Quantitative analysis of medicinal plants used to treat musculoskeletal ailments by non-institutionally trained siddha practitioners of Virudhunagar district, Tamil Nadu, India.

BACKGROUND: Siddha is one of the traditional medical systems of India; previous ethnobotanical survey in Virudhunagar district indicated a high consensus for treating musculoskeletal ailments. OBJECTIVES: This study was aimed to quantitatively document the medicinal plants used to treat musculoskeletal ailments by non-institutionally trained siddha practitioners of Virudhunagar district, Tamil Nadu, India. MATERIALS AND METHODS: This work was the outcome of free-list interviews conducted among 45 informants between April 2016 and January 2017. Sampling sufficiency was assessed by plotting Shannon-Wiener's index and cumulative number of UR. Informant consensus was assessed using Informant Consensus Factor (Fic) and Informant Agreement Ratio (IAR). RESULTS: This study recorded the data regarding 116 plant species which were used to prepare 129 formulations; analysis of the data yielded 490 UR. Among these, 65.3% of UR dealt with internal applications and 34.6% dealt with external applications. In the case of internally used formulations, pain and general musculoskeletal ailments had high Fic values. In the case of externally used formulations, headache and pain had high Fic values. CONCLUSION: Important species prescribed by the informants to treat various musculoskeletal ailments were: Azima tetracantha, Ricinus communis, Sesamum indicum, Moringa oleifera, Cardiospermum halicacabum (internal application), Calophyllum inophyllum, Justicia adhatoda, Curcuma longa, Calotropis gigantea, Zingiber officinale, Withania somnifera, Strychnos nux-vomica, Dodonaea viscosa (external application), Azadirachta indica, Clerodendrum phlomidis,Delonix elata, Pergularia daemia and Vitex negundo (internal and external applications). Robust studies on these local claims will help to improve the community healthcare and will yield some novel agents to treat musculoskeletal ailments.

Antihyperlipidemic effect of iridoid glycoside deacetylasperulosidic acid isolated from the seeds of Spermacoce hispida L. - A traditional antiobesity herb.

ETHNOBOTANICAL RELEVANCE: The interest on herbal health supplements for obesity is increasing globally. Our previous ethnobotanical survey in Tiruvallur district, Tamil Nadu, India indicated the use of Spermacoce hispida L. seeds for the treatment of obesity. AIM OF THE STUDY: This study was aimed to validate the traditional claim and to identify the antihyperlipidemic principle in the seeds of Spermacoce hispida using bioassay guided fractionation method. METHODS: Bioassay monitored fractionation of the aqueous extract from Spermacoce hispida seeds was carried out using triton WR 1339 induced hyperlipidemic animals. It yielded deacetylasperulosidic acid (DAA) as the active ingredient. Pharmacokinetic properties of DAA were predicted using DataWarrior and SwissADME tools. In vitro antiobesity and antihyperlipidemic effects of DAA were evaluated in 3T3L1 preadipocytes and HepG2 cells, respectively. The chronic antihyperlipidemic efficacy of DAA was evaluated in high fat diet fed rats. RESULTS: DAA did not show any mutagenic and tumorigenic properties. It bound with PPARα with comparable ligand efficiency as fenofibrate. The treatment with DAA significantly lowered the proliferation of matured adipocytes, but not preadipocytes. The treatment of steatotic HepG2 cells with DAA significantly decreased the LDH leakage by 43.03% (P < 0.05) at 50 µM concentration. In triton WR 1339 induced hyperlipidemic animals, the treatment with 50 mg/kg dose significantly lowered the TC, TG and LDL-c levels by 40.27, 46.00 and 63.65% respectively. In HFD fed animals, the treatment at 10 mg/kg decreased BMI and AC/TC ratio without altering SRBG. It also improved serum lipid, transaminases and phosphatases levels of HFD fed animals. The treatment lowered adipocyte hypertrophy and steatosis of hepatocytes. CONCLUSION: This preliminary report supported the traditional use of Spermacoce hispida for the treatment of obesity. Further detailed investigations on the long term safety, efficacy and molecular mode of action of Spermacoce hispida and DAA will throw more light on their usefulness for the management of obesity.

Hepatoprotective effect of bisbenzylisoquinoline alkaloid tiliamosine from Tiliacora racemosa in high-fat diet/diethylnitrosamine-induced non-alcoholic steatohepatitis.

