A.R. Shivashankara

Ginger Protects the Liver against the Toxic Effects of Xenobiotic Compounds: Preclinical Observations

According to the World Health Organization, chronic liver disease is a major ailment and causes significant morbidity and mortality in both western and developing countries. However, till date no ideal hepatoprotective agents are available in the modern system of medicine to effective prevent and cure liver ailments. This has necessitated the need to depend on complementary and alternative systems of medicine for liver ailments and diseases. Zingiber officinale Roscoe commonly known as ginger is arguably one of the most commonly used spice, and is an integral part of our diet. In addition to its dietary use, ginger is also reported to possess myriad health benefits, and has been used in the various traditional and folk systems of medicine to treat various ailments and illnesses. Preclinical studies carried out in the past decade have shown that ginger possesses hepatoprotective effects, and to protect against diverse xenobiotic compounds like alcohol, acetaminophen, fungicides, tetracycline, heavy metals and organophosphorus compounds. Mechanistic studies have shown that the protective actions are mediated through free radical scavenging, antioxidant, cytoprotective, and to modulate the levels of the detoxifying enzymes. This review for the first time summarizes the results related to the beneficial properties of ginger in ameliorating the toxic effects of hepatotoxins, and also emphasizes the aspects that warrant future research to establish its activity and utility as a broad spectrum hepatoprotective agent.

Antidiabetic and Cardioprotective Effects of Amla ( Emblica officinalis Gaertn) and its Phytochemicals: Preclinical Observations

Amla is a very important medicinal plant and has been widely used by Ayurvedic practitioners for centuries. In Ayurveda, amla is regarded as a very powerful rejuvenating herb and its regular consumption is also considered to be useful in stalling degenerative and senescence process, and to prevent/cure a wide variety of ailments that include such as hemorrhoids, nervine debility, anemia, jaundice, liver complaints, menorrhagia, leucorrhea, hematuria, osteoporosis, weak vision, and inflammation of the eyes. Amla is a rich source of vitamin C, and it contains phytochemicals such as alkaloids, flavanoids, tannins, and polyphenolic compounds. Phytochemicals like gallic acid, ellagic acid, quercetin, and corillagin possess antidiabetic, antihyperlipidemic, antioxidant, anti-inflammatory, and direct cardioprotective effects. Amla regenerates pancreatic beta cells, increases the utilization of glucose, improves glucose tolerance, and inhibits gluconeogenesis. Amla reduces the diabetic complications, corrects dyslipidemia and metabolic syndrome, and prevents atherogenesis. It also possesses potent antioxidant action, ameliorates oxidative stress, increases antioxidants, and inhibits low density lipoprotein oxidation. Amla possesses an anti-inflammatory effect and shows cytoprotective action against cardiotoxicity induced by isoproterenol, ischaemic reperfusion, doxorubicin, and Coxsackie virus B-3. This chapter summarizes the antidiabetic and cardioprotective effects of amla and some of its phytochemicals and the mechanisms responsible for this property.

Gastrointestinal and Hepatoprotective Effects of Ocimum sanctum L. Syn (Holy Basil or Tulsi): Validation of the Ethnomedicinal Observation

Since antiquity, Ocimum sanctum L. Syn Ocimum tenuiflorum L., commonly known as Tulsi, is a very important religious and medicinal plant of India. Tulsi is used in various traditional and folk systems of medicine to treat cough, bronchitis, asthma, diarrhea, dysentery, skin diseases, arthritis, painful eye diseases, chronic fever, and insect bite. Additionally, scientific studies have also shown that Tulsi possesses several useful pharmacological properties like antimicrobial, anti-inflammatory, analgesic, antipyretic, antiasthmatic, antiemetic, diaphoretic, antidiabetic, hypotensive, hypolipidemic, antioxidant, adaptogenic, anticarcinogenic, radioprotective, immunomodulatory, neuroprotective, cardioprotective, and antistress properties. Tulsi is also shown to possess hepatoprotective, gastroprotective, and to prevent chemical-induced carcinogenesis in both liver and stomach and at nontoxic concentrations. The present article addresses the hepatoprotective and gastroprotective effects of Tulsi and also emphasizes the possible mechanisms responsible for the observed pharmacological benefits.

