Non-alcoholic steatohepatitis: an overview including treatments with herbals as alternative therapeutics

Non-alcoholic steatohepatitis (NASH), an under- recognized hepatic ailment with increasing prevalence, isfast emerging as the dark horse of hepatic related morbidity and mortality. Though introduced as a hepaticcondition as early as 1980, detailed exploration of its causes, underlying mechanisms and therapeutics haslargely remained an ignored or neglected field. Only recently, the focus of attention has gravitated towardsan understanding of NASH as a pathological manifestation of significance and a search for possibletherapeutic interventions. Treatment schedules as of now involve life style management and usage ofanti-diabetic or anti-obesity drugs and antioxidants. In the present review, we have focused on the availabletreatment schedules including herbal agents, plant extracts, polyherbal formulations and isolatedphytocompounds. We present here a review of the available literature on pre-clinical and clinical evaluationsof herbals including our recent findings on two plant extracts which can be used in mitigating NASH. Thisreview attempts to provide a comprehensive account of NASH and the future of therapeutics and remediationby herbal principles, an aspect of the urgent need to target this important medical condition that contributesto many cases of silent morbidity and mortality.