|
 
 |
| REVIEW ARTICLE |
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| Year : 2021 | Volume
: 6
| Issue : 3 | Page : 141-149 |
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Prospects of Ayurveda formulations as alternative approach for treatment of microbial diseases
Susmita Roy1, Amit K Dixit1, Ranjit K Dey1, Saroj K Debnath1, Peyyala Venkata Vara Prasad1, Narayanam Srikanth2
1 Central Ayurveda Research Institute-CCRAS, 4-CN Block, Sector V, Bidhan Nagar, Kolkata 700091, India
2 Central Council for Research in Ayurvedic Sciences (CCRAS), Ministry of AYUSH, Government of India, Jankarpuri, New Delhi, India
| Date of Submission | 24-Sep-2021 |
| Date of Acceptance | 02-Dec-2021 |
| Date of Web Publication | 25-Mar-2022 |
Correspondence Address:
Dr. Amit K Dixit
Central Ayurveda Research Institute, CCRAS, 4-CN Block, Sector V, Bidhan Nagar, Kolkata 700091.
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/jdras.jdras_61_21
Infectious diseases are responsible for largest burden of premature deaths globally and frequent pandemics which threaten the existence of entire population. The current rise of drug resistance and the side-effects associated with antibiotics and synthetic drugs have posed a new challenge to the modern healthcare system. Ayurveda is one of the most ancient and traditional medical systems where poly-herbal compounds and crude plant extracts are tested and applied in many types of microbial and infectious diseases, e.g., Triphala churna, Neem extracts, etc. This study focuses on the scope and applicability of Ayurveda for management of infectious diseases. The reviews have followed the PRISMA model and guidelines and Ayurevdic classical literature along with electronic databases like PubMed, Web of Science, Google, Google scholar, Researchgate, and SciFinder were searched for this study. India is a rich source of biodiversity and lots of plants and plant products are still unexplored. Review suggests that Ayurveda can develop not only therapeutic compounds but also prophylactic compounds which can be helpful for preventing the microbial diseases, especially the viral ones. From ancient times, home remedies like honey, turmeric has been used as preferred and safer option for treatment of many diseases. Herbs like Tulsi, Neem and their extracts have medicinal value. Both single and poly-herbal compounds have various ranges of bioactive molecules. Fine powders or Churna like Triphala Churna, Ajmodadi Churna, and Dasamoola Churna have been found to act against a wide range of pathogenic bacteria. The scope of Ayurveda can involve research on medicinal plants available in the country and can be proved a safer, cheaper, and sustained alternative to the antibiotics and synthetic drugs. Keywords: Antimicrobial treatment, Ayurveda, drug-resistance, polyherbal compounds, side effects
How to cite this article:
Roy S, Dixit AK, Dey RK, Debnath SK, Prasad PV, Srikanth N. Prospects of Ayurveda formulations as alternative approach for treatment of microbial diseases. J Drug Res Ayurvedic Sci 2021;6:141-9 |
How to cite this URL:
Roy S, Dixit AK, Dey RK, Debnath SK, Prasad PV, Srikanth N. Prospects of Ayurveda formulations as alternative approach for treatment of microbial diseases. J Drug Res Ayurvedic Sci [serial online] 2021 [cited 2023 Sep 23];6:141-9. Available from: http://www.jdrasccras.com/text.asp?2021/6/3/141/340873 |
| Introduction | |  |
Infectious diseases are a great threat to the human system, caused by microbial agents such as viruses, bacteria, fungi, and protozoa. The infectious agents are mostly microbial in nature and when the immune system is weak or the infectious agent overpowers the immune system, the disease indications develop.[1] The possible ways to regulate the rise of infectious diseases are through vaccines for the prevention of the disease or through antimicrobial drugs to control the disease. Till now, in contrast to other human diseases, infectious diseases are unpredictable and uncontrollable, occasionally leading to global outbreaks.[2],[3]
A microbial system is a highly vibrant system and there is fierce inter-species competition and each species strives to outcompete. Although previously the reason behind microbial diseases was studied by many scientists, the discovery of Penicillin by scientist Alexander Fleming in 1928 changed the course of infectious diseases to a large extent. Thus, antibiotics, a secondary metabolite produced by the microbes itself, have been the major weapon to combat the infectious diseases for long time.[3] Antibiotics have been established to control various kinds of infectious diseases caused by microbes, but the rise of microbial drug resistance has posed new challenges for researchers. The rise and spread of drug resistance are attributed to over-use, evolutionary selection pressure against antibiotics, and also human movement across the globe.[3]
Until recently, many novel pharmacologically active compounds were derived directly or indirectly from plants and further developed to potential drugs. Despite the current rise of synthetic chemistry to discover and produce drugs, the contribution of plants and herbal compounds in the treatment and prevention of diseases is still enormous, as they have a long history of clinical use, more patient tolerance, and acceptance.[4] From earlier times, natural plant products have played a vital role in drug discovery, for cancer and infectious diseases, and in other clinical areas too, including cardiovascular diseases.[4]
However, there are barriers in drug development from natural products too, such as technical obstructions in initial screening, separation, validation, and optimization, which posed hindrance to their use by the pharmaceutical industry.[4] In recent years, numerous scientific and technological progresses including improved analytical techniques, genome editing strategies, advancements in culturing techniques of microbes, and prophylactic immunization are tackling such challenges well and opening up new opportunities. Consequently, usage of natural products for use as drugs is being strengthened, particularly for addressing multidrug resistance.[5],[6]
