Stress, Anxiety, and Immunomodulation: A Pharmacological Analysis.

Stress and stressful events are common occurrences in our daily lives and such aversive situations bring about complex changes in the biological system. Such stress responses influence the brain and behavior, neuroendocrine and immune systems, and these responses orchestrate to increase or decrease the ability of the organism to cope with such stressors. The brain via expression of complex behavioral paradigms controls peripheral responses to stress and a bidirectional link exists in the modulation of stress effects. Anxiety is a common neurobehavioral correlate of a variety of stressors, and both acute and chronic stress exposure could precipitate anxiety disorders. Psychoneuroimmunology involves interactions between the brain and the immune system, and it is now being increasingly recognized that the immune system could contribute to the neurobehavioral responses to stress. Studies have shown that the brain and its complex neurotransmitter networks could influence immune function, and there could be a possible link between anxiogenesis and immunomodulation during stress. Physiological and pharmacological data have highlighted this concept, and the present review gives an overview of the relationship between stress, anxiety, and immune responsiveness.

Anticandidal synergistic activity of green tea catechins, antimycotics and copper sulphate as a mean of combinational drug therapy against candidiasis.

The present investigation aims at evaluating synergistic herbal based composition of purified catechins with fluconazole, amphotericin B and copper sulphate against Candida albicans (MTCC 3017) and Candida glabrata (MTCC 3019). The catechins were isolated from green tea leaves of Assam, Himachal Pradesh and Uttarakhand regions of India. The synergistic activity of combinations against Candida species was assessed following microdilution checkerboard technique and time kill assay. The inhibitory action of most significant combination on treated Candida cells was assessed by scanning electron microscopy. Cytotoxicity of synergistic compositions was further analyzed by performing MTT assay on Vero cell lines. Purified catechins of Assam and Himachal Pradesh green tea showed synergistic activity with fluconazole and amphotericin B against Candida species. Time kill assay depicted synergistic activity at minimum inhibitory concentration and twice of minimum inhibitory concentration of purified catechins and antimycotics. Further, Copper sulphate increased anticandidal efficacy of synergistic combinations by 0.4% to 6.63%. SEM analysis revealed morphological distortions of treated Candida cells. Cytotoxicity analysis of synergistic composition depicted high percentage viability (≥91.4% to≥100%) of Vero cell line, which suggests non-cytotoxic activity of proposed composition on healthy cells. It can be inferred that present evaluated synergistic composition can confer promising anticandidal efficacy and requires further investigation of safety and translational guidelines for effective and safer green tea based potent therapeutic drug.

An appraisal of the bioavailability enhancers in Ayurveda in the light of recent pharmacological advances.

The concept of bioavailability enhancer is new to the modern system of medicine. Basically, this concept originated in Ayurveda and being used in this system of medicine since centuries. Bio-enhancers augment the bioavailability or biological activity of drugs when co-administered with principal drug at low doses. Ayurveda is using several drugs such as Piper longum Linn., Zingiber officinale Rosc., and Glycyrhhiza glabra Linn. as bio-enhancers and different methods for bio-enhancing since centuries. The bio-enhancement leads to reduction in therapeutic dose of principal drug, thus reducing the possibilities of toxicity and side effects of drug, potentiating the efficacy, reducing the resistance, decreasing the requirement of raw material for drug manufacture, and ultimately benefitting to the world economy by reducing the treatment cost. This review article attempts to consolidate different drugs as well as methods being used traditionally for enhancing bioavailability in Ayurvedic system of medicine and to discuss their possible mechanism of action. Authentic subject material has been reviewed from different Ayurvedic texts and from different related research and review articles. Thus, it is a humble effort to explore the different aspects of bio-enhancers including therapeutic techniques such as Shodhana, the drugs such as Pippali, and properties such as Yogavahi and Rasayana, which have been described in Ayurveda along with their mechanism of action and uses wherever available.

Clinical evaluation of the efficacy of Shvitrahara kashaya and lepa in vitiligo.

Vitiligo is a progressive, idiopathic, pigmentation disorder of the skin, characterized by hypopigmented white lesions. PUVA therapy is the treatment of choice in the modern system of medicine. In Ayurveda, Shvitra or Kilasa is the term employed to describe hypopigmentation disorders of the skin. Shvitra is caused by various dietic and behavioral factors which aggravate the tridoshas, especially the Kapha dosha vitiating the Meda dhatu. Many Ayurvedic drugs are well known for the regeneration of melanocytes, among which Bakuchi is one. The present study was planned to study its efficacy in the regeneration of melanocytes. The outcome of treatment in 50 cases of Shvitra vis-à-vis vitiligo receiving Shvitrahara kashaya and Shvitrahara lepa was analyzed and compared. Group I (n = 25) patients were treated with Shvitrahara kashaya and Shvitrahara lepa; Group II (n = 15) patients received Shvitrahara lepa only; and the remaining 10 patients of Group III used both (Western medicine) oral psoralens and UV-A therapy. Assessment was done after 6 months with bi-monthly follow-ups. Out of 25 cases in Group I, 17 showed 80% improvement (t = 7.65; P < 0.01) in the surface area, number of lesions, pigmentation and associated symptoms like itching; out of 15 patients in Group II, 10 showed partial repigmentation, i.e. 50% (t = 5.72; P < 0.01) response was observed. In Group III, 90% response (t = 6.14; P < 0.001) in repigmentation and number of lesions as well was noted but eight patients developed adverse effects like sunburn, severe itching and gastric upset on taking oral psoralen. On the basis of results and observations, it can be concluded that Ayurvedic formulation containing Bakuchi is efficacious and has no untoward effects when compared to oral psoralens and UV-A therapy.

