Transcript KMC Ayurveda Wing

Conference on Healthy Gujarat- “Agenda
for Actions”
December 3rd , 2013
Dept of Health and FW – Govt of Gujarat
Gandhinagar
“ Recent Advances in Experimental Medicine”
( Focus on areas for possible convergence )
Dr.B.Ravishankar
SDM Centre for Research in Ayurveda and Allied
Sciences
Udupi
Gandhinagar Dept of HFW- Dec 3rd 2013
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Why convergence or integration is requited ?
None of the existing systems can meet all the
requirements of health care- existence of ‘
therapeutic gap’
Different systems work on different Scientific
paradigmsExample – unitary or reductionists approach of
conventional medicine
Holistic approaches of ISM like Ayurveda – combining
the approaches may be beneficial
Unique mechanisms of action - possible benefits - through
synergestic therapy
Patients acceptability and preference high for integrated
approach
Gandhinagar Dept of HFW- Dec 3rd 2013
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Potential areas of convergence :
Prophylaxis
Diagnosis
Drug therapy
Combination of non-drug therapies and drugs
Requirement : Data generation as Evidence base through
experimental studies- both basic and clinical
Gandhinagar Dept of HFW- Dec 3rd 2013
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Prophylaxis- Concepts of proper daily, seasonal routines
advocated in Ayurveda can be integrated
Constitution types – similar to genomic studies – ex- 1
Functional FoodsProphylactic measures in ISM
Avoidance of incompatibilities – adoption of the concept of
incompatibilities
Drug research- the fundamental concept for drug selection and
incorporation to therapeutics is known as
Rasapanchaka . < Rasa < Guna < Veerya < Vipaka and
Prabhava are the five attributes considered in candidate
plant or formulations .
Interesting recent developments – related to rasapanchaka
Gandhinagar Dept of HFW- Dec 3rd 2013
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Drug related incompatibilities:
Incompatibility of climate, season and soil- (desaand kala viruddha) –
Incompatibility of drug preparation-(Samskaraviruddha)
Arrangement of order of drug administration (krama)
Drug preparation method (Paka)
Physical and chemical factors (Samyoga)
Quantitative (mana-virodha)- ghee and honey
taken in equal quantity
Qualitative- (karma virodha)- dhataki and danti
Gandhinagar Dept of HFW- Dec 3rd 2013
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Combined drug therapy
B kalpana- the
science of
formulation in ayurveda is highly
sophisticated and formulation
factors have tremendous influence
over the expression of the
biological activity. > 22 types of
formulation forms are in vogue
Gandhinagar Dept of HFW- Dec 3rd 2013
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Drug action through bio-enhancement (Trikatu):
The mechanism of drug bioavailability enhancing effect of Piperine:
a-increased blood supply to the gastrointestinal tract,
b- increased enzymatic activities like gamma-glutamyl transpeptidase which
participates in active transport of nutrients across the intestinal cells
c- non-specific mechanisms inhibiting enzymes involving in biotransformation
of drugs, preventing their inactivation and elimination (Goldstein,
1984; Esposito, 1984)
d- by increasing the membrane fluidity Piperine, or mixtures containing piperine, has been shown to increase the bioavailability,
blood levels and efficacy of a number of drugs including ingredients of vasaka
leaves, vasicine, sparteine, sulfadiazine, rifampicin, phenytoin and propranolol
Gandhinagar Dept of HFW- Dec 3rd
2013
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AS adjuvant
Cyclo –Immunosuppression- Table-A and Fig-A
Cyclo-myelosuppression- Table-B
Table- A – Effect of VDAV and ADJ on Cyclophosphamide induced
suprression of anti-SRBC antibody in rats/
Groups
Anti body titre Log2value
Control
6.01  0.23
Cycl control
4.46  0.37*
Cycl + VDAV
5.78  0.29*a
Cycl + ADJ
5.68  0.67
* P< 0.05 Vs- control *a P <0.05 Vs Cyclo
Gandhinagar Dept of HFW- Dec 3rd 2013
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Effect on fasting blood sugar
300
Blood glucose (mg%)
250
200
Disease control
Jasad bhasma
150
Jasad +Betle
Lipoic acid
100
Normal control
50
Basal
1
2
3
4
5
6
Month of Treatment
Normal Control
Disease Control
Jasad + Betle
Lipoic acid
Courtesy Dr. Supriya
Bhale
Gandhinagar
DeptRao
of HFW- Dec 3rd 2013
Jasad Bhasma
9
Effect on nerve conduction velocity
55
Nerve conduction velocity (m/s)