The importance of prophylactic immunization against microbial diseases is best illustrated by vaccines. Vaccines composed of intact non-pathogenic microbes are made by treating the microbe in such a way that it can no longer cause disease or by killing the microbe while retaining the immunogenicity. The great advantage of vaccines is that they can elicit both innate and adaptive immunity.[7] But development of vaccines is a time-taking process and the success rate for all diseases is not alike. As maintenance of lifestyle is a vital role in supporting our immune system, Ayurveda may also play a great role in the prophylactic treatment of microbial diseases. Eating foods rich in micronutrients, such as vitamins C–E and zinc, as well as Ω-3 fatty acids, may help to improve immune function. Vitamin C also plays an important role in boosting the body’s defense against infection. In the 1.5 years for the management of COVID-19, the main focus of research and therapeutic strategies to control viruses has been either to directly target the virus or get immunized against it. This does not consider the host immunity—one of the most major factors in the disease dynamics. Ayurveda has also shown its potential in the prevention and management of COVID-19, supported by tangible evidence on its efficacy against the viral diseases.[7],[8]
Ayurveda is a comprehensive, natural healthcare system that originated in the ancient times, in the times of Rigveda and Atharvaveda in India.[6] It involves a scientific tradition of harmonious living and is based on holistic view of treatment, which is believed to cure human diseases by creating a balance in the different elements of human life, the mind, the body, the intellect, and the soul.[8] Ayurveda emphasizes on the host factors and prefers maintaining a healthy lifestyle over the use of medicine. Charaka Samhita also defines and describes immunity as the ability to prevent disease and depicts its role to maintain homeostasis. The concept of developing strength of mind and body, so that it can cope with various stress factors, including infection, is a keystone of Ayurveda treatment. Like modern concept of innate and acquired immunity, the Ayurveda concept of immunity (Bala or strength) is also classified as Sahaja (natural), Kalaja (chronobiologic), and Yuktikrut (acquired). The holistic idea of Ayurveda for promoting good health (Swasthavritta) includes personalized interventions influenced by host and environmental factors. The interventions include therapeutic procedures (known as Panchakarma) and application of certain immunomodulators (known as Rasayana).[8] Several Ayurvedic remedies have been used for the treatment and control of various microbial diseases in human beings from long back. Several drugs have been developed and practiced too from Ayurveda from ancient times to modern practice. However, more research and clinical trials are still required to establish this approach as a major contributor to treat microbial diseases.[9]
Current approaches of modern medicines and pitfalls
Antibiotic usage was started in 1928 to eradicate severe infections as there an urgent need of rapid, broad-spectrum way to eradicate infectious agents.[10],[11] From the initial days, antibiotics have saved many lives.[12],[13] However, they are not exempted from side effects, including the enormous and unselective disruption of the helpful microbiota, the composition of microbiota plays a major role in human health and disease.[11] The bacterial communities living in the mouth, skin, urinary tract, and especially the gastrointestinal tract greatly affect many parts of human health, which includes immunity and metabolic system.[11] For instance, an unbalanced or disrupted gut microbiota has been associated with autoimmune disorders such as inflammatory bowel disease and irritable bowel syndrome.[14] Moreover, currently, growing numbers of multidrug-resistant bacteria are a major concern and a global health problem.[15] In fact, this increasing antibiotic resistance has given rise to an era in which many antibiotics are no longer effective. The decline in antibiotic innovation is the major cause behind it as no new class of antibiotics has been developed for Gram-negative infections in the last few years, and only fewer antibiotic drugs are in clinical trials as reported in 2016. Therefore, there is a serious need to develop alternate approaches for the management of multidrug-resistant bacterial infections.[11]
Nowadays, gene therapy is being investigated as a substitute treatment for a diverse range of infectious diseases, which are not otherwise amenable to standard clinical treatment. Human gene therapy is the alteration of the genetic setup through introduction of new genetic material into the cells of an individual with the purpose of a therapeutic benefit for that patient. For infectious diseases, gene therapy approaches include immune cell engineering, engineering of antibody genes, and gene editing for removal of pathogen receptors.[16] The most sophisticated method of gene delivery would involve synthetic particles such as liposomes or polymers to carry DNA. However, these methods have not yet been successful as it has not achieved proficient uptake and stable gene expression in vivo.[16] The gene therapy trials involving viral vectors for delivery of the genes have been clinically acceptable. It is because viruses are highly adapted for gene delivery to their host cells; the strategies have included direct injection of viral vectors to aim tissues such as liver, or alteration of cell lines using viral vectors, followed by cell growth. Gene therapy research has also included viral vectors for vaccine development for infectious diseases and cancer.[17],[18] The major problem of the gene therapy has been the delivery challenge. This is because there is no easy way to deliver genes stably and successfully to a large number of cells in tissues such as the lung epithelium, skeletal muscle, etc.[18] For treatments where cell modification is required ex vivo, however, there will be a continuous requirement for the production of cells with genetic modification. However, better production and purification methods for viral vectors are the main prerequisite.[18]
