The effect of probiotics and zinc supplementation on the immune response to oral rotavirus vaccine: A randomized, factorial design, placebo-controlled study among Indian infants.

BACKGROUND: Strategies are needed to improve oral rotavirus vaccine (RV), which provides suboptimal protection in developing countries. Probiotics and zinc supplementation could improve RV immunogenicity by altering the intestinal microbiota and immune function. METHODS: Infants 5weeks old living in urban Vellore, India were enrolled in a randomized, double-blind, placebo-controlled trial with a 4-arm factorial design to assess the effects of daily zinc (5mg), probiotic (1010Lactobacillus rhamnosus GG) or placebo on the immunogenicity of two doses of RV (Rotarix®, GlaxoSmithKline Biologicals) given at 6 and 10weeks of age. Infants were eligible for participation if healthy, available for the study duration and without prior receipt of RV or oral poliovirus vaccine other than the birth dose. The primary outcome was seroconversion to rotavirus at 14weeks of age based on detection of VP6-specific IgA at ≥20U/ml in previously seronegative infants or a fourfold rise in concentration. RESULTS: The study took place during July 2012 to February 2013. 620 infants were randomized equally between study arms and 551 (88.9%) completed per protocol. Seroconversion was recorded in 54/137 (39.4%), 42/136 (30.9%), 40/143 (28.0%), and 37/135 (27.4%) infants receiving (1) probiotic and zinc, (2) probiotic and placebo, (3) placebo and zinc, (4) two placebos. Seroconversion showed a modest improvement among infants receiving probiotic (difference between groups 1, 2 and 3, 4 was 7.5% (97.5% Confidence Interval (CI): -1.4%, 16.2%), p=0.066) but not zinc (difference between groups 1, 3 and 2, 4 was 4.4% (97.5% CI: -4.4%, 13.2%), p=0.272). 16 serious adverse events were recorded, none related to study interventions. CONCLUSIONS: Zinc or probiotic supplementation did not significantly improve the low immunogenicity of rotavirus vaccine given to infants in a poor urban community in India. A modest effect of combined supplementation deserves further investigation. TRIAL REGISTRATION: The trial was registered in India (CTRI/2012/05/002677).

Aflatoxin B1-induced DNA damage in Labeo rohita: protective effect of an antioxidant supplement, Amrita Bindu.

The present study was undertaken to investigate the effect of potent hepatocarcinogen aflatoxin B1 in adduct formation and DNA damage in Labeo rohita. Also, the salubrious efficacy of an antioxidant supplement Amrita Bindu (based on Indian system of Medicine) was investigated. Fish weighing 175-250 g were administered intraperitoneally a single dose of 100 microg aflatoxin B1/100 g body wt. and another group was given 20% solution of Amrita Bindu along with aflatoxin B1 at 100 microg/100 g body wt. On the 3rd and 6th day, the liver tissue was analyzed for aflatoxin concentration, aflatoxin-DNA adduct formation and DNA damage measured in terms of single strand breaks. The fishes administered with aflatoxin B1 showed elevated concentration of aflatoxin along with a parallel increase in the DNA adduct when compared with the controls. While the fish co-administered with Amrita Bindu showed 34% and 24% reduction in aflatoxin deposition (accumulation) and aflatoxin-DNA adduct formation respectively on the 3rd day, a further reduction by around 41% and 33% in aflatoxin deposition and DNA adduct formation respectively was observed on the 6th day. Furthermore, the increased single strand breaks (measured by alkaline single cell gel assay) and fragmentation observed in agarose gel electrophoresis in aflatoxin B1 administered fish were significantly reduced by Amrita Bindu co-administration. In conclusion, this is the first report to show aflatoxin B1-induced DNA adduct formation and DNA damage in one of the major Indian culturable fish, Labeo rohita. Also, our observations show that the antioxidant supplement, Amrita Bindu, has a potential role in ameliorating the aflatoxin B1-induced DNA damage thus suggesting its applicability in preventing the vital macromolecule DNA.

