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Herbal Medicines fortheTreatment ofCOPD
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Biological applicationsPlant extracts/secondary metabolites
• Lung cleansing
• Relieves breath illness
• Boosts immune systems
• Potential antioxidant activity
• Ease lung congestion
• Cleaning and purify lungs
Composition
racemosa, turmeric, vitamin C, Stinging Nettle, Lotus, gingever, pine bark
extract, and grape seed extract
Malabar nut, Glycyrrhiza glabra, Echinacea, curcumin, Arjuna, beetroot,
Stinging nettle, kateri, trikuta, punarnava, ginger and piperine
• Improves breathing
• Boost immunity
• Fights against lung damage
• Relied from mucus
Vasaka leaf, arjuna bark, Beetroot, stringing nettke root, kateri, trikatu,
• Stronger respiratory systems
• Lessens inammation
punarnava roots, echinacea roots, curcumin, and piperine
pollution
• Healthier breathing
• Protects the lungs against the harmful effects of
Stinging nettle extract, quercetin, Echinacea, lotus, ginger, licorice, Piper
nigrum, Inula Racemosa root extract, vitamin C, and grape seed extracts
• Helps detoxify the lungs
• Improves breathing by easing congestion
• Boosts respiratory health
• Puries and detox lungs
• Heals tissue damage due to the pollutions
• Provides relief from smoker’s cough
• Boosts lung immunity and strength
bark, oregano
congestion
• Potent bronchodilator
• Helpful in liquefying and relieving nasal and bronchial
• Its antimicrobial action combats infections caused by
Clerodendrumserratum, Aconitum ferox, Tinospora cordifolia, Zinziber
ofcinale, Piper nigrum, Piper longum, Datura mete, bambusaarundinacea,
Myristica gragrans, Elettaria cardamomum, Syzygiumaromaticum,
Gram-positive and Gram-negative bacteria
(COPD)
• Useful in chronic obstructive pulmonary disease
• Support overall lung and respiratory health
• Maintain healthy lung function
Cinnamomum zeylanicum
Inula helenium, Grindelia, Ceanothus americanus, Hawthorn and Schisandra
chinensis
• Promotes healthy lung functions
• Supports clear respiratory passages
• Supports healthy breathing capacity
• Naturally relieves
• Shortness of breath
• Relieves coughing
• Improves vital capacity
• Promotes expectoration
• Support overall lung and respiratory health
• Maintain healthy lung function
ofcinale, Tylophora asthmatica, Ganoderma lucidum and Vitamin C
Platycodon, ophiopogon, long pepper fruit, black cherry, cassia, elecampane,
mullein, licorice, and ginger
S.No. Name/brand
Table 3 List of commonly used herbal medicine and formulation available in market for COPD
1 Trurbasics/lung detox tablet Quercetin, Glycyrrhiza glabra, vitamin K2, Echinacea urpurea, Inula
2 Foresta organics/lung detox
tablet
detox tablet
3 Himalayan organics/lung
lung detox tablet
4 Pure nutrition (naturals)/
5 Nature sure/lungs pure tablet Vasika, guduchi, dhanyaka, kantakari, haridra, shunthi, bharangi, pipali, pine
lung complex
6 Shaleen/breath-easy Salanumsurrsttense, Adhatodavasica, Glycyrrhiza glabra, Ocimum sanctum,
7 Gaia herbs/mighty lungs Olea europaea, Ocimum sanctum, Mullein, Althaea ofcinalis, Plantain,
8 Redd remedies/lung care Adhatodavasica, Verbascum thapsus, Frillaria thunbergit, Zingiber
9 Organic India/breathe free Inula racemose, Ocimum sanctum, Terminalia belerica, Piper longum • Relieves asthma and other respiratory complications
10 Planetary herbals/mullein
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7 Secondary Metabolites Involved
intheInhibition ofCOPD
Herbal plants are the traditional and greatest extensive system of the drug for the cure of numerous human sicknesses
all over the world. Usually, the most successful sources of
potential natural products drugs have been derived from the
plants [124]. Plant-derived natural products are categorized
by huge chemical units with molecule structure and it shows
various biomedical applications [125]. Plant-derived natural
products such as Resveratrol (1), Curcumin (2), Emodin (3),
Linalool (4), Carvacrol (5), Quercetin (6), Forsythiaside (7),
Berberine (8), Baicalin (9), Chrysin (10), Casticin (11),
Oroxylin A (12), Asiatic acid (13), Lcariin (14),
Andrographolide (15), Betulin (16), Eucalyptol (17),
Epigallocatechin-3-gallate (18), p-Coumaric acid (19),
Salidroside (20), Silymarin (21), Tanshinone IIA (22),
Ursolic acid (23), and Phloretin (24) (Fig.3) showed promising activity, particularly in the inhibition of COPD [126].
