Oxymatrine: Hepatoprotective Effects of a Multitarget Natural Alkaloid

Liver diseases are a major global health burden with an occult onset and atypical symptoms, hindering early diagnosis. Herbal medicines feature low toxicity and multitarget effects; oxymatrine (OMT) from Sophora flavescens possesses anti-inflammatory, antioxidant, antiapoptotic, and antitumor activities, with prominent hepatoprotective effects. This systematic review explores the impact and molecular mechanisms of oxymatrine in managing various liver ailments, including liver injury, nonalcoholic fatty liver disease (NAFLD), liver fibrosis, and hepatocellular carcinoma (HCC), based on the findings from in vitro and in vivo studies. Using scientific databases such as PubMed, Web of Science, and Science Direct, studies were analyzed focusing on oxymatrine's pharmacological actions in liver disease. The search incorporated terms including "oxymatrine," "hepatoprotection," and "liver disease." Oxymatrine mediates liver protection by modulating oxidative stress, suppressing inflammation, promoting lipid metabolism, and inhibiting fibrosis. Additionally, it exhibits tumor-suppressive effects through apoptosis induction and pathway modulation.