Antioxidant activity of a salt-spice-herbal mixture against free radical induction.

A combination of spices (Piper nigrum, Piper longum and Zingiber officinale), herbs (Cyperus rotundus and Plumbago zeylanica) and salts make up Amrita Bindu. The study was focused to evaluate the antioxidant property of individual ingredients in Amrita Bindu against the free radical 2,2'-azinobis-(3-ethylbenzothiazoline-6-sulphonic acid) (ABTS). The analysis revealed the antioxidant potential of the ingredients in the following order: Piper nigrum>Piper longum>Cyperus rotundus>Plumbago zeylanca>Zingiber officinale. Two different experiments were designed. In experiment I, rats were fed with normal diet whereas in experiment II rats were given feed mixed with Amrita Bindu for 3 weeks (4 g/kg of feed). Rats from both experimental groups were challenged against a single intraperitonial injection of phenylhydrazine (PHZ) (7.5 mg/kg body weight). At the end of 24 and 72 h, blood was analysed for free radicals and antioxidant levels. It was interesting to note that rats with Amrita Bindu pretreatment showed significantly lower levels of free radicals, lipid peroxidation and protein carbonyls along with significantly higher levels of antioxidants when compared with rats without Amrita Bindu pretreatment on PHZ administration. These results reveal that Amrita Bindu, a salt-spice-herbal mixture exerts a promising antioxidant potential against free radical induced oxidative damage.

Amrita Bindu--a salt-spice-herbal health food supplement for the prevention of nitrosamine induced depletion of antioxidants.

Ayurveda, practised in India, identified a large number of plant components to be used in the diet for the prevention or the delayed development of degenerative disorders. They include some of the commonly used spices, namely pepper and ginger. The Materia Medica includes both naturally occurring and artificially produced salts, as a partial substitute for common salt. Health promoting herbs and spices which are classified pharmacologically as rejuvenating, nourishing, invigorating, cleansing, wound-healing, etc., are used as food additives. Amrita Bindu is a salt-spice-herbal mixture based on these principles and was tested for its effect in maintaining antioxidant defense systems in blood and liver when exposed to a carcinogenic nitrosamine, N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). Amrita Bindu supplementation prevented MNNG induced depletion of the antioxidant enzymes and the scavenger antioxidants glutathione and vitamins A, C and E. Amrita Bindu provides protection against free radical and reactive oxygen species induced tissue lipid peroxidation and the resultant tissue degeneration.

Brahmighritham, an Ayurvedic herbal formula for the control of epilepsy.

Brahmighritham is an Ayurvedic herbal recommended for the control of epilepsy. The preparation of the drug is described. It was tested for its oral effectiveness in controlling pentylenetetrazole-induced seizures in male albino rats and was compared with benzdiazepam. Alterations in the EEG pattern and gross neurological function were measured or rated 60 min after pentylenetetrazole administration. Thirty-day pretreatment with both Brahmighritham and benzdiazepam served to make the rats more insensitive to epileptogenic events.

Double-blind cross-over study of modified Anna Pavala Sindhooram in patients with hyperlipidemia or ischemic heart disease.

The plasma lipid lowering effect of modified Anna Pavala Sindhooram (APSm) was tested in 30 patients with plasma lipid abnormalities and with symptomatic ischemic heart disease (IHD) in a double-blind cross-over design. HDL2 cholesterol and total HDL cholesterol were increased during APSm therapy leading to a reduction in the coronary risk index. Plasma cholesterol, LDL and VLDL cholesterol, triglycerides, phospholipids and free fatty acids were significantly reduced during APSm therapy while withdrawal of the drug led to a slow increase in these lipids. No adverse side effects were noticed. Some patients were able to reduce their daily doses of antihypertensive and vasodilator drugs during APSm therapy.

Possible regeneration of the islets of Langerhans in streptozotocin-diabetic rats given Gymnema sylvestre leaf extracts.

