Abstract
The purpose of this study was to determine the efficacy of a Peruvian botanical formulation for treating disorders of hepatic function and gastric mucosal integrity. The formulation A4+ (Sabell Corporation) contains extracts of Curcuma longa rhizome, Cordia lutea flower, and Annona muricata leaf. Individually these plants have been used as traditional remedies for liver disease. We report the efficacy of A4+ and its components using a variety of in vitro and in vivo disease models. The methods used included tests for antioxidant, anti-inflammatory, and antiviral activity as well as mouse models of liver disease, including Concanavalin A-induced immune-mediated hepatitis and a bile duct ligation model for evaluating sickness behaviour associated with liver disease. Rat models were used to evaluate the gastric mucosal protective property of A4+ following indomethacin challenge and to evaluate its anti-inflammatory action in an “air pouch” model. In all tests, A4+ proved to be more effective than placebo. A4+ was antioxidant and anti-inflammatory and diminished Hepatitis C virus replication in vitro. In animal models, A4+ was shown to protect the liver from immune-mediated hepatitis, improve behavioural function in animals with late stage liver disease, and protect the rat gastric mucosa from ulceration following NSAID exposure. We conclude that A4+ ameliorated many aspects of liver injury, inhibited hepatitis C virus replication, and protected the gastric mucosa from NSAIDs. These varied beneficial properties appear to result from positive interactions between the three constituent herbs.
Highlights
A4+ is an herbal product formulated to support healthy liver function
In vitro and animal studies were conducted to determine the potential for A4+ to ameliorate liver disease and one study to assess its ability to protect the gastric mucosa from nonsteroidal anti-inflammatory drugs (NSAIDs). e doses selected for these assays were largely based on the individual investigators’ experience with the individual assays and to be within the range of safety described in the toxicology studies [5]. e recommended human adult daily dose of A4+ (533 mg/day) as a Natural Health Product was taken into account [4]
Patients with liver disease often exhibit a number of associated symptoms including fatigue, malaise, loss of interest in engaging in social activity, and inability to concentrate, which have been collectively termed sickness behaviors [18, 19]. e purpose of these studies was to investigate whether A4+ could attenuate the sickness behavioural and biochemical effects associated with liver injury in two well-characterized mouse models of liver injury
Summary
A4+ is an herbal product formulated to support healthy liver function. It contains extracts of three herbs: Curcuma longa rhizome, Cordia lutea flower, and Annona muricata leaf, combined in the w/w ratio of 10 : 80 : 10. is unique combination of herbs and their relative proportions was developed by Dr Jose Cabanillas, a Peruvian physician with extensive experience of traditional medicine in the Amazon basin. e herbal components originate from the Amazon rainforest and the Coastal plains of Peru. A4+ is an herbal product formulated to support healthy liver function It contains extracts of three herbs: Curcuma longa rhizome, Cordia lutea flower, and Annona muricata leaf, combined in the w/w ratio of 10 : 80 : 10. E herbal components originate from the Amazon rainforest and the Coastal plains of Peru These plants have been used as a source of traditional remedies in Evidence-Based Complementary and Alternative Medicine many countries, and monographs have been published supporting the use of Curcuma longa and Annona muricata for the treatment of patients with liver disorders [1, 2]. We have previously reported on the toxicology and chemistry of A4+ [5]
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