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Llamasares-Castillo A, Uclusin-Bolibol R, Rojsitthisak P, Alcantara KP. In vitro and in vivo studies of the therapeutic potential of Tinospora crispa extracts in osteoarthritis: Targeting oxidation, inflammation, and chondroprotection. JOURNAL OF ETHNOPHARMACOLOGY 2024; 333:118446. [PMID: 38857679 DOI: 10.1016/j.jep.2024.118446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 05/13/2024] [Accepted: 06/06/2024] [Indexed: 06/12/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The increasing incidence of osteoarthritis (OA), especially among the elderly population, highlights the need for more efficacious treatments that go beyond mere symptomatic relief. Tinospora crispa (L.) Hook. f. & Thomson (TC) boasts a rich traditional heritage, widespread use in Ayurveda, traditional Chinese medicine (TCM), and diverse indigenous healing practices throughout Southeast Asia for treating arthritis, rheumatism, fever, and inflammation. AIM OF THE STUDY This study investigates the anti-inflammatory and chondroprotective potential of TC stem extracts, including ethanolic TC extract (ETCE) and aqueous TC extract (ATCE), in modulating OA pathogenesis through in vitro and in vivo approaches. MATERIALS AND METHODS The study utilized LC-MS/MS to identify key compounds in TC stem extracts. In vitro experiments assessed the antioxidative and anti-inflammatory properties of ETCE and ATCE in activated macrophages, while an in vivo monoiodoacetate (MIA)-induced OA rat model evaluated the efficacy of ETCE treatment. Key markers of oxidative stress, such as superoxide dismutase (SOD) and catalase (CAT), were assessed alongside pro-inflammatory cytokines TNF-α and IL-1β, and matrix-degrading enzymes, matrix metalloproteinase (MMP 13 and MMP 3), to evaluate the therapeutic effects of TC stem extracts on OA. RESULTS Chemical profiling of the extracts was conducted using LC-MS/MS in positive ionization, identifying seven compounds, including pseudolaric acid B, stylopine, and reticuline, which were reported for the first time in this species. The study utilized varying concentrations of TC stem extracts, specifically 6.25-25 μg/mL for in vitro assays and 500 mg/kg for in vivo studies. Our findings also revealed that both ETCE and ATCE exhibit dose-dependent reduction in reactive oxygen species (41%-52%) and nitric oxide (NO) levels (50% and 72%), with ETCE displaying superior antioxidative efficacy and marked anti-inflammatory properties, significantly reducing TNF-α and IL-6 at concentrations above 12.5 μg/mL. In the MIA-induced OA rat model, ETCE treatment notably outperformed ATCE, markedly lowering TNF-α (1.91 ± 0.37 pg/mL) and IL-1β (26.30 ± 3.68 pg/mL) levels and effectively inhibiting MMP 13 and MMP 3 enzymes. Furthermore, macroscopic and histopathological assessments, including ICRS scoring and OARSI grading, indicate that TC stem extracts reduce articular damage and proteoglycan loss in rat knee cartilage. These results suggest that TC stem extracts may play a role in preventing cartilage degradation and potentially alleviating inflammation and pain associated with OA, though further studies are needed to confirm these effects. CONCLUSION This study highlights the potential of TC stem extracts as a novel, chondroprotective therapeutic avenue for OA management. By targeting oxidative stress, pro-inflammatory cytokines, and cartilage-degrading enzymes, TC stem extracts promise to prevent cartilage degradation and alleviate inflammation and pain associated with OA.
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Affiliation(s)
- Agnes Llamasares-Castillo
- The Graduate School, University of Santo Tomas, Manila, 1015, Philippines; Research Center for the Natural and Applied Sciences (RCNAS), University of Santo Tomas, Manila, 1015, Philippines; Faculty of Pharmacy, Department of Pharmacy, University of Santo Tomas, Manila, 1015, Philippines.
| | | | - Pornchai Rojsitthisak
- Center of Excellence in Natural Products for Ageing and Chronic Diseases, Chulalongkorn University, Bangkok, 10330, Thailand; Department of Food and Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand.
| | - Khent Primo Alcantara
- Center of Excellence in Natural Products for Ageing and Chronic Diseases, Chulalongkorn University, Bangkok, 10330, Thailand; Department of Food and Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand.
