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Tiwana G, Cock IE, Cheesman MJ. Phytochemical Analysis and Antimicrobial Activity of Terminalia bellirica (Gaertn.) Roxb. and Terminalia chebula Retz. Fruit Extracts Against Gastrointestinal Pathogens: Enhancing Antibiotic Efficacy. Microorganisms 2024; 12:2664. [PMID: 39770866 PMCID: PMC11728670 DOI: 10.3390/microorganisms12122664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2024] [Revised: 12/12/2024] [Accepted: 12/20/2024] [Indexed: 01/16/2025] Open
Abstract
Terminalia bellirica (Gaertn) Roxb. and Terminalia chebula Retz. are significant botanicals in ancient Ayurvedic medicine. They are renowned for their therapeutic properties, notably in addressing gastrointestinal (GI) diseases. These plants have undergone thorough examination related to their antibacterial, anti-inflammatory, and antioxidant properties, which make them highly efficient natural treatments for controlling gastrointestinal infections. The current research demonstrated the antibacterial efficacy of fruit extracts of Terminalia bellirica and Terminalia chebula against Bacillus cereus, Shigella sonnei, Shigella flexneri, and Salmonella typhimurium. We performed disc diffusion and liquid microdilution experiments to evaluate the antibacterial efficacy. All extracts of Terminalia bellirica and Terminalia chebula showed good antibacterial effects against B. cereus and S. flexneri. The minimum inhibitory concentration (MIC) values ranged from 94 µg/mL to 556 µg/mL. The methanolic extracts from both plants also showed noteworthy antibacterial activity against S. sonnei and S. typhimurium, with MIC values of 755 µg/mL for both. Fractional inhibitory concentration studies revealed additive interactions between some conventional antibiotics and the plant extracts when used concurrently. Liquid chromatography-mass spectrometry (LC-MS) analyses revealed that the T. bellirica and T. chebula extracts contained various tannins including methyl gallate, propyl gallate, gallic acid, and ellagic acid. Lethality assays conducted using Artemia franciscana Kellogg nauplii indicated that all the plant extracts are non-toxic. The antibacterial properties and absence of toxicity in T. bellirica and T. chebula fruit extracts indicate their potential for antibiotic development, warranting additional mechanistic and phytochemical studies.
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Affiliation(s)
- Gagan Tiwana
- School of Pharmacy and Medical Sciences, Gold Coast Campus, Griffith University, Gold Coast 4222, Australia;
| | - Ian Edwin Cock
- School of Environment and Science, Nathan Campus, Griffith University, Brisbane 4111, Australia;
| | - Matthew James Cheesman
- School of Pharmacy and Medical Sciences, Gold Coast Campus, Griffith University, Gold Coast 4222, Australia;
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Efficient separation of uranium from aqueous solution using sustainable biomass: an insight of adsorption isotherm and kinetics. J Radioanal Nucl Chem 2023. [DOI: 10.1007/s10967-023-08861-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
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Kumari U, Zafar T, Shafqat S, Askary SH, Qasim M, Kamran MA, Baig EA, Shaikh AC, Qureshi A. Caries-affected dentin disinfection using Triphala, Indocyanine green, and Potassium Titanyl Phosphate laser and their effect on adhesive bond strength. Photodiagnosis Photodyn Ther 2022; 41:103257. [PMID: 36592785 DOI: 10.1016/j.pdpdt.2022.103257] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 12/23/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022]
Abstract
AIM To assess the impact of new cavity sterilization types using ozone water (OW), Potassium Titanyl Phosphate laser (KTPL), Triphala, and indocyanine green photosensitizer (ICGP) on adhesive bond strength. MATERIALS AND METHODS Fifty human permanent molars were included based on the criteria of International Caries Detection and Assessment System (ICDAS) scores 4 and 5 visual examinations, surface hardness valuation, staining by a caries detector solution, and radiographs. Caries-affected dentin (CAD) samples were randomly distributed into groups based on methods of disinfection (n = 10). Group 1: chlorhexidine, group 2: ow, group 3: KTPL, group 4: Triphala, and group 5: ICGP. Following disinfection, specimens were applied with Adper prime and bond NT and then restored with resin composite. All specimens were positioned in a jig of the universal testing machine for shear bond strength (SBS). The debonded samples were analyzed under a stereomicroscope at 40x magnification to determine the type of failure. Analysis of variance (ANOVA) and Tukey HSD tests were used keeping the level of significance p < 0.05. RESULTS The highest bond of adhesive resin was displayed by group 2 specimens cleaned using OW (16.71 ± 0.19 MPa). Whereas, the lowest bond integrity was observed by group 5 specimens disinfected using ICGP (11.21 ± 0.16 MPa). It was observed samples disinfected with OW (16.71 ± 0.19 MPa) in group 2 and samples in group 4 (16.09 ± 0.26 MPa) treated with Triphala displayed comparable outcomes of bond strength (p > 0.05). It was observed that group 2 (70%) and 4 (80%) treated specimens accounted mostly for cohesive failure. However, groups 1 (80%), 3 (60%), and 5 (70%) displayed an adhesive failure pattern. CONCLUSION OW and Triphala displayed better bond integrity of adhesive resin to CAD and therefore have the potential to be used as a cavity disinfectant in clinical settings. However, ICGP and KTPL displayed weak bonds of adhesive to CAD. More work is needed to extrapolate the findings of the present study.
