Nanomedicine: A New Therapeutic Approach in Liver Diseases

Special Article - Nanocarriers

Austin J Nanomed Nanotechnol. 2019; 7(1): 1053.

Nanomedicine: A New Therapeutic Approach in Liver Diseases

Sharma H, Flora SJS, Panghal A and Naqvi S*

Department of Pharmacology & Toxicology, National Institute of Pharmaceutical Education and Research Raebareli, India

*Corresponding author: Saba Naqvi, Department of Pharmacology & Toxicology, National Institute of Pharmaceutical Education and Research, Raebareli, New Transit Campus, Bijnor Road, Sarojini Nagar, NIPER-R/ Communication/068, Near CRPF Base Camp, Lucknow (UP), 226002, India

Received: April 23, 2019; Accepted: May 20, 2019; Published: May 27, 2019


Liver fibrosis is known as a reversible wound healing process. It is defined as the collection of Extracellular Matrix (ECM) in the liver followed by liver injury where injured tissue displaced by the scar tissue. An advanced form of the liver fibrosis is known as liver cirrhosis. The cause for liver injury is heavy alcohol consumption, hepatitis B & C virus, and nonalcoholic fatty liver disease, etc. Liver cirrhosis, portal hypertension, ascites, and liver failure are some of the symptoms occurred due to liver fibrosis. Worldwide, liver disease is the 14th most common cause of death. Mortality due to liver diseases is approximately 1.03 million per year worldwide. Liver diseases became the 12th leading cause of death up to 2020. Nanotechnology is the emerging technology in the field of medicine, which opens the new avenues for the treatment of liver diseases. The present review explains about etiology, pathogenesis, symptoms, conventional approaches, current therapeutic strategies, and the role of nanotechnology in the liver fibrosis treatment. Conventional approaches provide only symptomatic treatment, it is not enough and effective to deliver the desired quantity of therapeutic agent in the liver. Nanotechnology is the current therapeutic approach, which involves various nanoparticles systems such as inorganic, liposomal, polymeric, albumin and nanomicelles, etc. These nanoparticles have numerous advantages over conventional treatment in the delivering of a therapeutic agent at specific sites. Various small drug moieties encapsulated in nanocarriers with modified surface chemistry used for the successful targeted delivery into the liver. Inorganic and liposomal nanoparticles have been widely studied for liver fibrosis treatment. Currently, nanomedicine generates much attention towards liver-associated diseases due to its high therapeutic efficacy and less adverse effect; hence it may provide great scope in the future for the treatment of liver disease.

Keywords: Liver fibrosis; liver cell receptors; Hepatic stellate cells; Nanotechnology; Inorganic nanoparticles; liposomes; micelles


Fibrosis is the formation of scar tissue in the liver cells; it occurs when the liver tries to repair and displaces injured tissue by scar tissue [1]. Fibrosis itself does not cause any symptoms but cirrhosis is an advanced form of fibrosis leads to a variety of symptoms like portal hypertension and liver failure. Liver transplantation is the last therapeutic strategies adopted by the clinician when all injured tissues displaced by scar tissues [2]. There are various causes of liver fibrosis, but the major causes are heavy alcohol consumption, hepatitis B & C virus and nonalcoholic fatty liver disease [3].

Globally, the liver disease appeared as a major cause of global health burden. Worldwide, liver disease is the 14th most common cause of death. Liver diseases result in morbidity and mortality of 1.03 million per year worldwide, according to the global burden of disease 2010 study [4]. In India, the prevalence of liver disease was found to be around 9%-32% of the general population. A rural area is more prevalent for liver disease in India due to less awareness of health education and lack of medical facilities. Recently, WHO published its data in May 2014 that, in India, death due to liver disease reached 216,865 or 2.44% of total deaths [5]. It is projected that a rise in the deaths from the liver disease became it the 12th leading cause of death in 2020 [6].

Till date, there is no cure for liver fibrosis has been reported yet. There is only symptomatic treatment available for liver diseases which are not much effective for delivering a sufficient amount of therapeutic agent into the liver, furthermore, conventional approaches lead to various adverse and toxic side effects. Nanotechnology opens new opportunities for drug delivery in the treatment of liver disease. Advancement in nanotechnology develops a carrier system which can help in delivering a drug/peptide/gene to a targeted specific organ. Targeted delivery into the liver is gaining further interest in nanomedicine towards liver-associated diseases. There are various types of Nanoparticles (NP) like inorganic nanoparticles, liposomal, polymeric, albumin and other surface modified nanoparticles currently investigated for the treatment of liver diseases [7].

In current years, approaches based on nanomedicine have been investigated for liver disease treatment. Hence, keeping in mind the current scenario of liver-associated problems, the present review article describes the different types of nanoparticles and various nanoformulations, which are used for the treatment of liver diseases.

Etiology of Liver Fibrosis

Liver fibrosis has numerous possible causes; more than one cause can be even present in a single person. Overall, 57% of fibrosis is diagnostic for either hepatitis C (27%) or hepatitis B (30%). Another major cause is alcohol consumption, which accounts for at least 20% of the cases [8].


Infection by chronic hepatitis C virus and hepatitis B virus causes liver cell injury and inflammation in the liver, this inflammation and damage can lead to fibrosis (Figure 1). Among all the viral infected persons, 85% of persons infected with chronic hepatitis C [8] and 15% of persons infected with chronic hepatitis B virus will develop chronic hepatitis and lead to fibrosis. A viral infection is reported as the most common reasons for a liver transplant [9].