Introduction
Medicinal plants and their therapeutic relevance
Medicinal plants are defined as plant species that exhibit therapeutic potential or pharmacological activity in humans or animals. Since antiquity, medicinal herbs have been integral to traditional medical systems across the world and continue to form a major component of complementary and alternative medicine. Plants biosynthesize a wide range of secondary metabolites that contribute to diverse biological activities, including therapeutic applications in multiple disease conditions.
Historically, medicinal plants have been extensively used in the management of various disorders, including hepatic diseases such as hepatitis, cirrhosis, and hepatocellular carcinoma (Tapsell et al., 2006; Zhang et al., 2025). The liver plays a central role in detoxification, metabolism of xenobiotics, and maintenance of glucose homeostasis by glycogen storage and mobilization.
Etiology of hepatotoxicity and liver dysfunction
Hepatotoxicity may result from multiple etiological factors, including chronic alcohol intake, metabolic and bleeding disorders, iron overload conditions, malnutrition, autoimmune diseases, environmental toxin exposure (inhalation, ingestion, or dermal absorption), genetic abnormalities, prolonged drug use, and rapid weight loss following surgical interventions. These factors contribute to progressive hepatic injury and impaired liver function.
Role of medicinal plants in liver protection
Recent experimental and clinical evidence supports the hepatoprotective potential of several medicinal plants in the management of liver disorders. Herbal medicines have therefore remained central to liver disease management in traditional and modern research contexts due to their antioxidant, anti-inflammatory, and detoxifying properties.
Overview of hepatic diseases and prevalence
Hepatic diseases comprise a broad spectrum of disorders affecting liver structure and function, including metabolic, infectious, autoimmune, toxic, and genetic conditions. The liver is a vital organ responsible for metabolism, detoxification, and systemic homeostasis. Hepatic disorders may present as acute or chronic conditions, often progressing to severe complications if untreated.
Epidemiology and global burden
Liver diseases represent a significant and growing public health concern, particularly in India, where incidence rates are increasing. Chronic liver diseases (CLDs) have shown a rising trend in mortality since 1980. Epidemiological transition, including adoption of Western dietary patterns, sedentary lifestyle, and increased alcohol consumption, has contributed to a rising burden of non-alcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD), alongside viral hepatitis (Kumar et al., 2023).
Globally, the World Health Organization (WHO) estimates that approximately 354 million individuals are affected by hepatitis B or C infections,1 while hepatitis E virus remains a major cause of acute liver failure. Reported prevalence of hepatitis A ranges from 2.1% to 52.5% across populations.
In India, liver cirrhosis and chronic liver diseases account for approximately 2.9% of total mortality. The country contributes nearly 18.3% of global cirrhosis-related deaths, with approximately 259,749 deaths attributed to liver diseases, representing about 2.95% of all deaths (World Life Expectancy data).
Comprehensive overview of hepatic diseases: Causes, impact, epidemiology, treatments, and limitations
Here is your content scientifically reformatted into a clean table:
|
Type of hepatic disease |
Cause of disease |
Impact on liver function |
Epidemiology |
Current treatments including drugs |
Limitations |
|
NAFLD |
Metabolic syndrome, insulin resistance, obesity |
Hepatic steatosis progressing to NASH, fibrosis, and cirrhosis |
Affects ~25% global population; NASH ~5–6%; leading cause of future liver transplantation |
Lifestyle modification (diet, exercise), vitamin E, pioglitazone; investigational agents like obeticholic acid and semaglutide |
No approved definitive pharmacotherapy; poor long-term adherence to lifestyle changes |
