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

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