Picrorhiza kurroa, Royle ex Benth:Traditional uses, phytopharmacology, and translational potential in therapy of fatty liver disease

Ethnopharmacologically important highly subsidized Indian medicinal plants: Systematic review on their traditional uses, phytochemistry, pharmacology, quality control, conservation status and future prospective

ETHNOPHARMACOLOGICAL RELEVANCE

India has an extensive reservoir of traditional wisdom and a diverse range of medicinal plants that enrich its heritage. Plants have actively been used for healthcare practices globally since the time immemorial. Medicinal uses of plants have been well recognized in India, evident from plant species documented in different traditional medicinal systems such as Ayurveda (1400-1800 species), Siddha (500-900 species), Unani (400-700 species), Homeopathy (about 372 species), and Sowa-Rigpa (about 250 species), etc. AIM OF THE STUDY: The primary purpose of this review is to provide systematic updated information on thirteen medicinal plants prioritized by the Indian government (providing75 % subsidy on cultivation cost) based on the availability and market demand of these plants. Updated information regarding the traditional uses, phytochemistry, pharmacology, quality control, and conservation status of these plants will help in understanding their pharmacological and commercial importance. This will also help in developing new strategies for their conservation.

MATERIAL AND METHODS

Online databases such as SciFinder, Web of Science, Pubmed, and Google Scholar were used to collect the electronically available literature on targeted thirteen plants. Also, different Indian government official websites such as AYUSH (https://www.ayush.gov.in); NMPB (National Medicinal Plants Board) (https://nmpb.nic.in); e.charak (https://echarak.in) were used for collecting information related to the amount of subsidy, trade and price related information of these plants.

RESULTS

To promote medicinal plant cultivation, the Indian government provides subsidies for cultivating some traditionally important medicinal plants. These plants are divided into three categories according to the subsidy provided to farmers, i.e., 30%, 50%, and 75% of the cost of cultivation. Thirteen medicinal plants which are provided 75% subsidy are Aconitum ferox Wall., Aconitum heterophyllum Wall., Aquilaria agallocha Roxb., Berberis aristata DC., Commiphora wightii (Arn.) Bhandari, Nardostachys jatamansi (D.Don) DC., Oroxylum indicum (L.) Benth. ex Kurz, Picrorhiza kurroa Royle ex Benth., Podophyllum hexandrum Royle, Pterocarpus santalinus L.f., Santalum Album L., Saussurea costus (Falc.) Lipsch., and Swertia chirayita (Roxb.) H.Karst. The literature survey reveals the enormous traditional medicinal importance, wide geographical distribution, diverse range of natural products, and broad spectrum of pharmacological activities of these plants.

CONCLUSION

A comprehensive literature survey revealed that although remarkable progress has been made in isolation, bioactivity evaluation, quality assessment, and conservation, there is still a lot of scope for further scientific interventions. Scientific validation of traditionally claimed medicinal potential is lacking for various bioactivities. Some of the bioactivities are performed just on extracts/fractions, so there is a need for proper phytochemical studies to identify active constituents responsible for the specific bioactivity. Further, quality assessment methods using both targeted and non-targeted tools are required to evaluate the quality of these highly-priced medicinal plants and their adulterants. Ultimately, to encourage the cultivation of these endangered medicinal plant species, it is imperative to implement proper legislation and employ in-situ and ex-situ conservation tools.

A randomized, placebo controlled, double blinded, parallel group clinical study to evaluate the efficacy and safety of AEV01 along with standard care for elderly patients with mild COVID-19

BACKGROUND

While several drugs are in the pipeline for treatment of various grades of COVID-19 disease, none of them have shown promise until now. Medicinal plants are crucial in developing and developed countries for their primary and basic health needs owing to better tolerability, superior compatibility with human body and having lesser side effects.

OBJECTIVE

To test adjuvant effect of AEV01, a patented herbal extract of kutki (Picrorhiza kurroa), in mild COVID19 in elderly patients at risk of complications and aging immunity.

METHODS

A prospective, phase 3, randomized, multicentric, placebo controlled double blinded parallel group interventional trial was conducted in elderly patients aged above 50 years diagnosed as COVID-19 with mild symptoms. 70 patients were randomized into two groups to receive AEV01 capsule (100 mg) and placebo respectively thrice daily for 30 days along with standard care of treatment as per national (WHO/ICMR) guidelines in both the groups. Clinical improvement timelines and corresponding scores using 8-point ordinal scale and NEWS were assessed for efficacy and safety of AEV01 in COVID-19 patients.

