PADMA 28 modulates interferon-γ-induced tryptophan degradation and neopterin production in human PBMC in vitro

Triphala (PADMA) extract alleviates bronchial hyperreactivity in a mouse model through liver and spleen immune modulation and increased anti-oxidative effects

OBJECTIVES

Triphala (TRP), a herbal extract from Tibetan medicine, has been shown to affect lymphocytes and natural killer T (NKT) cell function. We hypothesize that TRP could ameliorate bronchial hyperreactivity through immune-cell modulations.

METHODS

Asthma mouse models were generated through intraperitoneal (IP) injections of ovalbumin (OVA)/2 weeks followed by repeated intranasal OVA challenges. Mice were then treated with normal saline (OVA/NS) or Triphala (OVA/TRP). Data were compared with mice treated with inhaled budesonide. All groups were assessed for allergen-induced hyperreactivity; lymphocytes from lungs, livers and spleens were analyzed for OVA-induced proliferation and their alterations were determined by flow cytometry. Oxidative reactivity using chemiluminescence, serum anti-OVA antibodies level and lung histology were assessed.

RESULTS

Both TRP and budesonide significantly ameliorated functional and histological OVA-induced bronchial hyperreactivity. TRP had no effect on serum anti-OVA antibodies as compared with decreased levels following budesonide treatment. Furthermore, a significant increase in lung and spleen CD4 counts and a decrease in the liver were noted after TRP treatments. Bronchoalveolar fluid from TRP-treated animals but not from the budesonide-treated animals showed anti-oxidative effects.

CONCLUSION

TRP and budesonide caused a significant decrease in bronchial reactivity. TRP treatment altered immune-cell distributions and showed anti-oxidative properties. These findings suggest that immune-cell modulation with TRP can ameliorate lung injury.

Amelioration of hepatic fibrosis via Padma Hepaten is associated with altered natural killer T lymphocytes

Hepatic fibrosis is the end-stage consequence of chronic liver disease, affecting many people worldwide. Unlike the anti-fibrotic effect of natural killer (NK) cells, CD8 and NK T subsets are considered as profibrogenic subsets. Padma Hepaten is a multi-compound herbal preparation derived from Tibetan medicine and has proven efficacy in some clinical trials and tests at the cellular level. In this study, we evaluate the immune efficacy of Padma Hepaten administered intraperitoneally (i.p.) and/or orally in a mice model of hepatic fibrosis. Hepatic fibrosis was induced by 6 weeks of biweekly i.p. carbon tetrachloride (CCl4) injections in male C57Bl6 mice. There were four groups, including naive mice, non-treated fibrotic mice and fibrotic mice treated by Padma Hepaten at weeks 5-6 of fibrosis induction either orally or by i.p. injections. Padma Hepaten was prepared at 10 mg/ml in saline and 250 microl (2.5 mg) were administered four times per week. After week 6, animals were killed. To isolate a Padma Hepaten-associated effect on lymphocytes, splenocytes were harvested from either naive or Padma Hepaten-treated non-fibrotic donors. Isolated splenocytes were therefore reconstituted into two groups of irradiated recipients. Recipients were then administered the same CCl4 regimen. Hepatic fibrosis was determined by sirius red staining of liver sections and by assessment of alpha smooth muscle actin expression compared with beta-actin (both by mRNA as well as the protein liver extract western blotting). Hepatic fibrosis and alanine aminotransferase serum levels were decreased significantly in both Padma Hepaten-treated groups compared with the non-treated fibrotic group. Padma Hepaten treatment was associated with attenuation of lymphocyte subsets in both treated groups. Using a chemiluminescence technique to assess total anti-oxidant capacities (TAC), it was found that both the plasmas and livers of mice treated by CCl4 had significantly higher TAC compared with controls. However, the levels of TAC in animals treated either by CCl4 alone or CCl4 with Padma Hepaten were similar. Adoptive transfer of Padma Hepaten-treated lymphocytes was associated with fibrosis amelioration compared with recipients with naive lymphocytes. CCl4 generates higher levels of anti-oxidant capacities, probably as a response to oxidative stress. Padma Hepaten administration attenuated hepatic fibrogenesis significantly, accompanied by attenuation of lymphocyte but not anti-oxidant capacities.

[Padma 28 in the treatment of chronic dental pulpitis: an observational case study in 49 patients]

BACKGROUND

In the case of pulpitis the dentist has to differentiate between a reversible and therefore treatable pulpal inflammation and an irreversible damage of the pulpa, accord-ing to the clinical symptoms. From these one cannot draw conclusions about the effective histological condition of the pulpa. Early stages of pulpitis cannot be recognized by X-rayeither.