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Affiliation(s)
- Ujala Kumari
- Dental Clinician, Private Dental Clinic, Karachi, Pakistan
| | | | | | - Syed Hussain Askary
- Department of Community Dentistry, Fatima Jinnah Dental College, Karachi, Pakistan
| | - Muhammad Qasim
- Department of Operative Dentistry and Endodontics King Khalid University, Abha, Saudi Arabia
| | - Muhammad Abdullah Kamran
- Department of Pedodontics and Orthodontics Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Eisha Abrar Baig
- Department of Operative Dentistry, Dow International Dental College, Karachi, Pakistan
| | - Amynah C Shaikh
- Department of Oral Biology, College of Dentistry, Dow International Dental College, Karachi, Pakistan
| | - Ambrina Qureshi
- Department of Community and Preventive Dentistry, Dow University of Health Sciences, Karachi, Pakistan.
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Ceviche-Natural Preservative: Possibility of Microbiota Survival and Effect on L. monocytogenes. Foods 2022; 11:foods11060860. [PMID: 35327282 PMCID: PMC8950590 DOI: 10.3390/foods11060860] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 11/23/2022] Open
Abstract
Ceviche is a marinated raw fish dish ready for consumption; it is a part of the cuisine of various countries on the Pacific coast and its preparation may differ among them. Although the process uses the traditional method of food preservation by lowering the pH, the exposure time is very limited, so the aim of the study was to determine the viability of bacteria often isolated from fish after the process of preparing traditional ceviche. For this purpose, the traditional plate method and flow cytometry were used, and for pathogenic L. monocytogenes strains, the influence of stress during the preparation of the dish on the pathogenic potential was determined. The study showed that the highest percentage of viable cells was observed in the case of L. monocytogenes and remained at the level of 98.54%, slightly less for L. innocua, 96.93%. For the remaining species the reduction did not exceed 10%, for E. faecalis it was 92.76%, for S. liqefaciens 91.44%, H. alvei 93.68%. In addition, the study of the antibacterial properties of individual ingredients showed that habanero and coriander did not show any bactericidal effect, while for onions the amount of live cells was 99.11%, and for lime juice 97.26%, Additionally, the study of changes in virulence, antibiotic resistance and gene expression showed that the stress during the preparation of ceviche has different effects depending on the strain and may cause virulence potential increase, levofloxacin and daptomycin minimum inhibiotory concentration increase and some crucial virulence gene expression induction; therefore, it is important to take care of the quality of the products used to prepare the ceviche and accurate pretreatment.
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Wang N, Luo J, Deng F, Huang Y, Zhou H. Antibiotic Combination Therapy: A Strategy to Overcome Bacterial Resistance to Aminoglycoside Antibiotics. Front Pharmacol 2022; 13:839808. [PMID: 35281905 PMCID: PMC8905495 DOI: 10.3389/fphar.2022.839808] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/08/2022] [Indexed: 12/15/2022] Open
Abstract
After the first aminoglycoside antibiotic streptomycin being applied in clinical practice in the mid-1940s, aminoglycoside antibiotics (AGAs) are widely used to treat clinical bacterial infections and bacterial resistance to AGAs is increasing. The bacterial resistance to AGAs is owed to aminoglycoside modifying enzyme modification, active efflux pump gene overexpression and 16S rRNA ribosomal subunit methylation, leading to modification of AGAs' structures and decreased concentration of drugs within bacteria. As AGAs's side effects and bacterial resistance, the development of AGAs is time-consuming and difficult. Because bacterial resistance may occur in a short time after application in clinical practice, it was found that the antibacterial effect of the combination was not only better than that of AGAs alone but also reduce the dosage of antibiotics, thereby reducing the occurrence of side effects. This article reviews the clinical use of AGAs, the antibacterial mechanisms, the molecular mechanisms of bacterial resistance, and especially focuses a recent development of the combination of AGAs with other drugs to exert a synergistic antibacterial effect to provide a new strategy to overcome bacterial resistance to AGAs.
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Affiliation(s)
| | | | | | | | - Hong Zhou
- Key Laboratory of Basic Pharmacology, Ministry of Education and Joint Laboratory of International Cooperation, Ministry of Education of Characteristic Ethnic Medicine, School of Pharmacy, Zunyi Medical University, Zunyi, China
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Abass S, Parveen R, Irfan M, Jan B, Husain SA, Ahmad S. Synergy based extracts of medicinal plants: Future antimicrobials to combat multidrug resistance. Curr Pharm Biotechnol 2022; 23:1527-1540. [PMID: 35081888 DOI: 10.2174/1389201023666220126115656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 12/17/2021] [Accepted: 12/28/2021] [Indexed: 11/22/2022]
Abstract
The use of herbal medicines and supplements in the last thirty years has increased enormously. Herbal medication has demonstrated promising and effective potential against various diseases. Herbal and phytoconstituent medications are gaining popularity globally and many people are adopting herbal remedies to deal with different health issues. The indiscriminate use of antibiotics, due to the development of antimicrobial resistance, poses an unprecedented problem for human civilization. Bacterial infections are difficult to cure because of the propensity of microbes to acquire resistance to a wide range of antimicrobial drugs. New compounds are being explored and quantified for possible antibacterial activity with little or no side effects. Researchers are investigating the range of therapeutic plants mentioned in Unani, Ayurveda, and Siddha around the globe. Known and commonly acclaimed global databases such as PubMed, Research Gate, Science Direct, Google Scholar, were searched using different search strings such as Indian medicinal plants, multidrug resistance (MDR), thin layer chromatography (TLC), antimicrobials, and Synergism were used in diverse combinations to reclaim numerous citations associated with this area. Thus, the current review aims to shed a light on the information of medicinal plants as a potential foundation of herbal drugs and elucidate how synergism and TLC bioautography plays a crucial role in finding antimicrobial compounds.