Cardioprotective Effects of Indian Gooseberry (Emblica officinalis Gaertn) and its Phytochemicals: A Review

Emblica officinalis Gaertn or Phyllanthus emblica Linn, colloquially known as the Indian gooseberry or amla, is an important medicinal plant in the Indian traditional system of medicine, the Ayurveda and is classified as a Hrudya which when translated means cardiotonic drug. Numerous preclinical studies with laboratory animals have shown that amla does possess cardioprotective and anticoagulant effects and is useful in delaying/preventing/ reducing experimentally induced cardiotoxicity, atherosclerosis, myocardial infarction, hypertension and reducing ischemic-reperfusion injury. The pleiotropic effect of amla is believed to be due to the presence of various phytochemicals and studies have shown that the tannoids (emblicanin-A and –B), gallic acid, ellagic acid and corilagin also possess cardioprotective properties. Additionally, clinical studies have also shown that the regular intake of amla was effective in reducing the cholesterol levels and the effect to be similar to that of the conventionally used HMG CoA reductase inhibitor, simvastatin. Recent studies have also shown that amla improves endothelial function and reduced biomarkers of oxidative stress and systemic inflammation in patients with type 2 diabetes mellitus. This review for the first time summarizes the results related to these properties and also emphasizes the aspects that warrant future research to establish its activity and utility as a cardioprotective/ cardiotonic therapeutic drug in humans.

Scientific Validation of the Hepatoprotective Effects of the Indian Gooseberry ( Emblica officinalis Gaertn): A Review

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 Indian medicinal and dietary plants. The fruits are of dietary and medicinal use and have wide applications in both traditional and folk systems of medicine to treat various ailments. Preclinical experiments with both in vitro and in vivo systems of study have shown that amla possesses protective effects against the hepatotoxic xenobiotics 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 the chemical-induced hepatocarcinogenesis in animal models of study. The major phytochemicals quercetin, gallic acid, corilagin, and ellagic acid are also observed to possess hepatoprotective effects against paracetamol, microcystins, galactosamine, and lipopolysaccharide-induced hepatic damage. The hepatoprotective actions of amla appear to be mediated through its antioxidant, anti-inflammatory and by modulating xenobiotic and lipid metabolism.

Antidiabetic and Hypoglycemic Effects of Syzygium cumini (Black Plum)

Diabetes mellitus, a metabolic disorder of the endocrine system, is one of the worlds oldest diseases known to man. It is caused by inherited or acquired deficiency or inadequate secretion of hormone insulin (type 1 or insulin-dependent diabetes mellitus) or due to an inadequate response of target cells to insulin (type 2 or noninsulin-dependent diabetes mellitus – NIDDM), or by a combination of these factors that ultimately culminates in hyperglycemia. The currently available therapeutic options, especially for NIDDM, such as oral hypoglycemics, and insulin, have limitations of their own. Before discovery of insulin and development of oral hypoglycemic drugs, the major form of treatment involved the use of plants. One such plant with immense use in the treatment of diabetes is Syzygium cumini (L.) SKEELS (syn. Syzygium jambolanum DC, Eugenia jambolana LAM.). It is commonly known as Indian black berry or black plum in English and Jamun in Hindi and has been an integral part in the treatment of diabetes in the Indian traditional system of medicine, Ayurveda. Experimental studies performed in accordance with modern medicine principles have shown that Jamun is effective in preventing both hyperglycemia and its complications. This review collates the traditional uses and validated antidiabetic effects of Jamun and the various mechanisms contributing to the therapeutic effects. An attempt is also made to address the lacunae in these published studies and emphasize aspects that need further investigations for it to be of clinical use in the future.

