A citrus-derived supplement modestly lowered a blood marker linked to liver health and bile flow in people with primary biliary cholangitis (PBC) in a small study published in Clinical and Translational Gastroenterology. The findings support further research into the supplement as an add-on treatment for PBC.
Treatment options for PBC remain limited, and some patients do not respond adequately to existing medications, underscoring the need for new therapeutic approaches.
One potential treatment target is oxidative stress. Oxidative stress occurs when the body cannot adequately counter unstable molecules called free radicals, leading to cellular damage.
Oxidative stress seems to contribute to liver and bile duct damage in PBC. The NRF2/KEAP1 pathway, which helps control the body’s antioxidant response, may also be impaired in people with the disease.
For this reason, researchers studied glucosyl hesperidin, a widely used antioxidant. Found in citrus fruits, the compound may activate the NRF2/KEAP1 pathway and strengthen the antioxidant response.
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The multicenter, open-label study included 71 adults with PBC who were already receiving maintenance care. Participants were randomly assigned to take either 500 mg or 1,000 mg of glucosyl hesperidin daily for 24 weeks.
Researchers tracked changes in blood tests related to liver and bile duct health, blood fats and antioxidant activity. The study did not include a placebo or a control group who received maintenance care alone.
After 24 weeks, the higher dose of glucosyl hesperidin reduced gamma-glutamyl transferase (GGT) by 6.2%. This decrease suggested a modest improvement in a laboratory marker of PBC. The lower dose of glucosyl hesperidin did not significantly change any blood test levels.
“High intake is not necessarily beneficial, and maintaining an appropriate balance is crucial,” the researchers cautioned. In other words, taking larger amounts of antioxidants may not improve outcomes and could carry risks. Patients should not start or increase antioxidant supplements without talking to their care team.
No adverse events were considered related to glucosyl hesperidin. However, the study was small and did not include a placebo group, so the findings need to be confirmed in larger controlled trials.
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