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Current Bioactive Compounds

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ISSN (Print): 1573-4072
ISSN (Online): 1875-6646

Research Article

Isolation, Characterization and Hepatoprotective Activity of Naturally Occurring Protopine against Simvastatin Induced Liver Toxicity in Experimental Rodents

Author(s): Ramesh K. Gupta*, Sudhansu R. Swain, Jagannath Sahoo, Sachin Chaudhary and Amresh Gupta

Volume 16, Issue 5, 2020

Page: [568 - 575] Pages: 8

DOI: 10.2174/1573407215666190211151306

Price: $65

Abstract

Background: The present research reported isolation, characterization of protopine from Hedyotis corymbosa and investigation of in-vivo hepatoprotective activity of protopine against simvastatin induced hepatotoxicity in experimental rodents.

Methods: Protopine was isolated from H. coryambosa by column chromatography using chloroform: methanol: diethylamine (9:1:1) as the mobile phase and structural characterization was done by UV, FTIR, 1H-NMR and 13C-NMR and mass spectroscopy, followed by determination of in-vivo liver protective effect of protopine against simvastatin (20 mg/kg, p.o.), induced hepatotoxicity in experimental rodents. The liver protective activity was assessed by interpreting distinct biochemical parameters like SGOT, SGPT, cholesterol, urea, total bilirubin, total protein and albumin along with the haematological and histopathological studies.

Results: The reports of spectroscopic techniques confirmed that the isolated compound is protopine, an isoquinoline alkaloid. The treatment with protopine significantly at (P<0.05-P<0.001) and dosedependently reversed simvastatin induced elevated level of SGOT, SGPT, cholesterol, urea, total bilirubin and restored the total protein and albumin level in rodents. Furthermore, protopine also signifies the blood parameters at a dose of 11 and 22 mg/kg and restored the defence mechanism of the body. The histological examination revealed that protopine at a dose of 22 mg/kg showed the regeneration of hepatocytes around central vein with near normal liver architecture.

Conclusion: The results of the current study confirm the liver protective effect of protopine against simvastatin induced hepatotoxicity and therefore, scientifically support its traditional use.

Keywords: Protopine, Hedyotis corymbosa, serum glutamic oxaloacetic transaminase, cholesterol, simvastatin, liver, cholesterol.

