# Hepatoprotective Evidence for the Individual Ingredients of a Standardized Sri Lankan Polyherbal Formulation: A Scoping Review

## TL;DR

This review summarizes the liver-protective effects of individual herbs in a Sri Lankan polyherbal formulation, showing potential for managing liver diseases.

## Contribution

The study provides a comprehensive evidence map of hepatoprotective properties of each ingredient in a traditional Sri Lankan herbal formulation.

## Key findings

- The ingredients show liver enzyme modulation and reduced oxidative stress in preclinical studies.
- Some ingredients inhibit inflammatory pathways and protect against chemically induced liver injury.
- Limited clinical data exist, and the synergistic effects of combining ingredients remain unexplored.

## Abstract

Chronic liver disease is a major global health burden and is increasingly driven by metabolic dysfunction, oxidative stress, inflammation, and fibrosis. Conventional therapy and lifestyle modification often achieve suboptimal adherence and incomplete reversal of hepatic injury, which has intensified interest in adjunctive hepatoprotective agents of botanical origin. A standardized Sri Lankan polyherbal formulation (LivosBEE™), combining Osbeckia octandra, Tamarindus indica, Piper nigrum, Piper longum, Cinnamomum verum, and multifloral bee honey, is traditionally used in the management of jaundice, fatty liver, and hepatocellular inflammation. However, its evidence base has not been comprehensively mapped.

A scoping review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and JBI methodological guidance to identify preclinical and clinical studies reporting liver-protective effects of the individual ingredients (O. octandra, T. indica, P. nigrum, P. longum, C. verum, and bee honey). Major electronic databases (including PubMed, Scopus, and Web of Science) and relevant grey literature were searched without date restriction. Eligible studies included in vitro experiments, in vivo animal models, and human trials that evaluated any single constituent of the formulation with respect to hepatocellular outcomes (e.g., serum aminotransferases, oxidative stress markers, lipid metabolism, histopathology, steatosis, fibrosis, and inflammatory signaling) or clinical/biochemical indicators of liver function. Data were charted for study design, model, intervention, dose, comparators, mechanistic endpoints, and safety findings. A total of 85 studies met the inclusion criteria.

Evidence indicates that the ingredients possess hepatoprotective properties, including modulation of liver enzymes, reduction of oxidative stress markers, inhibition of inflammatory pathways, and protection against chemically induced liver injury. Limited clinical data were available for some ingredients, and the synergistic potential of combining these ingredients is yet to be investigated. On the whole, however, this scoping review demonstrates that the ingredients of this polyherbal formulation have scientific support for hepatoprotective effects, providing a preliminary evidence base for its development. Future research should focus on human studies, optimal dosing, and mechanistic investigations to establish efficacy and safety.