Protective Effect of Garlic ( Allium sativum L.) Against Atherosclerosis

Globally, atherosclerosis is a leading cause of death and disability as it is a prelude to cardiovascular disease (CVD) and stroke. The uses of antiatherogenic drugs, especially the hypolipidemics, although beneficial have limitations of their own and are associated with undue side effects. Lifestyle change and diet can affect a vast majority of the modifiable risk factors for atherosclerosis and CVD. Nutraceuticals and herbals consumed regularly in diet offer an alternative to the synthetic compounds and are considered either nontoxic or less toxic than their synthetic counterparts. Since antiquity, the culinary spice Allium sativum Linn (garlic) has been used clinically in the various traditional systems of medicine to treat and prevent CVD and hyperlipidemia. Additionally, observations from both preclinical and clinical studies have shown that garlic when studied in the raw, aged, aqueous extract, dried powder, and oil forms retards the process of atherosclerosis. Garlic is rich in both water-soluble and water-insoluble organosulfuric compounds. These phytochemicals are responsible for their pungent odor and taste and are responsible for the myriad cardioprotective effects, which include free radical scavenging, antioxidant, anti-inflammatory, antihyperlipidemic, antiplatelet, and antihyperglycemic actions. Biochemical studies have shown that garlic reduces the plasma levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol, and increases the plasma level of high-density lipoprotein cholesterol. Garlic also inhibits cholesterol biosynthesis, accumulation of cholesterol in tissues, and lipogenesis. Garlic is reported to enhance the plasma fibrinolytic activity, antiplatelet effect, and antioxidant properties. Garlic is also reported to possess antihypertensive and hypoglycemic effects, which are a major contributor to the process of atherogenesis. Garlic also slows the development of diabetic complications by inhibiting free radical generation, glycation of proteins, and accumulation of advanced glycation end products. This chapter collates the antiatherosclerotic effects of garlic and also addresses the lacunae for future research to validate.

A Critical Appraisal of the Individual Constituents of Indian Diet in Modulating Cardiovascular Risk

Cardiovascular diseases, comprising ischemic heart disease, stroke and congestive heart failure, is the leading cause of death in India. Diet is believed to be a major factor in the etiology of cardiovascular disease, but there is still considerable scientific uncertainty about the relationship between specific dietary components and cardiovascular disease risk, and epidemiological doubts about the adequacy of the classic diet–heart hypothesis. The Indian diet is very diverse and varies according to geographic location and religion. This review addresses the role of the individual constituents of the Indian diet and their roles in enhancing/preventing cardiovascular risk.

Antiatherogenic Effects of Ginger ( Zingiber officinale Roscoe): Scientific Observations and Ethnomedicinal Validation

Atherosclerosis is fast becoming a leading cause for obstructive vascular diseases (like stroke, peripheral vascular diseases, and cardiovascular diseases) and is a major burden in both developing and developed countries; therefore, its prevention preferably by using dietary constituents is considered to be an attractive concept. Experimental studies performed in accordance to the principles of modern medicine have shown that the commonly used kitchen spice ginger ( Zingiber officinale Rosc.) possesses properties that contribute toward the prevention of atherosclerosis and its complications. Scientific studies have shown that ginger reduces the plasma level of total cholesterol, triglyceride, and low-density lipoprotein cholesterol; increases high-density lipoprotein cholesterol; and inhibits cholesterol biosynthesis, lipid peroxidation, and aggregation of lipid. Further, ginger also enhances plasma fibrinolytic activity and the antiplatelet effect which contributes to reduction of atheroma. This chapter addresses these aspects and emphasizes on the various mechanistic aspects that contribute toward the prevention/reduction of atherosclerosis.

Correlation of histopathological observations of appendicitis tissue with glutathione, lipid peroxidation, and lactate dehydrogenase: An investigational study

Objective: The present study was conducted to investigate the levels of antioxidant glutathione (GSH), lactate dehydrogenase (LDH), and lipid peroxidation (LPx) in the excised appendicitis tissue and investigate as to whether there is any correlation with the histopathological grading and clinical scoring. Materials and Methods: Appendix was collected from people requiring appendectomy (n = 30) and people with normal appendix but requiring gastrointestinal (GI) surgery for some other GI diseases and willing for complementary appendectomy (n = 4). The levels of GSH, LPx, and LDH were evaluated and statistically compared. In addition, statistical analysis is used to observe for correlation between these parameters with histological grading and Alvarado scores. Results: When compared to the normal appendix, in the tissues of appendicitis, the levels of LPx were high and that of LDH and GSH were significantly low. A negative correlation for GSH and positive correlation for LPx were observed. With respect to LDH, a negative correlation for tissue was observed with both histopathological and clinical grading. Multiple regression analysis for the biochemical endpoint in tissue showed that these parameters contribute 67.9 and 30.1% toward the histopathological and clinical grading, respectively. Conclusions: The results of the study indicate that the levels of LPx are increased and that of LDH and GSH are decreased in appendicitis and they are dependent on the pathological and clinical manifestation.