Efficacy of a Peruvian Botanical Remedy (Sabell A4+) for Treating Liver Disease and Protecting Gastric Mucosal Integrity

Abstract

The purpose of this study was to determine the efficacy of a Peruvian botanical formulation for treating disorders of hepatic function and gastric mucosal integrity. The formulation A4+ (Sabell Corporation) contains extracts of Curcuma longa rhizome, Cordia lutea flower, and Annona muricata leaf. Individually these plants have been used as traditional remedies for liver disease. We report the efficacy of A4+ and its components using a variety of in vitro and in vivo disease models. The methods used included tests for antioxidant, anti-inflammatory, and antiviral activity as well as mouse models of liver disease, including Concanavalin A-induced immune-mediated hepatitis and a bile duct ligation model for evaluating sickness behaviour associated with liver disease. Rat models were used to evaluate the gastric mucosal protective property of A4+ following indomethacin challenge and to evaluate its anti-inflammatory action in an “air pouch” model. In all tests, A4+ proved to be more effective than placebo. A4+ was antioxidant and anti-inflammatory and diminished Hepatitis C virus replication in vitro. In animal models, A4+ was shown to protect the liver from immune-mediated hepatitis, improve behavioural function in animals with late stage liver disease, and protect the rat gastric mucosa from ulceration following NSAID exposure. We conclude that A4+ ameliorated many aspects of liver injury, inhibited hepatitis C virus replication, and protected the gastric mucosa from NSAIDs. These varied beneficial properties appear to result from positive interactions between the three constituent herbs.

A review on traditional uses and applications of Cordia spp. (Boraginaceae) as a natural polymer in the development of food and pharmaceutical products

“…employed for prostate cancer as a chemo-preventive (Rojas-Armas et al 2020), as a protector of the gastric mucosa (Swain et al 2019), and as a healing agent for oral wounds (Crisologo 2020). An important anti-allergic effect has been evidenced in floral extracts of Cordia lutea Lam.…”

“…together with soursop flowers (Annona muricata L.) and turmeric rhizome (Curcuma longa L.) (Arroyo-Acevedo et al 2016). In addition, the same extract mixture has been applied for the treatment of liver diseases and as a protector of gastric mucosa (Swain et al 2019). The effective results obtained with this mixture led to the publication of a patent for the prevention and treatment of hepatitis Table 1.…”

“…Additional information stipulates that the carbohydrate content of cocoa mucilage is estimated to be between 67% and 69% (Martínez et al 2012). At this point, it is important to identify whether the carbohydrates of the fruit mucilage of the genus Cordia L. are fermentable, since this will affect the yield of the final product (Swain et al 2019). Therefore, the possible use of mucilage from the fruits of species of the genus Cordia L. as a source of nutrients for the growth of useful microorganisms in industry could be evaluated.…”