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Affiliation(s)
- Sageer Abass
- Department of Biotechnology, Jamia Millia Islamia, New Delhi 110025, India
- Bioactive Natural Product Laboratory, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India
- Department of Biosciences, Jamia Millia Islamia, New Delhi 110025, India
| | - Rabea Parveen
- Bioactive Natural Product Laboratory, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India
- Department of Biosciences, Jamia Millia Islamia, New Delhi 110025, India
| | - Mohammad Irfan
- Department of Biotechnology, Jamia Millia Islamia, New Delhi 110025, India
- Bioactive Natural Product Laboratory, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India
| | - Bisma Jan
- Bioactive Natural Product Laboratory, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India
| | - Syed Akhtar Husain
- Department of Biosciences, Jamia Millia Islamia, New Delhi 110025, India
| | - Sayeed Ahmad
- Bioactive Natural Product Laboratory, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India
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Gantait S, Mahanta M, Bera S, Verma SK. Advances in biotechnology of Emblica officinalis Gaertn. syn. Phyllanthus emblica L.: a nutraceuticals-rich fruit tree with multifaceted ethnomedicinal uses. 3 Biotech 2021; 11:62. [PMID: 33489680 PMCID: PMC7801590 DOI: 10.1007/s13205-020-02615-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 12/24/2020] [Indexed: 02/06/2023] Open
Abstract
Emblica officinalis Gaertn. syn. Phyllanthus emblica L., universally known as ‘Amla’ or ‘Aonla’ or ‘Indian gooseberry’, is a popular fruit tree belonging to the family Euphorbiaceae and order Geraniales. It is said to be the very first tree that originated on earth, as claimed by age-old Indian mythology. Almost all parts of the tree i.e., root, bark, leaf, flower, fruit and seed are utilized in Ayurvedic and Unani medicinal formulations to improve the overall digestive process, decrease fever, act as a blood purifier, relieve asthma and cough, improve heart health, etc. This tree contains major secondary metabolites like emblicanin-A and emblicanin-B, and also is an affluent source of vitamin-C. Additionally, some other secondary metabolites like tannins, gallic acid, pyrogallol, and pectin are also present in significant amounts. Conventional propagation has been improved via suitable interventions of agrotechnology both in production and protection areas. However, the rate of propagation remains slower; therefore, attempts have been made for biotechnological advancements on E. officinalis. The present review makes an attempt to highlight the botanical description, geographical distribution, ethnopharmacological importance, conventional propagation and protection of this medicinal tree, describing the in vitro-based plant organ and tissue culture methods like direct and indirect organogenesis and somatic embryogenesis along with interventions of molecular marker-based biotechnology and nanotechnology. Further, the prospect of the yet-to-be-explored biotechnological methods for secondary metabolite enhancement like cell suspension, protoplast culture, genetic transformation, etc. and their potential for enhanced emblicanin production have also been discussed in this appraisal.
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Affiliation(s)
- Saikat Gantait
- Crop Research Unit (Genetics and Plant Breeding), Bidhan Chandra Krishi Viswavidyalaya, Mohanpur, Nadia, 741252 West Bengal India
| | - Manisha Mahanta
- Crop Research Unit (Genetics and Plant Breeding), Bidhan Chandra Krishi Viswavidyalaya, Mohanpur, Nadia, 741252 West Bengal India
| | - Soumen Bera
- College of Agriculture, Bidhan Chandra Krishi Viswavidyalaya, Burdwan, 713101 West Bengal India
| | - Sandeep Kumar Verma
- Institute of Biological Science, SAGE University, Baypass Road, Kailod Kartal, Indore, 452020 Madhya Pradesh India
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Tiwana G, Cock IE, White A, Cheesman MJ. Use of specific combinations of the triphala plant component extracts to potentiate the inhibition of gastrointestinal bacterial growth. JOURNAL OF ETHNOPHARMACOLOGY 2020; 260:112937. [PMID: 32464314 DOI: 10.1016/j.jep.2020.112937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Triphala is used in Ayurveda to treat a wide variety of diseases, including numerous bacterial infections. Interestingly, the plant components of triphala (Terminalia bellirica, Terminalia chebula and Emblica officinalis) are also good inhibitors of bacterial growth when used individually, yet plant preparations are generally used in combination in traditional medicine. Surprisingly, no previous studies have addressed the reason why the combination is preferred over the individual components to treat bacterial infections. AIM OF THE STUDY To test and compare the antibacterial efficacy of triphala and its component parts to quantify their relative efficacies. The individual plant components will also be tested as combinations, thereby determining whether combining the individual components potentiates the antibacterial activity of the components used alone. MATERIALS AND METHODS Triphala and the three individual plant components were extracted using solvents of varying polarity (methanol, water, ethyl acetate) and the antibacterial activity of the aqueous resuspensions was quantified by disc diffusion and broth microdilution MIC assays. Combinations of extracts produced from the individual components were also tested against each bacterial species and the ΣFICs was calculated to determine the class of interaction. Where synergy was detected, isobologram analysis was used to determine the optimal component ratios. The Artemia nauplii bioassay was used to test for toxicity and GC-MS headspace profiling analysis was used to highlight terpenoid components that may contribute to the antibacterial activity of triphala. RESULTS The aqueous and methanolic triphala, T. bellirica, T. chebula and E. officinalis extracts displayed good inhibitory activity against all bacterial strains, with MICs often in the 250-750 μg/mL range. The methanolic extracts were generally more potent than the aqueous extracts and T. chebula was the most potent of the individual plant components. Combining the extracts of the different plant species resulted in potentiation of the growth inhibitory activity of most combinations compared to that of the individual components. Indeed, with the exception of S. flexneri, all bacterial species were potentiated by at least one combination of methanolic plant extracts, with a substantial proportion of these displaying synergistic interactions. All extracts were found to be either non-toxic, or of low to moderate toxicity in Artemia nauplii assays. CONCLUSION Whilst the individual plant components of triphala all inhibit the growth of multiple pathogenic bacteria, the activity is potentiated for multiple combinations. Therefore, the traditional usage of the combination of the three plant materials in triphala not only extends the activity profile of the mixture over that of the individual components, but it also substantially potentiates the inhibitory activity towards multiple bacteria, partially explaining the preference of triphala compared to the individual components.
