Herb-induced Liver Injury-A Guide to Approach. Lessons from the Tinospora cordifolia (Giloy) Case Series Story

Background

Tinospora cordifolia (TC) is being increasingly consumed in India for its health and suggested immune-enhancing benefits in preventing and countering COVID-19. We previously published our experience of hepatotoxicity with self-medication of TC in six individuals. Since herb-induced liver injury (HILI) has been described with Tinospora crispa (TCR) consumption, it was contested that our patients may have mistakenly self-medicated with TCR which is similar in appearance to TC.

Methods

We collected the four plant samples and two commercial preparations that were consumed by our patients for further analysis. The six samples underwent high performance thin layer chromatography phytochemical analysis and DNA barcoding studies for the confirmation of the genus and species. The four plant part samples which included stems and leaves were also analysed by a botanist for the characteristic morphological and microscopic features.

Results

Based on morphological, microscopic, phytochemical and DNA studies, the four plant part samples were identified as TC. The two commercial preparations could not be analysed on phytochemical analysis or DNA barcoding studies due to other ingredients that most likely interfered with the analysis. The herb consumed by our study subjects was confirmed to be Tinospora cordifolia.

Conclusion

We have highlighted the key morphological and phytochemical differences between these two species. We propose an algorithmic approach to accurately identify the implicated herb in cases of HILI. Future studies on causality need to focus on the serological/histopathological identification of active herb/metabolites in human tissues.

Activity based evaluation of a traditional Ayurvedic medicinal plant: Saraca asoca (Roxb.) de Wilde flowers as estrogenic agents using ovariectomized rat model

ETHNOPHARMACOLOGICAL RELEVANCE

Saraca asoca (Roxb.) de Wilde, Ashok, is a popular traditional plant used for gynecological disorders. In India, the juice of Ashok flowers is traditionally consumed as a tonic by women in case of uterine disorders. But despite the use, its estrogenic potency is not yet evaluated and thus lacks the scientific recognition and acclaim.

AIM OF THE STUDY

This study is designed to investigate the estrogenic potential of standardized ethanolic extract of Saraca asoca flowers (SAF) using ovariectomized (OVX) female albino Wistar rat model.

MATERIALS AND METHODS

Saraca asoca flowers were extracted in ethanol using hot maceration technique and the extract was standardized in terms of content of four phytoestrogens like quercetin, kaempferol, β-sitosterol and luteolin using HPTLC technique. Safety of the extract was evaluated at a dose of 2000mg/kg body weight in female albino Wistar rats as per the OECD guidelines. Bilateral ovariectomy surgery was performed for the excision of both the ovaries. The OVX animals were treated with the ethanolic extract of SAF at three dose levels- 100mg/kg, 200mg/kg and 400mg/kg body weight in distilled water as a vehicle, orally once a day for two weeks. Estradiol valerate was employed as a modern drug for comparative evaluation of the results. Estrogenic potency was studied by assaying the activities of serum and plasma marker enzymes and hormones viz. G6PDH, LDH, 17β-estradiol, progesterone along with cholesterol, triglycerides and HDL, and vaginal cornification. The uterotrophic effect was evaluated by studying the histoarchitecture of the uterus, effect on uterine weight and changes in the levels of uterine glycogen content.

RESULTS

HPTLC revealed the presence of markers like quercetin, kaempferol, β-sitosterol and luteolin from the ethanolic extract of SAF. The content of the four markers was found to be 1.543mg/g, 0.924mg/g, 4.481mg/g and 2.349mg/g, respectively. SAF extract was found to be safe at an oral dose of 2000mg/kg body weight in rats. Among the three doses administered to ovariectomized rats, treatment with high dose was found to be more efficacious when compared with ovariectomized rats.

CONCLUSION

The findings of this study firmly support the estrogenic potency of ethanolic extract of SAF which may be by the reason of phytoestrogens.

Standardization of Shadbindu Taila: An Ayurvedic oil based medicine

Shadbindu Taila (ST) is an Ayurvedic formulation used as a remedy for loosening of tooth, weakness of the eyesight, loss of hair, diseases of head, etc., Present study is an attempt to develop some newer approaches for the quality control and standardization of ST. Standardized operating procedure for the preparation of ST was developed in accordance with Ayurvedic Formulary of India. Preliminary phytochemical, physicochemical, and chromatographic evaluation of ST was carried out. Safety of ST was evaluated in terms of skin irritation test and presence of heavy metals. Chemical characterization of ST was done on the basis of kaempferol using validated -High Performance Thin Layer Chromatographic (HPTLC) method. ST did not show presence of any of the heavy metals analyzed and was found non-irritant on rabbit skin. The quality control parameters resulted after scientific evaluation of ST can be used as reference standard for quality control/assurance laboratory of a pharmaceutical firm in order to have a proper quality check over its preparation and processing.

