Mitigating Tuberculosis Drug‑induced Liver Injury: The Role of Moringa oleifera and Other Herbal Extracts

Abstract

Background: Tuberculosis (TB) is a significant public health issue, and drug‑induced liver injury (DILI) from anti‑TB medications poses a major challenge to treatment efficacy. This study aims to evaluate the protective effects of a blended polyherbal extract consisting of Moringa oleifera Lam., Camellia sinensis, Curcuma zanthorrhiza, and Caesalpinia sappan L. against DILI induced by TB drugs. Methods: A total of 25 male Wistar rats were divided into five groups: a control group, a DILI group receiving anti‑TB drugs, and three groups receiving varying doses of the polyherbal extract. Key parameters, including CYP450 expression and liver enzyme levels (alanine aminotransferase [ALT] and aspartate aminotransferase [AST]), were assessed using colorimetric techniques. Results: The administration of the highest dose of the polyherbal extract significantly reduced CYP450 expression and lowered ALT and AST levels compared to the DILI group. These findings suggest that the polyherbal remedy effectively protects the liver from damage caused by TB medications. Conclusions: The study concludes that the polyherbal extract MOC3 exhibits hepatoprotective properties, indicating its potential as a preventive treatment for DILI in TB therapy. Further clinical investigations are recommended to explore its applicability in human subjects.