Tinospora cordifolia (Guduchi), a reservoir plant for therapeutic applications: A clinical study



The present study was carried out to investigate the effects and safety of Tinospora cordifolia (Guduchi), a reservoir plant for therapeutic applications.

Tinospora cordifolia (Guduchi or Amrita) is an important drug of Ayurvedic System of
Medicine and found mention in various classical texts for the treatment of diseases such as
jaundice, fever, diabetes and skin disease etc. In present times, this drug has been subjected for numerous chemicals, pharmacological, pre-clinical and clinical investigations and many new therapeutic applications have been indicated. This paper presents a critical review in areas of chemical constituents, proved pre-clinical and clinical trials along with its medicinal uses in different streams of medical sciences.

Tinospora cordifolia (Willd.) Miers ex Hook. F. & Thoms. (Family: Menispermaceae) commonly-known, as €œAmrita€ or €œGuduchi€, is an important drug of Indian Systems of Medicine (ISM) and used in medicines since times immemorial. The drug is well-known Indian bitter and prescribed in fevers, diabetes, dyspepsia, jaundice, urinary problems, skin diseases, and chronic diarrhea, and dysentery. It has been also indicated useful in the
treatment of heart diseases, leprosy, helminthiasis, and rheumatoid arthritis'*,
The starch obtained from the stem known as €œGuduchi-satva€ 1s highly nutritive and digestive and used in many diseases. During the last two decades, the drug has been
subjected to extensive phytochemical, pharmacological, and clinical investigations and many interesting findings in the areas of immunomodulation, anticancer activity, liver disorders, and hypoglycaemic are reported.

Therapeutic Applications

Pre-Clinical Studies (Animal Model)During the last two decades, T. cordifoliahas demonstrated various pre-clinical activities in animal models/in vitro testings. Some of such notable findings are reported here: J Anti-cancer/anti-tumour activity: Exposure of HeLa cells to 0, 5, 10, 25,50, and 100 g/ml of extracts methanol, aqueous, and methylene chloride resulted in a dose-dependent but significant increase in cell killing, when compared to non-drug-treated controls. The results demonstrate that Guduchi killed the cells very effectively in vitro and deserves attention as an antineoplastic agent„¢€™. Ad-ministration of 7. cordifolia stem methanolic extract to BALB/e mice (200mg/kg, 1.p. daily for 5 days) increased the total white blood cell count significantly(P<0.001). It also increased bone marrow cellularity (18.16x106/femur) and a-esterase positive cells (1423/4000 cells)in bone marrow indicating increased maturation in stem cells. Administration of the extract was also found to significantly increase humoral immune response, as seen from the increase in plaque-forming cells in the spleen (1575PFC/106 spleen cells) and circulating antibody titer (256), and to produce an enhancement (129%) in macrophage activation. Tinospora extract reduced solid tumor growth and synergistically acted with cyclophosphamide in _ reducing(3%) the animal tumors€. The effect ofT. cordifolia, on the functions of macrophages obtained from mice treated with the carcinogen ochratoxin A (OTA), was investigated. Treatment with plant significantly inhibited OTA-induced suppression of chemotactic activity and production of IL-1 and TNF-a by macro pages. One of the compounds, NII-70, isolated from 7. cordifolia, has been found to activate the macrophages and induced production of IL-12 and TNF-« and anti-gen specific Th, response; NII-70 also induces production of nitric oxide by macrophages and has shown therapeutic effect against Leishmania infection and tumour implant in experimental animals.

Clinical Studies.

Anti-Cancer activity: A prospective, randomized, double-blind placebo controlled clinical trial was conducted on breast cancer patients. Con-sending breast cancer patients, who were receiving adjuvant therapy (CMF reign-men), were recruited, and randomized to drug and placebo group. From the results, it appears that the drug 7. Cord folia pro-voided some protection against the cancer chemotherapy induced leukopenia. I. Immunomodulatory activity: In clinical studies, it also showed immunosuppression on obstructive jaundice patients** *, III. Hepatic disorders: In clinical studies 20 patients of infective hepatitis were selected on the basis ofclmical and biochemical findings. Four tablets (500mg each) thrice in a day, orally with fresh water were given to the patient for 4 weeks. Comparison between before and after treatment of those pa-tents (N=20) were showed that drug T.cordifolia (Gauche) played an important role in relieving the symptoms as well as normalization of altered liver function test®®.IV. Post-menopausal syndrome: Clinical evaluation of a non-hormonal drug muinofil containing 7. cordifoliaalong with other plant drugs was done in women of post-menopausal syndrome. Breast discomfort, nausea and fluid retention was observed in 22% (7 cases) withestriol and almost no side effect was ob.-served with mindful. Mindful with short period of therapy and more sustained effect and without side effects is cost effective and may be an alternative to HRT, which is still in controversy. However, long term follow up is required before universal use in post-menopausal syndrome*€.Others multi-ingredient herbal preparation containing 7. Cord folia has demonstrated anabolic potential®. The study carried out so far on evaluation of adjuvant therapy of a multi-ingredient herbal preparation in

TINOSPORA CORDIFOLIA (GUDUCHI): A REVIEW 267patients of tuberculosis on anti-tubercular therapy has also showed the benefit of the subjective (appetite, sense of wellbeing) and objective (weight, serum proteins) parameters*€.Toxicity No significant information on side effects is available so far€™. Nothing con-spacious has been done as yet in this as-pact although many experiments have already been conducted on this plant. Ac-cording to Ayurveda, herbs are taken in combination with other herbs with the opposing effect of the other or to enhance the particular effect of one herb with the help of the other. Safety Aspects the drug is traditionally considered Tobe safe in the dosage mentioned€™. Conclusion the therapeutic efficacy of Tinosporacordifolia extensively used in Indian Sys-tem of Medicine (ISM) has been established through modern testing and evaluation (pre-clinical and clinical trials) indifferent disease conditions. These stud-is place this indigenous drug a novel candidate for bioprospecting and drug development for the treatment of such diseases as cancer, liver disorders, ulcers, diabetes, heart diseases and postmenopausal syndrome, etc. where satisfactory cure managements are still not available.

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