The development of monoclonal antibodies and specific immunomodulatory drugs produce new treatment options for fighting against infectious diseases.[19] For viral infections, owing to the high frequency of mutation rate, antiviral medicines have never been a very effective way to control disease. Rather, development of vaccines has been proved to be the basis to combat against viral diseases. For other microbial diseases, the development of new vaccines has the ability to reduce not only mortality and morbidity due to infectious disease, but also the usage of antibiotics and subsequently the development of antimicrobial resistance. In contrast to the immunotherapeutic approach, the modification of the immune system has been a new idea, and it has been an attractive conception to improve and exploit the specificity and functionality of immune cells and molecules, with a primary emphasis on antibodies.[20] In fact, considering the initial concept that the immune response is the key element to resolve an infection, immune-based approaches can always be considered a better alternative, a prophylactic, and a therapeutic strategy for controlling infectious diseases. In particular, immune-prophylactic strategies exploit the generation of a specific immune response against the pathogen, which is also called active immunization.[21] Alternatively, immune-therapeutic approaches depend on the concept of a passive immunization, where immunoglobulins were obtained from the sera of immunologically active individuals or by the development of antigen-specific monoclonal antibodies to provide a rapid protection to a susceptible or infected host.[22]
Apart from passive transfer of antibodies and engineered antibodies, other immune-therapies are also currently available for the treatment of infectious diseases, where modulation and engineering of immune cells are involved. Adoptive transfer of pathogen-specific T cells is nowadays a striking alternative to the anti-infectious therapies.[23] But, pathogen-specific T cells are difficult to isolate and expand, owing to the low frequencies in the blood of patients, and moreover, in case of viral infections, they might prove inefficient by the mutation mechanisms of the viruses, and development of other better approaches is required. Development of chimeric T cell receptor against viral epitope has been observed as a novel immunotherapeutic approach.[24]
Ayurveda is considered as the most ancient healthcare system, where crude plant extract and herbo-metallic/poly-herbal compounds are being used in many types of microbial and infectious diseases. However, the studies related to the antimicrobial properties of Ayurvedic medicines against specific microorganism and its mechanism are very few and inconclusive. This review is a compilation of the applicability and prospects of Ayurvedic drugs for the prevention and management of microbial diseases.
| Materials and Methods | | |
The reviews have followed the PRISMA model and guidelines and Ayurvedic classical literature along with electronic databases such as PubMed, Web of Science, Google, Google Scholar, ResearchGate, and SciFinder. The information regarding antimicrobial treatment and its mechanism of action was collected from research papers. The Ayurvedic concept of diseases and immune system was obtained from the ancient classical texts such as Charaka Samhita and Atharvaveda.
| Results | | |
The Ayurvedic concept of infectious diseases
The concept of infectious diseases has long been described in the Charaka Samhita, where both internal factors (Doshavikriti) and external factors (Agantuja) are stated to be responsible for the occurrence of infectious diseases.[25],[26] According to Atharvaveda, jantu (organism) can originate from anywhere in the environment. They can grow on the earth, water, air, also in medicinal plant, food material, and in other animals or organisms too. The modes of transmission of the infectious diseases have also been described and for that, the roles of Udak (water), Vayu (air), Desha (soil and area), and Kala (time) have been shown accountable for the evolution of Janapadodhwansha (epidemics).[25],[26] The existence of two types of microbes, i.e. pathogenic and non-pathogenic, has also been described both in Atharvaveda and Charaka Samhita as durnam or vaikaric (Pathogenic) and sunam or sahaja (non-pathogenic). The term “jeevanu” was introduced by Acharya Gananath Sen in the 19th century and further has been attributed to the development of various diseases such as enteric diseases, respiratory diseases, skin diseases, etc.[26],[27]
The importance of Ayurvedic formulations as antimicrobial treatment
There are many herbs which are having antibacterial properties and are being used from ancient times and even today. Historical evidences propose that home remedies such as wine, honey, turmeric, vinegar, indigenous herbs like neem, and dietary therapies were very effective for the control of wound. They are even proved to be safer than modern antibiotics. Herbs like Tulsi (Ocimum sanctum L.), Guggulu (Commiphora wightii (Arn.) Bhandari), Neem (Azardiaracta indica A. Juss.) , Garlic (Allium sativam L.), Vacha (Acorus calamus L.), Kushtha (Saussurea costus (Falc.) Lipsch.), Pippali (Piper longum L.), and Amlaki fruit (Phyllanthus emblica L.) are routinely used for the treatment of microbial infection.[28] Various parts of plants can be used as dietary support and prevent disease development, for example, turmeric in lukewarm milk and citrous fruits for vitamins.[29],[30] Honey has effective antiseptic and anti-inflammatory actions, owing to its viscous and hypotonic nature. Moreover, honey has the ability to absorb the exudates from the wound and improves the healing process, probably due to its hypo-osmolarity.[29],[30] Furthermore, honey is rich in antimicrobial and anti-inflammatory properties particularly against E. coli, coagulase-negative staphylococci, community-acquired MRSA, and Staphylococcus aureus infection. These antimicrobial properties are mainly due to the diverse interaction of the various components of honey, for example, bee defensin-1, hydrogen peroxide, and methylglyoxal [Table 1].[30],[31],[32] Similarly, Tankan bhashma and sphatika bhashma are other remedies used for the treatment of tonsillitis and dysphagia.[33] In current years, panchghavya made from body fluids of cow researchers has been extensively studied for the treatment of various diseases, e.g., bacterial/viral infections, chicken pox, hepatitis, rheumatoid arthritis, and many others.[34] Cow urine has been studied and further granted U.S. patents, especially for its use accompanied by antibiotics for the management of bacterial infection, especially drug-resistant bacterial infections and as a bio-enhancer with antituberculous drugs.[35],[36]
