Safety and efficacy of Qurse-e-istisqua in chronic hepatitis C infection: an exploratory study

Nardostachys jatamansi (D.Don) DC.-Challenges and opportunities of harnessing the untapped medicinal plant from the Himalayas

ETHNOPHARMACOLOGICAL RELEVANCE

Nardostachys jatamansi (D.Don) DC. (family Caprifoliaceae) is prized in the Chinese, Tibetan, Nepalese, Bhutanese, Indian and Japanese systems of medicine. Its medicinal properties are well documented in ancient literature such as the Ayurvedic classics, the Old Testament, Ben-Cao- Shi-Yi, and Homer's Iliad. The plant is critically endangered and found in the alpine and sub-alpine regions of the Himalayas.

AIM OF THE STUDY

Our study aims to show the challenges and opportunities of harnessing the untapped pharmaceutical resources of N. jatamansi. Another aim is to explore the possibilities of translating ethnobotanical information into health benefit applications.

MATERIALS AND METHODS

The sources of information used in the study are government reports, dissertations, books, research articles and databases like Science-Direct, SciFinder, Web of Science, PubMed, Wiley Online Library, and ACS Publications on N. jatamansi.

RESULTS AND DISCUSSION

In the study, we have examined and discussed reports on phytochemicals present in the plant, their structure, biological activity, pharmacological properties of extracts derived from plant parts, isolated compounds, and commercially available products from the plant. We have identified and discussed ambiguities and confusions about the plant's nomenclature and geographical distribution, and highlighted various studies that failed to discuss this issue. We analyzed the links between various reports on ethnobotanical information as well as studies on phytochemistry and pharmacologyconfirming the therapeutic properties of N. jatamansi. However, in many of these findings which had used dried samples, there was an uncanny resemblance between the phytochemical profiles and biological activities of N. jatamansi and Valeriana jatamansi Jones ex Roxb. (another genus from family, Caprifoliaceae). Since both the species share identical vernacular names, a possible reason could be that the samples may not have been of two separate species. Other limitations of different studies were the use of out-dated techniques for phytochemical profiling, absence of toxicology studies using animal models and clinical trials using human subjects.

CONCLUSIONS

Analysis of various studies revealed a confusion about the botanical nomenclature of the plants and their geographical distributions. Absence of proper markers for identification of correct samples and improperly conducted studies on N. jatamansi were found to be the major hurdles to the use of ethnobotanical information and research findings into applications for human health. Development of markers using molecular, chemical and pharmacognosy based approaches for plant authentication and, in vitro propagation of authenticated material for easy availability of genuine plant material are the possible solutions to the problems identified.

Meta-Analysis of Combination Therapy of Chinese Herbs Plus Interferon and Ribavirin in Patients with Chronic Hepatitis C

BACKGROUND We aimed to evaluate the combination therapy of Chinese herbs plus interferon and ribavirin in treatment of patients with chronic hepatitis C (CHC). MATERIAL AND METHODS Related databases were searched to identify randomized controlled trials (RCTs) that evaluated biochemical response, virological response, histological response, and/or adverse reactions to combination therapy of interferon and ribavirin with and without Chinese herbs. The RR (relative risk) with a 95% confidence interval (CI) was calculated. Sensitivity analysis was conducted by omitting one study at a time. Publication bias among the eligible studies was evaluated by Egger's test. RESULTS A total of 17 RCTs matched the selection criteria. Overall, combination therapies of Chinese herbs plus interferon and ribavirin achieved significantly higher ALT (alanine transaminase) and ETVR (the end-of-treatment viral response), and significantly lower levels of HA (hyaluronic acid), LN (laminin), PC III (procollagen iii peptide), IV-C (type IV collagen), decreased LC (decreasing leukocyte count), ATF (abnormal thyroid function), psychosis, and anemia in CHC patients compared with those treated without Chinese herbs. Sensitivity analysis showed no changes and no potential publication bias was found. CONCLUSIONS The current evidence suggests that combination therapy of Chinese herb plus interferon and ribavirin yields better outcome and fewer adverse events in CHC patients than that of interferon plus ribavirin therapy.