Anti-fibro-hepatocarcinogenic Chinese herbal medicines: A mechanistic overview

Abstract

Chinese herbal medicine (CHM) is an integral component of complementary/alternative medicine and it is increasingly becoming the preferred therapeutic modality for the treatment of liver fibrosis and hepatocellular carcinoma (HCC) worldwide. Accordingly, the World Health Organization (WHO) has attested to the popularity and efficacy of indigenous herbal therapies including CHM as a first line of treatment for some diseases including liver disorders. However, the WHO and drug discovery experts have always recommended that use of indigenous herbal remedies must go hand-in-hand with the requisite mechanistic elucidation so as to constitute a system of verification of efficacy within the ethnobotanical context of use. Although many CHM experts have advanced knowledge on CHM, nonetheless, more enlightenment is needed, particularly mechanisms of action of CHMs on fibro-hepato-carcinogenesis. We, herein, provide in-depth mechanisms of the action of CHMs which have demonstrated anti-fibro-hepatocarcinogenic effects, in pre-clinical and clinical studies as published in PubMed and other major scientific databases. Specifically, the review brings out the important signaling pathways, and their downstream targets which are modulated at multi-level by various anti-fibro-hepatocarcinogenic CHMs.

Keywords: Chinese herbal medicine; fibro-hepato-carcinogenesis; immunomodulation; inflammation; mechanistic elucidation.

Figure 1

A diagrammatic depiction of the multi-modulatory and multi-target pharmacological effects of Chinese herbal medicine (CHM) which underpin the promising efficacy of CHM against liver disease in general

Figure 2

An illustration of the multi-etiology of fibro-hepato-carcinogenesis. Many etiological factors may act synergistically to promote progression of chronic liver injury to liver fibrosis and cirrhosis if left untreated, and this ultimately increases the risk of HCC and the manifestation of the six phenotypic hallmarks of HCC