Tea and liver fibrosis: a bibliometric analysis of mechanisms, translational challenges, and emerging trends

Although tea and its bioactive constituents, particularly epigallocatechin gallate (EGCG), demonstrate promising anti-liver fibrotic potential, the global research landscape has yet to be systematically characterized through quantitative visualization, leaving research priorities and clinical translational barriers unclear. This bibliometric analysis aims to delineate the current status, emerging hotspots, and developmental trends in tea-related liver fibrosis research, providing strategic insights for future studies.

A dual-database search with reciprocal verification was conducted in the Web of Science Core Collection (WoSCC) and Scopus using refined search strategies. Bibliometric analyses and visualizations were performed using R (v4.5.1), VOSviewer (v1.6.19), and CiteSpace (v6.4.R1).

Annual publication output in this field has increased steadily. China led in publications (n = 120), with Nutrients and Frontiers in Pharmacology as the leading journals. Tea bioactives exert anti-fibrotic effects through: (1) molecular mechanisms, including inhibition of hepatic stellate cell activation via TGF-β/Smad, Nrf2, NF-κB, AMPK, and MAPK pathways; (2) gut-liver axis modulation, such as intestinal microbiota remodeling, bile acid homeostasis restoration, and barrier integrity enhancement; (3) synergistic effects with other natural products; and (4) epidemiological evidence showing that regular tea/caffeine intake reduces fibrosis progression, cirrhosis, and hepatocellular carcinoma risk. However, EGCG clinical translation is limited by poor solubility, environmental instability, rapid clearance, low oral bioavailability, and dose-dependent hepatotoxicity. Nano-delivery systems and structural modifications have been developed to enhance its bioavailability.

This study elucidates the therapeutic potential of tea and its bioactive constituents against liver fibrosis, encompassing their pharmacological mechanisms, emerging molecular targets, and bioavailability enhancement strategies. With advances in nanomedicine and pharmaceutical technologies, coupled with rigorously designed multicenter randomized controlled trials, tea-derived bioactives are anticipated to overcome current limitations and establish clinical value in liver fibrosis prevention and adjuvant therapy.