Graphical Abstract

[1]
Chen, S.L.; Yu, H.; Luo, H.M.; Wu, Q.; Li, C.F.; Steinmetz, A. Conservation and sustainable use of medicinal plants: problems, progress, and prospects. Chin. Med., 2016, 11(37), 37.
[http://dx.doi.org/10.1186/s13020-016-0108-7] [PMID: 27478496]
[2]
Hamilton, A.C. Medicinal plants, conservation and livelihoods. Biodivers. Conserv., 2004, 13, 1477-1517.
[http://dx.doi.org/10.1023/B:BIOC.0000021333.23413.42]
[3]
Balunas, M.J.; Kinghorn, A.D. Drug discovery from medicinal plants. Life Sci., 2005, 78(5), 431-441.
[http://dx.doi.org/10.1016/j.lfs.2005.09.012] [PMID: 16198377]
[4]
Cole, I.B.; Saxena, P.K.; Murch, S.J. Medicinal biotechnology in the genus scutellaria. In Vitr. Cell. Dev. Biol. Plant., 2007, 43(4), 318-327.
[http://dx.doi.org/10.1007/s11627-007-9055-4]
[5]
Pareek, A.; Godavarthi, A.; Issarani, R.; Nagori, B.P. Antioxidant and hepatoprotective activity of Fagonia schweinfurthii (Hadidi) Hadidi extract in carbon tetrachloride induced hepatotoxicity in HepG2 cell line and rats. J. Ethnopharmacol., 2013, 150(3), 973-981.
[http://dx.doi.org/10.1016/j.jep.2013.09.048] [PMID: 24140589]
[6]
Chaudhry, S.; Pal, A. Indian medicinal plants used in liver disease: A short review. Pharmacogn. J., 2011, 3(19), 91-94.
[http://dx.doi.org/10.5530/pj.2011.19.17]
[7]
Shailajan, S.; Joshi, M.; Tiwari, B. Hepatoprotective activity of Parmelia perlata (Huds.) Ach. against CCl4 induced liver toxicity in albino wistar rats. J. Appl. Pharm. Sci., 2014, 4(2), 70-74.
[8]
Chaudhary, S.; Gupta, R.K.; Kumar, A.; Tarazi, H. Hepatoprotective and antioxidant potential of Nyctanthes arbor-tristis L. leaves against antitubercular drugs induced hepatotoxicity. J. Pharm. Pharmacogn. Res., 2018, 6(3), 205-215.
[9]
Li, W.L.; Zheng, H.C.; Bukuru, J.; De Kimpe, N. Natural medicines used in the traditional Chinese medical system for therapy of diabetes mellitus. J. Ethnopharmacol., 2004, 92(1), 1-21.
[http://dx.doi.org/10.1016/j.jep.2003.12.031] [PMID: 15099842]
[10]
Rivera-Espinoza, Y.; Muriel, P. Pharmacological actions of curcumin in liver diseases or damage. Liver Int., 2009, 29(10), 1457-1466.
[http://dx.doi.org/10.1111/j.1478-3231.2009.02086.x] [PMID: 19811613]
[11]
Wan, X.Y.; Luo, M.; Li, X.D.; He, P. Hepatoprotective and anti-hepatocarcinogenic effects of glycyrrhizin and matrine. Chem. Biol. Interact., 2009, 181(1), 15-19.
[http://dx.doi.org/10.1016/j.cbi.2009.04.013] [PMID: 19426721]
[12]
Sabir, S.M.; Rocha, J.B. Antioxidant and hepatoprotective activity of aqueous extract of Solanum fastigiatum (false “Jurubeba”) against paracetamol-induced liver damage in mice. J. Ethnopharmacol., 2008, 120(2), 226-232.
[http://dx.doi.org/10.1016/j.jep.2008.08.017] [PMID: 18790038]
[13]
Karthikeyan, R.; Somasundaram, S.T.; Manivasagam, T.; Balasubramanian, T.; Anantharaman, P. Hepatoprotective activity of brown alga Padina boergesenii against CCl4 induced oxidative damage in wistar rats. Asian Pac. J. Trop. Med., 2010, 3(9), 696-701.
[http://dx.doi.org/10.1016/S1995-7645(10)60168-X]
[14]