Normal control
Lipoic acid
45
Jasad + Betle
Jasad bhasma
35
Disease control
25
Basal
1
2
3
4
5
6
Month of Treatment
Normal Control
Disease Control
Jasad + Betle
Lipoic acid
Gandhinagar Dept of HFW- Dec 3rd 2013
Jasad Bhasma
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Bacopa and Centella extracts increase neuronal
branching -Paper 1
Net work and System pharmacology concepts
Example-1
Result a new discipline Quantitative and Systemic
Pharmacology- An NIH White Paper by the QSP Workshop Group – October, 2011
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Examples of unique
mechanisms of
action of Ayu drugs
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Modulation of nuclear receptors :
Guggulsterone- antagonizes the
farnesoid X receptor
which regulates cholesterol metabolism in the liver
(FXR),
Guggulsterones also modulate the activity of multiple nuclear
receptors- involved in steroid hormone regulationglucocorticoid, progesterone , mineralocorticoid, androgen
and estrogen receptors
Guggulsterone up-regulates the bile salt export pump
favours metabolism of
cholesterol to bile
acids
(BSEP-
The cembranoids (from guggul)
lowered
the
cholate
(1)activated rate of human pancreatic-IB
phospholipase
A2 (hPLA2), which controls gastrointestinal absorption
of
fat
and
cholesterol
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2013
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Multimodal mechanism of action-
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2013
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Multimodal mechanism of action- 3
( Effect on networks)
FIG 1. Targets of curcumin. Abbreviations: MEKK, MAPK/ERK kinase kinase; IKK, IB kinase; IB, inhibitory kappa B; CBP, CREB-binding protein; HDAC, histone
deacetylase; P, phosphorylation; U, ubiquitination; MAPK, mitogen activated protein kinase; MEK, MAPK/ERK kinase; MKK, MEK kinase; ERK, extracellular signal
regulated kinase; JNK, cJun N-terminal kinase; TAK/ASK, transforming growth factor--activated /apoptosis signal-regulated kinase; PI3K, phosphatidylinositol-3kinase; ISRE, IFN-stimulated responsive element; GAS, IFN activation site; mTOR Mammalian target of rapamycin; PKC, protein kinase C; Keap, Kelch-like ECHassociated protein 1. (Color version of figure is available
online.)
Gandhinagar
Dept of HFW- Dec 3rd
2013
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Effect on Epigenetic factors
From : Simone Reuter • Subash C. Gupta • Byoungduck Park • Ajay Goel • Bharat B. Aggarwal. Epigenetic changes induced
by curcumin and other natural compounds. Genes Nutr (2011) 6:93–108. DOI 10.1007/s12263-011-0222-1
Gandhinagar Dept of HFW- Dec 3rd
2013
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Synergistic pharmacology : Synergy research: approaching a new
generation of phytopharmaceuticals-H. Wagner G. UlrichMerzenich
Two events initiated synergy research in phytomedicine: first, the
new methods of analytical chemistry and molecular
biology that have become available during the past
decade, and second, an unexpected change of paradigm
in chemotherapy that appeared without great attention
Multidrug therapy is already being practiced worldwide in the
treatment of AIDS and other infectious diseases,
hypertension, numerous types of cancer and rheumatic
diseases
Gandhinagar Dept of HFW- Dec 3rd
2013
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Review on herb drug interactions
Drug transporters are now widely acknowledged as important
determinants governing drug absorption, excretion,
and, in many cases, extent of drug entry into target
organs
Examples of drug transporter modulators from plants- curcumin,
piperine, silymarin, ginsenosides, catechin and
flavonoids etc
Can be an important target for drug formulation development
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From
the above facts it becomes clear that data
generation through
experimental (research)
studies are the first requisite to identify
the
potential areas for convergence of
conventional
and Traditional medical systems
Thus
there
is
urgent
requirement
for
the
establishment of dedicated research and
innovation centres in the field of Ayurveda
and Integrative Medicine
Establishment of ISM Innovation and Research
Universities would be a welcome initiative
Legislation for dual or multiple medical practice licence is
also required
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Thank you
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