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World J Hepatol. Feb 27, 2023; 15(2): 180-200
Published online Feb 27, 2023. doi: 10.4254/wjh.v15.i2.180
Antioxidant and anti-inflammatory agents in chronic liver diseases: Molecular mechanisms and therapy
Chun-Ye Zhang, Shuai Liu, Ming Yang
Chun-Ye Zhang, Christopher S. Bond Life Sciences Center, University of Missouri, Columbia, MO 65211, United States
Shuai Liu, The First Affiliated Hospital, Zhejiang University, Hangzhou 310006, Zhejiang Province, China
Ming Yang, Department of Surgery, University of Missouri, Columbia, MO 65211, United States
Author contributions: Zhang CY, Liu S, and Yang M designed, collected data, wrote, revised, and finalized the manuscript, contributed equally, and shared the first authorship.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ming Yang, DVM, PhD, Postdoctoral Fellow, Department of Surgery, University of Missouri, Room 2203, NexGen Precision Building, 1030 Hitt Street, Columbia, MO 65211, United States. yangmin@health.missouri.edu
Received: November 9, 2022
Peer-review started: November 9, 2022
First decision: November 23, 2022
Revised: November 30, 2022
Accepted: February 7, 2023
Article in press: February 7, 2023
Published online: February 27, 2023
Processing time: 107 Days and 10.5 Hours
Abstract

Chronic liver disease (CLD) is a continuous process that causes a reduction of liver function lasting more than six months. CLD includes alcoholic liver disease (ALD), non-alcoholic fatty liver disease (NAFLD), chronic viral infection, and autoimmune hepatitis, which can lead to liver fibrosis, cirrhosis, and cancer. Liver inflammation and oxidative stress are commonly associated with the development and progression of CLD. Molecular signaling pathways such as AMP-activated protein kinase (AMPK), C-Jun N-terminal kinase, and peroxisome proliferator-activated receptors (PPARs) are implicated in the pathogenesis of CLD. Therefore, antioxidant and anti-inflammatory agents from natural products are new potent therapies for ALD, NAFLD, and hepatocellular carcinoma (HCC). In this review, we summarize some powerful products that can be potential applied in all the stages of CLD, from ALD/NAFLD to HCC. The selected agents such as β-sitosterol, curcumin, genistein, and silymarin can regulate the activation of several important molecules, including AMPK, Farnesoid X receptor, nuclear factor erythroid 2-related factor-2, PPARs, phosphatidylinositol-3-kinase, and lysyl oxidase-like proteins. In addition, clinical trials are undergoing to evaluate their efficacy and safety.

Keywords: Chronic liver disease; Alcoholic liver disease; Non-alcoholic fatty liver disease; Hepatocellular carcinoma; Natural products; Inflammation; Oxidative stress; Treatment; Clinical trials

Core Tip: Chronic liver disease (CLD) is a continuous process that causes a reduction of liver function lasting more than six months. CLD can be subclassified into alcoholic liver disease, non-alcoholic fatty liver disease, chronic viral infection, and autoimmune hepatitis, which can lead to liver fibrosis, cirrhosis, and cancer. Liver inflammation and oxidative stress are commonly associated with the development and progression of CLD. Therefore, anti-inflammatory and antioxidant agents are promising drugs for CLD treatment. Clinical trials are undergoing to evaluate their efficacy and safety.