Sunitha, S.; Nagaraj, M.; Varalakshmi, P. Hepatoprotective effect of lupeol and lupeol linoleate on tissue antioxidant defence system in cadmium-induced hepatotoxicity in rats. Fitoterapia, 2001, 72(5), 516-523.
[http://dx.doi.org/10.1016/S0367-326X(01)00259-3] [PMID: 11429246]
[15]
Adebajo, A.C.; Iwalewa, E.O.; Obuotor, E.M.; Ibikunle, G.F.; Omisore, N.O.; Adewunmi, C.O.; Obaparusi, O.O.; Klaes, M.; Adetogun, G.E.; Schmidt, T.J.; Verspohl, E.J. Pharmacological properties of the extract and some isolated compounds of Clausena lansium stem bark: anti-trichomonal, antidiabetic, anti-inflammatory, hepatoprotective and antioxidant effects. J. Ethnopharmacol., 2009, 122(1), 10-19.
[http://dx.doi.org/10.1016/j.jep.2008.11.015] [PMID: 19095054]
[16]
Rao, G.M.; Rao, C.V.; Pushpangadan, P.; Shirwaikar, A. Hepatoprotective effects of rubiadin, a major constituent of Rubia cordifolia Linn. J. Ethnopharmacol., 2006, 103(3), 484-490.
[http://dx.doi.org/10.1016/j.jep.2005.08.073] [PMID: 16213120]
[17]
Noiarsa, P.; Ruchirawat, S.; Otsuka, H.; Kanchanapoom, T. Chemical constituents from Oldenlandia corymbosa L. of Thai origin. J. Nat. Med., 2008, 62(2), 249-250.
[http://dx.doi.org/10.1007/s11418-007-0212-1] [PMID: 18404335]
[18]
Sadasivan, S.; Latha, P.G.; Sasikumar, J.M.; Rajashekaran, S.; Shyamal, S.; Shine, V.J. Hepatoprotective studies on Hedyotis corymbosa (L.) Lam. J. Ethnopharmacol., 2006, 106(2), 245-249.
[http://dx.doi.org/10.1016/j.jep.2006.01.002] [PMID: 16495024]
[19]
Rathi, M.A.; Pearl, D.L.B.; Sasikumar, J.M.; Gopalkrishnan, V.K. Hepatoprotective activity of ethanolic extract of Hedyotis corymbosa on perchloroethylene induced rats. Pharmacologyonline, 2009, 3, 230-239.
[20]
Patel, T.; Jain, V.; Dodia, R. Oldenlandia corymbosa L.: A phytopharmacological review. Int. J. Phytopharm., 2014, 4(3), 79-82.
[21]
Saeed, S.A.; Gilani, A.H.; Majoo, R.U.; Shah, B.H. Anti-thrombotic and anti-inflammatory activities of protopine. Pharmacol. Res., 1997, 36(1), 1-7.
[http://dx.doi.org/10.1006/phrs.1997.0195] [PMID: 9368908]
[22]
Janbaz, K.H.; Saeed, S.A.; Gilani, A.H. An assessment of the potential of protopine to inhibit microsomal drug metabolising enzymes and prevent chemical-induced hepatotoxicity in rodents. Pharmacol. Res., 1998, 38(3), 215-219.
[http://dx.doi.org/10.1006/phrs.1998.0353] [PMID: 9782072]
[23]
Ustünes, L.; Laekeman, G.M.; Gözler, B.; Vlietinck, A.J.; Ozer, A.; Herman, A.G. In vitro study of the anticholinergic and antihistaminic activities of protopine and some derivatives. J. Nat. Prod., 1988, 51(5), 1021-1022.
[http://dx.doi.org/10.1021/np50059a043] [PMID: 2904975]
[24]
Kim, S.R.; Hwang, S.Y.; Jang, Y.P.; Park, M.J.; Markelonis, G.J.; Oh, T.H.; Kim, Y.C. Protopine from Corydalis ternata has anticholinesterase and antiamnesic activities. Planta Med., 1999, 65(3), 218-221.
[http://dx.doi.org/10.1055/s-1999-13983] [PMID: 10232064]
[25]
Rathi, A.; Srivastava, A.K.; Shirwaikar, A.; Singh Rawat, A.K.; Mehrotra, S. Hepatoprotective potential of Fumaria indica Pugsley whole plant extracts, fractions and an isolated alkaloid protopine. Phytomedicine, 2008, 15(6-7), 470-477.
