valence. 3. The weights of liver and spleen were not able to restore to the normal level. But on a general level, they were reduced more than the control group.

• Journal of Environmental Health Sciences
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• v.33 no.3
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• pp.202-206
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• 2007

Petasites japonicus (Compositae) is a perennial herb which has been used as treatment of antitussive, expectorant, sedatives, paralysis, diurectics in folk remedies. The pharmacological studies of this natural drug have not yet estabilished. So, we examined anti-lipid peroxidative effects and liver protective effect on $CCl_4$ induced lipid peroxidation and hepatotoxicity in rats. In vivo liver lipid, MeOH Ex. revealed significant increase of anti-lipid peroxidative effects according to concentration dependently. In chemical parameters obtained from serum analysis, MeOH Ex. as a increase of medicine concentration (0.25 g/kg, 0.5 g/kg, 1.0 g/kg), GOT, GPT, AlP decreased. In 0.5 g/kg GPT administered group, there was relative in GOT, AlP. Cholesterol decreased in 1.0 g/kg and 1.0 g/kg administered group, BUN decreased relatively in 1.0 g/kg administered group.

• YAKHAK HOEJI
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• v.55 no.4
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• pp.352-360
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• 2011

Standard combination chemotherapy including isoniazid, rifampin, pyrazinamide, and ethambutol is very effective against tuberculosis. But, these medicines can cause hepatotoxicity which is the main reason for treatment interruption or change in drug regimen. In order to identify risk factors associated with hepatotoxcity in Koreans and assess elevated baseline LFTs' contributions to hepatotoxicity, a retrospective case control study was performed. The medical records of 277 patients who diagnosed with tuberculosis at a community hospital from January 1st, 2007 to June 30th, 2010 were reviewed. Patients were categorized into 3 groups (non toxic group, patients without increase in LFT levels; mild to moderate hepatotoxic group and severe hepatotoxic group). And the correlation between risk factors and hepatotoxicity was analyzed by using SPSS program. The overall incidence of hepatotoxicity was 18% and 8.7% of patients developed severe toxicity. Patients in the severe toxic group had the longest treatment period among the three groups. In 75% of severe toxic group, hepatotoxicity occurred within 18.3 days after starting medication. Hypoalbuminemia (serum albumin <3 g/dl) was a significant risk factor for development of severe toxicity. Elevated baseline transaminase (except ALT), total bilirubin, and preexisting hepatitis were also risk factors which were more than twice as likely to increase risk of severe hepatotoxicity (p>0.05). In conclusion, hypoalbuminemia (serum albumin level <3 g/dl) was a significant risk factor for anti-tuberculosis druginduced severe toxicity. Therefore, before starting antituberculosis chemotherapy, serum albumin level should be assessed at baseline. In high-risk patients (hypoalbuminemia, elevated LFTs) for hepatotoxicty, liver function should be closely monitored up to at least 21 days after taking medication.

• YAKHAK HOEJI
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• v.54 no.2
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• pp.97-101
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• 2010

Recently, it was found that the formation of reactive metabolites by cytochrome P450s as well as the depletion of glutathione would play important roles in hepatotoxicity induced by 1-bromopropane. In the present study, possible roles of anti-oxidants in 1-bromopropane-induced hepatotoxicity were investigated in male ICR mice. The hepatotoxicity induced by 1-bromopropane was significantly protected by the co-treatment with either N-acetyl cysteine or silymarin. 1-Bromopropane-induced decrease in hepatic glutathione level was significantly protected by the pretreatment with N-acetyl cysteine. Taken together, the present results indicated that the reduction of hepatic glutathione level caused by 1-bromopropane treatment might be associated in 1-bromopropane-induced hepatotoxicity in mice.

• YAKHAK HOEJI
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• v.51 no.2
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• pp.140-144
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• 2007

Polygonum cuspidatum has been used as treatments of dermatitis, gonorrhea, inflammation, and hyperlipidaemia in traditional medicine. We examined liver protective effect on CCl$_4$ inducing hepatotoxicity and anti-oxidative activity by TBA method. Phytochemical examination of Polygonum cuspidatum led to the isolation and characterization of emodin 8-O-${\beta}$-D-glucopyranoside (compound 1), and trans-resveratrol 3-O-${\beta}$-D-glucopyranoside (compound 2). Compounds 1 and 2 enhanced the inhibition of anti-lipid peroxidative effects in liver homogenate. In chemical parameters obtained from serum analysis, compounds 1 and 2 also revealed significant decrease in hepatotoxicity. These results suggested that the antraquinone and stilbene which were isolated from Polygonum cuspidatum might be used as therapeutic agent of hepatitis.

