Ciplukan (Physalis Angulata Linn.) Extract Potential on High-Fat Diet- Induced Non-alcoholic Fatty Liver Disease (NAFLD) for Liver Anti- Fibrotic Drug Development

An increasing proportion of the global population have or are at risk of developing non-alcoholic fatty liver disease (NAFLD). Fibrosis is the most important predictor of prognosis in NAFLD patients. Ciplukan (Physalis angulata Linn.) has been reported to have antifibrotic potency in CCl4-induced liver fibrotic rats, so this study was designed to evaluate the antifibrotic effect of ciplukan extract on liver function, inflammation, and cholesterol levels. The liver fibrosis model was established using 20% margarine injected subcutaneously 8 times twice a week for 4 weeks in 35 male and 35 female Wistar rats. The rats were then treated orally with ciplukan extract (CPL) in 70% alcohol, starting the 6th week of treatment with 2 different doses, namely 13.5 mg (CPL-1) and 27 mg (CPL-2) every day for 4 weeks. The histopathological changes in the liver were analyzed by Haematoxylin Eosin (HE) staining. Serum IL-6 and TGF-beta 1 levels were determined by ELISA. ALT and cholesterol levels were measured using a diagnostic kit. Single and multiple doses of ciplukan extract with or without standard therapy (Vitamin E) reduced the fibrotic scores to 1.30 +/- 0.95 (p=0.001), TGF-beta 1 levels to 24.20 +/- 2.02 ng/mL (p = 0.000), IL-6 levels to 1.68 +/- 0.52 pg/mL (p=0.156), ALT levels to 104.57 +/- 2.02 U/mL (p=0.001), and cholesterol levels to 81, 07 +/- 2.02 mg/dL (p=0.000). In conclusion, the ciplukan herb ethanol extract possesses potent liver antifibrotic activity, thus it is a potential new liver fibrotic drug.