[http://dx.doi.org/10.1016/j.phymed.2007.11.010] [PMID: 18164606]
[26]
Posokhov, Y.; Erten, S.; Koz, O.; Anil, H.; Kirmizigul, S.; Icli, S. UV/VIS spectral properties of novel natural products from Turkish lichens. Int. J. Photoenergy, 2005, 7(1), 27-35.
[http://dx.doi.org/10.1155/S1110662X0500005X]
[27]
Boeriu, C.G.; Bravo, D.; Gosselink, R.J.A.; Van Dam, J. E.G. Characterisation of structure-dependent functional properties of lignin with infrared spectroscopy. Ind. Crops Prod., 2004, 20(2), 205-218.
[http://dx.doi.org/10.1016/j.indcrop.2004.04.022]
[28]
Holzgrabe, U.; Diehl, B.W.; Wawer, I. NMR spectroscopy in pharmacy. J. Pharm. Biomed. Anal., 1998, 17(4-5), 557-616.
[http://dx.doi.org/10.1016/S0731-7085(97)00276-8] [PMID: 9682143]
[29]
Barkan, E.; Luz, B. High-precision measurements of 17O/16O and 18O/16O of O2 and O2/Ar ratio in air. Rapid Commun. Mass Spectrom., 2003, 17(24), 2809-2814.
[http://dx.doi.org/10.1002/rcm.1267] [PMID: 14673831]
[30]
Jain, M.P.; Koul, S.K.; Dhar, K.L.; Atal, C.K. Novel nor-harmal alkaloid from Adhatoda vasica. Phytochemistry, 1980, 19(8), 1880-1882.
[http://dx.doi.org/10.1016/S0031-9422(00)83845-5]
[31]
Gupta, R.K.; Swain, S.R.; Sahoo, J.; Gupta, A.; Chaudhary, S. Hepatoprotective potential of Trichosanthes dioica Roxb in hepatotoxicity induced by simvastatin and its consequences on biochemical and haematological indices. Pharmacogn. J., 2018, 10(4), 73-82.
[http://dx.doi.org/10.5530/pj.2018.4.120]
[32]
Shakeel, M.; Jabeen, F.; Qureshi, N.A.; Fakhr-E-Alam, M. Toxic effects of titanium dioxide nanoparticles and titanium dioxide bulk salts in the liver and blood of male Sprague-Dawley rats assessed by different assay. Biol. Trace Elem. Res., 2016, 173(2), 405-426.
[http://dx.doi.org/10.1007/s12011-016-0677-4] [PMID: 27008428]
[33]
Janckila, A.J.; Yam, L.T. Biology and clinical significance of tartrate-resistant acid phosphatases: new perspectives on an old enzyme. Calcif. Tissue Int., 2009, 85(6), 465-483.
[http://dx.doi.org/10.1007/s00223-009-9309-8] [PMID: 19915788]
[34]
Malloy, H.T.; Evelyn, K.A. The determination of bilirubin with the photoelectric colorimeter. J. Biol. Chem., 1937, 119, 481-490.
[35]
Lowry, O.H.; Rosebrough, N.J.; Farr, A.L.; Randall, R.J. Protein measurement with the Folin phenol reagent. J. Biol. Chem., 1951, 193(1), 265-275.
[PMID: 14907713]
[36]
Verma, N.; Singh, A.P.; Amresh, G.; Sahu, P.K.; Rao, ChV. Protective effect of ethyl acetate fraction of Rhododendron arboreum flowers against carbon tetrachloride-induced hepatotoxicity in experimental models. Indian J. Pharmacol., 2011, 43(3), 291-295.
[http://dx.doi.org/10.4103/0253-7613.81518] [PMID: 21713093]
[37]
Sharma, A.; Chakraborti, K.K.; Handa, S.S. Anti-hepatotoxic activity of some Indian herbal formulations as compared to silymarin. Fitoterapia, 1991, 62, 229-235.
[38]
Shrestha, R.L.; Jha, R.N. An isoquinoline alkaloid, protopine from Corydalis govaniana growing in Himalayan region of Nepal. J. Nepal Chem. Soc., 2011, 28, 106-109.
