MEDICINAL PLANTS OF ANTI-ARTHRITIC POTENTIAL: A REVIEW
Lekhni Soni1, Rupesh K. Gautam1*, Prateek K. Jain2
1. Department of Pharmacology, 2Department of Pharmaceutical Chemistry, ADINA Institute of Pharmaceutical Sciences, Bhopal Road, Sagar , India.
Rheumatoid arthritis (RA) is a chronic inflammatory condition of the connective tissues throughout the body, but especially around the joints. RA is the most common inflammatory arthritis and affects about one percent of the population. RA affects three times more women than men. This is a long lasting disease that can affect joints in any part of the body, most commonly the hands, wrists, and knees. Popularity of medicinal plants is increasing day by day due to side effects of allopathic medicines. The present review will become a beneficial tool for the mankind who totally depends upon the herbal medicines.
Key word: Anti-arthritic Activity, Anti-inflammatory Activity, Momordica charantia, Karela.
Arthritis means joint inflammation; it is a chronic, progressive and disabling autoimmune disease. Arthritis can progress very rapidly causing swelling and damaging cartilage and bone around the joints. Any joint may be affected but it is commonly at the hands, feet and wrists1 .Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disease predominantly affecting the joints and periarticular tissue. RA still remains a terrifying disease 2. RA this is an inflammatory form of arthritis the synovial membrane (synovial) is attacked resulting in swelling and pain3.
The regulation of these mediators secreted by macrophages and other immune cells4 and modulation of arachidonic acid metabolism by inhibiting enzymes like COX and LOX are the potential target for chronic inflammatory conditions5. Its prevalence depends upon age. It occurs more frequently in women than in men. It is an inflammation of synovial joint due to immune mediated response. All anti inflammatory drugs are not anti arthritic because it does not suppress T-cell and B-cell mediated response. Epidemiological studies overall show a female to male ratio of about 3:1. There are many class of anti-arthritic drugs are available like NSAIDS, Monoclonal antibodies, uricosuric agents, gold compounds, anti-cytokinine, immunosuppressant like glucocorticoids, etc. But this all class of drugs is responsible for symptomatic relief.
The pain from arthritis is due to inflammation that occurs around the joint, damage to the joint from disease, daily wear and tear of joint, muscle strains caused by forceful movements against stiff painful joints and . Arthritis is an auto immune disorder 6-9.
Figure 1 :Joint Status in Rheumatoid arthritis
Herbal source of Anti-arthritic activity
Table 1: Herbal drugs showing Anti-arthritic activity
|S. no.||Scientific name||Comman name||Family||Part of plant||Model|
|1||Abrus prectarius 10||Gunja||Papilionaceae||Leave||FCA|
|2||Acacia catechu willd11||Black catechu, cutch||Mimosaceae||Root||FCA|
|3||Acalypha indica Linn12||Khokali||Euphorbiaceae||Root||Inhibition protein denaturation|
|4||Achyranthes aspera Linn13||Chaff-flower, Apang||Amaranthaceae||Seed||Inhibition protein denaturation|
|5||Asystasia Dalzelliana 14||Neelkanth||Acanthaceae
|6||Boswellia serrata 15||Salallai||Burseraceae||Whole plant||CFA|
|7||Bauhinia variegata L. 16||Orchid tree||Fabaceae||Leave||FCA|
|8||Cassia uniflora 17||Senna uniflora||Caesalpiniaceous||Stem||CFA|
|9||Curcuma longa18||Turmeric, Haldi||Zingiberaceae||Rhizomes||CIA|
|10||Desmodium gangeticum L.19||Dhurva, Salpani||Fabaceae||Root, Arial part||CIPO|
|11||Elaeocarpus Sphaericus 20||Rudraksha||Elaeocarpaceae||Fruit||FCA|
|Malayan spurge Tree||Euphorbiaceae||Plant||Hot Plate|
|13||Elaeocarpus Serratus Linn22||Veralu, Ceylon olive||Elaeocarpaceae||Leaf, Seed||Inhibition Protein denaturation|
|14||Ficus bengalensis 23||Bargad, Banyan||Moraceae||Stem bark||FCA, FIA, , AIA|
|15||Ichnocarpus frutescens 24||Black creeper||Apocynaceace||Root||HRBC ,Protein denaturation|
|16||Merremia Emarginata Burm25||Kupit-Kupit||Convolvulaceae||whole plant||FCA|
|17||Pluchea lanceolata26||Rasana||Asteraceae||leaf, stem, root and callus||Inhibition Protein denaturation and HRBC|
|18||Thunbergia grandiflora Roxb27||Blue skyflower, Bengal clockvine||Acanthaceae||Leave||HRBC|
|19||Trichodesma indica Linn28||Indica borage||Boraginaceae||Leave||CIPO|
|20||Wedelia calendulacea L. 29||Chinese wedelia||Asteraceae||Leaves||CFA|
FCA or CFA- Freunds adjuvant arthritis model (FAC), Carrageenan-induced paw oedema model(CIPO), Streptococcal cell wall-induced arthritis, Collagen Type II Induced Arthritis(CIA) Formaldehyde Induced Arthritis (FIA), Complementary Alternative Medications (CAMs), Aureus-induced septic arthritis (AIA), Inhibition of protein denaturation, HRBC (Human red blood cell)
Acalypha indica Linn.
