Hepatoprotective properties of the Indian gooseberry (Emblica officinalis Gaertn): a review.

Liver diseases characterized by inflammation or tissue damage affect the optimal functioning and increase the morbidity and mortality of the affected individual. Liver diseases are a largely neglected health issue and recent reports indicate that they affect over 10% of the world population, with the highest burden in low and middle income countries that have minimal medical resources. To complicate matters the currently available pharmacological therapies are not optimal and when used for extended periods of time impart systemic toxicity. Diet can modify pathophysiological processes, including those of hepatotoxins, and studies have shown that some dietary constituents can afford heptoprotection. Emblica officinalis Gaertn or Phyllanthus emblica Linn, commonly known as the Indian gooseberry in English or amla in Hindi, is one of the most important medicinal and dietary plants in the Indian subcontinent. The fruits are of dietary and medicinal use and have wide applications in both traditional and folk systems of medicine. Scientific studies have shown amla to be effective in preventing/ameliorating the toxic effects of hepatotoxic agents like ethanol, paracetamol, carbon tetrachloride, heavy metals, ochratoxins, hexachlorocyclohexane, antitubercular drugs and hepatotoxicity resulting from iron overload. Amla is also reported to impart beneficial effects on liver function and to mitigate hyperlipidemia and metabolic syndrome. Amla possesses protective effects against chemical-induced hepatocarcinogenesis in animal models of study. Additionally, the phytochemicals quercetin, gallic acid, corilagin and ellagic acid are also reported to protect against the cytotoxic effects of paracetamol, microcystins, galactosamine and lipopolysaccharide. The hepatoprotective actions of amla appear to be mediated by its free radical scavenging, antioxidant, anti-inflammatory and modulation of the xenobiotic detoxification process and lipid metabolism.

Peripheral Blood T-Cell Populations in COPD, Asymptomatic Smokers and Healthy Non-Smokers in Indian subpopulation- A Pilot Study.

BACKGROUND: COPD is a major global health problem affecting 4-10% of Indian adult male population. Immunological processes have been implicated in the pathogenesis of COPD. As compared to healthy smokers, COPD patients have airway inflammation indicated by the presence of CD8+ T cells in the lung. This predominant increase in CD8+ T cells in the lung may be reflected in the peripheral blood. In an attempt to understand why only some smokers develop COPD, we compared the peripheral T-cell markers in COPD patients with that of asymptomatic smokers, and healthy nonsmokers. METHODS: Twenty healthy non-smokers (HNS), 19 asymptomatic smokers (AS) and 21 COPD male patients (age and pack year-matched) were identified after clinical evaluation and spirometry. Blood CD3+, CD4+, CD8+ T-cell populations were measured. RESULTS: Smokers with COPD had severe airflow limitation (FVC, 69.8+16.7%; FEV1, 47.47+16.9%; FEV1/FVC, 53.1+13.3%). The BMI was found to be significantly lower among patients with COPD (19.1+4.8kg/m(2)) as compared to AS (23+4.3kg/m(2)) and HNS (23.7+4.0kg/m(2)) (p value = 0.003 HS). The mean CD3+T-cell absolute count in COPD patients (1154.3+582.2), showed a marked decline as compared to that of AS (1251.9+491.6) and HNS (1424.9+352.2). The mean CD4+T-cell counts in COPD patients (652.7+340.5) were also lower when compared to AS (745.7+313.8) and HNS (832.5+220.7). The mean CD8+T-cell counts among COPD patients (424.7+264.3) were, similar to the counts observed among AS (426.9+193.2) and HNS (500.4+191). Though not statistically significant, the absolute counts of CD3+, CD4+ and CD8+ lymphocytes among COPD patients tended to be lower. No significant difference in the CD4+/CD8+ lymphocyte ratio between the patient groups was observed. CONCLUSION: Our study indicates that BMI is related to the severity of COPD, hence proving a systemic component to its pathogenesis. However, we found similar percentages of CD8+Tcells in all the study groups suggesting that predominant CD8+ T cells in the airways may be due to its de novo origin rather than recruitment from blood. However, larger studies are needed to clarify the effect of disease severity, beedi smoking and ethnicity.