Published online Jul 27, 2020. doi: 10.4254/wjh.v12.i7.363
Peer-review started: February 13, 2020
First decision: April 29, 2020
Revised: May 12, 2020
Accepted: May 29, 2020
Article in press: May 29, 2020
Published online: July 27, 2020
Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver diseases worldwide. However, there is no Food and Drug Administration (FDA) approved medication for the treatment of NAFLD. Aloe vera has previously been shown to have anti-inflammatory and anti-oxidant properties, which might be beneficial in the treatment of NAFLD.
With the absence of FDA-approved treatment for NAFLD, we attempted to find a safe and effective treatment for NAFLD. Alternative medicines that are safe, effective and inexpensive are attractive options for the management of life-long diseases, such as non-alcoholic steatohepatitis (NASH).
The main objective of this study was to evaluate the effects of aloe vera on NASH development in an animal model.
Rats were divided into 3 groups: Control, NASH [rats received high-fat high-fructose diet (HFHFD) to induce NASH pathology], and NASH + aloe vera. We compared liver histopathology, oxidative stress marker [malondialdehyde (MDA)], anti-oxidant level [glutathione (GSH)], inflammatory marker (IL-18), degree and markers of hepatocyte apoptosis [terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL), caspase-3, cytochrome-C], and PPAR-γ expression among the three groups.
We found that by administering aloe vera along with HFHFD, we were able to significantly reduce the severity of NASH pathology in this animal model. In this study, aloe vera treatment increased the level of natural anti-oxidant (GSH), reduced oxidative stress (MDA) and inflammatory markers (IL-18), and decreased the degree of hepatocyte apoptosis (TUNEL). At the subcellular level, we also found that aloe vera increased the expression of PPAR-γ and reduced the expression of NF-kβ, caspase-3 and cytochrome-C.
This is the first study to evaluate the effects of aloe vera in rats with NASH. We found that aloe vera reduced the severity of NASH pathology in rats that received HFHFD. We hypothesized that aloe vera exerted its treatment effects by reducing oxidative stress and inflammation in the liver.
The rats in our model were lean, so our results might not be entirely applicable to obese NASH that is seen more commonly in humans. Further studies with an obese rat model are warranted to confirm the effects of aloe vera in those conditions. Moreover, we used aloe vera crude extract in this study. Additional studies will be needed to identify the active ingredients in aloe vera that have anti-NASH effects.