Effect of Hydroalcoholic Root Extract of Aerva lanata on Acetaminophen Induced Hepatotoxicity in Wistar Rats

Abstract

Introduction: Acute acetaminophen poisoning leads to fulminant hepatic failure and renal tubular damage. N-Acetyl Cysteine (NAC), an antidote for acetaminophen poisoning, carries its own adverse effect profile such as anaphylactoid reactions, cerebral oedema and hyponatremia at high doses. Aerva lanata, an erect or prostate herbaceous weed has a wide range of medicinal uses like, hepatoprotection, nephroprotection, antiasthamatic and antiamoebic. Previous study on rats have shown that hydroalcoholic root extract of Aerva lanata has significant hepatoprotective property when administered before acetaminophen. Aim: To evaluate the effect of hydroalcoholic root extract of Aerva lanata and NAC, as monotherapy and in combination, for acetaminophen induced hepatotoxicity in albino Wistar rats. Materials and Methods: This was an experimental animal study. Thirty adult male albino Wistar rats were equally divided into five groups: group I-vehicle, group II-acetaminophen only, group III- acetaminophen+NAC, group IV-acetaminophen+Aerva lanata root extract, group V-Acetaminophen+NAC+Aerva lanata root extract. Hepatotoxicity was induced in rats belonging to groups II, III, IV and V using acetaminophen (2 g/kg p.o). All rats were sacrificed after 72 hours of drug administration, blood samples were sent for biochemical analysis. Liver and kidney samples were sent for histopathological studies. Results were analysed using one-way ANOVA followed by post hoc Dunnett t-test. Results: Root extract of Aerva lanata significantly reduces the liver enzyme markers Aspartate Transaminase (AST), Alanine Transaminase (ALT), Gamma Glutamyl Transferase (GGT) and bilirubin) and blood urea concentration. The combination therapy (root extract with NAC) showed a highly significant decrease in AST, ALT, GGT (p<0.001), bilirubin (p<0.01) and blood urea (p<0.001) when compared with the paracetamol group. A significant reversal of liver injury was seen in histopathological studies. Conclusion: The combination therapy showed better improvement of liver enzyme and renal parameters, along with significant improvement in histopathological changes. Hence, combination of hydroalcoholic root extract of Aerva lanata along with NAC can be effective in treating acetaminophen poisoning.