Computational identification of potential bioactive compounds from Triphala against alcoholic liver injury by targeting alcohol dehydrogenase.

Alcoholic liver injury resulting from excessive alcohol consumption is a significant social concern. Alcohol dehydrogenase (ADH) plays a critical role in the conversion of alcohol to acetaldehyde, leading to tissue damage. The management of alcoholic liver injury encompasses nutritional support and, in severe cases liver transplantation, but potential adverse effects exist, and effective medications are currently unavailable. Natural products with their potential benefits and historical use in traditional medicine emerge as promising alternatives. Triphala, a traditional polyherbal formula demonstrates beneficial effects in addressing diverse health concerns, with a notable impact on treating alcoholic liver damage through enhanced liver metabolism. The present study aims to identify potential active phytocompounds in Triphala targeting ADH to prevent alcoholic liver injury. Screening 119 phytocompounds from the Triphala formulation revealed 62 of them showing binding affinity to the active site of the ADH1B protein. Promising lipid-like molecule from Terminalia bellirica, (4aS, 6aR, 6aR, 6bR, 7R, 8aR, 9R, 10R, 11R, 12aR, 14bS)-7, 10, 11-trihydroxy-9-(hydroxymethyl)-2, 2, 6a, 6b, 9, 12a-hexamethyl-1, 3, 4, 5, 6, 6a, 7, 8, 8a, 10, 11, 12, 13, 14b-tetradecahydropicene-4a-carboxylic acid showed high binding efficiency to a competitive ADH inhibitor, 4-Methylpyrazole. Pharmacokinetic analysis further confirmed the drug-likeness and non-hepatotoxicity of the top-ranked compound. Molecular dynamics simulation and MM-PBSA studies revealed the stability of the docked complexes with minimal fluctuation and consistency of the hydrogen bonds throughout the simulation. Together, computational investigations suggest that (4aS, 6aR, 6aR, 6bR, 7R, 8aR, 9R, 10R, 11R, 12aR, 14bS)-7, 10, 11-trihydroxy-9-(hydroxymethyl)-2, 2, 6a, 6b, 9, 12a-hexamethyl-1, 3, 4, 5, 6, 6a, 7, 8, 8a, 10, 11, 12, 13, 14b-tetradecahydropicene-4a-carboxylic acid from the Triphala formulation holds promise as an ADH inhibitor, suggesting an alternative therapy for alcoholic liver injury.

Chemical fingerprint analysis and quality assessment of Tibetan medicine Triphala from different origins by high-performance liquid chromatography.

INTRODUCTION: Although the Tibetan medicine Triphala (THL) is widely used in many countries, insufficient progress has been made in quality control. OBJECTIVES: The present study aimed to propose a methodology for quality control of THL based on HPLC fingerprinting combined with an orthogonal array design. METHODS: Seven identified peaks were used as indicators to examine the effects of temperature, extraction time, and solid-liquid ratio on the dissolution of active ingredients in THL. Fingerprint analysis was performed on 20 batches of THL from four geographical areas (China, Laos, Thailand, and Vietnam). For further chemometric assessment, analysis techniques including similarity analysis, hierarchical clustering analysis, principal component analysis, and orthogonal partial least squares discrimination analysis (OPLS-DA) were used to classify the 20 batches of samples. RESULTS: Fingerprints were established and 19 common peaks were identified. The similarity of 20 batches of THL was more than 0.9 and the batches were divided into two clusters. Four differential components of THL were identified based on OPLS-DA, including chebulinic acid, chebulagic acid, and corilagin. The optimal extraction conditions were an extraction time of 30 min, a temperature of 90°C, and a solid-liquid ratio of 30 mL/g. CONCLUSION: HPLC fingerprinting combined with an orthogonal array design could be used for comprehensive evaluation and quality assessment of THL, providing a theoretical basis for further development and utilization of THL.

Comparative Evaluation of the Effectiveness of Triphala and Chlorhexidine in Full-mouth Disinfection Treatment of Periodontitis in Type 2 Diabetes Patients.

