Hepatoprotective properties of Cordia africana leaf extract inhibiting isoniazid and rifampicin-related toxicity in mice

Introduction

Despite baseline investigation before the start of therapeutic management, patients being treated for pulmonary tuberculosis often suffer from liver injury due to the effects of anti-tuberculosis drugs, particularly isoniazid (INH) and rifampin (RIF). However, there is no treatment against the hepatotoxic effect of INH and RIF. Therefore, it is better to focus on medicinal plants for the prevention of liver injury caused by these drugs. Cordia africana has been used traditionally as a treatment for liver related diseases. This study aimed to evaluate the hepatoprotective effect of aqueous extract of Cordia africana leaves against isoniazid and rifampicin-induced liver toxicity in mice.

Methods

Cordia africana leaf powder was decocted in water and 30 Swiss albino mice 28.0–35.0 g were grouped into five groups: Group I mice were given 20 ml/kg distilled water and Group II mice were given 75mg/kg INH and 150 mg/kg RIF body weight. Group III, group IV, and group V mice were given, 75 mg/kg INH plus 150 mg/kg RIF in addition to 200 mg/kg extract, 400 mg/kg extract, and 50 mg/kg silymarin respectively. The treatments lasted for 14 days. Blood samples were taken from each study subject for liver biochemical tests. In addition, livers were also taken for histopathological examination.

Results

Compared to Group I, Group II showed a significant increase (P < 0.05) in serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and total bilirubin. This elevation likely dictates the possibility of liver dysfunction or damage. Also, in the groups of mice that were treated with Cordia africana at a dose of 400 mg/kg and silymarin demonstrated that a marked decrease in ALT, AST, ALP and total bilirubin levels. This reduction indicates that both Cordia africana and silymarin might have a protective effect on liver function, especially when compared to Group II which they didn't receive such treatment. The liver index of Group IV mice showed a decrease significantly (P < 0.05) compared to Group II. Besides histopathologic analysis showed that the plant extract at a higher dose did not show inflammation and showed negligible degeneration of hepatocytes and congestion in sinusoids, whereas in the negative control severe degeneration of hepatocytes and moderate inflammation were seen.

Conclusion

From this experiment we found that the aqueous extract of Cordia africana has hepatoprotective effect against isoniazid and rifampicin-induced hepatotoxicity in mice. This protective effect of Cordia africana extract might be due to its anti-inflammatory and antioxidant activity and could be considered a potential therapeutic option against INH and RIF induced liver injury.