Numerous reports revealed that many of the natural products
have employed efciently for the treatment of COPD in current studiesand it also exhibit efcacy on chronic lung
inammation related to COPD as summarized in Fig.3.
Resveratrol (1) (Fig.3) is a natural polyphenol antioxi-
dant agent and also called as 3,5,4′-trihydroxystilbene. It
was mainly identied from the roots of the white hellebore
Veratrum grandiorum and Polygonum japonicum [127]. It
has been used as traditional medicine such as asthma, antiseptic, wound healing for almost 2000 years [128]. It is
important to consider that resveratrol have been to found to
show anti-inammatory activity is displayed in COPD [129,
130]. Curcumin (2) is a chief component of Curcuma longa
(usually named as turmeric) and used as traditional medicine in the treatment of various inammatory disorders
(Fig.3). In addition to that, it shows different pharmacological including antioxidant, antimicrobial, anti-inammatory,
anticancer, and antidiabetic properties. Curcumin might be
an efcient COPD agent by preventing NF-κB signaling in
CS-induced COPD mice [131].The emodin (3) is known as
6-methyl-1,3,8-trihydroxyanthraquinone Fig. 3, an important compound and it was isolated from the Ventilago
madraspatana. It shows anti-inammatory activity via ele-
vation of Nrf-2 activation. Linalool (4) (Fig.3) is a fragrant
monoterpene alcohol, and it was isolated mainly from
Melissa ofcinalis and it displayed COPD property by preventing NF-κB initiation [132]. Carvacrol (5) Fig.3 is a terpenoid based compound which was identied from Zataria
multiora and which were used as traditional medicine such
as an antiseptic and anti-inammatory properties. Quercetin
(6) is avonoid-based polyphenol compound and it was
obtained from Polygonum aviculare medicinal plants.
Quercetin (Fig. 3) reduces chronic obstructive pulmonary
disease by Nrf2 activation [133]. The compound forsythia-
side (7, Fig. 3) contains 4-hydroxycinnamic acid moiety,
and it was isolated from Forsythia suspense herbal plant. It
exhibited COPD properties through inhibition of NF-κB
signaling pathway [134]. It is known that the alkaloid berberine (8) Fig. 3, from the Mexican traditional medicine
plant Argemone ochroleuca, in the treatment of asthma,
through NF-κB activation [135, 136]. A avonoid molecule
Baicalin (9) (Fig. 3) has been identied from the root of
Scutellaria baicalensis and it was exhibited promising
HDAC2 activity [137]. Chrysin (10) Fig. 3 was obtained
from medicinal plant of Passiora caerulea and showed bet-
ter anti-inammatory properties via potency of ERK and
p38 phosphorylation (Shen etal., 2015). Casticin (11) is avonoid compound Fig.3, isolated from the species of Vitex
such as Vitex rotun difolia and Vitex agnus-castus. It has
been found to have anti-inammatory lung diseases, chronic
obstructive pulmonary disease (COPD) [138]. The avonoid Oroxylin A (12) Fig.3 was found from medicinal plant
Scutellaria baicalensis Fig.3, attenuates CS-induced lung
inammation by Nrf2 activation [88]. Asiatic acid (13,
Fig.3), one of the bioactive natural products, isolated from
Centella asiatica, and it possesses inhibitory property
COPD through activation in lung tissue of MAPKs and
NF-kB.A new avonoid, icariin (14) Fig.3, has been isolated from Epimedium spp and considerably showed COPD
properties through the suppression of NF-kB activation. A
labdane diterpenoid Andrographolide (15, Fig. 3) was
mainly isolated from Andrographis paniculata herbal plant
and shown anti-inammatory properties through activation
of Nrf2 signaling pathway [139]. Betulin (16) Fig. 3 is a
rich, naturally occurring triterpene which was isolated from
the bark of birch trees. It exhibited COPD with decreasing
the amount of malondialdehyde (MDA) within the lung
[140]. Eucalyptol (17) Fig. 3 is a monoterpenoid bicyclic
ether and obtained from the plants of Eucalyptus globulus.