AIM: To evaluate and compare the efficacy of triphala and chlorhexidine (CHX) in the treatment of stages II and III periodontitis with one-stage complete mouth disinfection in type 2 diabetes mellitus (DM) patients. MATERIALS AND METHODS: A total of 24 type 2 diabetic subjects with either stage II or stage III periodontitis were randomly divided into test and control groups with 12 patients in each group. For control group, full-mouth disinfection (FMD) was done using CHX and for test group, FMD was done using triphala. Clinical parameters were evaluated at baseline and at 6 months which comprised of probing pocket depth (PPD), plaque index (PI), clinical attachment level (CAL), papillary bleeding index (PBI). The primary outcomes considered were a reduction in PPD and a gain in CAL. The data were recorded, tabulated, and statistically analyzed. RESULTS: The PPD reduction for the test group was 3.38 ± 0.75 mm and for the control group was 3.39 ± 0.76 mm. The CAL gain for the test group was 3.39 ± 0.76 mm and for the control group was 3.18 ± 0.74 mm. Although there was a statistically significant PPD reduction, statistically not significant CAL gain was observed. CONCLUSION: Both the groups with the FMD protocol showed beneficial results in terms of PPD reduction and CAL gain but the test group showed slightly better results. CLINICAL RELEVANCE: Clinically, there is more PPD reduction and CAL gain from baseline to 6 months in the test group compared to the control group. Clinically, the test group has more favorable results compared to the control group.

Experimental Study on the Effect of Tibetan Medicine Triphala on the Proliferation and Apoptosis of Pancreatic Islet ß Cells through Incretin-cAMP Signaling Pathway.

According to the data, there are 387 million people with diabetes in the world, and the number of people with diabetes is expected to reach 600 million by 2035 (Nature Reviews Endocrinology, 14, 2018, Zheng et al.). At present, there are nearly 110 million diabetic patients in China, the incidence of which is increasing (Diabetologia, 61, 2018, Ma). Islet ß cell apoptosis and proliferation is an important basis for the occurrence and development of diabetes. It has been reported that enhancing the activity of incretin-cAMP signaling pathway can also promote islet ß cell proliferation, reduce ß cell apoptosis and promote insulin secretion (Diabetologia, 59, 2016, Iida et al.). Tibetan medicine Triphala (THL) is a traditional national medicine, it plays a good role in anti-fatigue, antioxidation, prevention and treatment of polycythemia at high altitude. Research have shown that it can reduce blood glucose in patients with diabetes and inhibit the activity of glucosidase in the intestines (The Journal of Alternative and Complementary Medicine, 23, 2017, Peterson et al.). After the diabetic Wistar rat model induced by Streptozocin (STZ) was successfully duplicated, the positive drug sitagliptin tablet and THL were given and the changes of body weight and blood glucose were measured. After 6 weeks, the expression of related factors in serum and pancreas was observed. Compared with the model group, in the treatment group, blood glucose decreased, body weight increased, incretin-cAMP signaling pathway related factors glucose-dependent insulin-promoting polypeptide (GIP), glucagon-like peptide-1 (GLP-1), GLP-1R, cAMP, P-protein kinase A (PKA), AKT were up-regulated, insulin secretion was increased, liporing protein interaction protein (TXNIP) expression was down-regulated. In addition, in the treatment group, the degree of islet atrophy was alleviated and the number of islet ß cells increased. This study shows that THL may enhance the activity of incretin-cAMP signal pathway and affect the proliferation and apoptosis of islet ß cells, so as to achieve the effect of anti-diabetes.

Triphala Ameliorates Nephropathy via Inhibition of TGF-ß1 and Oxidative Stress in Diabetic Rats.

INTRODUCTION: Advanced glycation end products, oxidative stress, and TGF-ß expression play a crucial role in pathophysiology of diabetic nephropathy. Inhibition of oxidative stress and TGF-ß expression by natural traditional medicines may give an economic and safe alternative treatment option. Triphala churna, a traditional medicine, has been proved to have potent antioxidant activity, and individual components of it have shown significant antidiabetic activity. Hence, the present study was designed to study the effect of Triphala churna in diabetic nephropathy in rats. METHODS: Diabetes was induced in rats by administration of streptozotocin (55 mg/kg i.p.). Four weeks after induction of diabetes, the animals were treated with Triphala churna at the doses of 250, 500, and 1,000 mg/kg for next 4 weeks. Various biochemical and urine parameters such as glucose, creatinine, blood urea nitrogen (BUN), total protein, and albumin were assessed at the end of study. Creatinine clearance, BUN clearance, and glomerular filtration rate were determined. Oxidative stress parameters such as malondialdehyde, catalase, reduced glutathione, and superoxide dismutase were determined in kidney tissues. TGF-ß1 expression was measured with ELISA, immunohistochemistry, and western blot techniques. Histopathology study was carried out with haemotoxylin and eosin, periodic acid-Schiff, and Masson's trichrome staining to determine histological changes. RESULTS: Treatment with Triphala churna significantly improved urine parameters. Triphala churna treatment also improved plasma proteins, albumin, creatinine, and BUN levels. The oxidative stress was reduced in the kidney with the treatment of Triphala churna. Histopathological studies revealed that Triphala churna reduced kidney damage. Immunohistochemistry, ELISA, and western blotting study revealed that treatment with Triphala decreased the expression of TGF-ß in kidney tissues. CONCLUSION: From the results, it can be concluded that Triphala churna has a significant nephroprotective effect because of its capability of inhibiting oxidative stress and TGF-ß in diabetes.