[http://dx.doi.org/10.3126/jncs.v28i0.8116]
[39]
Shim, H.J.; Lee, J.Y.; Kim, B.; Hong, J. General fragmentations of alkaloids in electrospray ionization tandem mass spectrometry. Mass Spectrom. Lett., 2013, 4(4), 79-82.
[http://dx.doi.org/10.5478/MSL.2013.4.4.79]
[40]
Lin, C.C.; Hsu, Y.F.; Lin, T.C.; Hsu, F.L.; Hsu, H.Y. Antioxidant and hepatoprotective activity of punicalagin and punicalin on carbon tetrachloride-induced liver damage in rats. J. Pharm. Pharmacol., 1998, 50(7), 789-794.
[http://dx.doi.org/10.1111/j.2042-7158.1998.tb07141.x] [PMID: 9720629]
[41]
Arem, A.E.; Ghrairi, F.; Lahouar, L.; Thouri, A.; Saafi, E.B.; Ayed, A.; Zekri, M.; Ferjani, H.; Haouas, Z.; Zakhama, A.; Achour, L. Hepatoprotective activity of date fruit extracts against dichloroacetic acid-induced liver damage in rats. J. Funct. Foods, 2014, 9, 119-130.
[http://dx.doi.org/10.1016/j.jff.2014.04.018]
[42]
Glauert, H.P.; Calfee-Mason, K.; Stemm, D.N.; Tharappel, J.C.; Spear, B.T. Dietary antioxidants in the prevention of hepatocarcinogenesis: a review. Mol. Nutr. Food Res., 2010, 54(7), 875-896.
[http://dx.doi.org/10.1002/mnfr.200900482] [PMID: 20512789]
[43]
Skała, E.; Sitarek, P.; Różalski, M.; Krajewska, U.; Szemraj, J.; Wysokińska, H.; Śliwiński, T. Antioxidant and DNA repair stimulating effect of extracts from transformed and normal roots of Rhaponticum carthamoides against induced oxidative stress and DNA damage in CHO cells. Oxid. Med. Cell. Longev., 2016, 20165753139
[http://dx.doi.org/10.1155/2016/5753139] [PMID: 27034736]
[44]
Govind, P. Medicinal plants against liver diseases. Int. Res. J. Pharm., 2011, 2(5), 115-121.
[45]
Niara, S.M.; Daniela, C.A.; Juliana, D.L.; Mariane, W.; Fernanda, M.; Marielle, M.; Fabiana, A.; Claudia, F.; Sabrina, B.; Caroline, D. In-vitro antioxidant activity of Passion fruit (Passiflora alata) extract by different kinds of treatment on rats liver. Curr. Bioact. Compd., 2018, 14(1), 21-25.
[http://dx.doi.org/10.2174/1573407213666161118120014]
[46]
Rehman, S.; Khan, H. Advances in antioxidant potential of natural alkaloids. Curr. Bioact. Compd., 2017, 13(2), 101-108.
[http://dx.doi.org/10.2174/1573407212666160614075157]
[47]
Agbafor, K.N.; Nwachukwu, N. Phytochemical analysis and antioxidant property of leaf extracts of Vitex doniana and Mucuna pruriens. Biochem. Res. Int., 2011, 2011459839
[http://dx.doi.org/10.1155/2011/459839] [PMID: 21547085]
[48]
Medeiros, N.S.; Almeida, D.C.; Lima, J.D.; Wohlemberg, M.; Machado, F.; Massolini, M.; Agostini, F.; Funchal, C.; Bortolazzi, S.; Dani, C. In vitro antioxidant activity of Passion fruit (Passiflora alata) extract by different kinds of treatment on rat liver. Curr. Bioact. Compd., 2018, 14(1), 21-25.
[http://dx.doi.org/10.2174/1573407213666161118120014]
[49]
Ekeuku, S.O.; Okechukwu, P.N.; Akowoah, G.A.; Sen, T.S.; Siyumbwa, S.N.; Froemming, G.R.A. Plasma glucose lowering activity of palmatine and its effect on liver, kidney and antioxidant enzymes parameters in STZ induced diabetic rat model. Curr. Bioact. Compd., 2015, 11(4), 256-263.