It has been played as a potential COPD agent for the action
of pulmonary inammation [141]. Epigallocatechin-3gallate (EGCG) (18) Fig.3 is a natural polyphenol isolated
from green leaf Camellia sinensis, and it showed promising
anti-inammatory activity through ameliorating oxidative
stress. The p-Coumaric acid (19) Fig. 3 is an important
hydroxycinnamic acid found in medicinal herbs Bambusae
Caulis in Taeniam and inhibits NF-κB activity and for treat-
ing pulmonary inammatory diseases. Salidroside (20)
Fig.3 is a glucoside of tyrosol was obtained from the medicinal plant Rhodiola rosea and it showed better COPD properties through MAPK/NF-κB mechanism [142]. An
important avonoid compound Silymarin (21), Fig.3, has
been isolated from the Silybum marianum, milk thistle, and
it exhibited COPD on adaptable MAPK activation mechanism [143]. Tanshinone IIA (22, Fig. 3) is the foremost
potential biomolecule which was isolated from the plant
root of Saviamiltiorrhiza. Tanshinone IIA induced COPD
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Fig. 3 Some plant-derived natural products involved in the inhibition of COPD
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and down-regulation of CFTR, and it could be a potential
anti- inammatory drug for COPD.Ursolic acid (23), Fig.3,
is a tripterine-based terpenoid molecule, and it was obtained
from various medicinal plants such as Uncaria rhyncho-
phylla, Rosmarinus offıcinalis, and Eugenia jambolana.
Ursolic acid displays excellent COPD properties through it
mechanism of down-regulation of PERK and upregulation
of Nrf2 [144]. Phloretin (24) is a natural phenol dihydrochalcone Fig.3, and it has been identied from the apple
tree leaves Fortunella japonica and it was pretreatment dra-
matically suppressed the mucins secretion [145].
8 Conclusion
Herbal medicines potentially are used in the treatment of a
variety of diseases with reduced side effects and toxicities.
Several herbal drugs and formulations have shown marked
inhibition of acute and chronic illnesses including
COPD. Thus, our chapter in detail describes the various
herbal drugs and formulations with their detailed pre-clinical
studies.
Acknowledgment The authors thank and acknowledge the Department
of Pharmaceuticals, Ministry of chemical and fertilizers, Government
of India
Declaration of Competing Interest All the authors declare no conict of interest to publish the article.
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ofLiver Cirrhosis
TanmoyBanerjee, ShuvamSar, SaptapadiSaha,
ArunBaidya, ArnabSarkar, SanmoyKarmakar,
AmitKumarHalder, andNilanjanGhosh
Abstract
Liver cirrhosis is a disastrous terminal consequence of
different types of chronic liver diseases (CLDs), with
brosis serving as an initial stage of cirrhosis. Obesity,
hyperlipidaemia, and type 2 diabetes mellitus (T2DM)
signicantly raise the possibility of liver cirrhosis and its
associated consequences. Non-alcoholic steatohepatitis
(NASH), a physiological condition with a 20% progression rate to cirrhosis, is brought on by the excessive lipid
accumulation in non-alcoholic fatty liver disease
(NAFLD) that results in inammation and destroys the
normal hepatocytes. Cirrhosis and brosis of the liver are
complex diseases that include different inammatory
cytokines and genetic, oxidative, and endoplasmic reticulum (ER) stress factors. The prevalence of cirrhosis in
humans is increasing, which is of particular concern to
medical specialists. However, there are not many efcient
treatments readily accessible right now. Numerous molecules from phytochemical classes, including alkaloid, avonoid, glycoside, polyphenol, tannin, and terpenoid,
have shown promising results in treating several CLDs
progressing to cirrhosis. These compounds inuence
hepatic lipid metabolism and de novo lipogenesis (DNL)
through various molecular signalling pathways. In this
chapter, several natural compounds implicated in reversing liver cirrhosis development via numerous molecular
pathways have been briey described. In-depth descriptions of various phytochemicals acting onmultiple cell
lines, and well-established animal models of cirrhosisare
discussed in detail. Therefore, with adequate scientic
evidence, this chapter conveys the role of herbal medicines in altering the progression of liver cirrhosis.
