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Friday, 11 May 2012

Solutions from Nature: 1. Learning from Traditional (Indian origin) Wisdom

Solutions from Nature

Learning from Traditional Wisdom
Complementary and alternative medicine has been utilized for several years in various parts of the world to alleviate human disease. The preventive role of complementary and alternative medicine, in particular, cannot be overemphasized. “Complementary” implies that it joins conventional medicine as an equal counterpart to make the healing process complete. Alternative medicine substitutes for conventional medicine. It neither works with nor enhances conventional medicine, but rather acts as its replacement. Complementary and alternative medicine has been used for the well-being of the general population, especially when conventional modern medicine has failed to deliver and has also been used at times in conjunction with conventional medicine to obtain synergistic effects.
The traditional Indian System of Medicine, namely, Ayurveda [8], Traditional Chinese medicine (TCM) [8, 9], Japanese traditional medicine (Kampo) [10], Unani [11], Siddha, and so forth, belong to the category of complementary and alternative medicines. For some or the other reason the alternative herbal treatment systems have so far been unable to enter mainstream medicine [12], though serious efforts are being made, in view of their effectiveness, to develop a strong evidence-based standardization of Ayurveda, Siddha, Unani, Traditional Chinese Medical Therapy [13], and other CAM so that they can aptly fit into the modern medicinal framework.
Ayurveda, the traditional Indian system of medicine, has been widely used since centuries and a number of plants of the Indian subcontinent have been utilized for tackling almost every human ailment. Ayurveda’s focus is more on creating an energetic balance at the higher energetic or inner level. It sees all life and nature as constantly evolving towards a higher level of consciousness [14]. Ayurvedic formulations have an impact at this higher level of consciousness, as well as the more gross body level. Ayurveda seeks to connect us with this intelligence inherent in nature. These profound concepts, based upon an astute understanding of the universal laws and practical observations about the world around, give us the indication about the holistic approach of Ayurveda and its potential in alleviating many health-related problems afflicting the whole of humanity. Several antiviral agents have been isolated from plants as a result of chemical and pharmacological studies in the recent years, and many have been derived from leads based on Ayurvedic and other traditional medicine principles. These agents include a variety of polyphenols, flavonoids, saponins, glucosides, and alkaloids [15]. Here, we discuss various potential herbs that have been evaluated for their efficacy against flu viruses and hence can prove to be useful to combat the novel H1N1 pandemic.
Glycyrrhiza glabra
Also known as Yashtimadhu (Sanskrit), Mulathee (Hindi), and Licorice (English), Glycyrrhiza glabra (Papilionaceae) derives its flavour principally from a sweet-tasting compound called anethole (“trans”-1-methoxy-4-(prop-1-enyl)benzene). Additional sweetness in licorice comes from glycyrrhizic acid, an antiviral compound significantly sweeter than sugar [16]. Powdered licorice root is an effective expectorant, and has been used for this purpose since ancient times, especially in Ayurvedic medicine. The roots of the plant have been used for throat and upper respiratory tract-related infections and contain many phenolic compounds such as flavonoids and their glycosides, coumarin, and cinnamic acid derivatives. Particularly from the Indian species, Glucosides, Liquiritin, and Isoliquiritin have also been isolated. The active compounds Triterpine, Saponins, particularly Glycyrrhizinic acid have shown antiviral activity [17]. Polysaccharide fractions obtained from Glycyrrhiza glabra stimulate macrophages [18] and hence elevate and assist immune stimulation [19]. Also animal studies have revealed its efficacy against the influenza a virus that is mediated by stopping the virus replication [20]. Glycyrrhizic acid present in the plant inhibits virus growth and inactivates virus particles [21].