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Affiliation(s)
- Gagan Tiwana
- School of Pharmacy and Pharmacology, Gold Coast Campus, Griffith University, Parklands Drive, Southport, Queensland, 4222, Australia; Menzies Health Institute Queensland, Quality Use of Medicines Network, Queensland, 4222, Australia
| | - Ian E Cock
- School of Environment and Science, Nathan Campus, Griffith University, 170 Kessels Rd, Nathan, Queensland, 4111, Australia; Environmental Futures Research Institute, Nathan Campus, Griffith University, 170 Kessels Rd, Nathan, Queensland, 4111, Australia.
| | - Alan White
- School of Environment and Science, Nathan Campus, Griffith University, 170 Kessels Rd, Nathan, Queensland, 4111, Australia
| | - Matthew J Cheesman
- School of Pharmacy and Pharmacology, Gold Coast Campus, Griffith University, Parklands Drive, Southport, Queensland, 4222, Australia; Menzies Health Institute Queensland, Quality Use of Medicines Network, Queensland, 4222, Australia.
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Peterson CT, Pourang A, Dhaliwal S, Kohn JN, Uchitel S, Singh H, Mills PJ, Peterson SN, Sivamani RK. Modulatory Effects of Triphala and Manjistha Dietary Supplementation on Human Gut Microbiota: A Double-Blind, Randomized, Placebo-Controlled Pilot Study. J Altern Complement Med 2020; 26:1015-1024. [PMID: 32955913 DOI: 10.1089/acm.2020.0148] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Objectives: Triphala (which contains Emblica officinalis, Terminalia bellerica, and Terminalia chebula) and manjistha (Rubia cordifolia), have received increased clinical attention. The aim of the study was to evaluate the effects of triphala, manjistha, or placebo dietary supplementation on gut microbiota as such studies in humans are lacking. Design: This was a 4-week randomized, double-blind, placebo-controlled pilot trial. Setting: This trial was conducted at the University of California Davis, Department of Dermatology. Subjects: A total of 31 healthy human subjects were randomized to 3 groups. Interventions: The 3 groups were instructed to take 2,000 mg of either triphala, manjistha or placebo daily for 4 weeks. Outcome Measures: The impact of treatment on gut microbiota composition was evaluated following a 4-week dietary intervention by profiling fecal communities with 16S rRNA profiling in triphala (n = 9), manjistha (n = 9), or placebo (n = 11) treated subjects that completed the intervention. Results: An average of 336 phylotypes were detected in each sample (range: 161 to 648). The analysis of gut microbiota in placebo control and herb-supplemented participants indicated that responses were highly personalized, and no taxa were uniformly altered by the medicinal herb supplementation protocol. Subjects in both treatment groups displayed a trend toward decreased Firmicutes to Bacteroidetes ratio and increased relative abundance of Akkermansia muciniphila. Both medicinal herb treatments reduced the relative abundance of Rikenellaceae, primarily reflecting changes in Alistipes spp. Conclusions: Dietary supplementation with medicinal herbs altered fecal microbial communities. Despite the lack of a clear response signature, a group of bacterial taxa were identified that were more commonly altered in herb-supplemented participants compared to placebo controls. Clinicaltrials.gov identifier NCT03477825.
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Affiliation(s)
- Christine T Peterson
- Department of Family Medicine and Public Health, Center of Excellence for Research and Training in Integrative Health, University of California San Diego, School of Medicine, La Jolla, CA, USA
| | - Aunna Pourang
- Department of Dermatology, University of California Davis, Sacramento, CA, USA
| | - Simran Dhaliwal
- Department of Dermatology, University of California Davis, Sacramento, CA, USA
| | - Jordan N Kohn
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Sasha Uchitel
- Department of Biology, Washington University, St. Louis, MO, USA
| | - Harjot Singh
- Department of Naturopathic Medicine, Bastyr University San Diego, La Jolla, CA, USA
| | - Paul J Mills
- Department of Family Medicine and Public Health, Center of Excellence for Research and Training in Integrative Health, University of California San Diego, School of Medicine, La Jolla, CA, USA
| | - Scott N Peterson
- Tumor Microenvironment and Cancer Immunology Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA
| | - Raja K Sivamani
- Department of Dermatology, University of California Davis, Sacramento, CA, USA.,Department of Biological Sciences, California State University, Sacramento, CA, USA.,College of Medicine, California Northstate University, Elk Grove, CA, USA.,Pacific Skin Institute, Sacramento, CA, USA.,Zen Dermatology, Sacramento, CA, USA
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Evaluation of Antimicrobial Activity of Triphala Constituents and Nanoformulation. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:6976973. [PMID: 32831876 PMCID: PMC7422007 DOI: 10.1155/2020/6976973] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/01/2020] [Accepted: 07/21/2020] [Indexed: 12/12/2022]
Abstract
The prevalence of nosocomial infections due to multidrug resistant (MDR) bacterial strains is associated with high morbidity and mortality. Folk medicine and ethnopharmacological data can provide a broad range of plants with promising antimicrobial activity. Triphala, an Ayurvedic formula composed of three different plants: Terminalia chebula Retz., Terminalia bellirica (Gaertn.) Roxb. (Combretaceae), and Phyllanthus emblica L. (Phyllanthaceae), is used widely for various microbial infections. Various extraction techniques were applied in the extraction of the biologically active constituents of Triphala in order to compare their efficiency. Microwave-assisted extraction (MAE) was shown to be the most efficient method based on yield, extraction time, and selectivity. The Triphala hydroalcoholic extract (TAE) has been chemically characterized with spectroscopic and chromatographic techniques. Triphala hydroalcoholic extract was evaluated alone or with carvacrol. Different drug formulations including cream and nanoemulsion hydrogel were prepared to assess the antimicrobial activity against selected microorganism strains including Gram-positive and Gram-negative bacteria and fungi. We used a lipophilic oil of carvacrol (5 mg/mL) and a hydrophilic TAE (5 mg/mL) ingredient in a dosage form. Two solutions were created: hydrogel containing nanoemulsion as a lipophilic vector dispersed in the gel as a hydrophilic vehicle and a cream formulation, an oil-in-water emulsion. In both cases, the concentration was 250 mg of active ingredient in 50 mL of final formulation. The formulas developed were stable from a physical and chemical perspective. In the nanoemulsion hydrogel, the oil droplet size ranged from 124 to 129 nm, with low polydispersity index (PdI) 0.132 ± 0.013 and negative zeta potential -46.4 ± 4.3 mV. For the cream, the consistency factor (cetyl alcohol and white wax) induced immobilization of the matrix structure and the stability. Triphala hydroalcoholic extract in drug nanoformulation illustrated might be an adjuvant antimicrobial agent for treating various microbial infections.
