Safety evaluation of an Ayurvedic medicine, Arogyavardhini vati on brain, liver and kidney in rats

Assessment of sub-chronic oral toxicity of Nityanand Rasa: An ayurvedic herbo-metallic formulation

ETHNOPHARMACOLOGICAL RELEVANCE

Nityananda Rasa (NR) is an ayurvedic herbo-metallic formulation used to treat gout, obesity, hypothyroidism, elephantiasis, and other diseases. However, its safety is a concern owing to the use of heavy metals like mercury and arsenic.

AIM OF THE STUDY

To study the sub-chronic oral toxicity of NR on albino wistar rats for safety evaluation.

MATERIALS AND METHODS

The male and female albino wistar rats were administered a daily dose of 30 (low), 300 (medium) and 600 (high) mg/kg BW/day of NR for 90-day period. The body weight and feed consumption were monitored once a week. After 90 days, blood and vital organs were harvested for genotoxicity, hematology, biochemistry, histopathology, gene expression and the biodistribution analysis.

RESULTS

There was no mortality or severe behavioural changes observed in rats. Significant changes in biochemical enzyme levels were seen at medium and high doses of NR i. e. 300 and 600 mg/kg BW/day respectively. No hematological changes were observed. Mild histopathological changes seen at high dose of NR which were found in concurrence with the biochemical alterations in liver and brain. There was mild genotoxicity and no detectable level of mercury but significant arsenic level in blood at high dose. Gene expression was mildly affected.

CONCLUSIONS

NR induced moderate toxic effects at high dose but can be considered safe at therapeutic doses.

Tissue distribution of mercury and copper after Aarogyavardhini Vati treatment in rat model of CCl4 induced chronic hepatotoxicity

Background

Aarogyavardhini Vati is a classical Ayurvedic herbomineral formulation. It contains mercury and copper compounds as principal minerals along with other minerals and herbal ingredients. Aarogyavardhini Vati is indicated in chronic liver ailments. However, safety concerns are often raised regarding the use of mercury containing ayurvedic drugs in disease conditions due to the risk of mercury and copper toxicity.

Objective

This study was performed to address the safety concerns regarding mercury and copper toxicity from Ayurvedic herbomineral formulations by investigating accumulation of these minerals in tissues and subsequent toxicity in chronic hepatotoxicity rat model.

Materials and methods

Quantification of mercury and copper in Aarogyavardhini Vati was done. Chronic hepatotoxicity was induced in the Wistar rats by repeated administration of CCl₄ for 8 weeks. Animals were treated with Aarogyavardhini Vati for various durations. Post treatment of 8 weeks, serum biochemical marker estimations was done. Estimation of mercury and copper from the liver, kidney and brain tissues was done after animal sacrifice. Histopathology evaluation of visceral organs was also performed.

Results

Treatment with Aarogyavardhini Vati exhibited significant accumulation of mercury in the kidney but not in the brain and liver. Similarly, no significant accumulation of copper was observed in liver, kidney, and brain due to the treatment of Aarogyavardhini Vati. Serum biochemical and histopathological changes were not affected by the treatment with Aarogyavardhini Vati.

Conclusion

Aarogyavardhini Vati did not show any biologically significant potential to cause toxicity due to its mercury and copper content when administered for prolonged duration to rats with chronic hepatotoxicity.

Ayurvedic management of necrozoospermia - A case report

Male factors are responsible for more than forty percent of the infertility cases. Necrozoospermia is one among the main cause for infertility in male. Necrospermia i.e. 100% immotile and 0% viable spermatozoa in ejaculate, is a rare and poorly documented cause of male infertility. A 56-year-old man was referred for reproductive counseling with secondary infertility and diagnosed as necrozoospermia (ShukraDosha). He presented with complaints of having no issues since 7 years of married life with his second wife. The patient has a son from divorced first wife. After the thorough clinical examination and laboratory investigations, diagnosis was confirmed as necrozoospermia. The patient was administered Koshtha-Shuddhi (purgation) with ErandaTaila (castor oil) as per the guidelines of Ayurvedic treatment. After the proper purificatory procedures depending on dominance of deranged Dosha, the patient was given ArogyavardhiniVati, ChandraprabhaVati, Shilapravanga and PhalaGhrita (medicated ghee) as Sneha (internal oleation). At the end of 3½ month, semen analysis showed marked improvement in sperm count and increase in the sperm motility. The present finding and the effective management of necrozoospermia with Ayurvedic formulations with no adverse effect highlight the promising scope of traditional medicine in male infertility disorders.