Effect of triphala mouthrinse on plaque and gingival inflammation: A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVES: To assess the efficacy of triphala mouthwash (TRP-MW) in being equally effective to chlorhexidine mouthwash (CHX-MW) in the treatment of plaque-induced gingivitis. MATERIALS AND METHODS: Electronic searches in MEDLINE/PubMed, EMBASE and CENTRAL were conducted in databases up to April 2020. Randomized clinical trials (RCTs) comparing clinical efficacy of TRP-MW (test group) in comparison with CHX-MW in treating plaque-induced gingivitis were considered. The primary outcome was gingival index (GI), whereas the secondary outcome was plaque index (PI). RESULTS: Seven RCTs were included. All studies showed that TRP-MW administration was significantly effective as compared to CHX-MW in the treatment of plaque-induced gingivitis. Considering the effects of TRP-MW on clinical gingival inflammatory parameters, significant heterogeneity for both GI (χ2  = 72.77, P < .0001, I2  = 91.76%) and PI (χ2  = 153.67, P < .0001, I2  = 96.10%) was observed between both TRP-MW and CHX-MW groups. The overall mean difference for both GI (WMD = -0.29, 95% CI = -0.40 to -0.17, P < .001) and PI (WMD = -0.43, 95% CI = -0.54 to -0.31, P < .001) was statistically significant between TRP-MW and CHX-MW at follow-up, respectively. CONCLUSION: Triphala mouthwash seems to significantly improve the clinical gingival inflammatory parameters in plaque-induced gingivitis with equal clinical efficacy as CHX-MW. TRP is a cost-effective alternative and is easily available with limited side effects on periodontal tissues.

Synergistic activity between Triphala and selected antibiotics against drug resistant clinical isolates.

BACKGROUND: Triphala is an indigenous medical product used for a variety of diseases. This study was conducted to determine the effect of Triphala on antibiotic properties of gentamicin and oxacillin against multi-drug resistant organisms. METHODS: The checkerboard method was used to determine the synergy of Triphala with gentamicin and oxacillin against multi-drug resistant (MDR) Gram negative bacilli and methicillin-resistant Staphylococcus aureus (MRSA) using 2,3,5-triphenyltetrazolium chloride (TTC) assay. Fractional inhibitory concentration (FIC) index was calculated. RESULTS: When tested alone, the minimum inhibitory concentration (MIC) values of gentamicin for Gram negative isolates ranged from 8 to > 64 µg/ml. The MIC values of gentamicin for the Gram negative isolates ranged from 1 to 32 µg/ml when tested with Triphala. The FIC index was < 1 indicating a synergistic interaction in 10 of the 11 isolates and it was 1 indicating an additive effect in one isolate. The MIC values of oxacillin for MRSA isolates ranged from 4 to > 16 µg/ml with all MICs being equal to or higher than the resistance cut-off level. The MIC level with the addition of Triphala ranged from 0.25 to 4 µg/ml. FIC index was < 1 for all tested isolates indicating a synergistic interaction. CONCLUSIONS: Triphala has synergistic activity with gentamicin against the selected MDR Gram negative bacilli and with oxacillin against MRSA isolates warranting further studies on the possibility of clinical use.

Chebulinic acid derived from triphala is a promising antitumour agent in human colorectal carcinoma cell lines.

