Pharmacological Activities of Alisma orientale against Nonalcoholic Fatty Liver Disease and Metabolic Syndrome: Literature Review.

Eunsol Choi,Eungyeong Jang,Jang-Hoon Lee

doi:10.1155/2019/2943162

Eunsol Choi, Eungyeong Jang + Show 1 more

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https://doi.org/10.1155/2019/2943162

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Abstract

Nonalcoholic fatty liver disease (NAFLD) is a rapidly emerging hepatic manifestation of metabolic syndrome. However, its unrevealed mechanism and complicated comorbidities have led to no specific medication, except for weight loss and lifestyle modification. Alisma orientale (Sam.) Juzep (A. orientale, Alismataceae) has been increasingly reported on therapeutic effects of A. orientale against NAFLD and metabolic syndrome such as insulin resistance, hyperlipidemia, and obesity. Therefore, this study aimed to review the preclinical efficacy of A. orientale and its chemical constituents including Alisol A 24-acetate, Alisol B 23-acetate, Alisol F, and Alismol against NAFLD and metabolic syndrome. A. orientale prevented hepatic triglyceride accumulation through suppressing de novo lipogenesis and increasing lipid export. In addition, it controlled oxidative stress markers, lipoapoptosis, liver injury panels, and inflammatory and fibrotic mediators, eventually influencing steatohepatitis and liver fibrosis. Moreover, it exhibited pharmacological activities against hyperlipidemia, obesity, and hyperglycemia as well as appetite. These biological actions of A. orientale might contribute to adiponectin activation or a role as a farnesoid X receptor agonist. In particular, Alisol A 24-acetate and Alisol B 23-acetate could be expected as main compounds. Taken together, A. orientale might be an effective candidate agent for the treatment of NAFLD and its comorbidities, although further assessment of its standardization, safety test, and clinical trials is consistently required.

Highlights

Nonalcoholic fatty liver disease (NAFLD), a new challenge of chronic liver disease in the 21st century, includes simple steatosis, nonalcoholic steatohepatitis (NASH), fibrosis, and cirrhosis
Levels of reactive oxygen species (ROS), thiobarbituric acid reactive substances (TBARS), free radicals, and peroxides were significantly reduced by A. orientale treatment in oxidative stress experimental models induced by palmitate [21] and tert-butyl hydroperoxide [20]. These results suggest that A. orientale has antioxidant effects to protect against liver damage initiated by oxidative stressors and it could be clinically applied as a therapeutic option to treat NAFLD patients
Elevated levels of ApoA-IV in the blood may reduce appetite for food by mediating hypothalamic melanocortin system [67]. These findings demonstrate that A. orientale may serve as an efficient drug to control food intake, reduce hyperplasia, hypertrophy, and differentiation of adipocytes and lose fat weight of obese and nonobese NAFLD patients

Summary

Introduction

Nonalcoholic fatty liver disease (NAFLD), a new challenge of chronic liver disease in the 21st century, includes simple steatosis, nonalcoholic steatohepatitis (NASH), fibrosis, and cirrhosis. A recent meta-analysis reported that global prevalence of NAFLD was assessed to be 25.24% [1], and its prevalence is likely to increase up to 33.5% in adults by 2030 [2]. As the prevalence of NAFLD constantly grows, economic burden is predicted to consistently increase [3]. Most NAFLD patients have a high risk of cardiovascular diseaserelated mortality rather than liver-related death. NAFLD is a type of chronic liver diseases and an independent risk factor of metabolic syndrome such as obesity, hypertension, type II diabetes mellitus (T2DM), and hyperlipidemia. There is still no gold standard medication to treat NAFLD. Unfavorable side effects such as gastrointestinal upset, hemorrhagic stroke, myopathy, pruritus, osteoporosis, and transient increase in serum creatinine have hampered the authority approval as standard medication to treat NAFLD [5]

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