Keywords
Liver cirrhosis · Herbal compounds · Chronic liver
diseases · Lipid metabolism · Molecular targets
Abbreviations
ACC Acetyl-CoA carboxylase
ALT Alanine aminotransferase
AST Aspartate aminotransferase
CCl4 Carbon tetrachloride
ChREBP Carbohydrate-responsive element-binding
protein
HDL-C High-density lipoprotein cholesterol
IL-1β Interleukin-1β
IL-6 Interleukin 6
LDL-C Low-density lipoprotein cholesterol
MDA Malondialdehyde
mRNA Messenger ribonucleic acid
NLRP3 NLR family pyrin domain containing 3
Nrf2 Factor-erythroid 2 related factor 2
p53 Tumour protein P53
PPAR-α Peroxisome proliferator-activated receptor α
PPAR-γ Peroxisome proliferator-activated receptor γ
PPAR-δ Peroxisome proliferator-activated receptor δ
SOD Superoxide dismutase
SREBP-1c Sterol regulatory element-binding protein-1c
TC Total cholesterol
T. Banerjee · S. Sar · S. Saha · A. Baidya · A. Sarkar · S. Karmakar
· N. Ghosh (*)
Department of Pharmaceutical Technology, Jadavpur University,
Kolkata, West Bengal, India
e-mail: nilanjanghosh.phamacy@jadavpuruniversity.in
A. K. Halder
Dr. B.C.Roy College of Pharmacy & Allied Health Sciences,
Durgapur, India
© The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023
A. K. Dhara, S. C. Mandal (eds.), Role of Herbal Medicines, https://doi.org/10.1007/978-981-99-7703-1_10
1 Introduction
Liver cirrhosis is a major cause of mortality and a serious
public health concern globally. In 2016, liver cirrhosis was
responsible for 2.2% of fatalities and 1.5% of patient disabil-
185
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T. Banerjee et al.
Fig. 1 Progression of liver cirrhosis from NAFLD and NASH to hepatocellular carcinoma
ity globally, making it the eleventh major death-related factor [1]. The majority of severe liver illnesses are characterized
by extracellular matrix protein buildup, particularly collagen, resulting in hepatic brosis. Liver cirrhosis is the outcome of progressive liver brosis [2]. The brosis and
regenerative nodule development can describe liver cirrhosis
because chronic damage disrupts the hepatic lobular structure. Viral infections, poisons, genetic disorders, and autoim-
drugs used to manage liver illnesses are now derived from
natural sources. Furthermore, some data states that the bioactive chemicals found in botanicals can operate as hepatoprotective agents [8]. Hence, this chapter aims to conduct an
in-depth evaluation of the bioactive chemicals from plant
species that inhibit liver cirrhosis and associated liver ailments by regulating multiple gene and protein expressions
by several molecular signalling pathways.
mune processes are all examples of assaults that may harm
healthy hepatocytes. In prolonged damage conditions, most
hepatocyte brosis results in liver impairment [3]. Non-
2 Pathophysiology
alcoholic fatty liver disease (NAFLD) can be described by an
accumulation of lipids in the liver that cannot be attributed to
alcohol intake in individuals [4]. Non-alcoholic steatohepatitis (NASH) is characterized by a higher degree of brosis
advancement from NAFLD [5]. NASH includes a spectrum
of clinical conditions that may progress from steatosis to cirrhosis and ultimately cause liver cancer (Fig.1) [6].
Synthetic medications traditionally used to cure liver disorders have proven fatal in several instances. Herbal medicines play a crucial role in a wide variety of hepatic disorders
for having less or negligible side effects and long-term therapeutic effects, which makes them signicantly popular [7].
About 65% of sufferers in Europe and the USA rely on
herbal medicaments for the treatment of liver ailments. The
prompting move towards natural compounds or their derivatives could be benecial in retarding liver cirrhosis. Most
The complicated processes that may be responsible for the
development of NAFLD in patients with type 2 diabetic mellitus (T2DM) have mostly been the focus of research [9]. It
has been established that fatty liver disease, obesity, and insulin resistance (IR) play a signicant role as co-factors in
developing liver damage [10]. Absorption of free fatty acids
(FFAs) and de novo lipogenesis (DNL) in the liver are the two
primary contributors to NAFLD, which is the outcome of an
intracellular buildup of triglyceride (TG). The hepatic damage comprises cellular destruction and inammation. These
illnesses result from a rise in mitochondrial oxidative stress
on TG, forming free radicals and peroxisomes as a downstream consequence [11]. DNL regulates the balance between
lipid synthesis and its breakdown, and the imbalance between
these two is what causes hepatic lipid accumulation. DNL is
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