The wild Egyptian artichoke as a promising functional food for the treatment of hepatitis C virus as revealed via UPLC-MS and clinical trials

Abstract

Infection by hepatitis C virus (HCV) and its subsequent complications are a major cause of mortality worldwide. The water extract of the wild Egyptian artichoke (WEA) (Cynara cardunculus L. var. sylvestris (Lam.) Fiori) leaves is a freely available herbal product that is used for treatment of HCV-infection complications such as jaundice and ascites. The purpose of this study was to evaluate whether WEA exhibits activity against HCV, identify bioactive chemicals in its extract and to tentatively examine the potential inhibitory interactions of WEA with human drug-metabolizing enzymes. The current pilot clinical trial revealed that the water extract of a WEA plant decreased the HCV viral load below the detection level in 12 out of 15 patients. Furthermore, the liver enzymes ALT and AST, as well as the level of bilirubin were normalized. The total WEA extract inhibited CYP2B6 (OH-BUP) and CYP2C19 (5-OH-OME) with high affinity, IC50 ∼ 20 μg ml(-1), while moderate inhibitory interactions were observed for CYP1A2, CYP2D6, CYP2E1 and CYP3A4. Results presented herein suggest that the WEA exhibits strong antiviral activity against HCV and may be useful for its treatment. Compared to the artichoke product "Hepar SL Forte(®)", WEA was found to be more enriched in sesquiterpenes versus the abundance of phenolic compounds, especially flavonoids in Hepar SL Forte(®) as revealed via UPLC-MS analysis coupled to chemometrics.

Randomized Clinical Trial: Bergamot Citrus and Wild Cardoon Reduce Liver Steatosis and Body Weight in Non-diabetic Individuals Aged Over 50 Years

“…None of these studies, testing a high concentration of BPF, reported any type of adverse events. In a study carried out in individuals infected by hepatitis C virus, CyC extract normalized ALT and AST, as well as the level of bilirubin (49). Furthermore, only a moderately interaction with human drug-metabolizing enzymes, such as CYP1A2, CYP2D6, CYP2E1, and CYP3A4, was observed (50).…”

Cynaropicrin: A Comprehensive Research Review and Therapeutic Potential As an Anti-Hepatitis C Virus Agent

“…The wild Egyptian artichoke exhibited promising activity against HCV (Elsebai et al, 2016a) which were related to its sesquiterpene lactones especially cynaropicrin (Elsebai et al, 2016b). Cynaropicrin demonstrated outstanding activity against HCV since, for the first time, the performed in vitro studies showed that cynaropicrin has potent and broad spectrum activity as a cell-entry inhibitor against all genotypes of HCV with EC 50 in the low micromolar range (Elsebai et al, 2016b).…”

Herbal Medicines for Hepatitis C Virus Infection: The Exploratory Journey from Bench to Bedside Still Has a Long Way to Go

“…Examples of herbal medicines targeting for inhibition of HCV entry include methanolic extracts of Bupleurum kaoi root, 36 Morinda citrifolia and Rhizoma coptidis, 37,38 ethanol extracts of fruits of Schisandra sphenanthera Rehd. et Wils, 39 water extracts of wild Egyptian artichoke, 52 and other extracts of Dipsacus asperoides, 40 Magnolia officinalis (Hou-Pu), 30 and compounds of epigallocatechin-3-gallate, delphinidin, 41 flavone and flavanbased compounds (amentoflavone, 7,40-dihydroxyflavanone, and orobol). 42 Others NS protein inhibition and HCV entry inhibition are the two main anti-HCV modes of herbal medicines.…”