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Medicinal Plants with Potential Anti- Arthritic Activity Journal of Intercultural Ethnopharmacology www.jicep.com Original Article DOI: 10.5455/jice.20150313021918 Medicinal plants with potential anti- arthritic activity Manjusha Choudhary1, Vipin Kumar2, Hitesh Malhotra1, Surender Singh3 1Department of ABSTRACT Pharmacology, Institute of Ethno Pharmacological Relevance: Traditional medicinal plants are practiced worldwide for treatment of Pharmaceutical Sciences, Kurukshetra University, arthritis especially in developing countries where resources are meager. This review presents the plants Kurukshetra, Haryana, profiles inhabiting throughout the world regarding their traditional usage by various tribes/ethnic groups for India, 2Department treatment of arthritis. Materials and Methods: Bibliographic investigation was carried out by analyzing classical of Pharmacy, School text books and peer reviewed papers, consulting worldwide accepted scientific databases from the last six of Chemical Science decades. Plants/their parts/extracts/polyherbal formulations, toxicity studies for arthritis have been included and Pharmacy, Central in the review article. The profiles presented also include information about the scientific name, family, dose, University of Rajasthan, methodology along with mechanism of action and toxicity profile. Research status of 20 potential plant species Ajmer, Rajasthan, has been discussed. Further, geographical distribution of research, plants distribution according to families has 3 India, Department of been given in graphical form. Results: 485 plant species belonging to 100 families, traditionally used in arthritis Pharmacology, All India Institute of Medical are used. Among 100 plant families, malvaceae constitute 16, leguminasae 7, fabaceae 13, euphorbiaceae Sciences, New Delhi, India 7, compositae 20, araceae 7, solanaceae 12, liliaceae 9, apocynaceae, lauraceae, and rubiaceae 10, and remaining in lesser proportion. It was observed in our study that majority of researches are carried mainly in AAddressddress fforor ccorrespondence:orrespondence: developing countries like India, China, Korea and Nigeria. Conclusion: This review clearly indicates that list of Vipin Kumar, Department medicinal plants presented in this review might be useful to researchers as well as practioners. This review of Pharmacy, School of can be useful for preliminary screening of potential anti-arthritis plants. Further toxicity profile given in the Chemical Science and Pharmacy, Central University review can be useful for the researchers for finding the safe dose. of Rajasthan, Ajmer, India. E-mail: vipbhardwaj@ rediffmail.com RReceived:eceived: January 07, 2015 AAccepted:ccepted: February 09, 2015 PPublished:ublished: March 14, 2015 KEY WORDS: Arthritis, plant, polyherbal, traditional uses INTRODUCTION is triggered by the combination of genetic predisposition and exposure to environmental factors like viruses [4]. The exact Immune system of our body plays a crucial role, as an overactive pathophysiology is still unknown but release of certain free immune system may lead to certain fatal disease because of radicals such as nitrous oxide and superoxide radicals generated various hypersensitive or allergic reactions which may cause as by-products of cellular metabolism. The release of such free numerous derangements; loss of normal capacity to differentiate radicals may induce the production of interleukins (IL) and self from non-self resulting in immune reactions against our tumor necrosis factor (TNF-α) from T-cells which ultimately own’s cells and tissues called autoimmune diseases. Certain influence the production of growth factors, cytokines and common autoimmune diseases like myasthenia gravis, serum adhesive molecules on immune cells as such factors may cause sickness, pernicious anemia, reactive arthritis etc., are the severe tissue destruction and inflammation [5]. Pathological changes issues for medical and pharmaceutical community because of in RA are hyperplasia of synovial membrane, infiltration of unknown etiology [1]. According to WHO, 0.3-1% of the world inflammatory cells and neovascularization, which results into population is affected from rheumatoid arthritis (RA) and cartilage erosion and articular destruction [3]. among them females are three times more prone to the disease as compared to males [2]. RA is a chronic, inflammatory, and The goal of treatment for rheumatoid arthitic patients systemic autoimmune disease [3]. The primary symptoms of is to eliminate symptoms, slow disease progression, and RA include pain, swelling, and destruction of cartilage and bone optimize quality-of-life [6]. Therefore, before starting the as a result of which permanent disability occur. Although the treatment of RA certain goals must be kept