BACKGROUND: Triphala is an Ayurvedic rasayana formulation reputed for its antitumour activities, and chebulinic acid and chebulagic acid, along with other phenolic acids, have been proposed to be responsible for its effects. METHODS: In this study, the anti-proliferative activities of these agents were evaluated in colorectal carcinoma cell lines with three phenotypes exposed to several batches of triphala samples with different quantities of chebulinic acid and chebulagic acid. The pro-apoptotic and anti-migratory activities and the probable antitumour mechanisms of the more potent anti-proliferative phytochemical were also investigated. RESULTS: The results demonstrated that chebulinic acid, which exerts potent anti-proliferative, pro-apoptotic and anti-migratory effects, is a key molecule for maintaining the antitumour efficacy of triphala. The antitumour mechanism of chebulinic acid is probably related to the PI3K/AKT and MAPK/ERK pathways. CONCLUSIONS: Chebulinic acid is not only a critical component of the anticancer activities of triphala but also a promising natural multi-target antitumour agent with therapeutic potential.

Triphala exhibits anti-arthritic effect by ameliorating bone and cartilage degradation in adjuvant-induced arthritic rats.

The present study was aimed to investigate the anti-arthritic effect of triphala and its underlying mechanism on adjuvant-induced rat model. For comparison purpose, non-steroidal anti-inflammatory drug indomethacin was used. Arthritis was induced by intradermal injection of complete Freund's adjuvant (0.1 ml) into the right hind paw of the Wistar albino rats. Triphala (100 mg/kg body weight [bwt]) was administered intraperitoneally (from 11th to 20th day) after the arthritis induction. Arthritis induction increased the levels of reactive oxygen species (LPO and NO), elastase, and mRNA expression of pro-inflammatory cytokines (TNF-α, IL-ß, IL-17, IL-6 and MCP-1), inflammatory marker enzymes (iNOS and COX-2), receptor activator of nuclear factor kappa-B ligand (RANKL), and transcription factors (NF-kB p65 and AP-1) in the paw tissues of rats. The levels of bone collagen were found to decrease with increased urinary constituents (hydroxyproline and total glycosaminoglycans) in arthritic rats. In addition, the immunohistochemistry analysis revealed increased expression of NF-kBp65 and COX-2 in the paw tissues of arthritic rats. However, administration of triphala significantly inhibited the biochemical and molecular alterations in adjuvant-induced arthritic rats compared to indomethacin (3 mg/kg bwt) as evidenced by the radiological and histopathological analysis. In conclusion, our results suggest that triphala administration ameliorate bone and cartilage degradation during rheumatoid arthritis.

The Efficacy of Triphala in the Management of Minor Aphthous Ulcers: A Case Report.

Aphthous ulcers, also known as canker sores, are the most frequently encountered lesions in the oral cavity by clinicians and particularly by dentists. It might affect populations of all age groups, although common in the younger age group. Though multifactorial causes are known to be associated with the occurrence of aphthae, the most common etiologies are stress, inadequate sleep, and improper digestion. They can appear on the oral mucosa, palate, gingiva, labial mucosa, and tongue. They can be very uncomfortable during mastication, speech, and deglutition. Generally, the management relies on identifying the cause and prescribing medications such as the local application of anesthetic, steroid ointments specifically for refractory cases, and multivitamin tablets to relieve the symptoms. Ayurvedic preparations such as Triphala oral rinse can prove to be really effective in relieving pain and burning sensation and also cause the lesions to subside, although, like other allopathy medications, it is not known to reduce the frequency of episodes. In this article, we present a case of a male patient aged 21 years who came with a complaint of ulcers on the right lateral border of the tongue. He was prescribed Triphala oral rinse and Triphala ingestion for 15 days, and on the follow-up visit, the patient reported the complete resolution of ulcers.

Study on the mechanism of natural polysaccharides on the deastringent effect of Triphala extract.

This present study investigated the masking effect of high methoxyl pectin, xanthan gum, and gum Arabic on the astringency of the traditional herbal formula Triphala and further examined the mechanism of polysaccharide reducing astringency. Results of sensory evaluation and electronic tongue illustrated that 0.6 % pectin, 0.3 % xanthan gum, and 2 % gum Arabic had a substantial deastringent effect. The polyphenols in Triphala are basically hydrolysable tannins, which with high degree of gallic acylation may be the main astringent component of Triphala. Moreover, the three polysaccharides can combine with ß-casein through CO and NH groups to form soluble binary complexes and decrease the secondary structure of ß-casein. When polysaccharides were added to the Triphala-protein system, polyphenol-protein precipitation was also diminished, and they were capable of forming soluble ternary complexes. Consequently, the competition between polysaccharides and polyphenols for binding salivary proteins and the formation of ternary complexes help decrease the astringency of Triphala.