Herbs such as ginger and garlic also have considerable medicinal value [Table 1]. Fresh ginger has been used for treating diseases such as cough, colic, nausea, asthma, heart palpitation, and rheumatism. In the 19th century, ginger is used to serve as a popular medication for asthma and cough wherein the juice of fresh ginger and a little juice of fresh garlic along with honey were mixed together and used to get cured. In a study, ethanolic extract of garlic and ginger has shown to be effective against drug-resistant clinical pathogens such as Pseudomonas aeruginosa, Escherichia More Details coli, S. aureus, etc.[37]Neem extracts are well known for their activity against oral pathogens. Nimbidin, the major component of neem, is well known for its anti-inflammatory and antibacterial action. There are other bioactive compounds such as margolone, margolonone, nimbolide, mahmoodin, and isomargolonone which also contribute to its antimicrobial and antifungal properties [Table 1].[38] The antibacterial activity against the oral pathogen, Streptococcus mutans, depends on polyphenolic tannins obtained in the extract, which effectively get attached to the surface-associated bacterial proteins and results in the bacterial aggregation and loss of the glucosyltransferase activity.[38] They have showed that aqueous extracts of clove and neem showed antimicrobial activity against S. mutans and Candida albicans.[38] Curcumin, obtained from turmeric, has extensively been studied for antimicrobial activity. Among all studies on antibacterial activity of curcumin, the most promising effect is against Helicobacter pylori, where it is used as a complementary to other existing medicines to control gastritis [Table 1].[39] Curcumin revealed fungicidal effect against various fungi too, the most significant effect being against Candida species and Paracoccidioides brasiliensis. In spite of various reports on biological activities of curcumin, till date, there are no clinical applications which have been reported for curcumin and rather clinical trials are still undergoing for various disorders and diseases, e.g., colon and pancreatic cancers, multiple myeloma, neuronal diseases such as myelodysplastic syndromes, Alzheimer, and skin problems such as psoriasis.[39]
Studies showed that essential oils were extracted from tulsi where 4.5% and 2.25% of that oil completely inhibited the growth of S. aureus, including MRSA and E. coli, whereas the same concentrations were not very effective and partly inhibited the growth of P. aeruginosa.[40] In another study, five plant formulations, namely, dried stem of Rubia cordifolia L., dried stem bark of Paullinia pinnata L., dried stem of Bhesa ceylanica, tender leaves of Jasminum officinale L., and dried pericarp of Garcinia zeylanica RoxB were collected and evaluated for antifungal activity and antibacterial activity.[41] The results showed sensitivity of C. albicans against the ethanolic extract of R. cordifolia and aqueous extracts of B. ceylanica, whereas the MRSA strains were affected by both aqueous and ethanolic extracts of G. zeylanica and ethanolic extracts of P. pinnata and J. officinale. Similarly, clinically isolated uropathogens were found to be sensitive to extracts of the stem of the plants manjishtha, anantmul, and gulkhair.[42]
Despite the ongoing studies on newer and better approaches to fight against infectious diseases, there is no gold standard. The drug resistance and side effects of antibiotics, the lack of universal acceptability of gene, and also immunotherapies have risen the need of safer, cheaper, and more universal alternatives. Moreover, because of high frequency of mutation, in case of viral infections, targeting viral molecules has never been an everlasting approach.[7]
In Ayurveda, from the ancient times, many medicinal plants and herbal formulations have been used for the benefit of the human healthcare system and curing various diseases. The plant-derived medicines are relatively safer and cheaper when compared with synthetic drugs and they offer major therapeutic benefits.[43] Both single and polyherbal compounds have various ranges of bioactive molecules. They have been studied and have been proved to play a major role in the management of diseases since ancient times.[43] There are more than 1500 herbal preparations which are commercially used as dietary supplements or traditional medicines. The most frequently used form of herbal compounds is the powder form or Churnas. Churnas are the fine powders of medicinal plants and either single or in combination.[44] Combinations of diverse medicinal plants may have synergistic effects, thereby increasing the antimicrobial spectrum and strength of the preparations. Moreover, the synthetic drugs also show synergistic effect with many herbal preparations, and combination therapy is a very common resolution to the problem of drug resistance. However, microbes are always evolving and thus developing ways to evade the harmful effects of synthetic drugs. So, combination therapy can be helpful as it may target through diverse pathways, and resistance to multiple pathways together is difficult.[44]