[http://dx.doi.org/10.2174/1573407212666151105185802]
[50]
Duthie, G.G.; Duthie, S.J.; Kyle, J.A. Plant polyphenols in cancer and heart disease: implications as nutritional antioxidants. Nutr. Res. Rev., 2000, 13(1), 79-106.
[http://dx.doi.org/10.1079/095442200108729016] [PMID: 19087434]
[51]
Gnanadesigan, M.; Ravikumar, S.; Anand, M. Hepatoprotective activity of Ceriops decandra (Griff.) Ding Hou mangrove plant against CCl4 induced liver damage. J. Taibah Univ. Sci., 2017, 11(3), 450-457.
[http://dx.doi.org/10.1016/j.jtusci.2016.07.004]
[52]
Gupta, R.K.; Kesari, A.N.; Watal, G.; Murthy, P.S.; Chandra, R.; Tandon, V. Nutritional and hypoglycemic effect of fruit pulp of Annona squamosa in normal healthy and alloxan-induced diabetic rabbits. Ann. Nutr. Metab., 2005, 49(6), 407-413.
[http://dx.doi.org/10.1159/000088987] [PMID: 16230844]
[53]
Shamsi-Baghbanan, H.; Sharifian, A.; Esmaeili, S.; Minaei, B. Hepatoprotective herbs, avicenna viewpoint. Iran. Red Crescent Med. J., 2014, 16(1)e12313
[http://dx.doi.org/10.5812/ircmj.12313] [PMID: 24719702]
[54]
Leo, M.A.; Arai, M.; Sato, M.; Lieber, C.S. Hepatotoxicity of vitamin A and ethanol in the rat. Gastroenterology, 1982, 82(2), 194-205.
[http://dx.doi.org/10.1016/0016-5085(82)90004-X] [PMID: 6274729]
[55]
Garcovich, M.; Zocco, M.A.; Gasbarrini, A. Clinical use of albumin in hepatology. Blood Transfus., 2009, 7(4), 268-277.
[PMID: 20011638]
[56]
Effiong, G.S.; Akpan, H.D. The effect of Nauclea latifolia leaf extract on some biochemical parameters in streptozotocin diabetic rat models. J. Med. Med. Sci., 2015, 6(3), 47-52.
[57]
Oyedeji, K.O.; Bolarinwa, A.F. Effect of crude extract of Portulaca oleracea on haematological and biochemical parameters in albino rats. Afr. J. Biomed. Res., 2012, 15(1), 41-47.
[58]
Jóźwik, M.; Jóźwik, M.; Jóźwik, M.; Szczypka, M.; Gajewska, J.; Laskowska-Klita, T. Antioxidant defence of red blood cells and plasma in stored human blood. Clin. Chim. Acta, 1997, 267(2), 129-142.
[http://dx.doi.org/10.1016/S0009-8981(97)00148-4] [PMID: 9469248]
[59]
Yahubu, O.E.; Olawale, O.; Arowora, K.A.; Imo, C. Biochemical changes in haematological and liver function parameters in intoxicated male albino rats treated with Hymenocardia acida leaves ethanolic extract. Insight. Biomed., 2017, 2(2), 1-5.
[60]
Lodish, H.; Flygare, J.; Chou, S. From stem cell to erythroblast: regulation of red cell production at multiple levels by multiple hormones. IUBMB Life, 2010, 62(7), 492-496.
[http://dx.doi.org/10.1002/iub.322] [PMID: 20306512]
[61]
Kucherenko, Y.V.; Bernhardt, I. Natural antioxidants improve red blood cell “survival” in non-leukoreduced blood samples. Cell. Physiol. Biochem., 2015, 35(5), 2055-2068.
[http://dx.doi.org/10.1159/000374012] [PMID: 25871329]
[62]
Irfan, M.A.; Ahmed, A.F.; Bakhtiary, S.A.; Ibrahim, M. Hepatoprotective activity of Leucas aspera Spreng against simvastatin induced hepatotoxicity in rats. Ann. Phytomed., 2012, 1(2), 88-92.
[63]