Comparative anti-plaque and anti-gingivitis efficiency of Triphala versus chlorhexidine mouthwashes in children: a systematic review and meta-analysis.

The aim of this systematic review is to comparatively evaluate the Triphala and chlorhexidine mouthwashes efficacies in decreasing plaque formation and gingivitis in children. With a priori-set inclusion and exclusion criteria's and relevant MeSH terms, the PubMed, Cochrane and Ovid SP were scrutinized from the year 1980 to April 2023 for prospective articles. Outcomes evaluated were plaque formation and gingivitis through Plaque index and Gingival index. Five studies were finally included and were analyzed qualitatively and quantitatively. Meta-analysis, was performed using a random effects model. Plaque index (PI) and Gingival Index (GI). There was no significant difference between reduction in the gingivitis and plaque accumulation between Triphala and chlorhexidine mouthwash groups in children (p value 0.83, 0.96).

Triphala ameliorates cognitive deficits and anxiety via activation of the Nrf2/HO-1 axis in chronic sleep-deprived mice.

Triphala is renowned for its curative attributes and has been utilized for centuries to address diverse health ailments. Moreover, the active component of Triphala, polyphenols, is widely recognized for its excellent pharmacological activities, such as anti-inflammatory properties, and has been utilized as a potential natural remedy. However, the precise mechanism through which Triphala alleviates cognitive dysfunction and anxiety induced by chronic sleep deprivation (SD) remains restricted. The objective of this investigation is to examine and clarify the potential mechanism of action that underlies the therapeutic benefits of Triphala in addressing cognitive dysfunction and anxiety induced by chronic SD. Our results demonstrated that Triphala significantly alleviates chronic SD-induced behavioral abnormalities. Additionally, Triphala was highly effective at preventing histopathological or morphological damage to neurons located in the hippocampus. The therapeutic effects of Triphala in treating cognitive dysfunction and anxiety induced by chronic SD involve the modulation of several biological pathways, including inflammation and immune responses, oxidative stress, cell growth and differentiation, metabolism, and neurotransmitter communication. Moreover, our study illustrated that Triphala increased the nuclear translocation of nuclear factor erythroid 2-related factor 2 (Nrf2) and significantly activated the Nrf2/hemeoxygenase-1 (HO-1) axis. Additionally, the neuroprotective properties of Triphala were found to be counteracted by the Nrf2 inhibitor ML385. Our study represented the first to unveil that Triphala exerts therapeutic benefits in alleviating chronic SD-induced cognitive deficits and anxiety by activation of the Nrf2/HO-1 axis. Triphala emerges as a promising nutraceutical ingredient for mitigating cognitive deficits and anxiety linked to chronic SD.

Comparing the Biofilm Removal Capacity of NaOCl, Povidone-Iodine, Chlorhexidine, Curcumin, and Triphala as Endodontic Irrigants.