The Ayurvedic formulations against microbes are mostly combination of different plant products, and those plant products themselves contain many constituents which together and collectively act against microbes. So, they can be a good alternative in terms of drug resistance. Moreover, the synthetic drugs and antibiotics may have severe side effects which can be overcome using natural products. The plant-derived compounds have a long history of clinical use, owing to the better patient acceptance and tolerance. The first purely natural plant product used for therapeutic purpose was morphine, marketed by Merck 1826. Later, further research on natural products led to the discoveries of Artemisinin from the Chinese plant Artemisia annua L. to combat against multi-drug-resistant Malaria and Silymarin from the plant Silybum marianum (L.) Gaertn to combat against liver diseases.[44]
A wide range of medicinal plants was tested against a wide range of pathogens in a recent study.[44] The medicinal plant products were polyherbal compounds which included Triphala churna, Haritaki churna, Mahasudarshan churna, Ajmodadi churna, Manjistadichurna, Dashmula churna, Pipramool churna, Shivksharpachan churna, Swadist virechan churna, and Sukhsarak churna. All of these compounds showed antibacterial activities. Triphala churna, a polyherbal medicine, consists of Terminalia belerica (Gaertn.) Roxb., Terminalia chebula Retz., and Phyllanthus emblica L. and is well known for its anti-inflammatory, wound-healing activity and also for action against constipation. In many studies, various techniques of extraction were applied for the extraction of the biologically active constituents of Triphala for comparing their efficiency. Cold aqueous extracts of Triphala churna were found to be effective against antibiotic-resistant clinical isolates, i.e., wound pathogens, namely, methicillin-sensitive S. aureus (MSSA), methicillin-resistant S. aureus (MRSA), P. aeruginosa, Klebsiella pneumonia, E. coli (ESBL producer), and Acinetobacter spp. [Table 1].[45]Triphala churna has been shown to have stronger antibacterial activity against Gram-positive bacteria such as Staphylococcus epidermidis, S. aureus as its activity is moderate against Proteus vulgaris, P. aeruginosa, Salmonella More Details typhi, and weak against Klebsiella pneumoniae, E. coli, Salmonella typhimurium, and Bacillus subtilis.[44] Two different extracts of Triphala churna namely microwave-assisted extraction and Triphala hydroalcoholic extract (TAE) were tested against a diverse range of clinical isolates including both Gram-positive and Gram-negative microorganisms and found that 17 out of 20 bacterial strains were sensitive to TAE, whereas S. epidermidis was the most sensitive strain.[45],[46]
Sudarshan churna is used by the Vaidyas from the ancient times to cure all types of fever. It has been studied and established for its antipyretic, antiviral, and antimicrobial properties. This churna is a combination of 42 constituents where Swertia chirata Buch.-Ham. ex Wall. alone contributes to 50%. The components of sudarshan churna contain flavonoids and sterol, which probably contributes to its antimicrobial property. Haritaki churna, in contrast, is effective against enteric pathogens [Table 1].[47]Dashmoola churna is composed of the root extracts of 10 plants. It has antioxidant and anti-inflammatory activity along with anti-fungal activity. Nagarkar et al.[48] and Aswatha et al. proved that ajmodadi churna has property in the anti-inflammatory model of wister strain albino rats [Table 1].[49]
There are other ethno-medical studies also, in which different parts of many medicinal plants have been tested for their antibacterial properties. The aqueous extracts of many parts of 20 medicinal plants were tested for antibacterial properties in another study.[50] It was found that Salmonella was the most susceptible and E. coli was the most resistant one. Similarly, in another study, 24 medicinal plants were tested against 12 pathogens and A. nilotica was found to be the most active plant.[51] There are other studies,[47] in which essential oils of some medicinal plants and antibiotics showed synergistic effect against few pathogenic bacterial strains. According to the literature studies, the essential oils of different species of medicinal plants are well known for their antibacterial activities. Jatyadi taila is extremely used for boils, wound boils, ulcers and is considered as a great wound healer.[52] A study also suggested that except against Pseudomonas all other bacteria were susceptible to the essential oils tested and the zones of inhibition were similar with standard antibiotics, indicating that the combination of essential oils of these five medicinal plants and the standard antibiotics can be an effective alternative for the development of new antibacterial treatment and decline of drug resistance.[53] In a similar study, the potential use of watercress extracts and 2-phenylethyl isothiocyanate was also demonstrated as antimicrobial tools against extended-spectrum β-lactamases E. coli, strengthening their ability to act synergistically with commercial standard antibiotics.[54],[55],[56] Researches on medicinal plants for the development of antiviral compounds have also some promising outcome. Previously, research on the medicinal plants for its antiviral activity was restricted owing to infectious nature of viruses and lack of appropriate isolation and purification techniques for the detection of antiviral components from the plants. Further, development of vector-based strategies, in which non-infectious molecular clone of a virus is used for antiviral activities and advancement in purification technologies, has improved the researches in this field.[55] Few researchers have tested 24 plant extracts for antiviral activities using herpes simplex virus and 5 out of those gave satisfactory output.[56] In Covid-19 pandemic also, the robust immune system has given support to fight against the virus.[57] AYUSH-64, a polyherbal compound, previously developed against malaria was found to be useful in patients with Covid-19, probably owing to the immune-modulatory activities of its components.[58] So, in viral infections rather than searching for direct antiviral medicines, Ayurveda can be a saviour as preventive treatment system, in which immune-modulatory compounds can help.
