To the best of my knowledge “modern medicine” has nothing to offer in these difficult conditions: Lungs ,liver, skin etc.
|Date: 11-27-2013||HC# 061346-485|
Re: Review of Selected Herbs with Antifibrotic Effects
Yarnell E, Abascal K. Antifibrotic herbs: Indications, mechanisms of action, doses, and safety information. Altern Complement Ther. April 2013;19(2):75-82.
Fibrosis, the formation of connective tissue, occurs in response to injury or inflammation. In normal repair processes, matrix material (collagen and related molecules) increases, and scar tissue may form. Excess fibrosis occurs especially if the underlying injury continues and can negatively affect the structure and function of organs and tissues. In cirrhosis, normal tissue is completely replaced by fibrotic cells. Fibrotic conditions include biliary cirrhosis, hepatic cirrhosis, renal fibrosis, localized or systemic scleroderma, Peyronie’s disease, Dupuytren’s contracture, hypertrophic scarring, spinal stenosis, oral submucous fibrosis, pulmonary fibrosis, and more.
Fibrosis is reversible, as has been seen in patients with hepatitis and cirrhosis who took interferon in large trials. Several herbs can also reverse fibrosis. The authors report on these while emphasizing herbs that prevent fibrotic conditions. Currently, there are more studies on Chinese medicinal herbs than on those from Western traditions, in part due to the epidemic of hepatitis B-induced cirrhosis in Asia and more prevalent use of herbal medicine there. However, Western antifibrotic herbs may be equally effective.
Licorice (Glycyrrhiza glabra syn. G. glandulifera) root can prevent and reverse fibrosis, notably in kidneys and liver. In an open trial with glycyrrhizin, licorice’s main triterpenoid saponin, and glycine, patients with hepatitis C in the active arm had significantly less cirrhosis risk than controls over 13 years. In a one-year study, patients with hepatitis C took part in a randomized trial followed by an open trial; 67% of those who had not improved with interferon and riboflavin had stable or improved fibrosis with five weekly injections of glycyrrhizin. While additional randomized clinical trials (RCTs) of glycyrrhizin are needed, other licorice compounds and whole-plant extracts are also antifibrotic, as are several combinations of licorice or constituents with other herbs. A Chinese formula, xiao chai hu tang (sho-saiko-to in Japanese), with licorice and six other herbs, prevented hepatocellular carcinoma in hepatic cirrhosis in several RCTs.
Gotu kola (Centella asiatica) is another herb of Asian origin now grown in tropical climates worldwide. The entire plant is used, but research often focuses on an extract of its three triterpenoid saponins. In one RCT, a titrated extract reduced inflammatory infiltration into livers of patients with hepatic cirrhosis. Open trials and case series report that extracts, administered orally and topically, help treat local and systemic prpscleroderma. Crude extracts reduced postsurgical scarring in two preliminary RCTs, and a topically titrated extract prevented postburn and hypertrophic postsurgical scars in an open trial. Gotu kola appears to promote healthy wound healing, reducing scarring in the process. In a recent RCT, 170 diabetics with chronic foot ulcers took a standardized extract or placebo orally for 21 days. The active group had better healing and less scarring. Both licorice and gotu kola may reduce fibrosis through multiple mechanisms of action.
A complex flavonolignan from milk thistle (Silybum marianum) seeds, silymarin, has been studied in liver fibrosis and cirrhosis and may be antifibrotic in kidneys and heart. Used with antivirals in patients with chronic hepatitis B, silymarin was more antifibrotic than those drugs. In RCTs involving biliary cirrhosis and severe alcoholic cirrhosis, it was ineffective, but a meta-analysis found it effective in early stage alcoholic cirrhosis. Some poor results may have been caused by poor absorption; combining silymarin with phosphatidylcholine in doses up to 2.1 g/d improves this aspect.
Colchicine, an antifibrotic alkaloid in the bulb of autumn crocus (Colchicum autumnale), effective against several unrelated conditions, has shown disappointingly contradictory results in fibrotic conditions. Neither whole-plant extracts nor the combination of autumn crocus with other therapies has been studied in modern times. In a retrospective chart review of 14 patients with chronic hepatitis C who were treated naturopathically with colchicine, silymarin, ursodeoxycholic acid, vitamins, minerals, and other botanicals including milk thistle seed, no patient’s disease progressed, a better sense of wellness was reported, and serum alanine transaminase fell an average 35 U/L. Autumn crocus and its alkaloid are toxic and should be used only in extreme cases, with careful supervision, clear instructions to patients, and at least quarterly serum aminotransferase and complete blood counts. Colchicine is metabolized by cytochrome P450 (CYP) 3A4 and its absorption is decreased by the P-glycoprotein (P-gp) transmembrane efflux pump; combination with P-gp pump or CYP3A4 inhibitors can cause serious toxicity or interfere with efficacy. It is especially contraindicated for use with statin drugs.
Chinese salvia (dan shen; Salvia miltiorrhiza) extracts inhibit fibrosis in many tissues and models in vitro and in vivo. In an RCT, Chinese salvia and prednisolone were more effective in advanced submucous fibrosis than prednisolone alone. In 97 patients with chronic hepatitis B, injectable Chinese salvia decreased liver fibrosis more effectively than shengmai, a formula with three herbs. In two case studies of localized scleroderma, oral Chinese salvia with topical asiaticoside, one of gotu kola’s active compounds, was more effective than Chinese salvia alone. Another Chinese formula, dang gui bu xue tang, with angelica (Angelica archangelica) and astragalus (Astragalus membranaceus), has antifibrotic effects in vivo. Historically, most used in female reproductive conditions, it would be interesting to test this formula in uterine fibroids. Eight other herbs with preclinical evidence of antifibrotic activity are briefly summarized.—Mariann Garner-Wizard