Yunita, F.; Hanani, E.; Kristianto, J. The effect of Carica papaya L. leaves extract capsules on platelets count and hematocrit level in dengue fever patient. Int. J. Med. Arom. Plants, 2012, 2(4), 573-578.
[64]
Eyong, E.U.; Umoh, I.B.; Eteng, M.U.; Antai, A.B.; Akpa, A.O. Haematoxic effects following ingestion of nigerian crude oil and crude oil polluted shellfish by rats. Niger. J. Physiol. Sci., 2008, 19(1-2), 1-6.
[PMID: 19434204]
[65]
Peters, J.M.; Boyd, E.M. Organ weights and water levels of the rat following reduced food intake. J. Nutr., 1966, 90(4), 354-360.
[http://dx.doi.org/10.1093/jn/90.4.354] [PMID: 5954817]
[66]
Racanelli, V.; Rehermann, B. The liver as an immunological organ. Hepatology, 2006, 43(2)(Suppl. 1), S54-S62.
[http://dx.doi.org/10.1002/hep.21060] [PMID: 16447271]
[67]
Sheth, K.; Bankey, P. The liver as an immune organ. Curr. Opin. Crit. Care, 2001, 7(2), 99-104.
[http://dx.doi.org/10.1097/00075198-200104000-00008] [PMID: 11373518]
[68]
Lawal, B.; Shittu, O.K.; Rotimi, A.A.; Olalekan, I.A.; Kamooru, A.A.; Ossai, P.C. Effect of methanol extract of Telfairia occcidentalis on haematological parameters in wister rats. J. Med. Sci., 2015, 15(5), 246-250.
[http://dx.doi.org/10.3923/jms.2015.246.250]
[69]
Jorum, O.H.; Piero, N.M.; Machocho, A.K. Haematological effects of dichloromethane-methanolic leaf extracts of Carissa edulis (Forssk.) vahl in normal rat models. J. Hematol. Thrombo. Dis., 2016, 4(1), 1-8.
[http://dx.doi.org/10.4172/2329-8790.1000232]
[70]
Lee, Y.S.; Lee, S.H.; Jeong, M.S.; Kim, J.B.; Jang, H.H.; Choe, J.S.; Kim, D.W.; Lillehoj, H.S. In vitro analysis of the immunomodulating effects of Allium hookeri on lymphocytes, macrophages, and tumour cells. J. Poult. Sci., 2017, 54, 142-148.
[http://dx.doi.org/10.2141/jpsa.0160108]
[71]
Amirghofran, Z.; Bahmani, M.; Azadmehr, A.; Javidnia, K.; Miri, R. Immunomodulatory activities of various medicinal plant extracts: effects on human lymphocytes apoptosis. Immunol. Invest., 2009, 38(2), 181-192.
[http://dx.doi.org/10.1080/08820130902817051] [PMID: 19330626]
[72]
Saukkonen, J.J.; Cohn, D.L.; Jasmer, R.M.; Schenker, S.; Jereb, J.A.; Nolan, C.M.; Peloquin, C.A.; Gordin, F.M.; Nunes, D.; Strader, D.B.; Bernardo, J.; Venkataramanan, R.; Sterling, T.R. ATS (American Thoracic Society) Hepatotoxicity of Antituberculosis Therapy Subcommittee An official ATS statement: hepatotoxicity of antituberculosis therapy. Am. J. Respir. Crit. Care Med., 2006, 174(8), 935-952.
[http://dx.doi.org/10.1164/rccm.200510-1666ST] [PMID: 17021358]
[73]
Ramappa, V.; Aithal, G.P. Hepatotoxicity related to anti-tuberculosis drugs: Mechanisms and management. J. Clin. Exp. Hepatol., 2013, 3(1), 37-49.
[http://dx.doi.org/10.1016/j.jceh.2012.12.001] [PMID: 25755470]
[74]
Jeong, I.; Park, J.S.; Cho, Y.J.; Yoon, H.I.; Song, J.; Lee, C.T.; Lee, J.H. Drug-induced hepatotoxicity of anti-tuberculosis drugs and their serum levels. J. Korean Med. Sci., 2015, 30(2), 167-172.
[http://dx.doi.org/10.3346/jkms.2015.30.2.167] [PMID: 25653488]

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