Chemical Compositions of Metals in Bhasmas and Tibetan Zuotai Are a Major Determinant of Their Therapeutic Effects and Toxicity

Minerals are alchemically processed as Bhasmas in Ayurvedic medicines or as Zuotai in Tibetan medicines. Ayurveda is a knowledge system of longevity and considers the mineral elixir made from “nature” capable of giving humans perpetual life. Herbo-metallic preparations have a long history in the treatment of various diseases in India, China, and around the world. Their disposition, pharmacology, efficacy, and safety require scientific evaluation. This review discusses the Bhasmas in Ayurvedic medicines and Zuotai in Tibetan medicines for their occurrence, bioaccessibility, therapeutic use, pharmacology, toxicity, and research perspectives. A literature search on Mineral, Bhasma, Ayurvedic medicine, Zuotai, Tibetan medicine, and Metals/metalloids from PubMed, Google and other sources was carried out, and the relevant papers on their traditional use, pharmacology, and toxicity were selected and analyzed. Minerals are processed to form Bhasma or Zuotai to alter their physiochemical properties distinguishing them from environmental metals. The metals found in Ayurveda are mainly from the intentional addition in the form of Bhasma or Zuotai. Bhasma and Zuotai are often used in combination with other herbals and/or animal-based products as mixtures. The advanced technologies are now utilized to characterize herbo-metallic preparations as Quality Assurance/Quality Control. The bioaccessibility, absorption, distribution, metabolism, and elimination of herbo-metallic preparations are different from environmental metals. The pharmacological basis of Bhasma in Ayurveda and Zuotai in Tibetan medicines and their interactions with drugs require scientific research. Although the toxic potentials of Bhasma and Zuotai differ from environmental metals, the metal poisoning case reports, especially lead (Pb), mercury (Hg), and arsenic (As) from inappropriate use of traditional medicines, are increasing, and pharmacovigilance is desired. In risk assessment, chemical forms of metals in Bhasma and Zuotai should be considered for their disposition, efficacy, and toxicity.

Autoimmune Bullous Skin Disease Managed with Ayurvedic Treatment: A Case Report

Autoimmune bullous diseases are a group of rare, acquired disorders characterized by overlapping features, resistance to treatment, and potential fatality. They need quick and proper management to avoid fatal complications. Ayurveda is found to provide better relief in some autoimmune disorders. Herein, we report a 40-year-old male of autoimmune bullous skin disorder (Visphoṭaka) who failed to respond to allopathic medicines and was subsequently treated with Ayurvedic medicines and achieved complete remission.

Ninety days repeated dose oral toxicity study of Makaradhwaja in Wistar rats

Context:

Makaradhwaja is a KupipakwaRasayana. Since it contains two heavy metals, namely mercury and gold, it is essential to evaluate its safety. Hence, the present study was undertaken with an objective to evaluate toxicity and target organ of toxicity of Makaradhwaja if so.

Aims:

The objective was to evaluate toxicological profile, the target organ of toxicity and to find no observed effect level (NOEL) or no observed adverse effect level (NOAEL) in rats after oral administration for ninety consecutive days.

Materials and Methods:

Makaradhawaja preparation was administered to male and female Wistar rats for ninety consecutive days at 2.7, 13.5, and 27 mg/kg body weight. All relevant biochemical and hematological changes were observed. At termination, all the rats were sacrificed and necropsy was performed. Histopathological evaluation was also performed.

Statistical Analysis Used:

Dunnett's test followed by analysis of variance.

Results:

There was a significant increase in high-dose group kidney weight of both sexes which could not be correlated with histopathology findings and serum biochemistry. Therefore, the change was not considered as an adverse effect.

Conclusions:

The dose level 27 mg/kg of Makaradhwaja was found as NOAEL and dose level 13.5 mg/kg of Makaradhwaja was found as NOEL.

