الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The use of herbs as medicine is becoming increasingly common, either as home
remedies or as complementary and alternative medicines. Myrrh is a well-known herb that
is widely used as a home remedy in Egypt. It is an oleo-gum resin obtained from the tree
Commiphora molmol, and the shrub-like tree Balsamodendron, myrrh, which grow in the
northern and eastern parts of Africa and Arabia. Myrrh consists of 2% to 10% of a
volatile oil composed predominantly of sesquiterpenes, sterols, and steroids. The water-soluble gum portion (30% to 60%) contains polysaccharides and proteins as well as
ethanol-soluble resins (25% to 40%).
Several researchers have discussed the use of myrrh in the treatment of ulcers,
diabete, and topically for wounds and abrasions. Myrrh acts as an antimicrobial and
antifungal healing tonic and immune stimulant, anti-inflammatory, it exhibits anti-tumor
properties, and is considered as a potent antioxidant that can protect from hepatic oxidative
damage and immuno- toxicity by reducing lipid peroxidation and enhancing the
antioxidant and immune defense mechanism.
The use of myrrh is common among Egyptians, but few studies have been conducted
on its clinical and general use, side effects, and interactions with other drugs.
NAFLD is now acknowledged to be the commonest liver condition in the world,
largely because of the considerable increase in metabolic diseases such as obesity and
diabetes. It is clear that NAFLD leads to liver related morbidity and mortality in a subset of
people, particularly those who are obese, diabetic, and who have non-alcoholic
steatohepatitis (NASH). However a better understanding of the natural history of NAFLD
will permit better identification of the availability of many effective therapies.
The aim of the present study is to evaluate from the biochemical and
histopathological points of view the expected efficacy of myrrh with different doses in the
protection from non-alcoholic fatty liver disease in induced rats.
To achieve this aim we conducted the study on 75 rats weighted 200-220 gm and
divided into five groups each of 15 rats
G I: Control group fed standard diet.
G II: Non-alcoholic fatty liver (NAFLD) group fed high fat diet (HFD) for 10
weeks .
G III: 125 mg myrrh group fed high fat diet (HFD) plus 125 mg/kg/day myrrh for 10
weeks .
G IV: 250 mg myrrh group fed high fat diet (HFD) plus 250 mg/kg/day myrrh for 10
weeks.
GV: 500 mg myrrh group fed high fat diet (HFD) plus 500 mg/kg/day myrrh for 10
weeks.
All group are scarified at the end of study to obtain blood and liver for the
assessment of Lipid profile , (Total cholesterol , High -density lipoprotein cholesterol
(HDL), Low-density lipoprotein cholesterol (LDL), and Triglycerides (TG) , Fasting b lood
sugar, Insulin and Insulin resistance , Aspartate aminotransferase (AST), Alanine
aminotransferase (ALT), Gamma-glutamyl transferase (GGT), Bilirubine (Bil) , Albumin
(Alb),Total Protein, Lipid peroxidation by malondialdehyde, Tumor necrosis factor - alpha
(TNF-α), and Interleukin-6 (IL-6). Also, the histopathological examination was performed
to confirm the staging of liver NAFLD.
The previous methods revealed the following results:
1- Total cholesterol, triglyceride (TG), low density lipoprotein (LDL -C) showed
significant higher levels in NAFL group when compared to control group after
administration of myrrh all these parameters showed a dose dependent decrease
compared to induced NAFL group but they did not reach the control value even at
500 mg myrrh group. Regarding high density lipoprotein (HDL-C), it showed a
significant change in NAFL group and in 125 mg myrrh group when compared to
control group, and by increasing the administration of myrrh dose it seems to be
normal when compared to NAFL group.
2- The results of glucose homeostasis parameters in different groups, showed a marked
significant increase in NAFL group when compared to control group. After
administration of myrrh these parameters showed a dose dependent significant
decrease but they did not reach the control values even at 500 mg myrrh group
3- Liver function parameters were found to be markedly and significantly higher in the
induced NAFL group (GII) than control group (G I) except albumin and total proteins
which showed non-significant decrease compared to control. After administration of
myrrh (G III, G IV, G V), all these parameters decreased in a dose dependent manner
where they reached a nearly normal values compared to NAFL group, except for GGT
and bilirubin where their levels in G V were still significantly higher than the control
value. Regarding the total protein and albumin levels there were non-significant
changes in NAFL group and all myrrh groups when compared to control group.
4- The results of serum malondialdehyde (MDA) concentration in serum of different
groups, MDA it showed marked significant increase in NAFL group, when compared
to control group. After administration of myrrh serum MDA concentration showed a
dose dependent decrease but they did not reach the control values but at least MDA
level is resolved by increasing the myrrh dose as in 500 mg myrrh group compared to
the NAFL group.
5- Serum level of TNF-α showed a markedly significant increase in NAFL group when
compared to control group. After administration of myrrh serum level of TNF-α
improved and showed a dose dependent decrease when compared to NAFL group but
they did not reach the control values even at 500 mg myrrh group.
6- Serum level of IL-6 showed marked significant increase in NAFL group when
compared to control group. After administration of myrrh serum level of IL-6 showed
a dose dependent decrease when compared to NAFL group but they did not reach the
control values even at 500 mg myrrh group.
These result suggested that myrrh can modulate NAFLD by targeting the component
of associated metabolic syndrome improving the insulin resistance regarding to the
hypoglycemic properties, and also reduce the serum lipid parameter in rat this can
modulate NAFLD by preventing the first hit hypothesis preventing lipid accumulation in liver , also myrrh can resolve the second hit hypothesis by decreasing the release of the
pro-inflammatory cytokines such as TNF & IL-6 regarding to it`s anti-inflammatory
properties so it can act as a potent antioxidant and can protect against hepatic oxidative
damage and immunotoxicity in case of non-alcoholic fatty liver by reducing MDA which
is a marker for lipid peroxidation .
In summary, the present study suggests that myrrh may serve as novel and promising
nutritional or pharmacological therapeutic agents in treating non-alcoholic fatty liver
disease.
Limited histological data support an association between improved
aminotransferases and biopsy findings, which require confirmation in a double-blind trial
with appropriate statistical power based on liver histology.