Acalypha indica methanol extract was evaluated using three different in vitro models to explore antiarthritic potential such as inhibition of protein denaturation, proteinase inhibitory action and antihyaluronidase activity. The concentrations of 10 to 200 μg/ml of A. indica methanol extract were prepared using DMSO. Diclofenac was used as the positive control. All in vitro determinations were done in triplicate. A dose dependent increase in percentage inhibition was observed for all the three models.
The inhibitory concentration (IC50) was found to be 52 μg/ml for protein denaturation assay, 37 μg/ml in proteinase inhibitory action and 18 μg/ml for anti-hyaluronidase activity. Diclofenac offered protective activity at even much lower concentrations compared to A. indica methanol extract producing IC50 values of 40 and 13 μg/ml for protein denaturation and proteinase inhibitory assays. A. indica exhibited a very good anti-arthritic activity in all the methods checked confirming its traditional use 30.
Anti-arthritic activity of ethanolic extract of Asystasia dalzelliana leaves was evaluated by Freund’s adjuvant induced arthritis model in rats. Paw edema, changes in organ weight, serum parameters such as SGOT, SGPT and ALP were estimated. Hind paw of experimental rats were also subjected for radiographic and histopathological examination for assessing the anti-arthritis potential of ethanolic extract of A. dalzelliana leaves. The results of the current investigation concluded that extract of dose of 800mg/kg possess a significant anti-arthritic activity than the lower doses of 200mg/kg and 400mg/kg.
The observed anti-arthritis activity of extract may be due to the presence of phytoconstituents such as alkaloid and flavonoids.14 A. dalzelliana for its possible anti‐arthritic activity by HRBC membrane stabilization and inhibition of protein denaturation method was evaluated. Methanolic extract upon the column chromatography yielded five fractions named (AD‐01, AD‐02, AD‐03, AD‐04, AD‐05) and were screened for their anti‐arthritic activity. Among the five fractions tested, AD‐3 and AD‐4 shown good anti‐arthritic activity when compared with standard Diclofenac sodium.
The maximum membrane stabilization of AD‐3 and AD‐4 fraction was found to be at 71.64% and 94.68% (average) respectively. The protein denaturation inhibition of AD‐3 and AD‐4 fraction was found to be 52.84% and 64.56% respectively. Therefore, the studies supported the use of active constituents from Asystasia dalzelliana leaves in treating rheumatoid arthritis 31.
Bauhinia variegata L.
The anti-inflammatory activity of the leaf extract of B. variegata, using three in vivo animal models: the carrageenan induced rat paw edema, cotton pellets induced granuloma formation, and adjuvant induced arthritis in rat was evaluated. Both the ethanol extract and the petroleum ether fraction obtained from this extract demonstrated activity in all the three bioassays. The activity was found to be more pronounced in the petroleum ether fraction. These bioactivities compared favorably with diclofenac sodium, which was used as positive control, and confirms the traditional usefulness of this plant for the treatment of both acute and chronic inflammatory conditions 16.
Curcuma longa Linn.
In this study, collagen-induced arthritis (CIA) model was utilized to study the effects of curcumin on joint inflammation in Sprague-Dawley rats. Body weight measurement, arthritis score assessment and radiology score assessment were carried out at specific intervals throughout this study. The results showed that the mean arthritis and radiology scores for animal groups designated as CIA CurcuminC and CIA CurcuminT were significantly lower compared with the negative control (CIA OV) group respectively.
