{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T11:00:22Z","timestamp":1790679622714,"version":"4.1.0"},"reference-count":89,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":271,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Toxicology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tuberculosis (TB) remains a major global health challenge. While effective, first\u2010line antitubercular drugs such as isoniazid and rifampicin often cause hepatotoxicity, limiting treatment safety. Herbal extracts with antioxidant and hepatoprotective properties may help mitigate this liver damage. This systematic review evaluates the protective effects of plant extracts against antitubercular drug\u2010induced hepatotoxicity, aiming to inform potential adjuvant strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA\u2010P guidelines, PubMed, Scopus, and Google Scholar were searched for \u201cin vivo studies assessing plant extracts against hepatotoxicity caused by anti\u2010TB drugs.\u201d Two independent reviewers screened and extracted data. Study quality was evaluated using SYRCLE\u2019s risk of bias tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty\u2010eight in vivo studies were included. Overall, plant extracts demonstrated variable hepatoprotective efficacy, with some showing significant improvement in certain species\u2014\n                      <jats:italic>Luffa acutangula<\/jats:italic>\n                      L.\n                      <jats:italic>, Lawsonia inermis<\/jats:italic>\n                      L., and\n                      <jats:italic>Cucumis trigonus<\/jats:italic>\n                      Roxb. showed the highest reduction in serum liver enzymes: aspartate aminotransferase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP) in U\/L, and total bilirubin (TBil) and antioxidant parameters glutathione (GSH), catalase (CAT), and superoxide dismutase (SOD), suggesting hepatoprotective potential.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Medicinal plants demonstrate variable hepatoprotective effects in animal models of anti\u2010TB drug\u2010induced liver injury, though their mechanisms of oxidative stress remain unclear. Among them, the extracts from\n                      <jats:italic>Luffa acutangula<\/jats:italic>\n                      L.,\n                      <jats:italic>Lawsonia inermis<\/jats:italic>\n                      L., and\n                      <jats:italic>Cucumis trigonus<\/jats:italic>\n                      Roxb. showed promising hepatoprotective effects. These effects are likely associated with antioxidant and cytoprotective mechanisms. However, further well\u2010designed preclinical and clinical research are required to establish their dosage, safety, and efficacy before integration into TB therapy.\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      PROSPERO: CRD42024563060.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/jt\/6698835","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T10:28:49Z","timestamp":1790677729000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Herbal Extracts on Antituberculosis Drug\u2010Induced Hepatotoxicity: A Systematic Review"],"prefix":"10.1155","volume":"2026","author":[{"given":"Surthi M.","family":"Ravedar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4560-330X","authenticated-orcid":false,"given":"Kranthi Kiran","family":"Akula","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9940-8764","authenticated-orcid":false,"given":"Kalesh M.","family":"Karun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flemin","family":"Felix","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0172-7423","authenticated-orcid":false,"given":"Kamran","family":"Zaman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyothi","family":"Bhat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subarna","family":"Roy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11195826"},{"key":"e_1_2_12_2_2","volume-title":"WHO Global Lists of High Burden Countries for Tuberculosis (TB), TB\/HIV and Multidrug\/Rifampicin-Resistant TB (MDR\/RR-TB)","author":"World Health Organization","year":"2021"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/prp2.902"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.31018\/jans.v3i2.186"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/s1875-5364(14)60054-6"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12906-015-0861-7"},{"key":"e_1_2_12_7_2","first-page":"1042","article-title":"Role of Liv. 52 DS Tablets as a Hepatoprotective Agent in Tuberculosis Patients Receiving Antitubercular Drugs: A Double Blind Placebo Controlled Study","volume":"5","author":"Choijamts G.","year":"2018","journal-title":"ournal of Liver and Clinical Research"},{"key":"e_1_2_12_8_2","first-page":"129","article-title":"Protective Effect of Methanolic Extract of Annona squamosa Linn in Isoniazid-Rifampicin Induced Hepatotoxicity in Rats","volume":"24","author":"Uduman T. 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