Non-alcoholic steatohepatitis (NASH) is one of the aggressive forms of non-alcoholic fatty liver disease (NAFLD) and is a potential risk factor of HCC. This study reports the curative effect of tiliamosine on NASH. Tiliamosine was isolated from Tiliacora racemosa Colebr. (Menispermaceae) and its structure was confirmed by studying the physical and spectroscopic data. The effects of tiliamsoine on lipid accumulation and lipotoxicity were evaluated using palmitate-oleate induced steatosis in HepG2 cells. The in vivo efficacy of tiliamosine was evaluated using HFD fed, DEN induced non-alcoholic steatohepatitis Wistar rats. In HepG2 cells, tiliamosine did not affect the cell viability up to 100 µM concentration and showed GI25 value of 264.28 µM. The treatment with tiliamsoine significantly lowered the ORO concentration by 44.17% and triglyceride accumulation by 69.32% at 50 µM concentration (P < 0.005). It also reduced the leakage of LDH and transaminases in PO-BSA induced HepG2 cells. The treatment with tiliamsoine significantly decreased the plasma levels of transaminases, phosphatase and LDH (P < 0.05) in HFD-DEN induced steatohepatitis. The histology and the immunohistochemistry of the hepatic sections were in accordance with the biochemical findings. Preliminary molecular analysis indicated that the hepatic FXR expression was upregulated and TNFα expression was downregulated by the treatment with tiliamsoine. This study provided preliminary evidence on the use of tiliamosine for the treatment of NASH.

Curative effect of arjunolic acid from Terminalia arjuna in non-alcoholic fatty liver disease models.

The prevalence of Non Alcoholic Fatty Liver Disease (NAFLD) is increasing globally. Terminalia arjuna W. & Arn. (Combretaceae) is an endemic tree found in India and Sri Lanka and used traditionally for its cardioprotective and hepatoprotective effects. Arjunolic acid (AA) is an oleanane triterpenoid found mainly in the heartwood of T. arjuna. This study was aimed to evaluate the hepatoprotective effect of AA using cellular and rodent models of NAFLD. AA was isolated from the ethyl acetate extract of the heartwood of T. arjuna. The structure of AA was confirmed by physical and spectroscopic data. Steatosis was induced in HepG2 cells using palmitate-oleate mixture and the effects of AA on triglyceride accumulation and lipotoxicity were assessed. In vivo effect of AA on NAFLD was assessed using HFD fed rats. The treatment with AA did not affect the cell viability upto 100 µM and showed GI25 value of 379.9 µM in HepG2 cells. The treatment with AA significantly lowered the ORO concentration by 35.98% and triglyceride accumulation by 66.36% at 50 µM concentration (P < 0.005) compared to the vehicle treated group. The treatment with AA also reduced the leakage of ALT and AST by 61.11 and 48.29% in a significant manner (P < 0.005). The in vivo findings clearly demonstrated that the animals treated with AA at 25 and 50 mg/kg concentrations showed a significant decrease in the levels of transaminases, phosphatase and GGT (P < 0.005). In the liver, the expression of PPARα and FXRα expressions were upregulated, while PPARγ expression was downregulated by the treatment with AA. The liver histology of the animals showed reduction in steatosis and MNC infiltration. These preliminary evidences suggested that AA might be a promising lead to treat NAFLD. Future robust scientific studies on AA will lead to tailoring it for the treatment of NAFLD.

A study on food-medicine continuum among the non-institutionally trained siddha practitioners of Tiruvallur district, Tamil Nadu, India.