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Kumar A, Sharma M, Chaubey SN, Kumar A. Homology modeling and molecular dynamics based insights into Chalcone synthase and Chalcone isomerase in Phyllanthus emblica L. 3 Biotech 2020; 10:373. [PMID: 32832333 DOI: 10.1007/s13205-020-02367-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 07/27/2020] [Indexed: 02/07/2023] Open
Abstract
Chalcone synthase (CHS) and chalcone isomerase (CHI) plays a major role in the biosynthesis of flavonoid in plants. In this study, we made extensive bioinformatics analysis to gain functional and structural insight into PeCHS and PeCHI proteins. The phylogenetic distribution of PeCHS and PeCHI genes encoding proteins demonstrated the close evolutionary relationship with different CHS and CHI proteins of other dicot plants. MicroRNA target analysis showed miR169n and 3p miR5053 targeting PeCHS gene while miR169c-3p and miR4248 are targeting PeCHI gene, respectively. Three-dimensional structural models of PeCHS and PeCHI proteins were elucidated by homology modeling with Ramachandran plots showing the excellent geometry of the proteins structure. Molecular docking revealed that cinnamoyl-coa and naringenin chalcone substrates are strongly bound to PeCHS and PeCHI proteins, respectively. Finally, molecular dynamics (MD) simulation for 30 ns, further yielded stability checks of ligands in the binding pocket and behavior of protein complexes. Thus MD simulation and interaction fraction analysis showed the stable conformation of PeCHS and PeCHI proteins with their respective substrates during theee simulation. Our study provides first-hand structural prospective of PeCHS and PeCHI proteins towards understanding the mechanism of flavonoid biosynthetic pathway in P. emblica.
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Affiliation(s)
- Anuj Kumar
- Advance Centre for Computational and Applied Biotechnology, Uttarakhand Council for Biotechnology (UCB), Dehradun, 248007 India
| | - Mansi Sharma
- Bioclues.Org, Kukatpally, Hyderabad, 500072 India
| | - Swaroopa Nand Chaubey
- Department of Bioinformatics, Biotech Park, Sector G, Jankipuram, Lucknow, UP 226021 India
| | - Avneesh Kumar
- Department of Botany, Akal University, Talwandi Sabo, Bathinda, 151302 India
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Phetkate P, Kummalue T, Rinthong PO, Kietinun S, Sriyakul K. Study of the safety of oral Triphala aqueous extract on healthy volunteers. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2020; 18:35-40. [DOI: 10.1016/j.joim.2019.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 05/17/2019] [Indexed: 01/05/2023]
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Manoraj A, Thevanesam V, Bandara BMR, Ekanayake A, Liyanapathirana V. Synergistic activity between Triphala and selected antibiotics against drug resistant clinical isolates. Altern Ther Health Med 2019; 19:199. [PMID: 31375093 PMCID: PMC6679468 DOI: 10.1186/s12906-019-2618-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 07/25/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Triphala is an indigenous medical product used for a variety of diseases. This study was conducted to determine the effect of Triphala on antibiotic properties of gentamicin and oxacillin against multi-drug resistant organisms. METHODS The checkerboard method was used to determine the synergy of Triphala with gentamicin and oxacillin against multi-drug resistant (MDR) Gram negative bacilli and methicillin-resistant Staphylococcus aureus (MRSA) using 2,3,5-triphenyltetrazolium chloride (TTC) assay. Fractional inhibitory concentration (FIC) index was calculated. RESULTS When tested alone, the minimum inhibitory concentration (MIC) values of gentamicin for Gram negative isolates ranged from 8 to > 64 μg/ml. The MIC values of gentamicin for the Gram negative isolates ranged from 1 to 32 μg/ml when tested with Triphala. The FIC index was < 1 indicating a synergistic interaction in 10 of the 11 isolates and it was 1 indicating an additive effect in one isolate. The MIC values of oxacillin for MRSA isolates ranged from 4 to > 16 μg/ml with all MICs being equal to or higher than the resistance cut-off level. The MIC level with the addition of Triphala ranged from 0.25 to 4 μg/ml. FIC index was < 1 for all tested isolates indicating a synergistic interaction. CONCLUSIONS Triphala has synergistic activity with gentamicin against the selected MDR Gram negative bacilli and with oxacillin against MRSA isolates warranting further studies on the possibility of clinical use.