The mean arthritis scores for CIA CurcuminC group is significantly lower compared with CIA CurcuminT group but there is no significant difference in the mean radiology scores between the CIA CurcuminC and CIA CurcuminT groups. In conclusion, the oral supplementation of curcumin at the dose of 110 mg/mL/kg/day has a potential to delay and improve joint abnormality and injury in Sprague-Dawley rats with CIA 18. Turmeric (Curcuma longa L., Zingiberaceae) rhizomes contain two classes of secondary metabolites, curcuminoids and the less well-studied essential oils. Having previously identified potent anti-arthritic effects of the curcuminoids in turmeric extracts in an animal model of rheumatoid arthritis (RA), studies were undertaken to determine whether the turmeric essential oils (TEO) were also joint protective using the same experimental model.
Crude or refined TEO extracts dramatically inhibited joint swelling (90-100% inhibition) in female rats with streptococcal cell wall (SCW)-induced arthritis when extracts were administered via intraperitoneal injection to maximize uniform delivery. However, this anti-arthritic effect was accompanied by significant morbidity and mortality. Oral administration of a 20-fold higher dose TEO was non-toxic, but only mildly joint-protective (20% inhibition). These results do not support the isolated use of TEO for arthritis treatment, but, instead, identify potential safety concerns in vertebrates exposed to TEO 32.
Cinnamomum zeylanicum L.
The efficacy of the polyphenol fraction from Cinnamomum zeylanicum bark (CPP) in animal models of inflammation and rheumatoid arthritis was evaluated. Dose-response studies of CPP (50, 100, and 200 mg/kg) used in a separate set of in vivo experiments were conducted in acute (carrageenan-induced rat paw edema), subacute (cotton pellet-induced granuloma), and sub-chronic (AIA, adjuvant-induced established polyarthrtis) models of inflammation in rats and the acetic acid-induced writhing model of pain in mice. Effects of CPP on cytokine (IL-2, IL-4, and IFNγ) release from Concanavalin (ConA)-stimulated lymphocytes were also evaluated in vitro. CPP showed a strong and dose-dependent reduction in paw volume, weight loss reversal effects against carrageenan-induced paw edema, and cotton pellet-induced granuloma models in rats. CPP (200 mg/kg p.o. for 10 days) showed a significant reduction in elevated serum TNF-α concentration without causing gastric ulcerogenicity in the AIA model in rats.
CPP also demonstrated mild analgesic effects during acute treatment as evidenced by the reduction in the writhing and paw withdrawal threshold of the inflamed rat paw during the acetic acid-induced writhing model and Randall-Selitto test. CPP was found to inhibit cytokine (IL-2, IL-4, and IFNγ) release from ConA-stimulated lymphocytes in vitro. In conclusion, CPP demonstrated prominent action in.33 Type-A procyanidine polyphenols (TAPP) extracted from Cinnamon (Cinnamomum zeylanicum) bark evaluated in animal models of inflammation and rheumatoid arthritis in rats. Carrageenan-induced rat paw edema (CPE) and adjuvant induced established arthritis (AIA), in rats were used as the experimental models for inflammation and arthritis respectively. Analgesic activity was evaluated in Randall–Selitto assay in AIA rats.
TAPP showed significant anti-inflammatory effect at dose of 4, 8 and 25 mg/kg, p.o. but not at 2 mg/kg, p.o. dose in CPE model. The dose of 8 mg/kg, p.o. was selected for the evaluation of anti-arthritic activity in AIA model. TAPP (8 mg/kg, p.o., daily from day-12 today-21) treatment in established arthritic rats showed significant reversal of changes induced in AIA with respect to body weight drop (cachexia), ankle diameter, arthritic score, serum C-reactive protein (CRP) levels. Moreover, TAPP was found to be non-ulcerogenic as compared to AIA control rats. However, TAPP did not show analgesic effect on AIA-induced pain as seen in Randall–Selitto assay. In conclusion, TAPP showed disease-modifying potential in animal models of inflammation and arthritis in rats 34.
The collection of plants in this review will be a remarkable tool for the researcher who involve in research in this area. The persons, seeking a better treatment for rheumatoid arthritis will also benefitted by this fruitful article.
- Murugananthan G, Sudheer Kumar G, Sathya Chethan P, and Mohan S: Anti Arthritic and Anti-Inflammatory Constituents from Medicinal Plants. Journal of Applied Pharmaceutical Science2013; 3(4):161-164.
- Singh V, Patel H, Suvagiya V, and Singh K:Some Anti arthritic herbs. International Research Journal of Pharmacy2011;2(11):43-45.
- Handout on Health. Systemic Lupus Erythematosus. National Institute of Arthritis and Musculoskeletal and Skin Diseases (US). United States: National Institute of health.1997:
- Shin HY, Jeong – tang inhibits the stem cell factor-induced migration and inflammatory cytokines secretion in mast cells. J. Ethanopharmacology. 2003; 85; 157-161.