|
Alcohol-related fatty liver disease (ALD) |
Chronic alcohol consumption |
Steatosis → alcoholic hepatitis → cirrhosis with progressive liver dysfunction |
~20% of heavy drinkers develop cirrhosis; major cause of liver-related mortality in Western countries |
Alcohol abstinence, corticosteroids (prednisolone), pentoxifylline, liver transplantation (advanced cases) |
Relapse risk, limited drug efficacy, donor shortage |
|
Hepatitis B (HBV) |
Viral infection (HBV) |
Chronic inflammation, fibrosis, cirrhosis, hepatocellular carcinoma risk |
~296 million chronic cases; ~820,000 deaths annually |
Tenofovir, entecavir, lamivudine, adefovir; pegylated interferon-α; HBV vaccine (prevention) |
Long-term therapy required; antiviral resistance (older drugs) |
|
Hepatitis C (HCV) |
Viral infection (HCV) |
Chronic hepatitis, cirrhosis, hepatocellular carcinoma risk |
~58 million cases worldwide; ~290,000 deaths annually |
Direct-acting antivirals (sofosbuvir, velpatasvir, daclatasvir, ledipasvir, glecaprevir, pibrentasvir) |
High treatment cost; limited access in low-income settings |
|
Cirrhosis |
Chronic HBV/HCV, alcohol, NAFLD |
Irreversible fibrosis, portal hypertension, hepatic failure, ascites, encephalopathy |
~1.2 million deaths/year globally |
Etiology-based therapy; diuretics (spironolactone, furosemide), albumin; liver transplantation |
Late diagnosis; limited donor availability; irreversible damage |
|
Hepatocellular carcinoma (HCC) |
Chronic liver disease, cirrhosis, HBV/HCV, alcohol |
Malignant transformation, metastasis, liver failure |
3rd leading cause of cancer-related deaths; >1 million deaths projected by 2030 |
Surgery, liver transplant, sorafenib, lenvatinib, immunotherapy (atezolizumab, nivolumab) |
Late-stage detection; high recurrence; limited curative options |
Exploring ayurvedic herbs for liver health
|
Herb |
Scientific name |
Pharmacological properties |
Therapeutic uses |
|
Amalaki |
Emblica officinalis Gaertn. |
Antioxidant, rejuvenating |
Improves liver function and immunity |
|
Bibhitaki |
Terminalia bellirica (Gaertn.) Roxb. |
Detoxifying |
Supports liver health and digestion |
|
Haritaki |
Terminalia chebula Retz. |
Detoxifying, laxative |
Improves liver function and gastrointestinal health |
|
Ashwagandha |
Withania somnifera (L.) Dunal |
Adaptogenic, antioxidant |
Improves liver health and stress regulation |
|
Brahmi |
Bacopa monnieri (L.) Wettst. |
Neuroprotective, antioxidant |
Supports liver function and cognition |
|
Shankhpushpi |
Convolvulus pluricaulis Choisy |
Nervine tonic |
Supports liver health and memory |
|
Shatavari |
Asparagus racemosus Willd. |
Rejuvenating, anti-inflammatory |
Supports hepatic and hormonal balance |
|
Manjistha |
Rubia cordifolia L. |
Blood purifier, anti-inflammatory |
Enhances hepatic detoxification and skin health |
|
Gokshura |
Tribulus terrestris L. |
Diuretic, rejuvenating |
Supports liver and urinary health |
|
Kutaja |
Holarrhena antidysenterica (L.) Wall. ex A. DC. |
Antidiarrheal, antimicrobial |
Supports liver and gastrointestinal health |
|
Amrutha (Giloy) |
Tinospora cordifolia (Willd.) Miers |
Immunomodulator, antioxidant |
Enhances liver function and immunity |
|
Musta |
Cyperus rotundus L. |
Digestive, carminative |
Supports hepatic and gastrointestinal health |
|
Daruharidra |
Berberis aristata DC. |
Antimicrobial, anti-inflammatory |
Improves liver function and digestion |
|
Kalmegh |
Andrographis paniculata (Burm.f.) Nees |
Hepatoprotective, antiviral |
Protects liver and inhibits infections |
|
Katuki |
Picrorhiza kurroa Royle ex Benth. |
Hepatoprotective, bitter tonic |
Supports liver function and bile secretion |
|
Pippali |
Piper longum L. |
Digestive, carminative |
Enhances liver and gastrointestinal function |
|
Vidanga |
Embelia ribes Burm.f. |
Anthelmintic, digestive |
Supports liver and antiparasitic action |
|
Arjuna |
Terminalia arjuna (Roxb. ex DC.) Wight & Arn. |
Cardioprotective, antioxidant |
Supports liver and cardiovascular health |
|
Giloy |
Tinospora cordifolia (Willd.) Miers |
Immunomodulatory, antioxidant |
Enhances liver immunity and detoxification |
