Cichorium intybus Improves Hepatic Complications Induced by Oxymetholone: An Animal Study

Document Type : Research Paper


1 Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran

2 Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran

3 Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran

4 Institute of Biodiversity and Ecosystem Research, Bulgarian Academy of Sciences, Sofia, Bulgaria


Oxymetholone (OM) is a 17-α-alkylated anabolic-androgenic steroid used at low doses for the treatment of diseases such as anemia and osteoporosis. The present study aimed to evaluate the hepatoprotective effect of Cichorium intybus L. (Chicory) extract on OM-induced changes in liver enzymes, serum antioxidant status and liver tissue in rats. 42 Wistar rats were divided into 6 groups (n=7): control group (0.5 ml distilled water), OM group (5 mg/kg), C. intybus groups (100 or 200 mg/kg), and OM+C. intybus groups (5 mg/kg OM+100 or 200 mg/kg extracts). After two weeks, the animals were weighed and serum was separated to assay liver enzymes [aspartate transaminase (AST), alanine transaminase (ALT) and alkaline phosphatases (ALP)], nitric oxide (NO) and total antioxidant capacity (TAC). The liver was separated, weighed, fixed and stained with the hematoxylin-eosin method. OM significantly increased NO and liver enzyme (AST, ALP, ALP) concentrations, and significantly decrease serum TAC, animal and liver weights (P<0.05) and changed liver histology. Different concentrations of C. intybus extract (100 or 200 mg/kg) improved these OM-induced changes significantly (P<0.05). Chicory reversed serum biochemical and histological changes due to OM consumption.


