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The Ayurvedic health concepts and their role in inflammation and cancer, integration with western medicine

The Ayurvedic health concepts and their role in inflammation and cancer, integration with western medicine Published on 09.02.2019 By Jeyatheepan Jeyaretnam1 1. MD (Western medicine) MSc (Biomedical research) as a visiting author from 06.01.2019 to 08.02.2019 at Government Ayurveda Hospital Kadamakkudy, Ernakulam, Kerala – 682027, India ABSTRACT This article addresses my host research hospital's approach to my recent search for a health organisation to elucidate the mode of action of compounds used in traditional medicine, including Ayurvedic medicine. Using a computational ('in silico') approach, I predict potential targets for Ayurvedic anticancer agents obtained from the Indian Plant Anticancer Database based on their chemical structure. In this analysis, the research group working already in Kerala haver found that: (I) the predicted targets can be linked to cancer pathogenesis, i.e. steroid-5-alpha-reductase 1 and 2 and oestrogen receptor-β, and (II) predominantly hormone-dependent anticancer targets were predicted for the anticancer compounds. Based on our in silico target prediction, we conclude that understanding the functioning of traditional medicines such as Ayurveda by linking it to the 'Western' understanding of chemistry and protein targets may be a fruitful way to bridge the gap between the two different schools of thought. Given that Ayurvedic medicines used in Ayurveda have been tried and used for thousands of years (though not in the same way as in Western medicine), they can potentially be developed into potential new medicines. Therefore, in order to further advance Ayurvedic medicine, we have made some suggestions, namely (a) application and integration of novel analytical methods in the face of progress and (b) sharing of experimental data and clinical results of studies on Ayurvedic agents in a simple and accessible manner. The Ayurveda is the oldest holistic medical system in the world. Its timeless teachings and methods enable us even today to live healthy, fit and happy. Because with Ayurveda the human being with his individual needs is the centre of attention. 2 INTRODUCTION Ayurveda - Ayurveda is a Sanskrit word that literally means "knowledge of life", often translated as "science of long and healthy life". This holistic health teaching originated on the Indian subcontinent over 5,000 years ago. The World Health Organization (WHO) officially recognized Ayurveda as "traditional medicine" in 1976. The Ayurveda knows a variety of preventive and curative methods. The main focus is on a beneficial diet and dietetics, cleansing and purification procedures, massages and manual treatments as well as yoga and meditation. In the meantime, the effectiveness of many of these remedies has also been scientifically proven according to Western standards. Furthermore, Ayurveda knows a comprehensive herbal medicine, used in ancient times Kumari Kandam or Kumai Nadu or Kumai Kandom is a legendary continent said to have sunk south of Cape Comorin, at the tip of India. The Kumari Kandam has often been compared and equated with Lemuria, where the oldest language and culture still in use today originated, which is still widely spoken in India today and is called Tamil culture. In the European Union, however, the sale of such Ayurvedic products is only permitted as dietary supplements or food. Which are the principles of Ayurveda? The highest goal of Ayurveda is the balance of inside and outside or - in other words - of body, mind, soul and environment. For if we are balanced, we are and remain healthy and efficient. To achieve this, the ancient Indian art of healing considers each person against the background of his or her personal conditions. The natural products in Ayurvedic formulations represent an interesting source of new molecular entities. This is all the more remarkable because between 1981 and 2007, 67% of the new medicines introduced in the "Western" world could be traced back to natural products or were inspired by natural products. [1] In addition, Ayurveda relies on the synergies of the various ingredients in a formulation not only to cure the disease in question but also to reduce side effects and improve adaptability. This concept is now being taken into account more and more in other cultures, for example, through combination treatments of medicines. [2] To illustrate the efficacy of the synergistic approach used in Ayurveda, we refer to a case study published by Prakash et al. in this particular journal, in which a 47-year-old