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. 2008 Dec;1(1):20-28.
doi: 10.4021/gr2008.10.1220. Epub 2008 Nov 20.

Ginkgo Biloba Extract EGb 761 Alleviates Hepatic Fibrosis and Sinusoidal Microcirculation Disturbance in Patients with Chronic Hepatitis B

Cai Fen Zhang  1 , Chun Qing Zhang  1 , Yu Hua Zhu  1 , Jing Wang  1 , Hong Wei Xu  1 , Wan Hua Ren  1
Affiliations

Ginkgo Biloba Extract EGb 761 Alleviates Hepatic Fibrosis and Sinusoidal Microcirculation Disturbance in Patients with Chronic Hepatitis B

Cai Fen Zhang et al. Gastroenterology Res. 2008 Dec.

Abstract

Background: Few clinical data are available regarding the effect of Ginkgo biloba extract (EGb 761) on liver microcirculation and fibrosis. This randomized, controlled trial is to investigate the effect of Ginko biloba extract EGb 761 on liver fibrosis and hepatic microcirculation in patients with chronic hepatitis B.

Methods: Sixty-four patients with chronic hepatitis B were randomized for intention-to-treat. Thirty-two patients were assigned to treated group receiving EGb 761 plus polyunsaturated phosphatidylcholine (Essentiale), 32 patients received Essentiale as controls. Blood samples were taken for measurement of transforming growth factor beta-1 (TGF-β1), platelet activate factor (PAF), endothelin 1 (ET-1). Twenty-six patients in treated group and 21 patients in control group underwent liver biopsies for histology before and after treatment. Ultrastructural study for sinusoidal microcirculation before and after treatment was carried out on 10 randomly selected patients in each group.

Results: In the treated group, after EGb 761 treatment, there was a significant reduction of blood TGF- β1, PAF and ET-1 (p<0.05), whereas this was not observed in the controls. After treatment in both groups, there were significant decrease of ALT, TBil and PT (p<0.05), and significant increase of ALB (p<0.05). Hepatic inflammation and fibrosis significantly alleviated in the treated group, but not in the controls. After EGb 761 treatment, electron microscopy showed red blood cell aggregates and microthrombosis disappeared or decreased in sinusoids; collagen deposits in sinusoidal lumen and Disse space reduced; sinusoidal capillarization alleviated.

Conclusions: EGb 761 can improve sinusoidal microcirculation, alleviate inflammation and inhibit fibrosis through multiple mechanisms, it is effective in the treatment of chronic liver diseases.

Keywords: Chronic Hepatitis B; EGb 761; Endothelin-1; Ginko biloba; Hepatic fibrosis; Hepatic microcirculation.

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Figures

Figure 1
Figure 1
Flowchart of patients included at various stages of the trial
Figure 2
Figure 2
Light microscopic observation after EGb 761 treatment. Light microscopy observations of liver biopsy samples. (a, b), H&E staining, before treatment, swollen and vacuolated hepatocytes, spotty and patchy acidophilic bodies were seen, inflammatory cells infiltration; aggregates of red blood cells in sinusoids (a); after EGb 761 treatment, acidophilic bodies were rare, no obstructed sinusoids (b). (c, d) Masson 3 staining, collagen fibrin hyperplasia, thickened fibrous septae (arrows, c); after EGb 761 treatment, collagen fibrin decreased, fibrous septa became thinner (arrow, d). (e, f) Meticular fibrin staining, reticular fibrin hyperplasia, fibrous septae thickened (arrow, e); after EGb 761 treatment, reticular fibrin significantly decreased, fibrous septae became thinner (f). Original magnification, a-f, x100.
Figure 3
Figure 3
Electron microscopic observation of sinusoids after EGB 761 treatment
See this image and copyright information in PMC

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