Efficacy of a Peruvian Botanical Remedy (Sabell A4+) for Treating Liver Disease and Protecting Gastric Mucosal Integrity

Mark G Swain; John L Wallace; D Lorne Tyrrell; José Cabanillas; Steven K H Aung; Hongqun Liu; Lindsay Finnie-Carvalho; Grishma Shrestha; Hugh A Semple; Francis H Y Green

doi:10.1155/2019/5486728

Efficacy of a Peruvian Botanical Remedy (Sabell A4+) for Treating Liver Disease and Protecting Gastric Mucosal Integrity

Evid Based Complement Alternat Med. 2019 Oct 24:2019:5486728. doi: 10.1155/2019/5486728. eCollection 2019.

Authors

Affiliations

¹ Liver Unit, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive N.W, Calgary, Alberta T2N 4Z6, Canada.
² Department of Physiology and Pharmacology, Cummings School of Medicine, University of Calgary, 3280 Hospital Drive N.W, Calgary, Alberta T2N 4Z6, Canada.
³ Li Ka Shing Institute of Virology, Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Alberta T6G 2J7, Canada.
⁴ Sabell Corporation, Suite 1250, 635 8 Avenue SW, Calgary, Alberta T2P 3M3, Canada.
⁵ Dr Steven K H Aung Clinic, 9904-106 Street, Edmonton, Alberta T5K 1C4, Canada.
⁶ Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive N.W, Calgary, Alberta T2N 4Z6, Canada.
⁷ Alberta Innovates-Technology Futures, Hwy 16A & 75 Street, Vegreville, Alberta T9C 1T4, Canada.
⁸ Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive N.W, Calgary, Alberta T2N 4Z6, Canada.

Abstract

The purpose of this study was to determine the efficacy of a Peruvian botanical formulation for treating disorders of hepatic function and gastric mucosal integrity. The formulation A4+ (Sabell Corporation) contains extracts of Curcuma longa rhizome, Cordia lutea flower, and Annona muricata leaf. Individually these plants have been used as traditional remedies for liver disease. We report the efficacy of A4+ and its components using a variety of in vitro and in vivo disease models. The methods used included tests for antioxidant, anti-inflammatory, and antiviral activity as well as mouse models of liver disease, including Concanavalin A-induced immune-mediated hepatitis and a bile duct ligation model for evaluating sickness behaviour associated with liver disease. Rat models were used to evaluate the gastric mucosal protective property of A4+ following indomethacin challenge and to evaluate its anti-inflammatory action in an "air pouch" model. In all tests, A4+ proved to be more effective than placebo. A4+ was antioxidant and anti-inflammatory and diminished Hepatitis C virus replication in vitro. In animal models, A4+ was shown to protect the liver from immune-mediated hepatitis, improve behavioural function in animals with late stage liver disease, and protect the rat gastric mucosa from ulceration following NSAID exposure. We conclude that A4+ ameliorated many aspects of liver injury, inhibited hepatitis C virus replication, and protected the gastric mucosa from NSAIDs. These varied beneficial properties appear to result from positive interactions between the three constituent herbs.