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Optimization of antibacterial activity ofEucalyptus tereticornisleaf extracts againstEscherichia colithrough response surface methodology. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2019. [DOI: 10.1016/j.jrras.2016.05.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Zhao Y, Wang M, Tsering J, Li H, Li S, Li Y, Liu Y, Hu X. An Integrated Study on the Antitumor Effect and Mechanism of Triphala Against Gynecological Cancers Based on Network Pharmacological Prediction and In Vitro Experimental Validation. Integr Cancer Ther 2018; 17:894-901. [PMID: 29742928 PMCID: PMC6142109 DOI: 10.1177/1534735418774410] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Objectives. Triphala is a herbal medicine that has been widely
used for treating a variety of ailments. This study aims to systematically
analyze the antitumor effects of Triphala on gynecological cancers.
Methods. The antineoplastic activities of Triphala on
gynecological cancers were analyzed using network pharmacology-based strategies.
Afterward, the human ovarian cancer cell line SK-OV-3, cervical cancer cell line
HeLa, and endometrial cancer cell line HEC-1-B were selected for experimetal
valification. Results. Network pharmacology analysis suggested
that Triphala could comprehensively intervene in proliferation and apoptosis
through diverse signaling pathways, mainly including MAPK/ERK, PI3K/Akt/mTOR,
and NF-κB/p53. The Cell Counting Kit 8 (CCK-8) assay illustrated that Triphala
was able to inhibit cell proliferation with half inhibition concentration
(IC50) values of 98.28 ± 13.71, 95.56 ± 8.94, and 101.23 ± 7.76
µg/mL against SK-OV-3, HeLa, and HEC-1-B cells, respectively. The ELISA
experiment demonstrated that Triphala was capable of promoting programmed cell
death, with dosage correlations. The antiproliferative and proapoptotic
activities were confirmed by flow cytometric analysis using Ki67 antibody and
Annexin V/propidium iodide (PI) dual staining. Western blotting revealed a
decrease in expression levels of phospho-Akt, phospho-p44/42, and phospho-NF-κB
p56 in cells administered Triphala, which indicated that the possible mechanism
could involve downregulation of MAPK/ERK, PI3K/Akt/mTOR, and NF-κB/p53 signaling
pathways, as was predicted. Conclusion. Triphala holds great
promise for treating gynecological cancers. Although the favorable
pharmacological properties have been preliminarily investigated in this study,
further studies are still needed to uncover the sophisticated mechanism of
Triphala in cancer therapy.
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Affiliation(s)
- Yuhang Zhao
- 1 Daqing Oilfield General Hospital, Daqing, China
| | - Min Wang
- 2 Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jokyab Tsering
- 3 Beijing Tibetan Hospital, China Tibetology Research Centre, Beijing, China
| | - Hanluo Li
- 4 University Leipzig, Leipzig, Germany
| | - Simin Li
- 4 University Leipzig, Leipzig, Germany
| | - Yuepeng Li
- 1 Daqing Oilfield General Hospital, Daqing, China
| | - Yinghua Liu
- 3 Beijing Tibetan Hospital, China Tibetology Research Centre, Beijing, China
| | - Xianda Hu
- 3 Beijing Tibetan Hospital, China Tibetology Research Centre, Beijing, China
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Abstract
Aim: The aim of this article is to review the current literature on the therapeutic uses and efficacy of Triphala. Herbal remedies are among the most ancient medicines used in traditional systems of healthcare such as Ayurveda. Triphala, a well-recognized and highly efficacious polyherbal Ayurvedic medicine consisting of fruits of the plant species Emblica officinalis (Amalaki), Terminalia bellerica (Bibhitaki), and Terminalia chebula (Haritaki), is a cornerstone of gastrointestinal and rejuvenative treatment. Methods: A search of the PubMed database was conducted. Results: In addition, numerous additional therapeutic uses described both in the Ayurvedic medical literature and anecdotally are being validated scientifically. In addition to laxative action, Triphala research has found the formula to be potentially effective for several clinical uses such as appetite stimulation, reduction of hyperacidity, antioxidant, anti-inflammatory, immunomodulating, antibacterial, antimutagenic, adaptogenic, hypoglycemic, antineoplastic, chemoprotective, and radioprotective effects, and prevention of dental caries. Polyphenols in Triphala modulate the human gut microbiome and thereby promote the growth of beneficial Bifidobacteria and Lactobacillus while inhibiting the growth of undesirable gut microbes. The bioactivity of Triphala is elicited by gut microbiota to generate a variety of anti-inflammatory compounds. Conclusions: This review summarizes recent data on pharmacological properties and clinical effects of Triphala while highlighting areas in need of additional investigation and clinical development.
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Affiliation(s)
- Christine Tara Peterson
- 1 Department of Family Medicine and Public Health, UC San Diego School of Medicine, Center of Excellence for Research and Training in Integrative Health , La Jolla, CA.,2 Chopra Foundation , Department of Ayurveda and Yoga Research, Carlsbad, CA
| | - Kate Denniston
- 3 Department of Naturopathic Medicine, Bastyr University , San Diego, CA
| | - Deepak Chopra
- 1 Department of Family Medicine and Public Health, UC San Diego School of Medicine, Center of Excellence for Research and Training in Integrative Health , La Jolla, CA.,2 Chopra Foundation , Department of Ayurveda and Yoga Research, Carlsbad, CA
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Mamgain P, Kandwal A, Mamgain RK. Comparative Evaluation of Triphala and Ela Decoction With 0.2% Chlorhexidine as Mouthwash in the Treatment of Plaque-Induced Gingivitis and Halitosis: A Randomized Controlled Clinical Trial. J Evid Based Complementary Altern Med 2016; 22:468-472. [PMID: 27932522 PMCID: PMC5871163 DOI: 10.1177/2156587216679532] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Present study evaluates efficacy of Trifala and Ela as plaque controlling agent and compares it with chlorhexidine.