• Journal of Ginseng Research
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• v.43 no.1
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• pp.10-19
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• 2019

Background: Frequent overdose of paracetamol (APAP) has become the major cause of acute liver injury. The present study was designed to evaluate the potential protective effects of ginsenoside Rk1 on APAP-induced hepatotoxicity and investigate the underlying mechanisms for the first time. Methods: Mice were treated with Rk1 (10 mg/kg or 20 mg/kg) by oral gavage once per d for 7 d. On the 7th d, allmice treated with 250mg/kg APAP exhibited severeliverinjury after 24 h, and hepatotoxicitywas assessed. Results: Our results showed that pretreatment with Rk1 significantly decreased the levels of serum alanine aminotransferase, aspartate aminotransferase, tumor necrosis factor, and interleukin-$1{\beta}$ compared with the APAP group. Meanwhile, hepatic antioxidants, including superoxide dismutase and glutathione, were elevated compared with the APAP group. In contrast, a significant decrease in levels of the lipid peroxidation product malondialdehyde was observed in the ginsenoside Rk1-treated group compared with the APAP group. These effects were associated with a significant increase of cytochrome P450 E1 and 4-hydroxynonenal levels in liver tissues. Moreover, ginsenoside Rk1 supplementation suppressed activation of apoptotic pathways by increasing Bcl-2 and decreasing Bax protein expression levels, which was shown using western blotting analysis. Histopathological observation also revealed that ginsenoside Rk1 pretreatment significantly reversed APAP-induced necrosis and inflammatory infiltration in liver tissues. Biological indicators of nitrative stress, such as 3-nitrotyrosine, were also inhibited after pretreatment with Rk1 compared with the APAP group. Conclusion: The results clearly suggest that the underlying molecular mechanisms in the hepatoprotection of ginsenoside Rk1 in APAP-induced hepatotoxicity may be due to its antioxidation, antiapoptosis, anti-inflammation, and antinitrative effects.

• Korean Journal of Veterinary Research
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• v.52 no.4
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• pp.275-280
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• 2012

The kiwi (Actinidia deliciosa) is well known to contain anti-oxidants. In this study, we investigated the anti-oxidant effects of kiwi extract on carbon tetrachloride ($CCl_4$) induced liver injury in BALB/c mice. The radical scavenging effect of 80% methanol extract of Halla-Gold kiwi was observed. For the animal study, mice were randomly divided into four groups: normal group, $CCl_4$-induced model group, kiwi extract administered group, and silymarin treated group. The kiwi extract was provided daily for 10 days. At the 24 h after last administration, $CCl_4$ was injected. The kiwi extract showed strong inhibitory effect of DPPH radicals and superoxide scavenging. In animal study, administration of $CCl_4$ resulted in significantly elevated plasma levels of ALT and AST but they decreased in kiwi-extract pretreated group. Anti-oxidant enzymes such as GSH-px and GSH-rd were restored in the kiwi extract treatment group. Histopathological degeneration was also prevented in the kiwi extract treated group compared with of the control group, which exhibited $CCl_4$-induced hepatotoxicity. On the basis of the obtained results, it can be concluded that kiwi extract showed protective effects, not only as anti-oxidant effects, but also in the protection of hepatotoxicity in $CCl_4$-intoxicated mice.

• The Korean Journal of Physiology and Pharmacology
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• v.20 no.1
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• pp.15-23
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• 2016

Acetaminophen (APAP) overdose is one of the most common causes of acute liver failure. The study aimed to investigate the protective effect of carnosic acid (CA) on APAP-induced acute hepatotoxicity and its underlying mechanism in mice. To induce hepatotoxicity, APAP solution (400 mg/kg) was administered into mice by intraperitoneal injection. Histological analysis revealed that CA treatment significantly ameliorated APAP-induced hepatic necrosis. The levels of both alanine aminotransferase (ALT) and aspartate transaminase (AST) in serum were reduced by CA treatment. Moreover, CA treatment significantly inhibited APAP-induced hepatocytes necrosis and lactate dehydrogenase (LDH) releasing. Western blot analysis showed that CA abrogated APAP-induced cleaved caspase-3, Bax and phosphorylated JNK protein expression. Further results showed that CA treatment markedly inhibited APAP-induced pro-inflammatory cytokines TNF-${\alpha}$, IL-$1{\beta}$, IL-6 and MCP-1 mRNA expression and the levels of phosphorylated $I{\kappa}B{\alpha}$ and p65 protein in the liver. In addition, CA treatment reduced APAP- induced hepatic malondialdehyde (MDA) contents and reactive oxygen species (ROS) accumulation. Conversely, hepatic glutathione (GSH) level was increased by administration of CA in APAP-treated mice. Mechanistically, CA facilitated Nrf2 translocation into nuclear through blocking the interaction between Nrf2 and Keap1, which, in turn, upregulated anti-oxidant genes mRNA expression. Taken together, our results indicate that CA facilitates Nrf2 nuclear translocation, causing induction of Nrf2-dependent genes, which contributes to protection from acetaminophen hepatotoxicity.

• 대한임상약리학회:학술대회논문집
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• 2006.11a
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• pp.93-93
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• 2006