Two water soluble extracts, GS3 and GS4, obtained from the leaves of Gymnema sylvestre, were tested in streptozotocin treated rats for their effects on blood glucose homeostasis and pancreatic endocrine tissue. In the diabetic rats, fasting blood glucose levels returned to normal after 60 days of GS3 and after 20 days of GS4 oral administration. Blood collected during the conduct of oral glucose tolerance tests was used to assay for serum insulin. GS3 and GS4 therapy led to a rise in serum insulin to levels closer to normal fasting levels. In diabetic rat pancreas, both GS3 and GS4 were able to double the islet number and beta cell number. This herbal therapy appears to bring about blood glucose homeostasis through increased serum insulin levels provided by repair/regeneration of the endocrine pancreas.

Use of Gymnema sylvestre leaf extract in the control of blood glucose in insulin-dependent diabetes mellitus.

GS4, a water-soluble extract of the leaves of Gymnema sylvestre, was administered (400 mg/day) to 27 patients with insulin-dependent diabetes mellitus (IDDM) on insulin therapy. Insulin requirements came down together with fasting blood glucose and glycosylated haemoglobin (HbA1c) and glycosylated plasma protein levels. While serum lipids returned to near normal levels with GS4 therapy, glycosylated haemoglobin and glycosylated plasma protein levels remained higher than controls. IDDM patients on insulin therapy only showed no significant reduction in serum lipids, HbA1c or glycosylated plasma proteins when followed up after 10-12 months. GS4 therapy appears to enhance endogenous insulin, possibly by regeneration/revitalisation of the residual beta cells in insulin-dependent diabetes mellitus.

Antidiabetic effect of a leaf extract from Gymnema sylvestre in non-insulin-dependent diabetes mellitus patients.

The effectiveness of GS4, an extract from the leaves of Gymnema sylvestre, in controlling hyperglycaemia was investigated in 22 Type 2 diabetic patients on conventional oral anti-hyperglycaemic agents. GS4 (400 mg/day) was administered for 18-20 months as a supplement to the conventional oral drugs. During GS4 supplementation, the patients showed a significant reduction in blood glucose, glycosylated haemoglobin and glycosylated plasma proteins, and conventional drug dosage could be decreased. Five of the 22 diabetic patients were able to discontinue their conventional drug and maintain their blood glucose homeostasis with GS4 alone. These data suggest that the beta cells may be regenerated/repaired in Type 2 diabetic patients on GS4 supplementation. This is supported by the appearance of raised insulin levels in the serum of patients after GS4 supplementation.

Control of alcohol addiction by SKV therapy--its action on water, food intake, brain function and cell membrane composition.

Alcohol being easily permeable through cell membrane causes toxic damage to many tissues. Rats drinking aqueous ethanol (25% v/v) for 120 days and 240 days showed an initial rise in body weight. The reduced rate in weight gain in chronic alcoholism is associated with a fall in food intake. Ethanol ingesting animals showed slow response to stimuli and increase in blood ethanol and serum GGTP levels. Liver plasma membrane, kidney brush-border membrane and pancreatic plasma membrane from alcoholic rats showed significant alterations in cholesterol/phospholipid molar ratio and membrane ATPases. Water retention with the enlargement of liver and kidney associated with increased fluid consumption are also seen during alcoholism. SKV by breaking alcohol dependence reduces drinking, lowers blood ethanol level and fluid intake without developing withdrawal symptoms. Restriction of ethanol intake by SKV therapy resulted in the reversal of organ enlargement and membrane composition in alcoholics.

Studies on brain structure and neurological function in alcoholic rats controlled by an Indian medicinal formula (SKV).

An Indian herbal brew known in Ayurvedic pharmacy as asavam (SKV) was tested for its effectiveness in controlling addiction to ethanol in rats. Rats on SKV therapy with free access to 15% ethanol showed a marked reduction in voluntary ethanol intake. Their performance in simple neurological tests improved and a reversal of ethanol-induced changes in the electroencephalogram and electrocardiogram were also recorded. SKV treatment appeared to correct the fatty changes in liver and the signs of haemorrhage, demyelination and spongiosis seen in the brain of ethanol-fed rats.