BACKGROUND AND AIM: A sessile multicellular organism that is immersed in a self-produced matrix of extracellular polymeric substances and has its cells firmly attached to a surface is referred to as a microbial biofilm. When it comes to pulp and periradicular pathosis, biofilms are crucial. To reduce the number of microorganisms in the root canal and assist in treating periapical pathosis, endodontic therapy must include decontamination of the system of tooth root canals through biomechanical preparation and irrigation of the root canal. This study compares sodium hypochlorite (NaOCl), povidone-iodine, chlorhexidine, curcumin, and triphala as endodontic irrigating solutions regarding their capacity to eliminate biofilm from root canals. MATERIALS AND METHODS: A total of 60 patients were included if they had pulpitis. Two specific samples (samples A and B) were chosen for analysis from a collection of samples so that their bacterial composition is most similar to that of acute pulpitis. The suspensions of bacterial cells from this polymicrobial culture have been collected from frozen stock and then regrown by inoculation on Columbia agar base (Basingstoke, UK) with the addition of vitamin K1, hemin, and 5% (v/v) calf blood. The pureness of the suspensions was assessed using colony morphology and Gram staining. Analytical profile index (API) 20A tests or automated test for bacteria (ATB) ID 32A tests were initially used to identify the isolates. These polymicrobial cultures' in vitro biofilms were developed using membrane filters made of cellulose nitrate. The tested irrigating solutions were as follows: 5.25% sodium hypochlorite, 10% triphala, 0.2% chlorhexidine gluconate, 10% povidone-iodine, and 5% curcumin (CUR). On the other hand, phosphate-buffered saline was taken as a control agent. RESULTS: As the standard of excellence in endodontic irrigation, NaOCl has eliminated all germs in sample A following 15 minutes of culture and in both of the specimens after 40 minutes. Iodine also eliminated all germs after 40 minutes of administration, indicating that it would be worth exploring using iodine as a potential endodontic irrigant. Iodine achieved total bacterial elimination after 40 minutes in both samples; however, it was less effective after 15 minutes. Our findings indicate that iodine solution is the most suitable alternative after the supremely effective NaOCl, although it requires longer contact times to generate the necessary and recognized broad-spectrum antibacterial properties, including in the case of biofilms. Furthermore, curcumin also showed significant results after NaOCl and iodine. CONCLUSION: The antibacterial potency of each studied irrigant was significant, supporting their usage in endodontics. It was observed that NaOCl has the maximum antibacterial activity.

Comparison of Antimicrobial Efficacy of Morinda citrifolia, Triphala, and Camellia sinensis Extracts as Root Canal Irrigants in Primary Molars: A Randomized Clinical Trial.

Objective: To evaluate the reduction of microbial loading using Morinda citrifolia (M. citrifolia), Triphala, and Camellia sinensis (C. sinensis) as irrigating agents in deciduous molars after pulpectomy. Materials and methods: A controlled, randomized clinical trial involving 150 multirooted deciduous molars from both genders between 6 and 9 years old children were included, 30 molars irrigated with M. citrifolia (group I), Triphala (group II), C. sinensis (group III), chlorhexidine (CHX) (group IV), and saline (group V) each. In all cases, two microbiological samples from within the canal were taken with sterile paper points, one before the first irrigation and the other immediately after pulp extirpation. Cleaning and shaping were completed with intermittent irrigation with 10 mL of experimental irrigants in the initial visit. After 3 days, reentry to the root canal was obtained, rinsed with 5 mL of the test irrigants, and the second microbial sample was collected. All the microbial samples obtained were cultured under anaerobic conditions on blood agar. The colony-forming units (CFUs) were counted using a colony counter. Data was analyzed using paired student t-test and Tukey's post hoc test. Results: After analysis of the pre- and postsamples in all groups, a strong significant decrease in bacterial load (p ≤ 0.001) was found with CHX, M. citrifolia, and Triphala. Conclusion: Morinda citrifolia (M. citrifolia) and Triphala, with effective antimicrobial efficacy, can be suggested as an alternative root canal irrigant as CHX, while C. sinensis was found ineffective in reducing microbial count as normal saline. How to cite this article: Pathivada L, Kapur D, Pandranki J, et al. Comparison of Antimicrobial Efficacy of Morinda citrifolia, Triphala, and Camellia sinensis Extracts as Root Canal Irrigants in Primary Molars: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2024;17(5):511-517.

Burning Mouth Syndrome in Association With Angular Cheilitis: A Case Report.

A burning sensation in the mouth without any obvious mucosal alterations is the hallmark of burning mouth syndrome, a chronic pain syndrome. BMS can worsen pain if it coexists with angular cheilitis, a condition characterized by inflammation around the corners of the mouth. Conventional therapies for angular cheilitis and burning mouth syndrome sometimes have unfavorable side effects and offer only little relief. When ozone is combined with oil, it accelerates tissue repair and oxygenation while destroying germs, fungi, and viruses. Triphala is a traditional treatment for oral health problems because of its anti-inflammatory, antioxidant, and antibacterial qualities. The effectiveness of alternative medicines, particularly ozonated oil, and triphala, a traditional herbal combination, in treating these diseases is examined in this case study. A 72-year-old woman reported a burning sensation in her mouth. The patient described the prolonged heat or burning sensation in the anterior two-thirds of her tongue. She was diagnosed with angular cheilitis and burning mouth syndrome. Conventional treatments, such as topical steroids and antifungal drugs, have not been effective. The patient was instructed to apply ozonated oil topically to the affected regions twice daily and to rinse their mouth with triphala. The patient reported full healing of the angular cheilitis lesions and considerable alleviation from burning feelings following two weeks of therapy. The patient noticed a significant decrease in the burning sensation in her mouth, characterized by a lack of discomfort, irritation, or pain. Throughout the treatment, no side effects were seen. According to this case study, ozonated oil and triphala may be useful in treating the symptoms of angular cheilitis and burning mouth syndrome, providing an alternative to traditional treatments.