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Affiliation(s)
- Pratibha Mamgain
- 1 Department of Ayurveda, Himalayan Institute of Medical Sciences, Swami Rama Himayalan University, Dehradun, Uttarakhand, India
| | - Abhishek Kandwal
- 2 Department of Dental surgery, Himalayan Institute of Medical Sciences, Swami Rama Himayalan University Dehradun, Uttarakhand, India
| | - Ravindra K Mamgain
- 1 Department of Ayurveda, Himalayan Institute of Medical Sciences, Swami Rama Himayalan University, Dehradun, Uttarakhand, India
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Takauji Y, Miki K, Mita J, Hossain MN, Yamauchi M, Kioi M, Ayusawa D, Fujii M. Triphala, a formulation of traditional Ayurvedic medicine, shows protective effect against X-radiation in HeLa cells. J Biosci 2016; 41:569-575. [DOI: 10.1007/s12038-016-9639-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Yang B, Liu P. Composition and biological activities of hydrolyzable tannins of fruits of Phyllanthus emblica. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2014; 62:529-41. [PMID: 24369850 DOI: 10.1021/jf404703k] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Fruits of emblic leafflower have been used as food and traditional medicine in Asia. A wide range of biological activities have been shown in modern research suggesting potential of the fruits as healthy food and raw material for bioactive ingredients of food. Hydrolyzable tannins are among the major bioactive components of the fruits. Mucic acid gallate, mucic acid lactone gallate, monogalloylglucose, gallic acid, digalloylglucose, putranjivain A, galloyl-HHDP-glucose, elaeocarpusin, and chebulagic acid are the most abundant hydrolyzable tannins. The compositional profiles of tannins in the fruits vary depending on the cultivars as well as ripening stages. Fruits and tannin-rich extracts of fruits have shown antidiabetic, antimicrobial, anti-inflammatory, and immune-regulating activities in vitro and in animal studies. The fruits and fruit extracts have manifested protective effects on organs/tissues from damages induced by chemicals, stresses, and aging in animal models. The fruits and fruit extracts have potential in inhibiting the growth of cancer cells and reducing DNA damage induced by chemicals and radiation. Antioxidative activities are likely among the mechanisms of the biological activities and physiological effects. Human intervention/clinical studies are needed to investigate the bioavailability and metabolism of the tannins and to substantiate the health benefits in humans. Emblic leafflower may be a potential raw material for natural food preservatives.
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Affiliation(s)
- Baoru Yang
- Food Chemistry and Food Development, Department of Biochemistry, University of Turku , FI-20014 Turku, Finland
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Santhosh SB, Ambi AB, Hiremath RR, Mannur VS. Development of a chewable tablet from Dugdhāmalakyādi Yoga: An Ayurvedic preparation. Anc Sci Life 2013; 32:34-7. [PMID: 23929992 PMCID: PMC3733205 DOI: 10.4103/0257-7941.113802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Āmalaki (Embelica officinalis Gaertn.) is one of the most celebrated herbs in the Indian system of traditional medicine. It is one of the best Rasāyana-s (health promoting) drug. In Dugdhāmalakyādi yoga, Āmalaki (Embelica officinalis Gaertn.) powder is administered along with milk in case of svarabhaṅga (hoarseness of voice). Here an attempt is made to convert this formulation into chewable tablet without altering its property to improve its palatability, shelf life and fixation of proper therapeutic dose. METHODOLOGY Chewable tablets were prepared by wet granulation method. Here, Āmalaki powder was prepared initially and it was mixed with additives and preservatives. Granules were prepared from this mixture by adding binding agent, finally compressed in to tablets. RESULTS AND CONCLUSION The physico-chemical analysis of Āmalaki standard are: Foreign Matter-Nil, Acid insoluble Ash-0.51%w/w, Water soluble Ash-2.01% w/w, Alcoholic Extractives-44.48%, Aqueous Extractives 67.52%, pH-3.1, Moisture content-8.19%. Quality control test for chewable tablet was carried out and found satisfactory with general characteristics of tablet viz. hardness 1.8, disintegration time 15-20 min, friability 0.5%, weight variation +/- 3%. The TLC of Āmalaki powder showed 3 spots with Rf value 0.14, 0.4, and 0.73 and the chewable tablets showed 2 spots with Rf value 0.31 and 0.89 under 254 nm. The adaptation of modern techniques or methods to convert the Ayurvedic formulations without altering its therapeutic property is necessary to made them suitable for the present trends of newer drug delivery dosage forms.