 Ocimum sanctum
O. sanctum, also known as Tulsi (Hindi) and Holy Basil (English), is an aromatic plant of the family Lamiaceae. The plant, as a whole, is a treasure house of potent compounds with its leaves, seeds, and roots, as well as flower being medicinally important and is considered divine by the Hindus. O. sanctum is considered to be an adaptogen par excellence [22, 23]. It harmonizes different processes in the body and is helpful in acclimatizing to stress. The main chemical constituents of O. sanctum are oleanolic acid, ursolic acid, rosmarinic acid, eugenol, carvacrol, linalool, and 𝛽-caryophyllene [23]. The antiviral activity of eugenol has been reported. Ocimum extracts are used in ayurvedic remedies for common colds, headaches, stomach disorders, inflammation, heart disease, various forms of poisoning, and malaria. Traditionally, O. sanctum is taken in many forms as herbal tea, dried powder, fresh leaf, or mixed with ghee. Essential oil extracted from Karpoora O. sanctum is mostly used for medicinal purposes and in herbal cosmetics, and is widely used in skin preparations due to its antimicrobial activity [24]. Recent studies suggest that O. sanctum may be a COX-2 inhibitor, like many modern painkillers, due to its high concentration of eugenol (1-hydroxy-2-methoxy-4-allylbenzene) [25]. O. sanctum is reported to be an effective treatment for diabetes and high cholesterol [26]. O. sanctum also shows promise for protection against radiation damage [27, 28]. O. sanctum leaves contain highest percentage of essential oils, infusion of which is given in malaria. Juice of the leaves is taken internally and is very effective in skin diseases such as itches fungal infections. Fresh leaves also cure chronic fever and when mixed with honey and ginger juice, it is useful in cough and bronchitis [29]. During the past decade the plant has been extensively investigated and has been shown to possess a range of biological activities such as antibacterial activity [30], antifungal activity [31], and antiviral activity [32]. Nitric oxide production was induced by O. tenuiflorum extracts in stimulated peripheral blood mononuclear cells in vitro and the active component(s) responsible for immunomodulatory action were identified [33]. The extract was also used to stimulate the cells individually and in combination with mitogens as well [34]. The antimicrobial properties of O. sanctum make it useful for the management of novel H1N1 flu.
 Alium sativum
Alium sativum, also known as Lahsan (Hindi) and Garlic (English), belongs to family Alliaceae. A. sativum has been used throughout recorded chronicles for both culinary and medicinal purposes. It has a characteristic pungent, spicy flavor. A. sativum has been used for hundreds of years to treat fungal, parasitic, and viral infections, and has anti-inflammatory properties that show promise for prevention of cardiovascular disease. It is known to kill influenza virus in vitro [35]. Researchers are focusing on an extract of A. sativum called ajoene, which appears to protect CD+ cells from attack by HIV early in the viral life cycle. At low concentrations, the drug appears to have little toxicity, and its anti-HIV activity is 45 times more powerful than the drug dextran sulfate. Ajoene is found only in fresh A. sativum and is not readily procurable. Recent investigations reveal that A. sativum impairs the activity of the liver enzymes that process protease inhibitors and raises the protease inhibitor levels. The in vitro antiviral activity of A. sativum extract (GE) on human cytomegalovirus (HCMV) was also evaluated in tissue cultures, plaque reduction, and early antigen assay. A dose-dependent inhibitory effect of GE was evident when GE was applied simultaneously with HCMV [36]. The in vitro antiviral effect of garlic against parainfluenza virus type 3 and human Rhinovirus type 2 has also been evaluated [37].
 Cocos nucifera
The coconut (Cocos nucifera) belongs to the Family Arecaceae (palm family). The most common form of its usage is the coconut oil, which is extracted from the kernel of matured coconut (Cocos nucifera). Throughout the tropical regions, it has been the primary source of fat in the diets of millions of people since aeons. Cocos nucifera oil has a long history of use, both as food and as medicine, throughout the world. It holds a high place of respect in Ayurvedic medicine in India. In folk remedies around the world, coconut is used to treat a wide assortment of ailments including abscesses, alopecia, amenorrhea, asthma, blenorrhagia, bronchitis, bruises, burns, cachexia, calculus, colds, constipation, cough, debility, dropsy, dysentery, dysmenorrhea, earache, erysipelas, fever, flu, gingivitis, gonorrhea, hematemesis, hemoptysis, jaundice, menorrhagia, nausea, phthisis, pregnancy, rash, scabies, scurvy, sore throat, stomachache, swelling, syphilis, toothache, tuberculosis, tumors, typhoid, venereal diseases, and wounds [20]. It has been reported that certain fatty acids, primarily medium-chain fatty acids (MCFA), and their derivatives (e.g., monoglycerides) have potent antiviral properties [59]. When C. nucifera oil is consumed, the medium-chain triglycerides (MCTs) are broken down into individual medium chain fatty acids and monoglycerides, which can kill or inactivate pathogenic microorganisms inside the body. The antiviral action, attributed to monolaurin (the monoglyceride of lauric acid), is that of solubilizing the lipids and phospholipids in the envelope of the pathogenic organisms causing the disintegration of their outer membrane. There is also evidence that MCFA interfere with the organism’s signal transduction [60] and the antimicrobial effect in viruses is due to interference with virus assembly and viral maturation [61].