A Novel Gum Paint Formulation Derived From Licorice and Triphala: Characteristics and Clinical Significance for Improved Oral Health.

BACKGROUND: The clinical use of antimicrobial agents for managing aphthous ulcers and periodontal diseases has long been a subject of intensive research by numerous investigators. As concerns over the side effects and antibiotic resistance associated with conventional therapies persist, there has been a concerted effort to explore alternative medicinal approaches. In line with this objective, our study introduces a novel herbal gum paint designed specifically to address the therapeutic needs of individuals suffering from oral ulcers and periodontal diseases. MATERIALS AND METHODS: The herbal formulation utilized in our study was prepared using extracts derived from Licorice (Glycyrrhiza glabra) and Triphala, a combination of three fruits: Emblica officinalis, Terminalia chebula, and Terminalia belerica. These ingredients were selected based on their documented medicinal properties. The preparation process involved extraction and formulation techniques optimized for maximum efficacy. Antimicrobial activity was assessed using the bacterial culture method, where the formulation's ability to inhibit the growth of specific bacterial strains relevant to oral health was tested. Meanwhile, cytotoxicity was evaluated using the Brine Shrimp Assay method. Statistical analysis was conducted using a one-way analysis of variance (ANOVA) and Tukey post hoc test to validate the significance of our findings with statistical significance set at p<0.05. RESULTS: The formulation exhibited significant activity against microbes when compared to the control. The cytotoxic activity was present at a concentration of 60 and 80µL, which indicated safe usage within specified concentration ranges, highlighting its potential for clinical application without adverse effects on biological systems. Statistically significant differences were obtained between the antimicrobial activity of the formulated gum paint and the commercial gum paint against Candida albicans species at 25 µL and 80 µL (p=0.00). CONCLUSION: The study underscores the promising therapeutic potential of the herbal gum paint developed in this research. By harnessing the natural antimicrobial and anti-inflammatory properties of Licorice and Triphala, the formulated gum paint showed efficacy against C. albicans. These findings contribute to the growing body of evidence supporting the integration of herbal remedies into mainstream oral healthcare practices. Future investigations could further elucidate the mechanisms underlying its therapeutic actions and explore its broader clinical applications in diverse patient populations.

The antitumor effects of herbal medicine Triphala on oral cancer by inactivating PI3K/Akt signaling pathway: based on the network pharmacology, molecular docking, in vitro and in vivo experimental validation.

BACKGROUND: This research aimed to investigate the anti-tumor effects and underlying genetic mechanisms of herbal medicine Triphala (TRP) in oral squamous cell carcinoma (OSCC). METHODS: The target genes of Triphala (TRP) in oral squamous cell carcinoma (OSCC) were identified, and subsequent functional enrichment analysis was conducted to determine the enriched signaling pathways. Based on these genes, a protein-protein interaction network was constructed to identify the top 10 genes with the highest degree. Genes deregulated in OSCC tumor samples were identified to be hub genes among the top 10 genes. In vitro experiments were performed to investigate the influence of TRP extracts on the cell metabolic activity, migration, invasion, apoptosis, and proliferation of two OSCC cell lines (CAL-27 and SCC-9). The functional rescue assay was conducted to investigate the effect of applying the inhibitor and activator of an enriched pathway on the phenotypes of cancer cells. In addition, the zebrafish xenograft tumor model was established to investigate the influence of TRP extracts on tumor growth and metastasis in vivo. RESULTS: The target genes of TRP in OSCC were prominently enriched in the PI3K-Akt signaling pathway, with the identification of five hub genes (JUN, EGFR, ESR1, RELA, and AKT1). TRP extracts significantly inhibited cell metabolic activity, migration, invasion, and proliferation and promoted cell apoptosis in OSCC cells. Notably, the application of TRP extracts exhibited the capacity to downregulate mRNA and phosphorylated protein levels of AKT1 and ESR1, while concomitantly inducing upregulation of mRNA and phosphorylated protein levels in the remaining three hub genes (EGFR, JUN, and RELA). The functional rescue assay demonstrated that the co-administration of TRP and the PI3K activator 740Y-P effectively reversed the impact of TRP on the phenotypes of OSCC cells. Conversely, the combination of TRP and the PI3K inhibitor LY294002 further enhanced the effect of TRP on the phenotypes of OSCC cells. Remarkably, treatment with TRP in zebrafish xenograft models demonstrated a significant reduction in both tumor growth and metastatic spread. CONCLUSIONS: Triphala exerted significant inhibitory effects on cell metabolic activity, migration, invasion, and proliferation in OSCC cell lines, accompanied by the induction of apoptosis, which was mediated through the inactivation of the PI3K/Akt pathway.