| Conclusion | | |
Although the innovation of new antibiotics is not keeping rapidity with the emergence of drug-resistant mutants, different options are being sought to reduce the selection pressure for drug-resistant mutants in the environment. The Ayurvedic concept of diseases resembles to the modern medicine, but the methods of therapy are different from the modern medicine. Ayurveda is a more of preventive way of tackling diseases where maintaining health is more emphasized. Moreover, in the Ayurveda, for infectious diseases, herbal formulations and medicinal plants are given more importance as treatment options. Owing to the great biodiversity of India, these treatment modalities in Ayurveda are cheaper and safer than synthetic drugs. In contrast, in medical emergencies, modern medicines are more equipped to handle it. Also more research and scientific studies have been conducted on synthetic drugs and antibiotics. Ayurvedic formulations are required to be studied in more details, mechanistically and in clinical setups. Many plant products act synergistically also with synthetic drugs, reducing its harmful effects. If toxicity studies are satisfactory and clinical trials are carried out, Ayurvedic formulations can complement modern medicine and can also be a reliable, less harmful, and cheaper alternative for infectious diseases. Viral diseases are also another point of concern, as high mutation rate cannot lead to the development of long-lasting antibiotics against viruses, depending on the immune system which is the only concern for prevention and control. Vaccine or combination therapy of antiviral drugs is the mainstay for the treatment. Ayurveda relies more on the prevention than cure, so immune-modulation and immune-prophylaxis through natural products can thus be more helpful. Development of vaccines against parasitic diseases is really very difficult, as they mostly have digenetic life cycles. Research is going on for developing better treatment alternatives to fight against drug-resistance problems in leishmaniasis and malaria, endemic in India, and many of these studies have involved plant extracts and polyherbal compounds and obtained good outputs. Collectively, it can be said that Ayurveda, the traditional and ancient medicine, has the potential to overcome the pitfalls of synthetic drugs and antibiotics; however, the efficacy of Ayurvedic medicine requires to be further explored with modern and advanced scientific validation techniques for better therapeutic leads.
Acknowledgements
The authors are grateful to the Research officers (Ayurveda) of Central Ayurveda Research Institute, Kolkata for their encouragement and valuable support.
Financial support and sponsorship
Nil.
Conflicts of interest
The authors show no conflict of interest.
| References | | |
| 1. | Libertucci J, Young VB. The role of the microbiota in infectious diseases. Nat Microbiol 2019;4:35-45.  |
| 2. | Gayer M, Legros D, Formenty P, Connolly MA. Conflict and emerging infectious diseases. Emerg Infect Dis 2007;13:1625-31. |
| 3. | McArthur DB. Emerging infectious diseases. Nurs Clin North Am 2019;54:297-311. |
| 4. | Atanasov AG, Zotchev SB, Dirsch VM, Supuran CT; International Natural Product Sciences Taskforce. Natural products in drug discovery: Advances and opportunities. Nat Rev Drug Discov 2021;20:200-16. |
| 5. | Cragg GM, Newman DJ. Natural products: A continuing source of novel drug leads. Biochim Biophys Acta 2013;1830:3670-95. |
| 6. | Jaiswal YS, Williams LL. A glimpse of ayurveda—The forgotten history and principles of Indian traditional medicine. J Tradit Complement Med 2017;7:50-3. |
| 7. | Pollard AJ, Bijker EM. A guide to vaccinology: From basic principles to new developments. Nat Rev Immunol 2021;21:83-100. |
| 8. | Tillu G, Chaturvedi S, Chopra A, Patwardhan B. Public health approach of ayurveda and yoga for COVID-19 prophylaxis. J Altern Complement Med 2020;26:360-4. |
| 9. | Yuan S, Guan C, Liu S, Huang Y, Tian D, Cui X, et al. Comparative transcriptomic analyses of differentially expressed genes in transgenic melatonin biosynthesis ovine HIOMT gene in switchgrass. Front Plant Sci 2016;7:1613. |
| 10. | Aminov RI. A brief history of the antibiotic era: Lessons learned and challenges for the future. Front Microbiol 2010;1:134. |
