Hepatoprotective activities of polyherbal formulations: Current evidence and future perspectives

Medicinal plants have long been used in the management of diverse diseases worldwide. In recent years, increasing attention has been directed toward the scientific evaluation of polyherbal formulations (PHFs) to integrate traditional knowledge with modern pharmacological principles and ensure safety and efficacy, particularly in liver disorders. This review summarises PHFs with hepatoprotective activity reported over the past decade, based on literature retrieved from MEDLINE, PubMed and Google Scholar. A total of 93 PHFs were identified, which utilised 166 plant species from 73 botanical families. The family Fabaceae was the most represented, with 14 species used in various formulations. Among the most frequently utilised ingredients were Picrorhiza kurroa Royle ex Benth. (aerial parts; 26 formulations), Cichorium intybus L. (seeds and root bark; 24 formulations) and Andrographis paniculata (Burm.f.) Wall. ex Nees (leaves; 23 formulations). Interestingly, several marketed PHFs also included non-herbal components such as olive oil, honey, bhasmas (calcined minerals) and cow ghee. Preclinical and clinical investigations have consistently demonstrated the hepatoprotective potential of these formulations against diverse models of liver injury. India accounts for the highest number of commercially available PHFs, followed by South Korea, Nigeria, Pakistan and Saudi Arabia, while countries such as Bangladesh, Iran, Sri Lanka, China and Taiwan predominantly utilise traditional herbal preparations. Despite their growing global acceptance, many classical PHFs lack rigorous scientific validation. Standardisation of composition, elucidation of the mechanisms of action and well-designed clinical trials are essential to validate the pharmacological effects of herbal ingredients and substantiate the therapeutic roles of PHFs in preventing and managing liver diseases.