Progress on traditional Chinese medicine in improving hepatic fibrosis through inhibiting oxidative stress

Abstract

Patients with liver cirrhosis are advised to limit their sodium consumption to control excessive fluid accumulation. Salt is the most common form in which sodium is consumed daily. Consequently, various recommendations urge patients to limit salt intake. However, there is a lack of consistency regarding salt restriction across the guidelines. Moreover, there is conflicting evidence regarding the efficacy of salt restriction in the treatment of ascites. Numerous studies have shown that there is no difference in ascites control between patients with restriction of salt intake and those without restriction. Moreover, patients with cirrhosis may have several negative effects from consuming too little salt, although there are no recommendations on the lower limit of salt intake. Sodium is necessary to maintain the extracellular fluid volume; hence, excessive salt restriction can result in volume contraction, which could negatively impact kidney function in a cirrhotic patient. Salt restriction in cirrhotic patients can also compromise nutrient intake, which can have a negative impact on the overall outcome. There is insufficient evidence to recommend restricted salt intake for all patients with cirrhosis, including those with severe hyponatremia. The existing guidelines on salt restriction do not consider the salt sensitivity of patients; their nutritional state, volume status and sodium storage sites; and the risk of hypochloremia. This opinion article aims to critically analyze the existing literature with regard to salt recommendations for patients with liver cirrhosis and identify potential knowledge gaps that call for further research.

Correspondence on Editorial regarding “Liver Sinusoidal Endothelial Cell: An Important Yet Often Overlooked Player in the Liver Fibrosis”

“…Blood-tonifying and blood-activating herbs that belongs to traditional Chinese medicine have shown therapeutic effects on angiogenesis-related conditions such as cardiovascular diseases and ischemiareperfusion injury in clinical practice [9,10]. Li et al extensively detailed Chinese herbs renowned for their ability to inhibit pathological angiogenesis, aiming to alleviate liver fibrosis [11]. In our review, we also reported that Fuzhenghuayu and Xuefuzhuyu significantly inhibited the dedifferentiation of LSECs, suggesting further investigation into Chinese herbs and related components regulating LSECs and their regulatory mechanisms.…”