Review
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jun 18, 2017; 9(17): 757-770
Published online Jun 18, 2017. doi: 10.4254/wjh.v9.i17.757
Liver immunology and herbal treatment
Yasemin H Balaban, Ceylan Aka, Ufuk Koca-Caliskan
Yasemin H Balaban, Gastroenterology Unit, Private Etimed Hospital, 06790 Ankara, Turkey
Ceylan Aka, Ufuk Koca-Caliskan, Department of Pharmacognosy, Gazi University - Pharmacy Faculty, 06330 Ankara, Turkey
Author contributions: We attest to the fact that all authors listed on the title page have contributed equally significantly to the work, have read the manuscript, and agree to its submission to the World Journal of Hepatology.
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Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Yasemin H Balaban, Professor, Gastroenterology Unit, Private Etimed Hospital, Elvan Mah, 1934 Sok, No. 4, 06790 Ankara, Turkey. ybalaban@hacettepe.edu.tr
Telephone: +90-533-2344232 Fax: +90-312-2930605
Received: March 4, 2017
Peer-review started: March 7, 2017
First decision: April 18, 2017
Revised: April 29, 2017
Accepted: May 18, 2017
Article in press: May 19, 2017
Published online: June 18, 2017
Processing time: 102 Days and 4 Hours
Abstract

Beyond the metabolic functions, the liver recently has been defined as an organ of immune system (IS), which have central regulatory role for innate and adaptive immunity. The liver keeps a delicate balance between hepatic screening of pathogenic antigens and immune tolerance to self-antigens. Herbal treatments with immunological effects have potential to alter this hepatic immune balance towards either therapeutic side or diseases side by inducing liver injury via hepatotoxicity or initiation of autoimmune diseases. Most commonly known herbal treatments, which have therapeutic effect on liver and IS, have proven via in vitro, in vivo, and/or clinical studies were summarized in this review.

Keywords: Herbal treatments; Hepatic immunology; Drug induced liver injury; Adaptive immunity; Innate immunity

Core tip: Herbal treatment is the mother of modern medicine. The ancient habit of treating diseases with plants still goes on as either primary or complementary to conventional medical treatment. The other side of medallion is the fact that the liver is number one target organ for herbal toxicity. Furthermore, liver has been recently defined as an active organ of immune system, which have central regulatory role on innate and adaptive immune response. The delicate homeostasis between immediate and efficient defense against threats (immune surveilance of antigens) without triggering harmful immune response towards self-structures (periferal immune tolerance to self antigens) is controled by liver. Herbal formulas are not a single plant extract, but is an interacting mixture of ingredients that determines the final clinical outcome as therapeutic and hepatotoxic effect. This review aimed to drive attention on both potentials of herbals from the point of immunology, in order to initiate a motivation for feature studies defining the mechanisms of immunological interaction between herbals and liver.