patient was successfully treated with an acute promyelocytic leukaemia, which had earlier after undergoing two cycles of chemotherapy (the first time with cytarabine and daunorubicin, then with etoposide and idarubicin) and relapsed on both occasions. From 1998 to 2003, the patient received the Ayurvedic treatment for three months each year and showed no signs of renal or hepatic toxicity at the time of publication. From the start of Ayurvedic therapy, the patient was cancer-free for 13 years of Ayurvedic therapy. [3] Notwithstanding these benefits, however, there are still major challenges that prevent even wider acceptance of Ayurvedic approaches. Four of these challenges were recently outlined by Corson and Crews. (I) isolation of the active components; (II) synthesis of the active ingredients; (III) elucidation of the mechanism of action (MOA); and (IV) development as a drug. Especially the elucidation or explanation of the MOA. [4] Relevant to our current work, which has recently been published and to which we would like to draw your attention with this article, is a way of bridging disease and treatment perceptions of traditional and 3 Western schools of thought. Given the renewed interest in the West in traditional approaches to healing, our work also has considerable resonance in Western news media, such as the BBC. (Available from: http://www.bbc.co.uk/mundo/noticias/2013/03/130318_salud_medicina_asia_acupuntura_gtg. html [Last accessed on 2013 Apr 05].) Figure 1: An overview of Ayurvedic plants that can be used in the prevention and treatment of cancer from (Ancient Medicine to Modern Medicine: Ayurvedic Concepts of Health and Their Role in Inflammation and Cancer February 2007. Journal of the Society for Integrative Oncology 5(1):25-37 DOI:10.2310/7200.2006.029 SourcePubMed Authors: Prachi Garodia) "in silico" targets modulated by compounds used in Ayurveda and traditional Chinese medicine, and then sought to understand MOA predictions of compounds in the context of their therapeutic use. While further details and successful examples can be found in the publication, here we will only illustrate our ability to rationalize MOAs of Ayurveda medicines by analysing a number of compounds from the Indian 4 Herbal Anticancer Database, as shown in the photo above. In the field of traditional medicines, electronic databases have recently developed strongly; the corresponding database in "Western" drug research is the CHEMBL database, which we also used in the study described here.). The first compound, designated CHEMBL273862 (10-hydroxycamptothecin), is a derivative of the anticancer agent camptothecin from the plant Camptotheca acuminate, and the second compound, designated CHEMBL463810 (cholesta-4, 25-diene-3, 6, 24-trione), is derived from the red alga Galaxaura marginata. [5] Ayurvedic medicines used for cancer treatment may be associated with cancer pathogenesis as understood by "Western" approaches. In this particular case, hormone-dependent cancer targets such as steroid 5-α-reductase 1 and 2 and the oestrogen receptor-β Receptor-β were predicted as targets for the structurally represented anticancer compounds used as active ingredients in Ayurveda. (For more information, such as the top 10 enriched targets predicted for the 560 Ayurvedic anticancer agents, which also list additional hormone-dependent anticancer targets, see the original publication. [6] In light of the above - which is discussed in more detail in the original publication, we conclude that linking treatment approaches from traditional medicine, such as Ayurveda, with the "Western" understanding of chemistry, goals, and is a very fruitful way to better understand how traditional to understand how traditional medicines work. Admittedly, in many cases this will be difficult to achieve, as the active ingredients are often unknown, and the same is true for the bioactivity of chemical structures and our scanty knowledge of the effects of the same is true for the bioactivity of chemical structures and our scant knowledge of the effects of protein target modulation on disease states. However, considering that Ayurveda assumes the ability to modulate a disease-relevant phenotype (which is (often a cause for concern in "Western" medicine), combined with our growing knowledge in databases of the above species, we anticipate that methods will gain importance in the future, such as the one presented here. We hope that this development will be mutually beneficial: On the one hand, we will learn more about the inner workings of traditional medicine, and on the other hand, also increase the recognition of traditional treatment methods in the Western