Zingiber officinale
Zingiber officinale (Ginger) is a plant which belongs to the family Zingiberaceae. The characteristic odor and flavor of ginger root is caused by a mixture of zingerone, shogaols, and gingerols, volatile oils that comprise of about one to three percent of the weight of fresh ginger. In laboratory animals, the gingerols increase the motility of the gastrointestinal tract and have analgesic, sedative, antipyretic, and antibacterial properties [62]. Ginger contains gingerol, a pungent ingredient of ginger volatile oil with sulphur-containing compounds (allicin, alliin, and ajoene), and enzymes (allinase, peroxidase, and myrosinase). The antibiotic properties of allicin are well known. The allicins have fibrinolytic activity, which reduces platelet aggregation by inhibiting prostaglandin E2. Compounds in ginger also increase levels of antioxidant enzymes, including superoxide dismutase and glutathione peroxidase, which may be beneficial in inflammatory reactions triggered by viral infections [63]. Anti-influenza agents have been isolated from Z. officinale. TNF-𝛼, reported as anti-influenza cytokine, has been reported to be present in ginger [64].
Phyllanthus emblica
The Indian gooseberry (Phyllanthus emblica, syn. Emblica officinalis) is a deciduous tree of the Euphorbiaceae family. It is also known as Amlaka (sanskrit) and Amla (Hindi). In traditional Indian medicine, dried and fresh fruits of the plant are used. All parts of the plant, including the fruit, seed, leaves, root, bark, and flowers, are used in various Ayurvedic/Unani Medicine herbal preparations. According to Ayurveda, Emblica officinalis fruit is sour and astringent in taste, with sweet, bitter, and pungent secondary tastes.
Methanol extract of the fruit of Emblica officinalis has potent inhibitory action against human immunodeficiency virus-1 reverse transcriptase. Emblica officinalis aqueous extracts are used in Cuban traditional medicine for their antiviral activity against Hepatitis B virus and A and B influenza virus. The cytotoxicity of the extract was tested by means of colony-forming ability and growth-inhibition assays, as well as by measuring the mitotic index. Apoptosis induction and cell-cycle kinetics were analyzed by cytofluorimetric methods [72]. In Ayurvedic polyherbal formulations, Emblica officinalis is a common constituent, and most notably is the primary ingredient in an ancient herbal preparation called Chyawanprash [73], which is itself an effective adaptogen and immunity booster that could help control swine flu infection.
Tinospora cordifolia
Tinospora cordifolia, also called Guduchi, is a herbaceous vine of the family Menispermaceae indigenous to the tropical areas of India, Myanmar, and Sri Lanka. The active constituents are diterpene compounds, including tinosporone, tinosporic acid, cordifolisides A to E, syringen, the yellow alkaloid, berberine, Giloin, crude Giloininand, and a glucosidal bitter principle, as well as polysaccharides, including arabinogalactan polysaccharide (TSP) [74, 75]. These compounds possess adaptogenic and immunomodulating properties. Picrotene and bergenin, possessing antioxidant properties have been reported from Tinospora. Tinospora cordifolia has been studied extensively for its immunomodulating activities. The active principles of Tinospora cordifolia were found to possess immunomodulatory activities and caused significant increases in IgG antibodies in serum, along with macrophage activation [76]. Enhancement in humoral immunity, evidenced by the hemagglutination titre, along with stimulation of cell-mediated immunity were observed in the leukocyte migration inhibition tests [77]. The plant has immense potential for use against novel H1N1 flu since it is a potent immunostimulant.
Mentha piperita
Mentha piperita, family Labiatae, is a herbaceous rhizomatous perennial plant widely used in Ayurveda [78]. It contains about 1.2%–1.5% essential oil. The volatile oil, also known as menthae piperitae aetheroleum, contains 30–70% free menthol, menthol esters and more than 40 other compounds. The principal components of the oil are menthol (29%), menthone (20%–30%), and menthyl acetate (3%–10%). Pharmaceutical grade oil, produced by distilling the fresh aerial parts of the plant at the beginning of the flowering cycle, is standardized to contain no less than 44% menthol, 15%–30% menthone, and 5% esters, in addition to various terpenoids. Other compounds found in it are flavonoids (12%), polymerized polyphenols (19%), carotenes, tocopherols, betaine, and choline [79]. The antimicrobial and antiviral activity of menthol has been reported. Mentha piperita has significant antiviral activity [80]. Menthol is virucidal against influenza, herpes, and other viruses in vitro. Aqueous extracts of peppermint leaves exhibited antiviral activity against Influenza A, Newcastle disease virus, Herpes simplex virus, and Vaccinia virus in egg and cell-culture systems [81]. The oil contains terpenoids such as 𝛼-pinene or 𝛽-pinene, 𝛼-phellandren, and also ester-connected with menthol or free acetic acid and isovaleric acid, which are mainly responsible for the antimicrobial activity of the herb [82].
