Research Article Open Access Volume 5 • Issue 4 • 1000257 Med Aromat Plants ISSN: 2167-0412 MAP, an open access journal Open Access Research Article Mostafa and Singab, Med Aromat Plants 2016, 5:4 DOI: 10.4172/2167-0412.1000257 *Corresponding author: Singab AN, Department of Pharmacognosy, Faculty of Pharmacy, Ain Shams University, 11566, Cairo, Egypt, Tel: +20224051120; Fax: +20224051107; E-mail: dean@pharma.asu.edu.eg (or) abdelnasser.sengab@pharma.asu.edu.eg Received June 16, 2016; Accepted June 30, 2016; Published July 04, 2016 Citation: Mostafa NM, Singab AN (2016) After HCV Eradication with Sovaldi®, Can Herbs Regenerate Damaged Liver, Minimize Side Effects and Reduce the Bill? Med Aromat Plants 5: 257. doi:10.4172/2167-0412.1000257 Copyright: © 2016 Mostafa NM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. After HCV Eradication with Sovaldi ® , Can Herbs Regenerate Damaged Liver, Minimize Side Effects and Reduce the Bill? Nada M Mostafa and Abdel Nasser Singab* Department of Pharmacognosy, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt Keywords: Hepatitis C virus; Herbal medicine; Sovaldi ® ; Hepatoprotective; Liver regeneration Introduction Hepatitis C virus (HCV) is considered a signifcant public health problem [1]. It currently infects more than 170 million people worldwide. Te great majority of patients develop chronic HCV infection, which can ultimately result in hepatic cirrhosis, failure or hepatocellular carcinoma, leading to about 350,000 deaths each year [2,3]. Egypt shows the highest prevalence (15%) of hepatitis C virus worldwide. It also has the highest predominance of HCV- 4 (67%), especially subtype 4a (55%). Te history of infection and the disease progression are infuenced by various factors such as level of HCV viremia, age at the onset of infection, sex, co-infection with hepatitis B virus and duration of infection [4]. Sofosbuvir (Sovaldi ® ) Sofosbuvir is a new antiviral candidate against multiple Hepatitis C virus genotypes [1]. It is a nucleotide analogue that is a potent inhibitor of NS5B polymerase in HCV. NS5B is a non-structural protein which is essential for viral RNA replication and has been a valuable target for many directly acting antiviral agents [3]. Numerous in vitro studies show promising results against all genotypes of HCV. Sovaldi ® is approved by the Food and Drug Administration for the treatment of chronic HCV infection [1]. It has shown high efcacy in combination with other drugs in antiviral treatment regimen. Tis drug is of special interest among directly acting antiviral drugs due to its high potency, oral administration, low side efects and high barrier to resistance [3]. Liver is the main organ responsible for the detoxifcation processes in our bodies and it is likely to be injured regularly by ingested toxins. Te regenerative properties of the liver are in fact logical adaptation procedures carried out by organisms, for which liver damage depends on for recovery [5]. Liver regeneration is achieved through a complex network consisting of liver cells (hepatocytes, Kupfer cells, hepatic stellate cells, sinusoidal endothelial cells and stem cells); and extrahepatic organs such as thyroid gland, pancrease, adrenal gland, duodenum and autonomous nervous system [6]. Liver regeneration is achieved by both cell proliferation and cell growth of hepatocytes, which are induced via stimulations of cytokines and growth factors. Restoration of liver volume depends mainly on hepatocyte proliferation, which includes initiation, proliferation and termination phases [5,6]. In the absence of reliable liver-protective drugs in the modern medicine, a variety of medicinal preparations are recommended for the treatment of liver disorders [7]. Herbal drugs contain a wide number of phytochemicals that occur naturally in the plants, and may have potential protective or disease preventive properties [8- 12]. Tus, studying the potential biological activity of crude drugs can result in the discovery of novel lead drugs for certain diseases and can lead to combining the strength of traditional application of herbal therapy with the modern concept of standardization, evidence-based pharmacological evaluation and controlled clinical trials in order to support clinical efcacy [13,14]. Hepatoprotective Plants Some fruits (grapefruit, grapes, cranberries and cactus pear fruit); plants such as chamomile and resin (propolis), which are consumed frequently by humans, in addition to some phytochemicals extracted from fruits, plants, algae, and yeasts have been evaluated in diferent models of hepatotoxicity and demonstrated hepatoprotective capacity [15]. A number of hepatoprotective plants have been tested in hepatotoxicity experimental models, which are ofen supported by histopathological examination of liver, thus provide an insight to the use of these plants against liver disorders in addition to regeneration of damaged hepatic tissues [16]. Some examples of these plants are listed below. Glycyrrhiza glabra (Leguminosae) Glycyrrhizic acid is a triterpene glycoside found in the roots of liquorice (Glycyrrhiza glabra). It possesses a variety of pharmacological Abstract Objective: Hepatitis C virus is a major health burden. It has infected millions of people worldwide with the highest prevalence in Egypt. Sofosbuvir (Sovaldi ® ) has been recently approved for treating chronic hepatitis C virus infections. Herbal medicine has been searched for centuries for the remedy of liver diseases. Key ings: Plants contain phytochemicals that proved to demonstrate hepatoprotective activity in vitro in various hepatotoxic models. Herbal drugs also proved effcacy in many clinical trials in reducing the viral load and improving the clinical manifestations in patients suffering hepatitis C virus. Conclusions: A hypothesis is postulated for the possibility of the use of a herbal mixture of plants, which are known for their hepatoprotective activity, in a combination therapy with directly acting antiviral drugs such as Sovaldi ® to help regenerate the liver, improve the clinical condition and reduce both the cost and side effects for hepatitis C virus patients. M e d i c i n a l & A r o m a t i c P l a n t s ISSN: 2167-0412 Medicinal & Aromatic Plants