Anti-hepatitis B activities of Myanmar medicinal plants: a narrative review of current evidence

Abstract

Hepatitis B is one of the major burdens for health services and is the leading cause of morbidity and mortality from cirrhosis of liver and hepatocellular carcinoma. Current treatment strategies using nucleos(t)ide analogue reverse-transcriptase inhibitors or interferons are targeted for the long-term suppression of hepatitis B DNA. However, functional cure of hepatitis B infection (HBsAg clearance) was difficult to attain with such treatments. Therefore, new treatment strategies or innovative treatments are urgently needed. The new treatments should focus on the potential therapeutic targets such as covalently closed circular DNA which may be important for the HBsAg clearance. Plant based medicines have been used in different traditional medicine practices and these natural products/compounds serve as a good source of information or clues for use in drug discovery and design. Many natural products were found to be effective against hepatitis B virus and some even have better therapeutic activities than currently used compounds. This review summarizes the current evidence of Myanmar medicinal plants in basic and clinical research which shows promising potential for the development of novel therapeutic agents for the treatment of hepatitis B.

Keywords: Drug discovery; Hepatitis B; Medicinal plants; Natural products.

Fig. 1

The anti-HBV mechanisms of selected plants and compounds in the life cycle of the Hepatitis B virus. 1—Aloe vera; 2—Caesalpinia sappan; 3—Curcuma longa; 4—Epedra sinica; 5—Hypericum perforatum; 6—Momordica charantia; 7—Moringa oleifera; 8—Morus alba; 9—Phyllanthus niruri/amarus; 10—Phyllanthus rheedei; 11—Terminalia chebula; 12—EGCG; 13—Glycyrrhizin. (HBV – hepatitis B virus; NTCP—sodium taurocholate cotransporting polypeptide; cccDNA—covalently closed circular DNA; mRNA—messenger RNA; RC DNA—relaxed circular DNA; DSL-DNA—double-stranded linear DNA; L/M/SHBsAg—large/middle/small HBsAg, ER—endoplasmic reticulum) (Fig. 1 was adapted from (4))