world. [7] Finally, I would like to offer readers a few suggestions for the promotion of Ayurvedic medicine, especially, but not only, in the "western" world: 1. Use and integration of new analytical methods, especially given the advances in omic Technologies, which allow the simultaneous study of the molecular effects of ayurvedic treatments e.g., using metabolomics, genomics, as well as proteomic analysis, and 2. Information on experimental data and clinical results from Ayurvedic studies with the public in an easily accessible form. According to the authors, many of the assumptions made about Ayurvedic medicine in the West are simply based on a Lack of reliable and accessible information. CONCLUSION Many argue that there is no such thing as traditional, alternative or holistic medicine. The only distinction should be based on whether a medicine works or not. If we argue logically only from the point of view of the beneficiaries, i.e., the patients, then the practise should be such that the drugs 5 that work are available to all physicians and their patients. The opposition between these sciences can only be ended if they complement each other in every way. For this concept to succeed, practitioners are expected to have similar levels of control, quality standards, norms, and requirements; their qualifications must be developed for all types of medical education and practice. In addition, all the concepts of the various branches of alternative medicine can be combined seamlessly, as can the integration of various treatments into courses of modern medicine, to produce physicians who are free to use the medicines that work and discard those that do not. Traditional medicine, especially herbal medicine, plays an important role in maintaining health in rural and remote areas. Incorporating traditional herbal medicine into clinical practice will help achieve the goal of "health for all". Traditional Indian medicine such as Ayurveda and others have a solid scientific background and their effectiveness has also been confirmed by recent research. Nevertheless, efforts are needed to overcome obstacles such as irrational use, quality control and standardization, high pharmacovigilance, etc. Consistent implementation of regulations, monitoring and periodic revision of regulations are absolutely necessary to promote traditional Indian medicine. Overall, adequate knowledge about the system, quality clinical trials, adequate information about such medicines and their efficacy in the population are required to promote this medicine. Integration of Ayurvedic and other traditional Indian medicines into clinical practice will help to promote the health of people who do not have access to modern medicine. The use of this medicine along with conventional medicines is certainly of greater value in promoting health or curing diseases in a better way. For this reason, the inclusion of Ayurveda and western medicine as integrated perspective along with allopathic medicines and a healthy lifestyle will be helpful in providing the best possible health care to all people around the globe. 6 REFERENCES 1. Schmidt, B. M., Ribnicky, D. M., Lipsky, P. E., & Raskin, I. (2007). Revisiting the ancient concept of botanical therapeutics. Nat Chem Biol, 3(7), 360-366. https://doi.org/10.1038/nchembio0707-360 2. Zimmermann, G. R., Lehár, J., & Keith, C. T. (2007). Multi-target therapeutics: when the whole is greater than the sum of the parts. Drug Discov Today, 12(1-2), 34-42. https://doi.org/10.1016/j.drudis.2006.11.008 3. Prakash, B., Parikh, P. M., & Pal, S. K. (2010). Herbo-mineral ayurvedic treatment in a high risk acute promyelocytic leukemia patient with second relapse: 12 years follow up. J Ayurveda Integr Med, 1(3), 215-218. https://doi.org/10.4103/0975-9476.72618 4. Corson, T. W., & Crews, C. M. (2007). Molecular understanding and modern application of traditional medicines: triumphs and trials. Cell, 130(5), 769-774. https://doi.org/10.1016/j.cell.2007.08.021 5. Sheu, J. H., Huang, S. Y., Wang, G. H., & Duh, C. Y. (1997). Study on cytotoxic oxygenated desmosterols isolated from the red alga Galaxaura marginata. J Nat Prod, 60(9), 900-903. https://doi.org/10.1021/np9701844 6. Mohd Fauzi, F., Koutsoukas, A., Lowe, R., Joshi, K., Fan, T. P., Glen, R. C., & Bender, A. (2013). Chemogenomics approaches to rationalizing the mode-of-action of traditional Chinese and Ayurvedic medicines. J Chem Inf Model, 53(3), 661-673. https://doi.org/10.1021/ci3005513 7. Arrowsmith, J. (2011). Trial watch: phase III and submission failures: 2007-2010. Nat Rev Drug Discov, 10(2), 87. https://doi.org/10.1038/nrd3375

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