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Nesari T, Kadam S, Vyas M, Huddar VG, Prajapati PK, Rajagopala M, More A, Rajagopala SK, Bhatted SK, Yadav RK, Mahanta V, Mandal SK, Mahto RR, Kajaria D, Sherkhane R, Bavalatti N, Kundal P, Dharmarajan P, Bhojani M, Bhide B, Harti SK, Mahapatra AK, Tagade U, Ruknuddin G, Venkatramana Sharma AP, Rai S, Ghildiyal S, Yadav PR, Sandrepogu J, Deogade M, Pathak P, Kapoor A, Kumar A, Saini H, Tripathi R. AYURAKSHA, a prophylactic Ayurvedic immunity boosting kit reducing positivity percentage of IgG COVID-19 among frontline Indian Delhi police personnel: A non-randomized controlled intervention trial. Front Public Health 2022; 10:920126. [PMID: 36052011 PMCID: PMC9424736 DOI: 10.3389/fpubh.2022.920126] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/18/2022] [Indexed: 01/22/2023] Open
Abstract
Objective The world continues to face the COVID-19 crisis, and efforts are underway to integrate traditional medicine interventions for its effective management. The study aimed to determine the efficacy of the "AYURAKSHA" kit in terms of post-interventional percentage of COVID-19 IgG positivity, immunity levels, and quality of life (QoL) against COVID-19. Method This was a non-randomized controlled, prospective intervention trial, done after the distribution of 80,000 AYURAKSHA kits (constituent of Sanshamani Vati, AYUSH Kadha, and Anu Taila) among Delhi police participants in India. Among 47,827 participants, the trial group (n = 101) was evaluated with the positivity percentage of IgG COVID-19 and Immune Status Questionnaire (ISQ) scores as a primary outcome and the WHO Quality of Life Brief Version (QOL BREF) scores along with hematological parameters as a secondary outcome in comparison to the control group (n = 71). Results The data showed that the percentage of COVID-19 IgG positivity was significantly lower in the trial group (17.5 %) as compared to the control group (39.4 %, p = 0.003), indicating the lower risk (55.6%) of COVID-19 infection in the trial group. The decreased incidence (5.05%) and reduced mortality percentage (0.44%) of COVID-19 among Delhi police officers during peak times of the pandemic also corroborate our findings. The ISQ score and WHO-QOL BREF tool analysis showed the improved scores in the trial group when compared with the controls. Furthermore, no dysregulated blood profile and no increase in inflammation markers like C-reactive protein, erythrocyte sedimentation rate, Interleukin-6 (IL-6) were observed in the trial group. However, significantly enhanced (p = 0.027) IL-6 levels and random blood sugar levels were found in the control group (p = 0.032), compared to a trial group (p = 0.165) post-intervention. Importantly, the control group showed more significant (p = 0.0001) decline in lymphocyte subsets CD3+ (% change = 21.04), CD4+ (% change = 20.34) and CD8+ (% change = 21.54) levels than in trial group, confirming more severity of COVID-19 infection in the control group. Conclusion The AYURAKSHA kit is associated with reduced COVID-19 positivity and with a better quality of life among the trial group. Hence, the study encourages in-depth research and future integration of traditional medicines for the prevention of the COVID-19 pandemic. Clinical trial registration http://ctri.nic.in/, identifier: CTRI/2020/05/025171.
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Affiliation(s)
- Tanuja Nesari
- All India Institute of Ayurveda (AIIA), New Delhi, India,*Correspondence: Tanuja Nesari
| | - Sujata Kadam
- Department of Prasuti and Stri Roga (Obstetrics and Gynaecology), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Mahesh Vyas
- Department of Maulik Siddhant (Fundamental Principles), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Vitthal G. Huddar
- Department of Kaya Chikitsa (Internal Medicine), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Pradeep Kumar Prajapati
- Department of Ras Shastra and Bhaishajya Kalpana (Ayurvedic Pharmaceutics), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Manjusha Rajagopala
- Department of Shalakya Tantra (Eye and ENT), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Anand More
- Department of Roga Nidan and Vikriti Vigyan (Pathology), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Shri krishna Rajagopala
- Department of Bala Roga (Pediatrics), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Santosh Kumar Bhatted
- Department of Panchkarma (Penta Bio-Purification Methods), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Rama Kant Yadav
- Department of Kaya Chikitsa (Internal Medicine), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Vyasdeva Mahanta
- Department of Shalya Tantra (Surgery), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Sisir Kumar Mandal
- Department of Roga Nidan and Vikriti Vigyan (Pathology), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Raja Ram Mahto
- Department of Kaya Chikitsa (Internal Medicine), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Divya Kajaria
- Department of Kaya Chikitsa (Internal Medicine), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Rahul Sherkhane
- Department of Shalya Tantra (Surgery), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Narayan Bavalatti
- Department of Shalakya Tantra (Eye and ENT), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Pankaj Kundal
- Department of Shalakya Tantra (Eye and ENT), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Prasanth Dharmarajan
- Department of Panchkarma (Penta Bio-Purification Methods), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Meera Bhojani
- Department of Shareer Kriya (Physiology), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Bhargav Bhide
- Department of Dravya Guna (Materia Medica and Pharmacology), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Shiva Kumar Harti
- Department of Swastha Vritta (Preventive and Social Medicine), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Arun Kumar Mahapatra
- Department of Bala Roga (Pediatrics), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Umesh Tagade
- All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Galib Ruknuddin
- Department of Ras Shastra and Bhaishajya Kalpana (Ayurvedic Pharmaceutics), All India Institute of Ayurveda (AIIA), New Delhi, India
| | | | - Shalini Rai
- Department of Roga Nidan and Vikriti Vigyan (Pathology), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Shivani Ghildiyal
- Department of Dravya Guna (Materia Medica and Pharmacology), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Pramod R. Yadav
- Department of Ras Shastra and Bhaishajya Kalpana (Ayurvedic Pharmaceutics), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Jonah Sandrepogu
- Department of Kaya Chikitsa (Internal Medicine), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Meena Deogade
- Department of Dravya Guna (Materia Medica and Pharmacology), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Pankaj Pathak
- Department of Maulik Siddhant (Fundamental Principles), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Alka Kapoor
- Hospital - All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Anil Kumar
- All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Heena Saini
- Department of Roga Nidan and Vikriti Vigyan (Pathology), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Richa Tripathi
- Department of Roga Nidan and Vikriti Vigyan (Pathology), All India Institute of Ayurveda (AIIA), New Delhi, India
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