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Affiliation(s)
- S B Santhosh
- Department of Bhaishajya Kalpana, KLE's Shri BMK Ayurveda Mahavidhyalaya, Shahapur, Belgaum, Karnataka, India
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Baliga MS, Meera S, Mathai B, Rai MP, Pawar V, Palatty PL. Scientific validation of the ethnomedicinal properties of the Ayurvedic drug Triphala: A review. Chin J Integr Med 2012; 18:946-54. [DOI: 10.1007/s11655-012-1299-x] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2011] [Indexed: 11/30/2022]
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Patil V, Bandivadekar A, Debjani D. Inhibition of Propionibacterium acnes lipase by extracts of Indian medicinal plants. Int J Cosmet Sci 2012; 34:234-9. [DOI: 10.1111/j.1468-2494.2012.00706.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Paur I, Carlsen M, Halvorsen B, Blomhoff R. Antioxidants in Herbs and Spices. ACTA ACUST UNITED AC 2011. [DOI: 10.1201/b10787-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Nandagopal B, Sankar S, Ramamurthy M, Sathish S, Sridharan G. Could the products of Indian medicinal plants be the next alternative for the treatment of infections? Indian J Med Microbiol 2011; 29:93-101. [DOI: 10.4103/0255-0857.81775] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Carlsen MH, Halvorsen BL, Holte K, Bøhn SK, Dragland S, Sampson L, Willey C, Senoo H, Umezono Y, Sanada C, Barikmo I, Berhe N, Willett WC, Phillips KM, Jacobs DR, Blomhoff R. The total antioxidant content of more than 3100 foods, beverages, spices, herbs and supplements used worldwide. Nutr J 2010; 9:3. [PMID: 20096093 PMCID: PMC2841576 DOI: 10.1186/1475-2891-9-3] [Citation(s) in RCA: 496] [Impact Index Per Article: 33.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2009] [Accepted: 01/22/2010] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND A plant-based diet protects against chronic oxidative stress-related diseases. Dietary plants contain variable chemical families and amounts of antioxidants. It has been hypothesized that plant antioxidants may contribute to the beneficial health effects of dietary plants. Our objective was to develop a comprehensive food database consisting of the total antioxidant content of typical foods as well as other dietary items such as traditional medicine plants, herbs and spices and dietary supplements. This database is intended for use in a wide range of nutritional research, from in vitro and cell and animal studies, to clinical trials and nutritional epidemiological studies. METHODS We procured samples from countries worldwide and assayed the samples for their total antioxidant content using a modified version of the FRAP assay. Results and sample information (such as country of origin, product and/or brand name) were registered for each individual food sample and constitute the Antioxidant Food Table. RESULTS The results demonstrate that there are several thousand-fold differences in antioxidant content of foods. Spices, herbs and supplements include the most antioxidant rich products in our study, some exceptionally high. Berries, fruits, nuts, chocolate, vegetables and products thereof constitute common foods and beverages with high antioxidant values. CONCLUSIONS This database is to our best knowledge the most comprehensive Antioxidant Food Database published and it shows that plant-based foods introduce significantly more antioxidants into human diet than non-plant foods. Because of the large variations observed between otherwise comparable food samples the study emphasizes the importance of using a comprehensive database combined with a detailed system for food registration in clinical and epidemiological studies. The present antioxidant database is therefore an essential research tool to further elucidate the potential health effects of phytochemical antioxidants in diet.
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Affiliation(s)
- Monica H Carlsen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Bente L Halvorsen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Kari Holte
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Siv K Bøhn
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Steinar Dragland
- The Norwegian Institute for Agricultural and Environmental Research Bioforsk Øst Apelsvoll, Kapp, Norway
| | - Laura Sampson
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Carol Willey
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Haruki Senoo
- Department of Cell Biology and Morphology, Akita University Graduate School of Medicine, Akita City, Japan
| | - Yuko Umezono
- Department of Cell Biology and Morphology, Akita University Graduate School of Medicine, Akita City, Japan
| | - Chiho Sanada
- Department of Cell Biology and Morphology, Akita University Graduate School of Medicine, Akita City, Japan
| | - Ingrid Barikmo
- Faculty of Health, Nutrition and Management, Akershus University College, Lillestrøm, Norway
| | - Nega Berhe
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Walter C Willett
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Katherine M Phillips
- The Biochemistry Department, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - David R Jacobs
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- The Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, USA
| | - Rune Blomhoff
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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Fritts M, Crawford CC, Quibell D, Gupta A, Jonas WB, Coulter I, Andrade SA. Traditional Indian medicine and homeopathy for HIV/AIDS: a review of the literature. AIDS Res Ther 2008; 5:25. [PMID: 19102742 PMCID: PMC2637286 DOI: 10.1186/1742-6405-5-25] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2008] [Accepted: 12/22/2008] [Indexed: 11/15/2022] Open
Abstract
Background Allopathic practitioners in India are outnumbered by practitioners of traditional Indian medicine and homeopathy (TIMH), which is used by up to two-thirds of its population to help meet primary health care needs, particularly in rural areas. India has an estimated 2.5 million HIV infected persons. However, little is known about TIMH use, safety or efficacy in HIV/AIDS management in India, which has one of the largest indigenous medical systems in the world. The purpose of this review was to assess the quality of peer-reviewed, published literature on TIMH for HIV/AIDS care and treatment. Results Of 206 original articles reviewed, 21 laboratory studies, 17 clinical studies, and 6 previous reviews of the literature were identified that covered at least one system of TIMH, which includes Ayurveda, Unani medicine, Siddha medicine, homeopathy, yoga and naturopathy. Most studies examined either Ayurvedic or homeopathic treatments. Only 4 of these studies were randomized controlled trials, and only 10 were published in MEDLINE-indexed journals. Overall, the studies reported positive effects and even "cure" and reversal of HIV infection, but frequent methodological flaws call into question their internal and external validity. Common reasons for poor quality included small sample sizes, high drop-out rates, design flaws such as selection of inappropriate or weak outcome measures, flaws in statistical analysis, and reporting flaws such as lack of details on products and their standardization, poor or no description of randomization, and incomplete reporting of study results. Conclusion This review exposes a broad gap between the widespread use of TIMH therapies for HIV/AIDS, and the dearth of high-quality data supporting their effectiveness and safety. In light of the suboptimal effectiveness of vaccines, barrier methods and behavior change strategies for prevention of HIV infection and the cost and side effects of antiretroviral therapy (ART) for its treatment, it is both important and urgent to develop and implement a rigorous research agenda to investigate the potential risks and benefits of TIMH and to identify its role in the management of HIV/AIDS and associated illnesses in India.
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