RESULTS

AEV01 group showed a significant improvement (p = 0.0001) in the normalization of the SpO2 rate and relief from cough. There was also significant difference in time to recovery, with patients in the AEV01 drug treated group recovering in 4.5 days as compared to Placebo in 9.1 days. ESR, LDH, serum ferritin, Neutrophil-Lymphocyte ratio (NLR), TNF- alpha, IL-6 and CD4 cell counts, which are considered as prognostic markers in COVID-19 infected patients, showed a significant improvement in patients treated with AEV01. The AEV01 drug treated group showed significant clinical improvement in the 8-point ordinal scale severity rating and National Early Warning Score (NEW) Score from day 3 onwards which continued up to end of study.

CONCLUSION

AEV01 has shown a significant improvement in clinical and laboratory parameters. There was also reduction in the progression of the COVID-19 disease in unvaccinated elderly patients from mild to moderate when treated at an earlier stage.

Promising hepatoprotective agents from the natural sources: a study of scientific evidence

Background

Natural bioactive components derived from plant secondary metabolites have been pronounced as valuable alternatives for anticipating and subsiding hepatotoxic effects and its chronic complications based on experimental verification. The focus of this review is to elucidate the commonly used modern medicine for the treatment of liver disease and how major phytoconstituents have been tested for hepatoprotective activity, mechanism of action of some promising agents from natural sources, and clinical trial data for treating in patients with different liver diseases by the aid of natural phytoconstituents.

Main text

The review shows fifteen major isolated phytoconstituents, their biological sources, chemical structures, utilized plant parts, type of extracts used, hepatoprotective assay method, and their possible mechanism of action on the hepatoprotection. Nine promising hepatoprotective leads from natural sources with their chemistry and hepatoprotective mechanism are mentioned briefly. The review further includes the recent clinical trial studies of some hepatoprotective leads and their clinical outcome with different liver disease patients. Scientific studies revealed that antioxidant properties are the central mechanism for the phytoconstituents to subside different disease pathways by upsurging antioxidant defense system of cells, scavenging free radicals, down surging lipid peroxidation, improving anti-inflammatory potential, and further protecting the hepatic cell injury. In this review, we summarize recent development of natural product-based hepatoprotective leads and their curative potential for various sort of liver diseases. Furthermore, the usefulness of hit and lead molecules from natural sources for significant clinical benefit to discover new drug molecule and downsizing the problems of medication and chemical-induced hepatotoxic effects is extrapolated.

Conclusion

Further research are encouraged to elucidate the pharmacological principle of these natural-based chemical agents which will stimulate future pharmaceutical development of therapeutically beneficial hepatoprotective regimens.

Pharmacological and Clinical Efficacy of Picrorhiza kurroa and Its Secondary Metabolites: A Comprehensive Review

Traditional remedies for the treatment of various ailments are gaining popularity. Traditionally, one of the most valuable therapeutic herbs has been Picrorhiza kurroa Royle ex Benth. Traditional and folk uses of P. kurroa include chronic constipation, skin-related problems, burning sensation, chronic reoccurring fever, jaundice, heart problems, breathing, digestion, allergy, tuberculosis, blood-related problems, prediabetes and obesity, laxative, cholagogue, and liver stimulatory. Phytoconstituents such as glycosides, alkaloids, cucurbitacins, iridoids, phenolics, and terpenes in P. kurroa have shown promising pharmacological potential. In order to uncover novel compounds that may cure chronic illnesses, such as cardiovascular, diabetes, cancer, respiratory, and hepatoprotective diseases, the screening of P. kurroa is essential. This study comprehensively evaluated the ethnopharmacological efficacy, phytochemistry, pharmacological activity, dose, and toxicity of P. kurroa. This review provides comprehensive insights into this traditional medication for future research and therapeutic application. The purpose of this review article was to determine the pharmacological effects of P. kurroa on a variety of disorders. P. kurroa may be a natural alternative to the standard treatment for eradicating newly evolving diseases. This study is intended as a resource for future fundamental and clinical investigations.