Antimicrobial potential of two traditional herbometallic drugs against certain pathogenic microbial species

Background

Mineral based preparations are widely used for centuries as antimicrobial agents. However, the efficacy and the mode of action of mineral based preparations are uncertain due to the insufficient antimicrobial studies. Arogyawardhana Vati (AV) and Manikya Rasa (MR) are such two Rasashastra herbo-minerallic drugs commonly in India and other countries in South Asia. Despite of their well known traditional use of skin diseases, reported antimicrobial and mineralogical studies are limited. Therefore, in this study antimicrobial activities of the drugs and their organic, inorganic fractions were evaluated against Pseudomonas aeruginosa, Escherischia coli, Staphylococcus aureus, Methecilline Resistance Staphylococcus aureus - MRSA and Candida albicans.

Methods

Antimicrobial activity of the drugs, their inorganic residues and organic extracts were determined using four assay techniques viz agar well diffusion, modified well diffusion, Miles and Misra viable cell counting and broth turbidity measurements. Mineralogical constituents of the drugs were determined using X-ray diffraction, while total cation constituents and water soluble cation constituents were determined using inductively coupled plasma-mass spectrometer and the atomic absorption spectrophotometer respectively. Thermogravimetric analysis was used to determine the weight percentages of organic and inorganic fraction of the drugs. Particle sizes of the drugs were determined using the particle size analyzer.

Results

AV and MR drugs showed antibacterial activity against both gram positive and gram negative bacterial species when analyzed separately. Inorganic residues of the drugs and organic extracts showed activity at least against two or more bacterial species tested. All tested components were inactive against C. albicans. Common mineral constituents of drugs are cinnabar, biotite and Fe-rich phases. Drugs were rich in essential elements such as Na, K, Ca, Mg and Fe and toxic elements such as Zn, Cu and As. However, the water soluble concentrations of the toxic elements were below the detection limits. Both drugs have significantly higher percentages of organic constituents and volatile minerals and particle sizes of drugs are in the nanometer range.

Conclusions

AV and MR Rasashastra preparations could provide alternatives to synthetic antibiotics against human bacterial infections. Improved solubility and reduced particle sizes are influential physicochemical properties used to enhance the antimicrobial efficacy of the drugs. Therefore, traditional knowledge on the use of antimicrobial mineral sources could provide a novel path for the producing of effective antimicrobial drugs. However, further chemical and toxicological studies are urgently needed for a greater understanding of their toxicity to humans.

The hypolipidemic activity of Ayurvedic medicine, Arogyavardhini vati in Triton WR-1339-induced hyperlipidemic rats: A comparison with fenofibrate

BACKGROUND

Hyperlipidemia is a major risk factor of coronary heart disease. Currently available hypolipidemic drugs have been associated with number of side effects. Arogyavardhini vati, an Ayurvedic polyherbal formulation has been used for liver disorders. Therefore, present study was designed to evaluate the effect of Arogyavardhini vati in Triton WR-1339-induced hyperlipidemia in rats.

OBJECTIVES

Anti-hyperlipidemic activity evaluation of Arogyavardhini vati against Triton WR-1339-induced hyperlipidemia in rats.

MATERIALS AND METHODS

Overnight fasted male Wistar rats (150-200 g) were randomly divided into normal control group [4% Dimethyl Sulfoxide (DMSO), i.p.], positive control group (Triton WR-1339 in 4% DMSO, 400 mg/kg, i.p.), standard drug treated (fenofibrate 65 mg/kg, p.o. for 7 days after inducing hyperlipidemia) and Arogyavardhini vati treated (50, 100, 200 mg/kg, p.o. for 7 days after inducing hyperlipidemia). Rat doses were calculated by extrapolating the equivalent human dose (therapeutic dose, sub-maximum, and maximum dose). Serum total cholesterol, triglyceride, low-density lipoprotein (LDL), high-density lipoprotein HDL, liver malondialdehyde (MDA), and glutathione (GSH) levels were estimated at end of experiments.