OBJECTIVES

By means of case studies in the course of daily dental practice the following questions are addressed:Is dental pulpitis an indication for the use of the Tibetan remedy Padma 28? Can a root canal treatment be prevented by administering Padma 28? What dosage is appropriate in this indication?

PATIENTS AND METHODS

53 patients with symptoms of chronic dental pulpitis but without clear indication for an im-mediate root canal treatment were prescribed 2 x 2 tablets Padma 28 daily, for 15 days. 49 patients took the preparation,and the course of symptoms was recorded and analyzed according to a simple scheme.

RESULTS

27 of these patients(55%) were free of pain within 1 month. A total of 40 patients(81%) reached a pain-free state after a longer period. By now, in most cases observations have been made for a period of 2-3 years (maximum: 5.5 years). 12 patients (24%) remained without relapse so far for more than 3 years. These experiences allow to deduce possible indications and clinical symptoms for the use of Padma 28.

CONCLUSIONS

These results en-courage the use of Padma 28 as a complementary preparation with little side effects, in unclear cases of pulpitis. The clinical development can be observed without further treatment if the patient does not need pain medication. Most patients (>80%) showed a complete remission, positively affect-ed and expedited by Padma 28; root canal treatments or ex-tractions could be prevented. In many cases the improvement has sustained over observation periods of >3 years. Criteria for therapeutic decisions are proposed.

Das anti-inflammatorische Potential von Padma 28 – Übersicht experimenteller Daten zur antiatherogenen Wirkung und Diskussion des Vielstoffkonzepts

BACKGROUND

The Tibetan remedy Padma 28 has been used in Europe for decades and has proved to be effective in inflammatory and atherosclerotic conditions. Beyond clinical trials, a large number of in vitro and ex vivo studies report various properties and biochemical activities of this complex herbal multicompound.

OBJECTIVE

To give an overview of the complex efficacy profile of Padma 28, to review available data, to relate findings to the development of atherosclerosis and thus to discuss the antiatherogenic potential of Padma 28.

METHODS

Published non-clinical original papers on Padma 28 were collected and classified according to the studied mechanisms of action. Results were correlated to the briefly described sequences of atherogenesis and various mechanisms of action were elaborated, laying particular emphasis on more recent articles.

RESULTS

The complex activity profile of Padma 28 spans mainly direct and indirect anti-inflammatory proper-ties as well as further categories of biochemical actions. These can be related to the complex processes of atherogenesis.

CONCLUSIONS

The described mechanisms support the therapeutic field of application of Padma 28, i.e. peripheral circulatory disorders as well as chronic inflammatory disorders. Moreover, the numerous effects as well as the diversity of sites of action allow to draw first conclusions on the conceptual design of this multicomponent formula.

Apoptosis induced by the Tibetan herbal remedy PADMA 28 in the T cell-derived lymphocytic leukaemia cell line CEM-C7H2

The Tibetan herbal remedy PADMA 28 revealed promising results to support treatment of atherosclerosis, Charot syndrome (intermittent claudication), chronic active hepatitis and infection of the respiratory tract. The remedy was confirmed to be closely linked with anti- and pro-oxidative properties in vitro. In this study, apoptogenic and survival effects of PADMA 28 were investigated in the T cell-derived lymphocytic leukaemia cell line CEM-C7H2. PADMA 28 led to a concentration-dependent inhibition of cell proliferation accompanied by the accumulation of CEM-C7H2 cells in subG1 phase, fragmentation of poly (ADP-ribose) polymerase (PARP) and nuclear body formation. Treatment with PADMA 28 rescued to some extent cells over-expressing Bcl-2 from apoptosis. This finding suggests that the mechanism of action of PADMA 28 may be via interference with Bcl-2 triggered survival pathways.

St. John's wort (Hypericum perforatum) counteracts cytokine-induced tryptophan catabolism in vitro

St. John's wort (Hypericum perforatum)is an ancient folk remedy that has antiviral and antibacterial properties. Anti-inflammatory effects of the plant have been described and the application ofH. perforatumextract as an effective antidepressant is well established. In this study we assayed the effect ofH. perforatumextract on cytokine-induced tryptophan degradation in human peripheral blood mononuclear cells. Simultaneously, changes in the production of the immune activation marker neopterin were monitored. Both these biochemical pathways are triggered by interferon-γ. Our results show that extracts ofH. perforatumstrongly down-regulate mitogen-mediated tryptophan degradation in a dose-dependent manner. This effect seems to be based on a suppressive activity ofH. perforatumon activated immunocompetent cells, resulting in a diminished production of interferon-γ. In line with this finding, neopterin synthesis was strongly down-regulated by the plant extract. Our results suggest that the reduction of tryptophan degradation byH. perforatummight be important in the action of the plant as an antidepressant.