Azadirachta indica
Azadirachta indica (Neem in Hindi) is a tree in the mahogany family Meliaceae. Three bitter compounds that have been extracted from neem oil are nimbin, nimbinin, and nimbidin, respectively [83]. The seeds contain a complex secondary metabolite azadirachtin. All parts of the plant yield 𝛽-sitosterol. The antiviral activity of azadirachtin, nimbin, and nimbidin has been reported. Azadirachta indica extracts possess antidiabetic, antibacterial, and antiviral properties. The tree stem, root, and bark possess astringent and tonic properties [84, 85]. In vitro antiviral activity of aqueous neem leaves extract, assessed in cloned cells of larvae of Aedes albopictus cells employing virus inhibition assay, showed inhibition in a dose-dependent manner [86].
Azadirachta indica has traditionally been used as an antiviral, and animal and laboratory research has shown promising results. While researchers have still not pinpointed the exact mode of action of neem phytoconstituents, there is some evidence to show that they interfere with viral reproduction, thus minimizing the impact of viral infections. The effect of A. indica leaf extract and pure compound (Azadirachtin) on the replication of Dengue virus type-2 has also been reported. Thus, neem can serve as a source of promising future antiviral drugs [85].
Aegle marmelos
Aegle marmelos also called Bael (Hindi) belongs to family Rutaceae. It contains primarily alkaloids, coumarins, and steroids. The leaves contain skimianinc, sterol, and aegelin. The active constituent of the fruit is marmorosin, which is identical to imperatorin. Coumarins contained in the fruits are altoimperatorin and 𝛽 sitosterol. Roots of the tree have been found to contain psoralin, xanthotoxin, scopoletin, and tebamide. A. marmelos from India is reported to possess imperetorin [87], which has certain interesting biological properties such as analgesic, anti-inflammatory, antibacterial, and antiviral properties.
All parts of this tree-stem, bark, root, leaves, and fruit at all stages of maturity have been used in Ayurveda since ages. Medicated oil prepared from bael leaves gives relief from recurrent colds and respiratory infections. Its regular use builds up resistance to colds and coughs. The unripe fruit possesses significant antiviral activity.
Trachyspermum ammi
Trachyspermum ammi, called as Ajwain in Hindi and Bishops weed in English, is a member of the family Apiaceae. The principal constituents of the essential oil from the fruit are the phenols, mainly thymol and some carvacrol. The oil possesses p-cymene, g-terpinene, α- and 𝛽-pinenes, and dipentene, minute amounts of camphene, myrcene, and carene [88]. The essential oil is a strong antiseptic [89], antispasmodic, aromatic, bitter, diaphoretic, digestive, diuretic, expectorant, and tonic [90]. It is used internally in the treatment of colds, coughs, influenza, and asthma. The essential oil is also added to various cough medicines as well [89].
Andrographis paniculata
Andrographis paniculata (Kalmegha in Hindi) is a herbaceous plant in the family Acanthaceae, native to India and Sri Lanka. It is sometimes called “Indian Echinacea” because it is believed to provide much the same benefits as Echinacea. Andrographolide, the major constituent of the extract is implicated towards its pharmacological activity. Studies have been conducted on the cellular processes and targets modulated by andrographolide treatment of immune cells. Andrographis was found to both reduce the symptoms and shorten the duration of colds in clinical trials [90]. Andrographis paniculata also reduced the cold symptoms such as fatigue, sore throat, sore muscles, runny nose, headache, and lymph node swelling [91]. Unlike the Echinacea, Andrographis does not have any side effects.
Terminalia chebula Retz
Terminalia chebula, is a deciduous tree of family Combretaceae native to Southern Asia from India and Nepal east to Southwestern China (Yunnan), and south to Sri Lanka, Malaysia, and Vietnam. It is regarded as a universal panacea. The dry nut's peel from this plant is used to cure cold-related nagging coughs. The bark/peel of the nut is placed in the cheek and this generates a huge amount of saliva as the material does not dissolve. The resulting saliva, bitter in taste, is believed to have medicinal qualities to cure cold related coughs. Its fruits possess digestive, anti-inflammatory, anthelmentic, cardiotonic, aphrodisiac, and restorative properties and are additionally beneficial in cough and colds. Terminalia chebula is an important medicine, which often promotes health through successive steps of purification and detoxification. It is known to have strong antimutagenic activity, because of its very rich content vitamin C [92]. Also it is an established potent free radical scavenger [93].

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