RESULTS

Arogyavardhini vati significantly decreased serum cholesterol, triglyceride, LDL, and C-reactive protein (CRP) and significantly increased serum HDL in a dose-dependent manner. Decreased MDA and increased GSH levels in liver were observed at all doses of Arogyavardhini vati (50, 100, 200 mg/kg) and fenofibrate-treated groups when compared with Triton-treated group. Atherogenic Index (AI) level was significantly decreased in fenofibrate and Arogyavardhini vati (200 mg/kg) treated rats when compared with normal control.

CONCLUSION

Arogyavardhini vati, a traditionally used Ayurvedic medicine may be a useful therapy for hypercholesterolemia through reducing oxidative stress (decreasing MDA and increasing GSH) and lipid levels.

Evidence for safety of Ayurvedic herbal, herbo-metallic and Bhasma preparations on neurobehavioral activity and oxidative stress in rats

Heavy metals in Ayurvedic formulations have been used for centuries with claimed efficacy and safety. However, concerns are often raised about the toxicity due to heavy metals used in Ayurvedic formulations. The aim of present study is to explore the effect of Calcury tablet, Energic-31 capsule and Basanta Kusumakara Rasa (BKR) on neurobehavioral activity and oxidative stress in rats. Male wistar rats weighing 200-250 g were used and divided into normal control, positive control (mercury chloride, lead acetate, cadmium chloride, sodium arsenite, each 10 mg/kg, p.o for 28 days) and treated group (Calcury tablets at doses of 130, 650, 1300 mg/kg, Energic-31 capsule at doses of 150, 750, 1500 mg/kg and BKR at doses of 26, 130, 260 mg/kg, p.o. for 28 days). After performing the behavioural parameters on the 29^th day, homogenate of rat's brain was used to determine malondialdehyde (MDA) and glutathione (GSH) levels and heavy metal level in brain. Results showed that there were no significant change in cognitive function, motor coordination, MDA and GSH levels as compared to normal control group at all doses of Calcury tablet, Energic-31 capsule and Basant Kusumkar Rasa. However, heavy metals level in rat's brain was higher as compared to normal control group at all doses of Calcury tablet, Energic-31 capsule and BKR. In conclusion, Calcury tablet, Energic-31 capsule and BKR in doses equivalent to the human dose does not have appreciable adverse effects on brain which demonstrates the non-toxic nature of metal based Ayurvedic formulations.

Safety and efficacy evaluation of Ayurvedic treatment (Arjuna powder and Arogyavardhini Vati) in dyslipidemia patients: A pilot prospective cohort clinical study

Cardiovascular disease has multifaceted in which dyslipidemia, inflammation, and immunity play an important role. Arjuna powder and Arogyavardhini Vati used for centuries has potential for combating these factors. Therefore, the objective of this study was to evaluate the safety and efficacy of Ayurvedic treatment (Arjuna powder and Arogyavardhini Vati) for dyslipidemia patients. Total of 108 patients were screened at CGHS Ayurvedic Hospital, New Delhi. Ninety-six patients satisfied inclusion criteria, and signed informed consent and detailed medical history was recorded. Arjuna powder (5 g, BD) for 3 weeks and then Arogyavardhini Vati (500 mg, BD) for 4 weeks were prescribed to the patients. The primary efficacy endpoint was reduction in serum total cholesterol, LDL, triglycerides, and increased HDL levels. Secondary endpoints included reduction in serum C-Reactive Protein (CRP) and blood glucose levels. Safety assessments included hepatic function (aminotransferase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), bilirubin, and β(2) microglobulin), renal function (urea and creatinine and NGAL) tests, and urine mercury level. The study was completed by 87 patients. The male and female patients were 65.5% (57/87) and 34.5% (30/87), respectively. There was a significant reduction in total cholesterol, LDL, triglycerides, CRP, and blood glucose. However, raised HDL level was also observed. Safety assessment results showed no significant change in serum ALT, AST, ALP and bilirubin, urea, creatinine β(2) microglobulin, and NGAL levels at the end of study as compared to the baseline levels. In conclusion, the results of the present prospective cohort study showed that Ayurvedic treatment (Arjuna powder and Arogyavardhini Vati) is safe and effective for dyslipidemia.