A validated RP-HPLC method for quantitation of trigonelline from herbal formulations containing Trigonella foenum-graecum (L.) seeds

Background:

Trigonella foenum-graecum (L.) (Fabaceae, Fenugreek) is an important ingredient of Ayurvedic and other marketed herbal formulations. Fenugreek seeds are employed in many traditional systems as an antibacterial and antidiabetic agent, gastric stimulant and galactogogue. Trigonelline, a major phytoconstituent found in fenugreek seeds, shows estrogenic, anti-diabetic and anti-invasive activity. Therefore, it is a suitable bioactive marker to establish the quality of crude drug and its formulations.

Objective:

To develop an efficient and effective RP-HPLC method for estimation of trigonelline from Trigonella foenum-graecum seeds and its marketed herbal formulations.

Materials and Methods:

Separation and detection of trigonelline was carried out on a Cosmosil CN-MS column eluted with methanol:distilled water [95:5, v/v; pH 3.5 using hydrochloric acid]. Detection was carried out at 267 nm using a Photo Diode Array detector. Fenugreek seeds and two marketed herbal formulations were subjected for HPLC analysis of Trigonelline.

Results:

The RP-HPLC method was validated as per ICH guidelines and the content of trigonelline in marketed polyherbal formulations such as Dibet powder and Amyron syrup was determined. The LOD and LOQ were found to be 5.00 ng/mL and 50.00 ng/mL, respectively. Detector response was linear from 100.00 to 8000.00 ng/mL. The method was found to be simple, sensitive, accurate, reproducible and rugged.

Conclusion:

This work can be recommended for quality assurance and marker-based standardization of formulations containing fenugreek seeds.

A simple, sensitive and accurate method for rat paw volume measurement and its expediency in preclinical animal studies

Several methods are used to evaluate the inflammatory changes. Measurement of edema is the most commonly used method for evaluating artificially induced inflammation in rat model. In this context, we present a method for the measurement of volume of rat paw, in which two glass columns containing fluid are connected by a glass tube. Paw is immersed in one column and the other column is placed on weighing balance. Upon immersion of paw, equal volume of fluid displaced applies a force F, which shows specific and proportional increment in the level of fluid in both the columns, which could then be detected by weighing balance, as 'Force = Weight' of displaced fluid, using the specific gravity of the fluid and the volume of paw, and thus the change in the volume of paw can be calculated. The rat paw immersed in column without touching the wall of the column facilitates the accurate measurement of volume of paw when measured several times. Present method is validated for its accuracy and reproducibility when internal radii of both the columns were same or different. Presented method is also cost-effective and hence can be used for the academic and the commercial animal research purpose, without compromising the precision of the evaluation.

A liquid chromatography/electrospray ionization tandem mass spectrometric method for quantification of asiatic acid from plasma: application to pharmacokinetic study in rats

RATIONALE

Asiatic acid (AA), a pentacyclic triterpene from Centella asiatica (L.) Urban, has shown numerous therapeutic activities. However, none of the published works to date has used high-performance liquid chromatography/tandem mass spectrometry (HPLC/MS/MS) for determination of AA from biological fluids. Therefore, the present paper describes a sensitive HPLC/electrospray ionization (ESI)-MS/MS method for quantification of AA in rat plasma.

METHODS

Ammonium adduct formation of AA was essential in the development of a sensitive method with the rat plasma samples being pre-treated by a simple solid-phase extraction method. The separation was achieved on a Cosmosil C(18) column using a gradient mobile phase flow. Detection was performed using an Applied Biosystems API Q-Trap 2000 mass spectrometer equipped with an ESI source operated in positive mode with colchicine used as internal standard.

RESULTS

An eight-point calibration curve over the concentration range of 1.02-407.88 ng/mL for AA from rat plasma provided an optimum linear detector response (with r(2) >0.9983). The mean percentage recovery (n = 3) for the low, middle and high quality control samples was 91.23 ± 1.88%, 90.36 ± 0.55% and 89.71 ± 0.21%, respectively. The intra-day and inter-day precision and accuracy of the quality control samples were within ≤5% and ±7% correspondingly.

