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World J Gastroenterol. Mar 21, 2017; 23(11): 1964-1973
Published online Mar 21, 2017. doi: 10.3748/wjg.v23.i11.1964
Traditional Chinese herbal extracts inducing autophagy as a novel approach in therapy of nonalcoholic fatty liver disease
Cong Liu, Jia-Zhi Liao, Pei-Yuan Li
Cong Liu, Jia-Zhi Liao, Pei-Yuan Li, Division of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Author contributions: Liu C wrote the manuscript; Liao JZ and Li PY reviewed the manuscript.
Supported by National Natural Science Foundation of China, No. 81372663 and No. 81672392.
Conflict-of-interest statement: The authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Pei-Yuan Li, Associate Professor, Division of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan 430030, Hubei Province, China. pyli@tjh.tjmu.edu.cn
Telephone: +86-27-83663661 Fax: +86-27-83663661
Received: November 14, 2016
Peer-review started: November 17, 2016
First decision: December 2, 2016
Revised: December 23, 2016
Accepted: January 18, 2017
Article in press: January 18, 2017
Published online: March 21, 2017
Processing time: 124 Days and 22.2 Hours
Abstract

Non-alcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver diseases around the world due to the modern sedentary and food-abundant lifestyle, which is characterized by excessive fat accumulation in the liver related with causes other than alcohol abuse. It is widely acknowledged that insulin resistance, dysfunctional lipid metabolism, endoplasmic reticulum stress, oxidative stress, inflammation, and apoptosis/necrosis may all contribute to NAFLD. Autophagy is a protective self-digestion of intracellular organelles, including lipid droplets (lipophagy), in response to stress to maintain homeostasis. Lipophagy is another pathway for lipid degradation besides lipolysis. It is reported that impaired autophagy also contributes to NAFLD. Some studies have suggested that the histological characteristics of NAFLD (steatosis, lobular inflammation, and peri-sinusoid fibrosis) might be improved by treatment with traditional Chinese herbal extracts, while autophagy may be induced. This review will provide insights into the characteristics of autophagy in NAFLD and the related role/mechanisms of autophagy induced by traditional Chinese herbal extracts such as resveratrol, Lycium barbarum polysaccharides, dioscin, bergamot polyphenol fraction, capsaicin, and garlic-derived S-allylmercaptocysteine, which may inhibit the progression of NAFLD. Regulation of autophagy/lipophagy with traditional Chinese herbal extracts may be a novel approach for treating NAFLD, and the molecular mechanisms should be elucidated further in the near future.

Keywords: Traditional Chinese herbal extracts; Non-alcoholic fatty liver disease; Autophagy

Core tip: Due to the modern sedentary and food-abundant lifestyle, the incidence of non-alcoholic fatty liver disease (NAFLD) has doubled during the past years, and its prevalence ranges from 20% in China and 27% in Hong Kong to 30% in Western countries. Although NAFLD is a major cause of chronic liver diseases, a satisfactory treatment targeting one or several pathological mechanisms of NAFLD has yet to be identified. Recent studies have suggested that Chinese herbal extracts (resveratrol, Lycium barbarum polysaccharides, dioscin, bergamot polyphenol fraction, capsaicin, garlic-derived S-allylmercaptocysteine) may inhibit NAFLD progression by inducing autophagy, the role and mechanisms of which are summarized in this review.