Efficacy of leech therapy in the management of osteoarthritis (Sandhivata).

Osteoarthritis (degenerative joint disease) is the most common joint disorder. It mostly affects cartilage. The top layer of cartilage breaks down and wears away. Osteoarthritis is of two types, primary (idiopathic) and secondary. In idiopathic osteoarthritis, the most common form of the disease, no predisposing factor is apparent. Secondary OA is pathologically indistinguishable from idiopathic OA but is attributable to an underlying cause. In Ayurveda the disease Sandhivata resembles with osteoarthritis which is described under Vatavyadhi. The NSAIDs are the main drugs of choice in modern medicine which have lots of side effects and therefore are not safe for long-term therapy. Raktamokshan, i.e., blood letting is one of the ancient and important parasurgical procedures described in Ayurveda for treatment of various diseases. Of them, Jalaukavacharana or leech therapy has gained greater attention globally, because of its medicinal values. The saliva of leech contains numerous biologically active substances, which have antiinflammatory as well as anesthetic properties. Keeping this view in mind we have started leech therapy in the patients of osteoarthritis and found encouraging results.

Clinical Evaluation of Shilajatu Rasayana in patients with HIV Infection.

AIDS is one of the serious global health concerns caused by Human Immuno Deficiency(HIV) virus and is predominantly a sexually transmitted disease. Currently there is no vaccine or cure for AIDS still Anti Retroviral Therapy (ART) is successful. It reduces both the mortality and the morbidity of HIV infection, but is expensive and inaccessible in many countries. However intense the therapy may be, HIV virus is rarely eliminated, and drug resistance is a major setback during long-term therapy. The development of new drugs and strategies and exploring alternative systems of medicine for antiviral herbs or drugs is the need of the age to improve treatment outcomes. Ayurveda describes many diseases which incorporate HIV like illness e.g. Rajayakshma, Ojo Kshaya, Sannipata jwara etc. HIV infection affects multisystems, chiefly the Immune System which can be correlated to Ojo Kshaya. Rasayana Chikitsa is the frontline therapy employed to treat Ojus disorders. Therefore Shilajatu (Mineral pitch), Centella asiatica (Mandukaparni), Tinospora cordifolia (Guduchi) and Emblica officinalis (Amalaki), well known for their Immuno-modulator and antioxidant properties were selected to evaluate their role on immune system. The study was carried on 20 patients from OPD and IPD of Kayachikitsa, S.S.Hospital, IMS, BHU and was randomly allocated into Treated group (Shilajatu+ART) and Control group (ART). Treated Group responded better to ART both clinically and biochemically. The results show that Shilajatu decreases the recurrent resistance of HIV virus to ART and improves the outcome of the therapy.

An experimental study of some indigenous drugs with special reference to hydraulic permeability.

The effect of commonly used indigenous drugs for hepatic disorders i.e. Tinospora cordifolia, (Guduchi/Amrita), Andrographis paniculata (Kalmegha), Picrorhiza kurroa (Kutki), Phyllantnus niruri (Bhoomyamalaki) and Berberis aristata (Daruharidra) was tested on the hydraulic permeability of water in the presence of bile salt through a transport cell model. The data on hydraulic permeability were calculated as t (time). JV = Lp x AP, where Lp = hydraulic conductivity and AP is the pressure difference. It was observed that the value of controlled hydraulic permeability (0.49 x 10(-8) M3 S(-1) N(-1)) decreased in the presence of indigenous drugs and bile salt. The results suggest that these drugs might have the cell membrane stabilizing property which may lead to prevention of the toxic effect of bile salts in various hepatic disorders.

[Results of operative couching of the lens (a study from Nepal)]. / Ergebnisse der operativen Reklination der Linse (Eine Studie aus Nepal).

In Southern Nepal 100 eyes were examined on which a couching operation (reclination of the lens) had been performed by "quacks". The postoperative period extended from 1 month to more than 10 years. At the time of the examination 42 eyes were found to be blind; 26 of these were still blind immediately after the operation or went blind again during the following 6 months. In the eyes in which vision was preserved throughout the first postoperative year, subsequent loss of vision was less than 10% a year. These surgical results may not appear desirable but they are at least acceptable considering that the couching had been performed in regions of Nepal where modern ophthalmic care is not yet available.