Polyherbal Formulation of Andrographis Paniculata, Berberis Aristata, Cichorium Intybus, And Rubia Cordifolia: A Hepatoprotective Approach Against Anti-Tb Drugs

Abstract

Hepatotoxicity induced by these drugs limits their therapeutic use and poses a significant clinical challenge. The use of hepatoprotective agents derived from medicinal plants offers a promising alternative strategy for mitigating drug-induced liver damage. Liver toxicity is a major adverse effect associated with the use of anti-tuberculosis (TB) medications, particularly isoniazid (INH) and rifampicin (RMP). This study investigates the hepatoprotective effects of natural compounds oleanolic acid, stigmasterol, and β-sitosterol obtained from Andrographis paniculata, Berberis aristata, Cichorium intybus and Rubia cordifolia Root extracts collectively referred to as ABCR compounds, against INH+RMP-induced hepatotoxicity. Chang liver cells and male Wistar albino rats were used as experimental models. The MTT assay assessed cell viability, and the in vivo study involved biochemical, histopathological, and antioxidant enzyme analyses. INH+RMP treatment significantly elevated serum levels of ALT, AST, ALP, and bilirubin, indicating liver damage. These alterations were markedly reduced in rats pre-treated with ABCR compounds and the standard hepatoprotective agent Silymarin. Histopathological examination revealed severe hepatocellular damavge in the INH+RMP group, while ABCR pre-treatment showed significant preservation of liver histology. Among the ABCR compounds, ABCR2 demonstrated the highest level of protection. The results suggest that ABCR compounds effectively mitigate INH+RMP-induced liver toxicity through their antioxidant and anti-inflammatory properties. Further clinical studies are warranted to explore their potential in preventing and managing drug-induced hepatotoxicity in TB patients.