CONCLUSIONS

The developed method was validated as per US FDA guidelines and applicability demonstrated by successful measurement of AA from plasma following oral administration of C. asiatica extracts to Wistar rats. The results suggest that the method could be applied to therapeutic monitoring of AA and pharmacokinetic studies in human volunteers.

A rapid HPLC-ESI-MS/MS method for determination of β-asarone, a potential anti-epileptic agent, in plasma after oral administration of Acorus calamus extract to rats

β-Asarone (BAS), a phenylpropanoid from Acorus calamus Linn., has shown biological effects in the management of cognitive impairment conditions such as Alzheimer's disease. The present paper describes a selective and sensitive liquid chromatography-tandem mass spectrometric method (HPLC-MS/MS) using electrospray ionization source (ESI) for quantification of BAS in rat plasma. Briefly, the plasma samples were pre-treated using a simple solid-phase extraction method. The separation of BAS and the internal standard, caffeine, was achieved on an Agilent Zorbax XDB C(18) column (50 × 2.1 mm i.d., 5 µm) using 0.2 mL/min isocratic mobile phase flow. The detection was performed using an Applied Biosystems Hybrid Q-Trap API 2000 mass spectrometer equipped with an ESI source operated in positive mode. Also, the developed bioanalytical method was validated as per the US FDA bioanalytical guidelines over the concentration range of 9.79-4892.50 ng/mL (r(2) ≥ 0.9951) for BAS from rat plasma. The mean percentage recovery (n = 3) for the low, middle and high quality control samples was 86.92 ± 3.89, 85.30 ± 1.09 and 87.24 ± 4.03%, respectively. The applicability of the validated HPLC-MS/MS method was demonstrated by successful measurement of BAS from plasma following oral administration of Acorus calamus rhizome extracts to three female albino Wistar rats.

Wound healing efficacy of Jatyadi Taila: in vivo evaluation in rat using excision wound model

ETHNOPHARMACOLOGICAL RELEVANCE

In traditional Indian medicinal treatise there are several Ayurvedic formulations mentioned which have been claimed as potential wound healing agents like Madhu Ghrita and Jatyadi Taila. Jatyadi Taila (JT) is a medicated oil formulation (Taila) popularly used in the treatment of various topical wounds.

AIM OF THE STUDY

Though JT has its composition recorded in ancient Ayurvedic texts, there have been minimal attempts to standardize its use in the management of wound. The current work evaluates the wound healing efficacy of JT and also provides evidence of the dermal absorption kinetics of Karanjin from JT.

MATERIALS AND METHODS

JT was subjected to preliminary phytochemical evaluation. Therapeutically active marker components β-sitosterol, lupeol and karanjin were detected and separated using HPTLC. As a part of safety evaluation, skin irritation potential of JT was evaluated on rabbit skin. Excision wound model in rats were used to evaluate the wound healing efficacy of JT. Histopathological and biochemical evaluations of excised skin tissues at wound sites were carried out. The HPTLC method developed was also validated to evaluate the pharmacokinetics of Karanjin from JT after topical application on pinna of rabbit.

RESULTS

Preliminary phytochemical evaluation of JT revealed presence of flavonoids, essential oils, tannins, glycosides, steroids and alkaloids while resins were found to be absent. HPTLC confirmed the presence of karanjin, lupeol and β-sitosterol in JT. JT was found to be non-irritant when applied to the skin of rabbits. Topical application of JT on excision wounds caused significantly faster reduction in wound area as compared to the application of modern topical formulation (Neosporin(®)) and untreated control wounds. Animals treated with JT showed significant increase in protein, hydroxyproline and hexosamine content in the granulation tissue when compared with the untreated controls. Wound healing potential of JT was found to be dose dependant. HPTLC method was successfully used to evaluate the pharmacokinetics of Karanjin after topical application of JT on rabbit pinna.

CONCLUSIONS

Current work demonstrates a modern approach towards standardization of the use of traditional topical formulation JT. The results justify the traditional claim of JT for its use in the management of wounds.

Effect of Asteracantha longifolia Nees. against CCl4 induced liver dysfunction in rat

Significant recovery after treatment with the whole plant slurry of A.longifolia Nees. was observed in plasma AST, ALT and cholesterol levels in CCl4 induced hepatotoxic rats. This was amply supported by electron micrographs, which indicated normalization of cytoarchitecture of mitochondria and endoplasmic reticulum. The results suggest that the slurry of the plant is useful as a liver tonic.