Preventive mechanisms of Chinese Tibetan medicine Triphala against nonalcoholic fatty liver disease.

BACKGROUND: Triphala (TLP), as a Chinese Tibetan medicine composing of Emblica officinalis, Terminalia chebula and Terminalia bellirica (1.2:1.5:1), exhibited hepatoprotective, hypolipidemic and gut microbiota modulatory effects. Nonetheless, its roles in prevention of high-fat diet (HFD)-induced nonalcoholic fatty liver disease (NAFLD) and the related mechanistic insights involving the interplay of gut microbiota and hepatic inflammation are not known. PURPOSE: The present study seeks to determine if TLP would prevent HFD-induced NAFLD in vivo and its underlying mechanisms from the perspectives of gut microbiota, metabolites, and hepatic inflammation. METHODS: TLP was subjected to extraction and chemo-profiling, and in vivo evaluation in HFD-fed rats on hepatic lipid and inflammation, intestinal microbiota, short-chain fatty acids (SCFAs) and permeability, and body weight and fat content profiles. RESULTS: The TLP was primarily constituted of gallic acid, corilagin and chebulagic acid. Orally administered HFD-fed rats with TLP were characterized by the growth of Ligilactobacillus and Akkermansia, and SCFAs (acetic/propionic/butyric acid) secretion which led to increased claudin-1 and zonula occludens-1 expression that reduced the mucosal permeability to migration of lipopolysaccharides (LPS) into blood and liver. Coupling with hepatic cholesterol and triglyceride lowering actions, the TLP mitigated both inflammatory (ALT, AST, IL-1ß, IL-6 and TNF-α) and pro-inflammatory (TLR4, MYD88 and NF-κB P65) activities of liver, and sequel to histopathological development of NAFLD in a dose-dependent fashion. CONCLUSION: TLP is promisingly an effective therapy to prevent NAFLD through modulating gut microbiota, mucosal permeability and SCFAs secretion with liver fat and inflammatory responses.

Indian Ayurvedic medicine: Overview and application to brain cancer.

Ayurveda is the traditional medicine system of India, and has been in practice for millennia. It is a traditional approach that uses 1000's of different plant preparations in various combinations for treatment of human ailments, including cancer. Ethnopharmacological and phytochemical analyses are now elucidating the bioactive constituents of the different plant species and herbal formulations, including ashwagandha, curcumin, guduchi, triphala, and others. To provide an overview of: 1) the ethnopharmacology of Ayurveda and several of its most important plant species and formulations, including pharmacological and molecular mechanisms of its anti-cancer effects; 2) review the literature applying Ayurvedic herbs and formulations to brain tumors. A detailed PubMed search was performed that included publications involving Ayurveda, cancer, ethnopharmacology, phytochemical analysis, molecular analysis, and brain tumors. In recent decades, significant research has begun to elucidate the bioactive compounds of ashwagandha, tumeric, guduchi, and triphala, such as withaferin A, withanolides, curcumin, palmatine, and many others. These compounds and extracts are now being applied to brain tumor cells in vitro and in animal models, with positive signs of anti-cancer activity including reduced cell growth, increased apoptosis, cell cycle arrest, increased differentiation, and inhibition of important internal signal transduction pathways. Several Ayurvedic herbs (ashwagandha, curcumin) have bioactive compounds with significant anti-cancer activity, and are effective in early pre-clinical testing against brain tumor cells in vitro and in animal models. Further pre-clinical testing is warranted, along with advancement into phase I and phase II clinical trials of patients with glioblastoma and other brain tumors.