Ilexhainanoside D is the major triterpenoid saponin isolated from Ilex hainanensis Merr, and it exerts significant anti-inflammatory activity when used in combination with Ilexsaponin A1.

Combined administration of Ilexhainanoside D and Ilexsaponin A (at doses of 60, 120 or 240 mg/kg for 8 consecutive weeks) significantly alleviated the pathological conditions of non-alcoholic fatty liver disease (NAFLD) induced by a high-fat diet in a dose-dependent manner. This combined intervention downregulated the Firmicutes/Bacteroidetes ratio and reduced the relative abundance of Desulfovibrio, while increasing the relative proportion of Akkermansia. The expression levels of zonula occludens-1 (ZO-1) and occludin in the ileal tissue were significantly elevated, indicating an effective improvement in intestinal barrier function. Meanwhile, this combined treatment also inhibited the entry of lipopolysaccharide (LPS) into the blood circulation and markedly downregulated the gene expression levels of proinflammatory cytokines in hepatic tissue [1].