| 11. | de la Fuente-Nunez C, Torres MD, Mojica FJ, Lu TK. Next-generation precision antimicrobials: Towards personalized treatment of infectious diseases. Curr Opin Microbiol 2017;37:95-102. |
| 12. | Ventola CL. The antibiotic resistance crisis: Part 1: Causes and threats. Pharm Therap 2015;40:277-83. |
| 13. | Rooks MG, Garrett WS. Gut microbiota, metabolites and host immunity. Nat Rev Immunol2016;16:341-52. |
| 14. | Carding S, Verbeke K, Vipond DT, Corfe BM, Owen LJ. Dysbiosis of the gut microbiota in disease. Microb Ecol Health Dis 2015;26:26191. |
| 15. | Prestinaci F, Pezzotti P, Pantosti A. Antimicrobial resistance: A global multifaceted phenomenon. Pathog Glob Health 2015;109:309-18. |
| 16. | Voss JE, Gonzalez-Martin A, Andrabi R, Fuller RP, Murrell B, McCoy LE, et al. Reprogramming the antigen specificity of B cells using genome-editing technologies. eLife 2019;8:e42995. |
| 17. | Bunnell BA, Morgan RA. Gene therapy for infectious diseases. Clin Microbiol Rev 1998;11:42-56. |
| 18. | Collins M, Thrasher A. Gene therapy: Progress and predictions. Proc Biol Sci 2015;282:20143003. |
| 19. | Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: Implications for virus origins and receptor binding. Lancet 2020;395:565-74. |
| 20. | Sautto GA, Diotti RA, Wisskirchen K, Kahle KM. New insights for immune-based diagnosis and therapy for infectious diseases. J Immunol Res 2017;2017:3104719. |
| 21. | Ebbers M, Hemmer CJ, Müller-Hilke B, Reisinger EC. Immunotherapy and vaccination against infectious diseases. Wien Klin Wochenschr 2021;133:714-20. |
| 22. | Manohar A, Ahuja J, Crane JK. Immunotherapy for infectious diseases: Past, present, and future. Immunol Invest 2015;44:731-7. |
| 23. | Berger C, Turtle CJ, Jensen MC, Riddell SR. Adoptive transfer of virus-specific and tumor-specific T cell immunity. Curr Opin Immunol 2009;21:224-32. |
| 24. | Seif Y, Monk JM, Mih N, Tsunemoto H, Poudel S, Zuniga C, et al. A computational knowledge-base elucidates the response of Staphylococcus aureus to different media types. Plos Comput Biol 2019;15:e1006644. |
| 25. | Hankey A. Ayurvedic physiology and etiology: Ayurvedo amritanaam. The doshas and their functioning in terms of contemporary biology and physical chemistry. J Altern Complement Med 2001;7:567-74. |
| 26. | Saini S, Porte SM. Ayurvedic aspect of bacteria and bacterial food poisoning. Int J Pharma Sci Res 2015;6:2281-90. |
| 27. | Fadanavis MV, Sawarkar P. Concept of airborne infectious disease in Ayurveda. Int J Res Pharm Sci 2020;11:4847-56. |
| 28. | Parham S, Kharazi AZ, Bakhsheshi-Rad HR, Nur H, Ismail AF, Sharif S, et al. Antioxidant, antimicrobial and antiviral properties of herbal materials. Antioxidants 2020;9:1309. |
| 29. | Yusof N, Hafizaa AHA, Zohdia R, Bakarb MZA. Development of honey hydrogel dressing for enhanced wound healing. Radiat Phys Chem 2007;76:1767-70. |
| 30. | Kavitha KV, Tiwari S, Purandare VB, Khedkar S, Bhosale SS, Unnikrishnan AG. Choice of wound care in diabetic foot ulcer: A practical approach. World J Diabetes 2014;5:546-56. |
| 31. | Badawy ME, Rabea EI, Rogge TM, Stevens CV, Smagghe G, Steurbaut W, et al. Synthesis and fungicidal activity of new N,O-acyl chitosan derivatives. Biomacromolecules 2004;5:589-95. |
| 32. | Kwakman PH, Van den Akker JP, Güçlü A, Aslami H, Binnekade JM, de Boer L, et al. Medical-grade honey kills antibiotic-resistant bacteria in vitro and eradicates skin colonization. Clin Infect Dis 2008;46:1677-82. |
| 33. | Sahoo I, More SS, Jadhav V, Dalai S, Sahoo M. Clinical appraisal on therapeutic efficacy of Tankana and Sphatika Bhasma with Madhu Pratisarana in Tundikeri. J Drug Del Ther2019;9:130-4. |
| 34. | Matzen RD, Zinck Leth-Espensen J, Jansson T, Nielsen DS, Lund MN, Matzen S. The antibacterial effect in vitro of honey derived from various Danish flora. Dermatol Res Pract 2018;2018:7021713. |
| 35. | Dhama K, Rajagunalan S, Chakraborty S, Verma AK, Kumar A, Tiwari R, et al. Food-borne pathogens of animal origin-diagnosis, prevention, control and their zoonotic significance: A review. Pak J Biol Sci 2013;16:1076-85. |
| 36. | Randhawa GK. Cow urine distillate as bioenhancer. J Ayurveda Integr Med 2010;1:240-1. [ PUBMED] [Full text] |
| 37. | Karuppiah P, Rajaram S. Antibacterial effect of Allium sativum cloves and Zingiber officinale rhizomes against multiple-drug resistant clinical pathogens. Asian Pac J Trop Biomed 2012;2:597-601. |
