Tang MJ, Feng KY, Zhuang ZJ, Wang HY, Wu MY, Li PH, Shi JP, Mi XX. Therapeutic efficacy and multitarget mechanisms of traditional Chinese medicine in hereditary liver diseases: Insights into bioactive components. World J Hepatol 2026; 18(9): 123969 [DOI: 10.4254/wjh.123969]
Corresponding Author of This Article
Xiao-Xiao Mi, Institute of Translational Medicine, The Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhoulu, Hangzhou 310015, Zhejiang Province, China. mixiaoxiao1987@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
review-article
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Tang MJ, Feng KY, Zhuang ZJ, Wang HY, Wu MY, Li PH, Shi JP, Mi XX. Therapeutic efficacy and multitarget mechanisms of traditional Chinese medicine in hereditary liver diseases: Insights into bioactive components. World J Hepatol 2026; 18(9): 123969 [DOI: 10.4254/wjh.123969]
Meng-Juan Tang, Hong-Yi Wang, Mei-Yin Wu, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou 311121, Zhejiang Province, China
Ke-Yi Feng, School of Clinical Medicine, Hangzhou Normal University, Hangzhou 311121, Zhejiang Province, China
Zhen-Jie Zhuang, Peng-Hua Li, Xiao-Xiao Mi, Institute of Translational Medicine, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, Zhejiang Province, China
Jun-Ping Shi, Department of Infectious Diseases and Hepatology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, Zhejiang Province, China
Co-first authors: Meng-Juan Tang and Ke-Yi Feng.
Co-corresponding authors: Jun-Ping Shi and Xiao-Xiao Mi.
Author contributions: Tang MJ, Feng KY, Mi XX, and Shi JP drafted the original manuscript; Mi XX and Shi JP conceived and designed the study, acquired funding, and critically reviewed and edited the final version as co-corresponding authors; Tang MJ and Feng KY interpreted the data and revised it critically for important intellectual content as co-first authors; Zhuang ZJ, Wang HY, and Wu MY participated in drafting the original manuscript and contributed to manuscript revision; Li PH performed chemical structure analysis. All authors approved the final version to publish.
AI contribution statement: Portions of this manuscript were edited using AI tools solely for language refinement. The authors carefully reviewed and verified all AI-assisted outputs and take full responsibility for the scientific content of the manuscript.
Supported by Huadong Medicine Joint Funds of the Zhejiang Provincial Natural Science Foundation of China, No. LHDMZ24H030001; National Natural Science Foundation of China, No. 82470599; and Hangzhou Municipal Health and Wellness Project, No. 2023WJC149.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Xiao-Xiao Mi, Institute of Translational Medicine, The Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhoulu, Hangzhou 310015, Zhejiang Province, China. mixiaoxiao1987@163.com
Received: June 2, 2026 Revised: July 2, 2026 Accepted: July 27, 2026 Published online: September 27, 2026 Processing time: 107 Days and 9.7 Hours
Abstract
Hereditary liver diseases (HLIDs) are a group of genetically driven disorders characterized by progressive hepatic dysfunction, multiorgan involvement, and limited therapeutic options. Traditional Chinese medicine (TCM) has a 2000-year legacy in liver disease management, with modern research highlighting its multitarget, multi-pathway pharmacological profile as a unique strength. This review synthesizes evidence on the potential therapeutic potential of TCM in HLIDs, focusing on: (1) The chemical diversity of hepatoprotective TCM components (alkaloids, flavonoids, terpenoids, etc.); (2) Their proposed mechanisms - from regulating metal ion homeostasis and oxidative stress to inhibiting nonapoptotic cell death (ferroptosis/pyroptosis) and remodeling the gut-liver axis; and (3) The translational value of compound TCM formulas (e.g., Gandouling Decoction) guided by the Jun-Chen-Zuo-Shi (sovereign-minister-assistant-messenger) principle. We also address current challenges (e.g., low bioavailability and quality control) and future directions (multiomics, nanotechnology, and rigorous randomized controlled trials). Our analysis underscores the potential of TCM to complement western medicine in HLID management by targeting root pathogenic links - a paradigm shift from symptom control to holistic, mechanism-based therapy.
Core Tip: This review highlights the therapeutic potential of traditional Chinese medicine in hereditary liver diseases, emphasizing its proposed multitarget mechanisms, regulating ion homeostasis, oxidative stress, cell death, and gut-liver axis. It explores bioactive components (alkaloids and flavonoids) and compound formulas (e.g., Gandouling Decoction) guided by Jun-Chen-Zuo-Shi principles, addressing challenges (bioavailability and quality control) and future directions (multiomics and nanotechnology) to complement western medicine via holistic, mechanism-based therapy.