|
Bhumiamalaki |
Phyllanthus niruri L. |
Detoxifying, hepatoprotective |
Protects liver and improves metabolic function |
Herbs and phytochemicals in fatty liver disorder
|
Medicinal plant (part) |
Bioactive compounds |
Mechanism of action / biological effect |
|
Hibiscus sabdariffa L. (polyphenol extract) |
Polyphenols |
Downregulation of p-JNK, Bax, tBid; increased GSH levels indicating anti-apoptotic and antioxidant effects |
|
Coffee (polyphenol extract) |
Polyphenols |
Increased GSH/GSSG ratio; reduced MDA and TNF-α; decreased lipid droplets indicating reduced steatosis and inflammation |
|
Aralia elata (Miq.) Seem. (total aralosides) |
Aralosides |
Downregulation of IL-6, TNF-α, NF-κB p65, and p-JNK signaling pathways |
|
Coptis chinensis Franch. |
Berberine |
Increased IRS-2 expression improving insulin resistance in NAFLD |
|
Coptis chinensis Franch. |
Berberine |
Inhibition of lipogenesis and stimulation of lipolysis via ↓SCD1, FAS, SREBP1c and ↑CPT1 expression |
|
Coptis chinensis Franch. |
Berberine |
Reduction of triglyceride accumulation in FFA-induced hepatic steatosis |
|
Gynostemma pentaphyllum |
Gypenosides |
Activation of PPAR α/β/γ leading to suppression of lipogenic genes and redu |
Medicinal plants and their therapeutic phytochemicals in hepatitis
|
Medicinal plant (part) |
Phytochemical |
Mechanism of action / biological effect |
|
Glycyrrhiza uralensis (roots) |
Glycyrrhizin |
Inhibition of HCV via phospholipase A2 suppression |
|
Glycyrrhiza uralensis (roots) |
Glycyrrhizin |
Inhibition of complement-mediated cytolytic activity |
|
Glycyrrhiza uralensis (roots) |
Glycyrrhizin |
Increased IL-10 secretion by dendritic cells |
|
Ocimum tenuiflorum L. (leaves) |
Oleanolic acid |
Reduction of fasting and postprandial blood glucose levels |
|
Ocimum tenuiflorum L. (leaves) |
Oleanolic acid |
Protection against galactosamine-induced hepatotoxicity |
|
Phyllanthus amarus (whole plant except roots) |
Hypophyllanthin |
Limited effect on HBsAg eradication |
|
Silybum marianum (fruits) |
Silibinin |
Inhibition of HCV entry via clathrin-dependent trafficking blockade |
|
Bupleurum chinense (roots) |
Saikosaponin C, saikosaponin b2 |
Inhibition of early HCV entry stages |
|
Sophora flavescens (roots) |
Matrine, oxymatrine |
Enhancement of lamivudine-mediated inhibition of HBeAg secretion |
|
Sophora flavescens (roots) |
Matrine, oxymatrine |
Improved hepatic blood flow via NO and eNOS upregulation |
|
Periploca sepium (bark) |
Periplocoside A |
Reduction of IL-4, IFN-γ, and ALT in autoimmune hepatitis |
|
Periploca sepium (bark) |
Periplocoside A |
Anti-inflammatory, antioxidant, and anti-apoptotic effects in hepatocytes |
|
Silybum marianum (fruits) |
Silymarin / flavonolignans |
Inhibition of HCV RNA, protein expression, and virion production |
|
Silybum marianum (fruits) |
Silymarin |
Reduction of pro-inflammatory cytokines and increased IL-10 levels |
|
Coptis chinensis |
Berberine |
Inhibition of HCV pseudoparticle entry (E1/E2 glycoproteins) |
|
Scutellaria baicalensis (roots) |
Baicalin, baicalein |
Promotion of hepatocyte regeneration via IL-6 and TNF-α modulation |
|
Phyllanthus niruri (whole plant) |
Phyllanthin |
Inhibition of HBsAg secretion and mRNA via annexin A7 upregulation |
|
Phyllanthus niruri (whole plant) |
Phyllanthin |
Clearance of HBsAg, HBeAg, and HBV DNA |
|
Astragalus membranaceus (roots) |
Astragalosides |
Enhanced clearance of HBeAg and HBV DNA in chronic hepatitis B |
Herbs and phytochemicals in liver cirrhosis
|
Medicinal plant (part) |
Bioactive compounds |
Mechanism of action / biological effect |
|
Coptis chinensis (rhizome) |
Berberine |
Inhibition of hepatic stellate cell proliferation; downregulation of TGF-β1 and α-SMA; reduction of oxidative stress via antioxidant pathways |
|
Coptis chinensis (rhizome) |
Berberine |
Induction of ferroptosis in hepatic stellate cells via ROS-mediated iron redox regulation |
|
Pueraria montana var. lobata |
Puerarin |
Induction of hepatic stellate cell apoptosis via downregulation of Bcl-2 expression |
|
Pueraria montana var. lobata |
Puerarin |