  1. Nejati V, Zahmatkesh E, Babaei M. Protective effects of royal jelly on oxymetholone-induced liver injury in mice. Iran Biomed J. 2016;20:229-34.
  2. Rohani A, Imanipour V. Effects of oxymetholone on hematological and liver factors in the male bodybuilder's serum. Procedia Soc Behav Sci. 2009;1:2814-6.
  3. Sanchez-Osorio M, Duarte-Rojo A, Martinez-Benitez B, Torre A, Uribe M. Anabolic-androgenic steroids and liver injury. Liver Int. 2008;28:278-82.
  4. Rasool M, Malik A, Saleem S, Ansari S.A, Iqbal J, Asif M, Kamal M.A, Al-Qahtani M. H, Karim S. Assessment of circulating biochemical markers in mice receiving cinnamon and glycyrrhizin under carbon tetrachloride induced hepatic injury. Proc Natl Acad Sci India Sect B Biol Sci. 2019;89:105-11.
  5. Lobo V, Patil A, Phatak A, Chandra N. Free radicals, antioxidants and functional foods: Impact on human health. Pharmacogn Rev. 2010;4:118-26.
  6. Ramos-Tovar E, Muriel P. Free radicals, antioxidants, nuclear factor-E2-related factor-2 and liver damage. J Appl Toxicol. 2020;40:151-68.
  7. Harasym J, Oledzki R. Effect of fruit and vegetable antioxidants on total antioxidant capacity of blood plasma. Nutrition. 2014;30:511-7.
  8. Mirzaei F, Khazaei M. Role of nitric oxide in biological systems:A systematic review. J Mazandaran Univ Med Sci. 2017;27:192-222.
  9. Iwakiri Y, Kim MY. Nitric oxide in liver diseases. Trends Pharmacol Sci. 2015;36:524-36.
  10. Amer A.M, Farid A.S, Fararah K.M. Hepatoprotective Effect of Allopurinol and Garlic extract against experimentally–induced hepatotoxicity. BVMJ. 2018;34:66-76.
  11. Khan MW, Priyamvada S, Khan SA, Khan S, Gangopadhyay A, Yusufi A.N. Fish/flaxseed oil protect against nitric oxide-induced hepatotoxicity and cell death in the rat liver. Hum Exp Toxicol. 2016;35:302-11.
  12. Azarmehr N, Afshar P, Moradi M, Sadeghi H, Sadeghi H, Alipoor B, Khalvati B, Barmoudeh Z, Abbaszadeh-Goudarzi K, Doustimotlagh AH. Hepatoprotective and antioxidant activity of watercress extract on acetaminophen-induced hepatotoxicity in rats. Heliyon. 2019;5:02072.
  13. Al-Reza S.M, Yoon J.I, Kim H.J, Kim J.S, Kang S.C. Anti-inflammatory activity of seed essential oil from Zizyphus jujuba. Food Chem Toxicol. 2010;48:639-43.
  14. Zaman R, Basar SN. A review article of Beekhe Kasni (Cichorium intybus) its traditional uses and pharmacological actions. Res J Pharm Sci. 2013;2:555-4.
  15. Janda K, Gutowska I, Geszke-Moritz M, Jakubczyk K. The common Cichory (Cichorium intybus L.) as a source of extracts with health-promoting properties-A Review. Molecules. 2021;26:1814.
  16. Hassan HA, Yousef MI. Ameliorating effect of chicory (Cichorium intybus L.)-supplemented diet against nitrosamine precursors-induced liver injury and oxidative stress in male rats. Food Chem Toxicol. 2010;48:2163-9.
  17. Akbari-Bazm M, Goodarzi N, Shahrokhi SR, Khazaei M. The effects of hydroalcoholic extract of Vaccinium arctostaphylos L. on sperm parameters, oxidative injury and apoptotic changes in oxymetholone-induced testicular toxicity in mouse. Andrologia. 2020;52:e13522.
  18. Akbari Bazm M, Khazaei M, Khazaei F, Naseri L. Nasturtium Officinale L. hydroalcoholic extract improved oxymetholone-induced oxidative injury in mouse testis and sperm parameters. Andrologia. 2019;51:13294.
  19. Khazaei M, Pazhouhi M, Khazaei S. Evaluation of hydro-alcoholic extract of Trifolium Pratens L. for its anti-cancer potential on U87MG cell line. Cell J. 2018;20:412-21.
  20. Moloudi M.R. Hassanzadeh K. Abdi M. Zandi F. Rahimi K. Izadpanah E. Hepatoprotective effect of the hydroalcoholic extract of Cichorium intybus in a rat model of obstructive cholestasis. Arab J Gastroenterol. 2021;22:34-39
  21. Khazaei F, Ghanbari E, Khazaei M. Protective effect of royal jelly against cyclophosphamide-induced thrombocytopenia and spleen and bone marrow damages in rats. Cell J. 2020;22:302-9.
  22. Naseri L, Khazaei M, Ghanbari E, Akbari-Bazm M. Rumex alveollatus hydroalcoholic extract protects CCL4-induced hepatotoxicity in mice. Comp Clin Path. 2019;28:557-65.
  23. Niedfeldt MW. Anabolic steroid effect on the liver. Curr Sports Med Rep. 2018;17:97-102.
  24. Khazaei M, Ansarian A, Ghanbari E. New findings on biological actions and clinical applications of royal jelly: a review. J Diet Suppl. 2018;15:757-75.
  25. Li G.Y, Gao H.Y, Huang J, Lu J, Gu J.K, Wang J.H. Hepatoprotective effect of Cichorium intybus L., a traditional Uighur medicine, against carbon tetrachloride-induced hepatic fibrosis in rats. World J Gastroenterol. 2014;20:4753-60.
  26. Moloudi M.R, Hassanzadeh K, Rouhani S, Zandi F, Ahmadi A, Khalwatian P, Rostami A, Esmaeili FS, Izadpanah E. Effect of chloroformic extract of Cichorium intybus on liver function tests and serum level of TNF-α in obstructive cholestasis in rat. SJKUMS. 2014;19:10-9.
  27. Ebrahiminia M, Esmaeili F, Shabani L. In vitro differentiation induction of embryonal carcinoma stem cells into insulin-producing cells by Cichorium intybus L. leaf extract. J Ethnopharmacol. 2020;246:112214.
  28. Asl Z.S, Malekirad A.A, Abdollahi M, Bakhshipour A, Dastjerdi HA, Mostafalou S, Poor RY. Effects of the mixture of Cichorium intybus L. and Cinnamomum zeylanicum on hepatic enzymes activity and biochemical parameters in patients with nonalcoholic fatty liver disease. Health. 2014;6:1212-17.
  29. Khalid A, Shahid S, Khan SA, Kanwal S, Yaqoob A, Rasool ZG, Rizwan, K. Antioxidant activity and hepatoprotective effect of Cichorium intybus (Kasni) seed extract against carbon tetrachloride-induced liver toxicity in rats. Tropical J Pharm Res. 2018;17:1531-8.
  30. Feyzmahdavia M, Khazaeia M, Gholamin B, Abbasabadia Z. Protective effect of Trogopogon Graminifolius hydroalcoholic extract against acute ethanol induced liver damages in rat. JRPS. 2017;6:161-6.
  31. Oshaghi E.A, Khodadadi I, Mirzaei F, Khazaei M, Tavilani H, Goodarzi MT. methanolic extract of Dill leaves inhibits AGEs formation and shows potential hepatoprotective effects in CCl4 Induced liver toxicity in rat. J Pharm. 2017;2017:1-9.
  32. Juibar F, Fattahi H, Sadaty F. The effects of sodium nitrite on nitric oxide levels and serum hepatic enzymes and liver histopathology in adult male rats. J Adv Med Biomed Res. 2017;25:109-19.
  33. Chan TY. Vegetable-borne nitrate and nitrite and the risk of methaemoglobinaemia. Toxicol Lett. 2011;200:107-8.
  34. Singh R, Chahal K.K. Cichorium intybus from India: GC-MS Profiling, Phenolic content and in vitro antioxidant capacity of sequential Soxhlet extracted roasted roots. Braz Arch Biol Technol. 2019;62.