in mind such as exact etiology is unknown but several hypotheses said that it relief of analgesia, reduction of inflammation, protection of J Intercult Ethnopharmacol ● Apr-Jun 2015 ● Vol 4 ● Issue 2 147 Choudhary, et al.: A comprehensive review articular structure, maintenance of function, and control of we have tried to cover all the ayurvedic strategies that are systemic involvement [5]. Presently for the treatment of RA, followed for the treatment of RA without any possible side strategies have changed from traditionally used non-steroidal effects. The future treatment of RA should provide more anti-inflammatory drugs (NSAIDs) or disease modifying effective relief [5]. antirheumatic drugs (DMARDs) to novel biological agents, like TNF monoclonal antibody. Clinically, the treatment of RA MATERIALS AND METHODS includes five strategies. The foremost approach is the use of NSAIDs followed by mild doses of glucocorticoids to minimize In this review, bibliographic investigation was carried out during the signs of inflammation as well as progression of disease. In July 2011-December 2013, by refering various text books and chronic patients, the use of DMARDs such as methotrexate, certain review papers and research papers, consulting globally sulfasalazine, gold salts or D-pencillamine can be included in accepted databases from last some decades. The data were the treatment. In certain cases, TNF-α neutralizing agents gathered from various databases i.e. Science Direct, PubMed, like infliximab, etanercept etc; IL-1 neutralizing agents like and Google and the information is compiled by reviewing anakinra; and the drugs which interfere with T-cell activation more than 250 research and review articles. The data which such as abatacept can also be included in treatment of chronic are relevant would be considered. The botanical correct names cases. Finally, immunosuppressive and cytotoxic drugs such and families were mentioned after verification from published as cyclosporine, azathioprine, and cyclophosphamide are literature and databases. used for the treatment of chronic patients [5,7,8]. The above- mentioned therapeutic agents reduce the inflammation and The method of scrutining the data for this review article joint destruction but their long-term risks are still unknown. includes those plants: (i) Which are native to India and other However, long-term risks of drugs includes gastrointestinal countries such as America, Africa or Europe, (ii) used in ulcers, cardiovascular complications, hematologic toxicity, traditional systems and in various polyherbal preparations, (iii) nephrotoxicity, pulmonary toxicity, myelosuppression, hepatic with reported anti-arthritic activity, (iv) appropriate dosage, fibrosis, stomatitis, cirrhosis, diarrhea, immune reactions, and (v) mechanism of action, (vi) safety profile, and (vii) models local injection-site reactions. Moreover, higher costs and side used. Plants/their parts/extracts used traditionally in acute effects which include high risks of infections and melagnancies rheumatic attacks, chronic analgesia, and chronic rheumatism reguires continous monitoring [1]. have been considered as anti-arthritic agents. Further, detailed information on research status of 20 plant species has been Herbal Therapy for the Treatment of Arthritis explained. Herbal medicines are used for the treatment of various Polyherbal Formulations for Arthritis ailments from ancient times and it is not an exaggeration to say that the use of the herbal drugs is as old as mankind Analgesics and NSAIDs are helpful in reducing pain and [9]. Herbal medicines are synthesized from the therapeutic inflammation in either acute or chronic RA patients [18]. experience of generation of practicing physicians of ancient Although the treatment of RA is available but due to potential system of medicine for more than hundreds of years [10]. adverse effects or irreversible organ damage the new approaches Nowadays, researcher shows a great interest in those medicinal are developed for maintaining the balance between these agents that are derived from plants because the currently potential risks and acknowledged benefits [19]. Currently for available drugs are either have certain side effects or are the treatment of RA safer and more potent medicaments are highly expensive [11]. Nature has blessed us with enormous developed from oriental sources. Large number of herbal extracts wealth of herbal plants which are widely distributed all over and products such as polyherbal formulations are prepared to the world as a source of therapeutic agents for the prevention reduce such side effects and increase the benefits [18]. and cure of various diseases [12]. According to WHO, world’s 80% population uses herbal medicines for their primary health Rheum off Gold
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