| 38. | Bansal SS, Ismahil MA, Goel M, Zhou G, Rokosh G, Hamid T, et al. Dysfunctional and proinflammatory regulatory T-lymphocytes are essential for adverse cardiac remodeling in ischemic cardiomyopathy. Circulation 2019;139:206-21. |
| 39. | Martins F, Kruszewski M, Scarpelli I, Schoumans J, Spertini O, Lübbert M, et al. Characterization of myelodysplastic syndromes progressing to acute lymphoblastic leukemia. Ann Hematol 2021;100:63-78. |
| 40. | Yamani HA, Pang EC, Mantri N, Deighton MA. Antimicrobial activity of Tulsi ( Ocimum tenuiflorum) essential oil and their major constituents against three species of bacteria. Front Microbiol 2016;7:681. |
| 41. | Gunasekara T, Radhika N, Ragunathan KK, Gunathilaka D, Weerasekera MM, Hewageegana H, et al. Determination of antimicrobial potential of five herbs used in Ayurveda practices against Candida albicans, Candida parapsilosis, and methicillin resistant Staphylococcus aureus. Anc Sci Life 2017;36:187-90. |
| 42. | Rawat S, Swarup S. Antimicrobial activity of Ayurvedic herbs against urinary tract infection pathogens. J Chem Pharm Res 2015;7:1461-5. |
| 43. | Mandrika I, Kumar S, Zandersone B, Eranezhath SS, Petrovska R, Liduma I, et al. Antibacterial and anti-inflammatory potential of polyherbal formulation used in chronic wound healing. Evid Based Complement Alternat Med 2021;2021:9991454. |
| 44. | Tambekar DH, Dahikar SB. Antibacterial activity of some Indian Ayurvedic preparations against enteric bacterial pathogens. J Adv Pharm Technol Res 2011;2:24-9. [ PUBMED] [Full text] |
| 45. | Nayak K, Patil A, Vishnuprasad S, Nayak DM. Antibacterial effect of Triphala churna against common wound pathogens. Int J Curr Res 2015;7:12074-77. |
| 46. | Omran Z, Bader A, Porta A, Vandamme T, Anton N, Alehaideb Z, et al. Evaluation of antimicrobial activity of Triphala constituents and nanoformulation. Evid Based Complement Alternat Med 2020;2020:6976973. |
| 47. | Singh S, Ballou DP, Banerjee R. Pre-steady-state kinetic analysis of enzyme-monitored turnover during cystathionine β-synthase-catalyzed H(2)S generation. Biochemistry 2011;50:419-25. |
| 48. | Nagarkar B, Jagtap S, Narkhede A, Nirmal P, Pawar N, Kuvalekar A, et al. Different Ayurvedic dosage forms of Dashamoola possess varied anti-inflammatory activity. World J Pharm Pharmaceut Sci 2013;2:3118-36. |
| 49. | Ram HN, Sriwastava NK, Makhija IK, Shreedhara CS. Anti-inflammatory activity of Ajmodadi churna extract against acute inflammation in rats. J Ayurveda Integr Med 2012;3:33-7. |
| 50. | Gonelimali FD, Lin J, Miao W, Xuan J, Charles F, Chen M, et al. Antimicrobial properties and mechanism of action of some plant extracts against food pathogens and spoilage microorganisms. Front Microbiol 2018;9:1639. |
| 51. | Dabur R, Gupta A, Mandal TK, Singh DD, Bajpai V, Gurav AM, et al. Antimicrobial activity of some Indian medicinal plants. Afr J Tradit Complement Altern Med 2007;4:313-8. |
| 52. | Singh B, Jindal N, Bansal R. Antimicrobial potential of polyherbo-mineral formulation Jatyadi Taila—A review. Int J Res Ayurveda Pharm 2021;2:151-8. |
| 53. | Moussaoui F, Alaoui T. Evaluation of antibacterial activity and synergistic effect between antibiotic and the essential oils of some medicinal plants. Asian Pac J Trop Biom 2016;6:32-7. |
| 54. | Freitas E, Aires A, de Santos Rosa EA, Saavedra MJ. Antibacterial activity and synergistic effect between watercress extracts, 2-phenylethyl isothiocyanate and antibiotics against 11 isolates of Escherichia coli from clinical and animal source. Lett Appl Microbiol 2013;57:266-73. |
| 55. | Mukhtar M, Arshad M, Ahmad M, Pomerantz RJ, Wigdahl B, Parveen Z. Antiviral potentials of medicinal plants. Virus Res 2008;131:111-20. |
| 56. | Jadhav SD, Rajguru JR, Momin HU, Shirsat MK. Gene therapy—Challenges & success. Intern J Trend Sci Res Dev 2020;4:870-4. |
| 57. | Patel K, Patel B, Moochhala S. Ayurvedic antivirals for management of COVID-19 patients. Biomed J Sci Tech Res 2020;28:21552-7. |
| 58. | Gundeti MS, Bhurke LW, Mundada PS, Murudkar S, Surve A, Sharma R, et al. AYUSH 64, a polyherbal Ayurvedic formulation in influenza-like illness—Results of a pilot study. J Ayurveda Integr Med2020;S0975-9476(20)30025-5. |
[Table 1]
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