Suppression of NF-κB and TNF-α signaling in hepatic fibrosis models |
|
Glycyrrhiza uralensis (roots) |
Glycyrrhizin |
Inhibition of TGF-β1/Smad2/Smad3/SP-1 signaling; reduction of collagen deposition and fibrosis progression |
|
Glycyrrhiza uralensis (roots) |
Glycyrrhizin |
Reduction in ALT levels; suppression of hepatic fibrosis and necroinflammation |
|
Coptis chinensis (whole plant aqueous extract) |
— |
Enhancement of antioxidant defense mechanisms; protection against CCl₄-induced liver fibrosis |
|
Saururus chinensis (whole plant ethanol extract) |
— |
Reduction of serum AST, ALT, heme oxygenase, and hepatic MDA levels indicating hepatoprotection |
|
Bupleurum chinense (root ethanol extract) |
— |
Upregulation of glutathione-mediated antioxidant activity; anti-inflammatory and antifibrotic effects |
|
Silybum marianum (fruits) |
Silybinin |
Reduction of hepatic inflammation via LPCAT downregulation and modulation of platelet-activating factor |
|
Silybum marianum (flavonolignans mixture) |
Silymarin |
Improvement in symptoms and quality of life in cirrhosis patients |
Herbs and phytochemicals in HCC
|
Medicinal plant (part) |
Phytochemicals |
Mechanism of action / biological effect |
|
Coptis chinensis (rhizome) |
Berberine |
Activation of miR-23a leading to induction of tumor suppressor genes GADD45α and p21 via p53-associated pathways in HCC cells |
|
Coptis chinensis (rhizome) |
Berberine |
Induction of mitochondrial apoptosis and autophagic cell death via Beclin-1 activation and mTOR pathway inhibition |
|
Bupleurum chinense (roots/leaves) |
Saikosaponin D |
Activation of caspase-3 and caspase-7 leading to enhanced apoptotic cell death in liver cancer cells |
|
Salvia miltiorrhiza (roots and rhizome) |
Cryptotanshinone, tanshinone IIA |
Induction of apoptosis in HCC cells; synergistic effect with doxorubicin without increasing oxidative stress |
|
Curcuma longa (rhizome) |
Curcumin |
Inhibition of proliferation and induction of programmed cell death in human hepatocellular carcinoma cells |
|
Silybum marianum (fruits) |
Silymarin (flavonolignans) |
Suppression of HCC progression via reduction of mitochondrial membrane potential and inflammatory signaling pathways |
Conclusion and future perspectives
This review highlights the therapeutic potential of medicinal plants in hepatic disorders, demonstrating their hepatoprotective effects through antioxidant, anti-inflammatory, antiviral, and hepatocyte-regenerative mechanisms. Evidence from traditional use and experimental studies supports their relevance in managing fatty liver disease, hepatitis, cirrhosis, and hepatocellular carcinoma.
Given the central role of the liver in metabolism and detoxification, maintenance of hepatic function is critical for overall health. Recent clinical and preclinical findings increasingly validate herbal interventions as supportive or adjunct therapies for liver diseases, offering multi-targeted pharmacological benefits.
Future research should focus on elucidating the molecular mechanisms of bioactive phytoconstituents, standardization of herbal formulations, and optimization of dose–response relationships. Well-designed clinical trials are essential to establish safety, efficacy, and population-specific therapeutic outcomes.
In conclusion, medicinal plants represent a promising and largely underexplored resource for liver disease prevention and treatment, warranting further rigorous scientific validation to facilitate their integration into evidence-based clinical practice.2
References:
- Sarkar A, Bhattacharya P, Das S, et al. Community-based Estimates of the Prevalence of Hepatitis B and C Infections and their Correlates in Two Districts of West Bengal, India. J Assoc Physicians India. 2025;73(11):43-48. doi:10.59556/japi.73.1247. https://www.japi.org/article/japi-73-11-43
- Saraswat I, Goel A, Gupta J. Herbal remedies for hepatic diseases: A review of medicinal herbs in the treatment of liver disorders. Chin Herb Med. 2026;18(2):329-342. Published 2026 Feb 14. doi:10.1016/j.chmed.2026.02.015. https://pmc.ncbi.nlm.nih.gov/articles/PMC13069626/