An Indian herbal formula (SKV) for controlling voluntary ethanol intake in rats with chronic alcoholism.

Chronic ethanol ingestion in rats showed metabolic and physiological changes similar to alterations reported in human alcoholics. There was a lowering of blood glucose concentration, urea and plasma proteins and elevated concentrations of serum gamma-glutamyl transpeptidase. Administration of SKV, an Ayurvedic formula produced by fermentation of cane sugar with raisins and 12 herbal ingredients brought down voluntary ethanol ingestion in the rats and increased food intake. ECG and EEG studies in alcoholic rats showed cardiac depression, augmentation of frequency and amplitude of the alpha, delta and theta waves and weakness in the beta waves. These changes were reversed during SKV-induced voluntary alcohol restriction. The involvement in the ECG and EEG wave patterns was associated with improvement in blood glucose, plasma protein levels and reduction in gamma glutamyl transpeptidase activities. SKV appeared to have no adverse reaction with ethanol (it contains 1-2% ethanol) and appears to be a promising way to combat alcoholism.

Plasma cholesterol and lipoprotein lowering effect of Anna Pavala Sindhooram.

Plasma lipid and lipoprotein lowering effect of Anna Pavala Sindhooram (APS), a Sidha medicinal preparation was investigated in normal rabbits, chicken and men, and in hypercholesterolemic rabbits. The drug exhibited a marked hypolipaemic and hypocholesterolemic action in the three species studied. In rabbits, marked reduction was observed in very low density lipoprotein cholesterol, while in chicks and in humans low density lipoprotein cholesterol was also reduced significantly when compared to the levels measured before the administration of the drug. The drug enhances faecal elimination of lipids and bile acids in atherosclerotic rabbits.

Anna Pavala Sindhooram--an antiatherosclerotic Indian drug.

The procedure for the preparation of Anna Pavala Sindhooram (APS), a drug based on the concepts of Indian medicine for the prevention and reversal of the atherosclerotic disease process is described in detail. The uniformity in the composition of samples of the drug obtained in 10 batches, prepared over a period of 5 years is evident from the chemical analysis of the mineral constituents. The possibility of iodine, copper, iron, calcium and magnesium present in the Anna Pavala Sindhooram, acting metabolically to reduce hypercholesterolemia is discussed. The ingredients used are green vitriol (Annabedi or ferrous sulphate), coral reef (Corallium rubrum or Pavalam), leaves of Acalypha indica (Kuppaimeni), Lippia nodiflora (Poduthalai), Vinca rosea (Nityakalyani), Lawsonia alba (maruthondri) and Cynodon dactylon (Arugampul) and the flowers of Hibiscus rosasinensis (Chemparathampoo) and the ripe fruits of Phyllanthus emblica (nellikkai). Sindhooram is the chief therapeutic form of herbo-mineral preparations used in the Sidha system of Indian medicine.

Enzyme changes and glucose utilisation in diabetic rabbits: the effect of Gymnema sylvestre, R.Br.

The administration of the dried leaf powder of Gymnema sylvestre regulates the blood sugar levels in alloxan diabetic rabbits. G. sylvestre therapy not only produced blood glucose homeostasis but also increased the activities of the enzymes affording the utilisation of glucose by insulin dependent pathways: it controlled phosphorylase levels, gluconeogenic enzymes and sorbitol dehydrogenase. The uptake and incorporation of [14C] glucose into the glycogen and protein are increased in the liver, kidney and muscle in G. sylvestre administered diabetic animals when compared to the untreated diabetic animals. Pathological changes initiated in the liver during the hyperglycemic phase are reversed by controlling hyperglycemia by G. sylvestre. G. sylvestre, a herb used for the control of diabetes mellitus in several parts of India, appears to correct the metabolic derangements in diabetic rabbit liver, kidney and muscle.