BACKGROUND: Medicinal properties of the food species are one of the poorly documented and important areas of ethnopharmacology. The present survey quantitatively documented the medicinal foods prescribed by the non-institutionally trained siddha practitioners of Tiruvallur district of Tamil Nadu. METHODS: Field work was carried out between December 2014 and April 2017 using a questionnaire. The illnesses mentioned by the informants were grouped as illness categories on the basis of emic perceptions. Sufficiency of sampling of this survey was assessed by plotting the cumulative number of UR and Shannon-Wiener's index. The indices such as informant consensus factor (FIC), Index of Agreement on Remedies (IAR), and Cultural Food Significance Index (CFSI) were calculated. RESULTS: This study documented 165 medicinal foods used by 82 non-institutionally trained siddha practitioners of Tiruvallur district, and 73.93% of these preparations were plant based. Among the animal taxa, 82.05% were represented by fish taxa. The illness category gastrointestinal ailments is the majorly cited illness category treated with plant-based formulations. The illness categories viz., gastrointestinal ailments, hemorrhoids, and neural ailments had high consensus under the group of plant-based medicinal foods. In animal-based medicinal foods, kapha ailments had gained 23.07% of UR. The illness categories such as bone fractures, male reproductive ailments, blood ailments, and anabolic had high FIC values. CONCLUSIONS: Deeper studies on different dietary cultures of India may help to derive better interpretations on food-medicine continuum. This study identified some important claims such as the use of citron, pomegranate and Solanum americanum (gastrointestinal ailments), Abutilon indicum, onions and elephant foot yam (hemorrhoids), Boerhavia diffusa (urinary ailments), Moringa oleifera (anemia), Aloe vera (gynecological ailments), Eclipta prostrata (liver ailments), ivy gourd (diabetes), citron (hypertension), Centella asiatica (psychological ailments), spade nose shark (lactogogue), reticulate whipray (wheezing and bronchitis), Katelysia opima (impotence), Indian squid (anemia), and Indian oil sardine (anabolic). More studies on these claims will help identify novel functional foods to add to the field of medical nutrition therapy, with traditional brand identity. Robust studies on the documentation of the traditional knowledge on marine resources will yield a good database for various stakeholders and policy makers.

Hepatoprotective effect of lawsone on rifampicin-isoniazid induced hepatotoxicity in in vitro and in vivo models.

The Drug-induced liver injury is one of the common unfavourable impacts, which seriously affects any drug therapy. This study documented the hepatoprotective efficacy of lawsone, the major bioactive naphthoquinone present in Lawsonia inermis L. (Lythraceae) using in vitro and in vivo models. Lawsone was isolated from the leaves of L. inermis and its structure was confirmed using spectroscopic data. In-vitro antioxidant effect of lawsone was evaluated using ABTS assay. Hepatoprotective effect of lawsone was determined with RIF-INH treated HepG2 cells and Wistar rats. Administration of RIF-INH reduced the viability of the HepG2 cells and the treatment with lawsone significantly restored the viability of the cells even at lower concentration (7.5 µM). The other parameters such as the leakage of transaminases and MDA levels were also significantly reduced by the treatment with lawsone. Oral administration of lawsone to the animals did not show any toxicity up to 2 g/kg b.w. concentration. Treatment with lawsone to the RIF-INH administered animals significantly lowered the serum transaminases levels. The ratio of albumin to globulin was improved and the level of bilirubin was lowered. This study indicated the hepatoprotective effect of lawsone; detailed investigations will give deeper understanding of the application of lawsone for hepatoprotection.

Effect of two andrographolide derivatives on cellular and rodent models of non-alcoholic fatty liver disease.

The prevalence of Non-Alcoholic Fatty Liver Disease (NAFLD) is increasing and there is an increasing interest in natural products to treat NAFLD. This study aimed to evaluate the hepatoprotective effect of andrographolide and two of its derivatives; in one the OH group at C-14 was removed and in the other OH groups at C-3 and C-19 were protected. Andrographolide (AN) was isolated from the aerial parts of Andrographis paniculata Wall. Isoandrographolide (IAN) and 3,19-acetonylidene andrographolide (ANA) were derivatized from AN. Drug likeness of the compounds was studied using DataWarrior. The effect of the compounds in ameliorating hepatic steatosis and lipotoxicity was assessed using palmitate-oleate induced steatotic HepG2 cell lines. In vivo efficacy of the compounds was assessed by using HFD fed rats. IAN showed comparatively high drug score and low irritability than AN. MTT assay indicated that the treatment with IAN had comparatively less toxicity than AN and ANA to HepG2 cells. The treatment with IAN significantly reduced the lipid accumulation and the leakage of LDH and transaminases, while the treatments with AN and ANA did not prohibit the leakage. In the in vivo experiment, the treatment with IAN showed comparatively better hepatoprotection by reducing the serum lipid, transaminases and ALP levels than with AN and ANA. Our results showed that IAN could be a promising lead to treat NAFLD with comparatively low toxicity and improved efficacy.

Antihyperlipidemic and hepatoprotective effects of Gardenin A in cellular and high fat diet fed rodent models.

