Table 1 Commonly used allopathic medicine for liver protection with clinical application

1

Corticosteroids

Reduce cytokine production

Antifibrotic

Switch off multiple activated inflammatory genes through inhibition of histone acetyltransferase (HAT) and recruitment of histone deacetylase 2 (HDAC2) activity to the inflammatory gene transcription complex

Studies revealed that it has less significant effect nowadays, and implication in future as liver-protective agent is also less recognized

[68, 165]

2

Interferons

Antiviral, antifibrotic

Inhibits hepatitis B and C virus replication by decreasing RNA transcription, occurring from covalently closed circular DNA

Hepatitis B and C could be treated. Antifibrotic activity is still not tested and proved in human. Side effects at therapeutic dose include depression, anxiety, agitation, suicidal ideation, and even suicide

[112, 133]

3

Lamivudine

Hepatitis B and cirrhosis

Converted intracellularly to its triphosphate form which then competes with cytosine triphosphate for incorporation into the developing viral DNA strand

Continuous usage might result in the development of resistant with hepatitis B virus

[85, 188]

4

Propylthiouracil

Alcohol hepatic diseases

Reacts with some of the oxidizing species derived from the respiratory burst in neutrophils and act as antioxidant resulting in the suppression of alcohol-induced hepatic necrosis

Render metabolically compromised patients hypothyroid

[8, 69]

5

Colchicine

Against gout, antifibrotic

Disrupts tubulin leading to subsequent downregulation of multiple inflammatory pathways and modulation of innate immunity

Beneficial properties were not demonstrated recently. Very toxic at high doses

[112, 160]

6

Pentoxifylline

Severe alcoholic hepatitis

Inhibits TNF-alpha synthesis and inflammation

Have appropriate therapeutic implication for hepatorenal syndrome due to its excellent safety profile. Patients with xanthine hypersensitivity should avoid use of pentoxifylline

[111]

7

Ursodeoxycholic acid

Non-alcoholic fatty hepatic disease

Inhibits DNA repair, coenzyme A, cyclic AMP, p53, and phagocytosis and inhibits induction of nitric oxide synthetase

Useful in the treatment of hepatobiliary diseases by ameliorating hepatic histology, enzymes, and different oxidative stress

Long use of ursodeoxycholic acid in human might result in taurine depletion

[44, 148]

8

Rosiglitazone

Non-alcoholic fatty hepatic disease

Activates intracellular receptor class of peroxisome proliferator-activated receptors (PPARs), specifically PPARγ

Increase risk of heart attack

[27, 82]