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Introduction
Cambodia is a tropical country featuring plateaus, flat plains, hills and highland, the area of which is covered predominantly in forest. By virtue of its tropical climate, Cambodia has a diverse range of natural resources, amongst which plants are primarily used for complementary medicines by the local population. As many as 515 species amongst 134 families of medicinal plants have been found in Cambodia (1), allowing Cambodians to couple the use of medicinal plants with their traditional treatment of diseases. Cambodian medicinal plants are crucial in folk medicine in communities, with traditional healers offering assurance for their curable effects (2). According to the Ministry of Health in Cambodia, 45% of the Cambodian population use herbal plants for therapeutic purposes, despite a shortage of scientific evidence (3).
Liver disease, predominantly attributed to hepatitis and alcoholism, is considered a primary contributor to morbidity and mortality rates in humans. The accumulation of deleterious substances in hepatocytes caused by infection, injury, exposure to xenobiotics, autoimmunity or genetic disorders may lead to liver damage in the form of inflammation, scarring, cirrhosis or liver dysfunction (4,5). Oxidative stress is critical in liver injury and may be triggered by reactive oxygen species (ROS) generated by various signal transduction pathways (6). Oxidant-induced liver injury is caused by toxins, including tert-Butyl hydroperoxide (t-BHP), which exerts cytotoxic effects through glutathione (GSH) depletion coupled with intracellular over-influx of Ca2+ (4,7). Although there is general recognition that the drugs currently available for treating patients with liver disease are mandatory, natural products originating from plants have attracted considerable interest among hepatologists in terms of their efficacy and safety (8).
Traditional medicinal plants have long been used in folk medicine for ameliorating liver diseases. A number of these plants have shown potential in the treatment of liver disease due to their therapeutic mechanisms. For example, Silybum marianum and Picrorhiza kurroa have been confirmed to be clinically efficacious in the treatment of toxic hepatitis, fatty liver disease, cirrhosis, ischemic injury, radiation toxicity and viral hepatitis, based upon their antioxidative, antilipid peroxidative, antifibrotic, anti-inflammatory, immunomodulatory and liver regenerating effects (9). In addition, phytochemicals, including glycyrrhizin, matrine and silymarin, have been shown to exert therapeutic effects against hepatitis, alcoholic liver disease and liver cirrhosis (10). Phytochemicals...