Clinacanthus nutans leaf extract prevents metabolic dysfunction-associated steatotic liver (MASL) to metabolic dysfunction-associated steatohepatitis (MASH) progression in western diet-fed C57BL/6 mice

The phytochemical profile and hepatoprotective, antioxidant, and lipid-modulating effects of the ethanolic extract of Clinacanthus nutans leaves were examined in male C57BL/6 mice fed a cholesterol-supplemented western diet. After 15 weeks of feeding, the untreated mice developed steatosis, lobular inflammation, and ballooning hepatocytes, with NAFLD activity scores ≥5, indicative of metabolic dysfunction-associated steatohepatitis (MASH). Treatment with Clinacanthus nutans extract at doses of 100, 200, and 400 mg/kg from week 8 to 15 significantly reduced the liver-to-body weight ratio and NAFLD activity score, with dose-dependent histological improvement, particularly reduced lobular inflammation. AST, ALT, and hepatic malondialdehyde levels were significantly lowered in the treated groups, with effects exceeding those of atorvastatin. However, Clinacanthus nutans extract did not attenuate the elevated LDL-to-HDL ratio. In conclusion, Clinacanthus nutans extract effectively prevented the progression from simple steatosis to steatohepatitis, likely through antioxidative mechanisms attributable to its high tannin content.