The gum of Gardenia resinifera Roth., is one of the important drugs used in the Indian system of medicine and a source of unique polymethoxylated flavones. This study was aimed to evaluate the antihyperlipidemic and anti-NAFLD effects of Gardenin A (Gar-A) from G. resinifera gum using in vitro and in vivo models. Gar-A was isolated from G. resinifera gum and was identified on the basis of the physical and spectral data. Toxicity of Gar-A to HepG2 cells was evaluated using MTT assay. The ability of Gar-A to reduce steatosis was assessed using oleate-palmitate induced HepG2 cell lines by estimating the lipid levels by ORO staining and by estimating the intracellular triglyceride content. Effect of Gar-A on amelioration of lipotoxicity was measured by estimating the LDH levels. The doses for in vivo experiments were fixed by Irwin test, between 50 and 100 mg/kg concentrations, through oral route. The acute antihyperlipidemic effect of Gar-A was assessed in Triton WR-1339 induced hyperlipidemic animals. The chronic antihyperlipidemic and anti-NAFLD effects of Gar-A were evaluated in HFD fed rats. In vitro experiments with HepG2 cell line indicated that the cells treated with Gar-A did not show any significant reduction in the viability up to 70 µg/mL concentration. Steatotic HepG2 cells treated with Gar-A showed a significant reduction in lipid accumulation at 2.5-10 µg/mL concentrations. In triton induced hyperlipidemic rats, the treatment significantly reduced the lipid levels at the synthesis phase. The treatment with Gar-A to the HFD fed animals significantly lowered the steatosis and transaminase levels. The other biochemical parameters such as TC, TG, LDL-c, ALP and ACP were also decreased significantly. Treatment with Gar-A significantly lowered the hyperlipidemia and fat accumulation in the liver; detailed molecular investigations are necessary to establish the antihyperlipidemic and hepatoprotective potentials of Gar-A.

Quantitative ethnomedicinal survey of medicinal plants given for cardiometabolic diseases by the non-institutionally trained siddha practitioners of Tiruvallur district, Tamil Nadu, India.

ETHNOBOTANICAL RELEVANCE: The burden of cardiometabolic diseases such as dyslipidemia, hyperglycemia, hypertension, visceral obesity and atherosclerotic cardiovascular diseases and the use of traditional medicine for the management of such diseases are high in India; hence there is a need to document and analyze such therapies. AIM OF THE STUDY: This study documented and analyzed the medicinal plants prescribed for cardiometabolic diseases by the non-institutionally trained siddha practitioners of Tiruvallur district of Tamil Nadu, India. METHODOLOGY: The field survey was conducted between December 2014 to November 2015. Successive free listing assisted with field-walks was used to interview the informants. After assessing the sampling sufficiency using rarefaction curve analysis, indices such as Informant Consensus Factor (Fic) and Index of Agreement on Remedies (IAR) were calculated for the data. The indicators of informant's medicinal plant knowledge such as Shannon's index, equitability index, etc., were regressed with the demographic profile of the informants. RESULTS: For this study 70 non-institutionally trained Siddha medical practitioners were approached; the data from 36 practitioners who were treating cardiometabolic diseases were documented. This study recorded the use of 188 species which were used to prepare 368 formulations to treat illnesses categorized under cardiometabolic diseases. In this, 53.04% claims were singletons. Regression analysis showed that single species dominance was reduced and the diversity of medicinal plants was increased with the increase in the age and experience. Increase in the years of formal education increased the equitability in the uses. The plants such as Nelumbo nucifera Gaertn. (cardiovascular diseases), Allium sativum L. (dyslipidemia), Cuminum cyminum L. (hypertension), Macrotyloma uniflorum Verdc. (obesity) and Azadirachta indica A. Juss. (type 2 diabetes) were the highly cited medicinal plants. CONCLUSION: This survey has identified the plants most commonly used by Siddha practitioners of Tiruvallur district, Tamil Nadu, India for cardiometabolic diseases. The prevalence of chronic, non-communicable metabolic illnesses such as type 2 diabetes, hypertension and obesity are increasing worldwide due to the rapid changes in the lifestyle. These ailments require a life-long care and in such instances, people tend to use complementary therapies in most cases, alongside with conventional therapies. In view of the high use of traditional therapies for treating cardiometabolic illnesses, this study supports the need for more research to evaluate the potential benefits of the treatments and to identify any safety concern.