Alisma Orientale
Also known as: Alisma orientalis, Oriental water plantain, Ze Xie, Alisma orientale
Overview
Alisma orientale, commonly known as Oriental water plantain or Ze Xie, is an aquatic plant deeply rooted in Traditional Chinese Medicine (TCM). It is primarily utilized for its purported effects on fluid metabolism, hypertension, and various metabolic disorders. The herb contains several bioactive triterpenoids, including Alisol A 24-acetate, Alisol B 23-acetate, Alisol F, and Alismol, which are believed to contribute to its therapeutic properties. Its traditional and emerging applications include the management of pregnancy-induced hypertension (PIH), nonalcoholic fatty liver disease (NAFLD), metabolic syndrome, hyperlipidemia, and atherosclerosis. While preclinical research is robust and growing, and some meta-analyses support its use, comprehensive clinical evidence from large-scale, high-quality trials is still limited, necessitating further research to fully validate its efficacy and safety in human populations.
Benefits
Alisma orientale has demonstrated several evidence-based benefits, primarily in metabolic and cardiovascular health. It shows efficacy in improving metabolic syndrome and nonalcoholic fatty liver disease (NAFLD) by reducing hepatic triglyceride accumulation, suppressing de novo lipogenesis, and enhancing lipid export. Preclinical studies indicate improvements in insulin resistance, hyperlipidemia, obesity, and hyperglycemia. For pregnancy-induced hypertension (PIH), network pharmacology and molecular docking studies suggest it targets multiple pathways, potentially lowering blood pressure and offering hepato-renal protection. In atherosclerosis, animal studies show it modulates gut microbiota and lipid profiles, leading to reduced adipose tissue, lower total cholesterol, triglycerides, and LDL-C, while increasing HDL-C, thereby attenuating disease progression. Furthermore, a meta-analysis of clinical studies indicates that Alisma orientale can significantly lower blood uric acid, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) in patients with gout or hyperuricemia, suggesting anti-inflammatory and uric acid-lowering effects. While preclinical evidence is strong, clinical data, especially for NAFLD and atherosclerosis, are still emerging and require more robust human trials.
How it works
Alisma orientale exerts its therapeutic effects through multiple mechanisms. It acts as a farnesoid X receptor (FXR) agonist, which is crucial for regulating bile acid metabolism and maintaining lipid homeostasis. The herb also modulates adiponectin activation, leading to improved insulin sensitivity and enhanced lipid metabolism. Its anti-inflammatory and anti-fibrotic properties are attributed to its ability to regulate oxidative stress markers, reduce lipoapoptosis, and modulate inflammatory mediators within liver tissue. Network pharmacology and molecular docking studies suggest it targets various proteins involved in blood pressure regulation and kidney/liver function. Additionally, Alisma orientale has been shown to alter the composition of gut microbiota, contributing to systemic metabolic improvements and the attenuation of atherosclerosis.
Side effects
Preclinical toxicology and network toxicology analyses of Alisma orientale indicate a potential risk of hepatotoxicity (liver damage) and nephrotoxicity (kidney damage), particularly at high doses or with prolonged use. This necessitates careful dose management and vigilant monitoring when considering its use. While meta-analyses of clinical studies have not reported major adverse effects, comprehensive safety data from large-scale, randomized controlled trials are currently lacking. Information regarding specific drug interactions and contraindications remains poorly characterized. Due to limited human data, caution is strongly advised for pregnant individuals and those with pre-existing liver or kidney impairment. Users should be aware of these potential risks and consult a healthcare professional before use, especially if they have underlying health conditions or are taking other medications.
Dosage
Currently, there is no standardized or clinically established dosing regimen for Alisma orientale due to the limited number of high-quality human clinical trials. Traditional use and preclinical studies show a wide variation in effective doses. While animal study dosages can be extrapolated to human equivalent doses, these require clinical confirmation for safety and efficacy in humans. The bioavailability and absorption characteristics of its active triterpenoids are not well-defined, which means specific formulations might be necessary to optimize delivery and therapeutic effects. Without clear clinical guidelines, it is challenging to recommend a precise dosage range, timing, or specific forms for different purposes. Users should exercise caution and consult with a qualified healthcare professional experienced in herbal medicine for guidance, especially given the potential for dose-dependent toxicity.
FAQs
Is Alisma orientale safe for long-term use?
Current evidence suggests caution for long-term use due to potential hepato-renal toxicity identified in preclinical studies. Comprehensive human safety data for prolonged use are insufficient.
Can it replace conventional treatments for NAFLD or hypertension?
No, Alisma orientale should not replace conventional treatments. It may serve as an adjunct therapy, but more robust clinical evidence is needed before it can be considered a primary treatment.
How soon can benefits be expected?
Preclinical studies show biochemical changes within weeks. However, the timeline for observable clinical benefits in humans is not well established due to limited human trials.
Research Sources
- https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.1027112/full – This in silico study used network pharmacology and molecular docking to identify multi-target mechanisms of Alisma orientale for treating pregnancy-induced hypertension (PIH). It also predicted potential toxicity pathways, highlighting the need for careful dose management and monitoring.
- https://pmc.ncbi.nlm.nih.gov/articles/PMC6582889/ – This systematic review of preclinical studies demonstrated Alisma orientale's efficacy in treating nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome. It highlighted mechanisms such as FXR agonism and adiponectin activation, though it noted the limited clinical trial data.
- https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0085008 – This systematic review and meta-analysis of clinical trials found that Alisma orientale significantly reduced blood uric acid, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) in patients with gout or hyperuricemia. It indicated improved clinical symptoms but noted variability in study quality and small sample sizes.
- https://onlinelibrary.wiley.com/doi/abs/10.1155/2019/2943162 – This review, similar to the PMC article, focused on preclinical findings, reinforcing the evidence for Alisma orientale's role in improving NAFLD and metabolic syndrome through mechanisms like FXR agonism and adiponectin activation. It underscored the need for more human clinical trials.
- https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2020.570555/full – This animal study using ApoE knockout mice showed that Alisma orientale reduced atherosclerosis progression. The mechanism involved the regulation of gut microbiota and improvement of lipid profiles, suggesting a promising role in cardiovascular health, though human translation is still needed.