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    Fruit and the Liver
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    Melissa Palmer, MD posted:
    BLUEBERRIES
    Studies conducted in an HCV subgenomic replicon cell culture have demonstrated that blueberry leaves contain a potent inhibitor of HCV replication known as proanthocyanidan. Further study on this provocative natural agent is anticipated.
    GRAPEFRUIT
    Naringenin, a flavanoid contained in grapefruit and other citrus fruits, has numerous beneficial properties that potentially can prevent and/or treat NAFLD/NASH. Naringenin has been reported to be an antiinflammatory, an antioxidant, and a lipid-lowering agent, and may act as a promoter of carbohydrate metabolism. Studies have demonstrated that naringenin may decrease insulin resistance and glucose intolerance, in addition to preventing obesity and the development of fatty livers in mice independent of total energy intake. Trials will need to be conducted to confirm these finding in humans. Furthermore, it appears that dose of naringenin required to correct metabolic disturbances associated with insulin resistance is much higher than the amount capable of obtaining from grapefruits. Thus, a more concentrated supplement will need to be produced, or intravenous administration may be necessary in humans for comparable efficacy to be acheived. It should be kept in mind that compounds in grapefruit juice — furanocoumarins, inhibit intestinal first-pass metabolism of many medications, resulting in increased systemic drug exposure and enhanced drug toxicity.
    A fatty liver develops in some patients with chronic HCV. This is believed to be due to the interaction of the virus with cholesterol and fatty acid metabolism. One step in the HCV life cycle involves attachment of the virus to very low density lipoprotein (vLDL) prior to secretion. The grapefruit flavanoid naringenin has been found to inhibit secretion of HCV from hepatocytes in cell culture in part by inhibiting vLDL secretion. Dosages of naringenin up to 1000 µM have been found to be nontoxic to hepatocytes in cell culture. Studies will need to be conducted on humans confirming these intriguing results and defining the role of naringenin in HCV treatment.
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