- Kore KJ, Shete RV: Anti-Arthritic activity of Hydro alcoholic extract of LawsoniaInnermis against adjuvant arthritis. International Journal Drug Development & Research 2011;3(4):217-224.
- The American Heritage Dictionary of the English Language, Fourth Edition copyright 2000.
- com. Collins English Dictionary –Complete & Unabridged 11th Edition.24; 2012
- Sudaroli and Chatterjee T. K. Evaluation of red and white seed extracts of Abrus Precatorius Linn. Against Frenud’s complete adjuvant induced arthritis in rats. Journal of Medicinal Plants Research. 2007; 1(4): 86-94.
- Vyas A.S., Patel N. G., Panchal A.H., Patel R.K. and Patel M. Anti-arthritic and vascular protective effects of Fenugreek, Boswellia serrata and Acacia catechu alone and in combinations Pharma science monitor An International Journal of Pharmaceutical Sciences 2010;1(2):
- Jayaprakasam R and Ravi T.K: Evaluation of Anti-arthritic activity of the root extract of Acalypha indica Linn. Using in vitro techniques. International Journal of Phytopharmacy 2012;2(6): 169-173.
- Sujatha K., Kavitha1 K. and Manoharan S: Assessment of invitro anti-arthritic activtiy of achyranthes aspera linn. World Journal of Pharmacy and Pharmaceutical Sciences 2010; 3(6): 894-901.
- Babushetty V., Sultanpur C.M: Evaluation of Anti-Arthritis Activity of Asystasia Dalzelliana Leaves. IJPBA 2012;3(2):
- Reddy V.J. S., Prof. Rao G.D. and Rajya L.G : A Review on Anti-arthritic activity of some medical plant. Journal of Global Trends in pharmaceutical Sciences 2014;5(4):2061-2073.
- Sahaa S. Subrahmanyamb E.V.S, Chandrashekarc K.S. and Shastryd S.C. In Vivo Study for Anti-inflammatory Activity of Bauhinia variegata L. Leaves Pharmaceutical Crops 2011;2: 70-73.
- Chaudhari S.S, Chaudhari S.R, Chavan M.J: Analgesic, anti- inflammatory and anti-arthritic activity of Cassia uniflora Asian Pacific Journal of Tropical Biomedicine 2012;S181-S186.
- Zahidah A.F., Faizah O., Aqilah K.N and Anna K.T: Curcumin as an Anti-arthritic agent in collagen-inducedarthritic sprague-dawley rats Sains Malaysiana 2012;41(5): 591–595.
- Bisht R., Bhattacharya S. and Jaliwala Y.A: COX and LOX inhibitory potential of Abroma Augusta and Desmodium gangeticum. The Journal of Phytopharmacology 2014; 3(3): 168-175.
- Ramasamy S.K., Rajendran V.K et al: Effect of Elaeocarpus sphaericus in freund’s complete adjuvant (fca) induced rheumatoid arthritis in albino rats. Indo-Global Research Journal of Pharmaceutical Sciences 2012; 2(3):
- Das B., Alam S., Bhattacharjee R. and Das B.K. Analgesic and Anti-inflammatory Activity of Euphorbia Antiquorum Linn American Journal of Pharmacology and toxicology 2015; 10(2): 46-55.
- Geetha D.H., Indhiramutha J. and M.Rajeswari: Invitro Anti-arthritic activity of Elaeocarpus Serratus Linn. (Elaeocarpaceae) International Journal of Pharmaceutical Sciences &Research 2015;6(6):
- Manocha N., Chandra S.K, Sharma V., Sangameswaran B. and Saluja M: Anti- Rheumatic and antioxidant activity of extract. Research Journal of Chemical Sciences 2011;1(2):
- Nanumala S.K., Guptha G.K. et al: In-Vitro Anti-Inflammatory and Anti-Arthritic Activity of Ichnocarpus frutescens Roots. Journal of Pharmacy Research 2012; 5(12):5300-5301.
- Purushoth P.T, Panneerselvam.P. et al: Anti-inflammatory, anti arthritis and analgesic effect of ethanolic extract of whole plant of Merremia Emarginata Burm. F Central European Journal of Experimental Biology 2012;1(3): 94-99.
- Arya D. and Patni V: Comparative analysis of in vitro anti-inflammatory and in vivo & in vitro anti-arthritic activity in methanolic extract of pluchea lanceolata oliver & hiern. International Journal of Biological & Pharmaceutical Research 2013;4(9): 676-680.
- Rahman M., Chowdhury I. A et al: In- vitro comparative study of Anti-inflammatory and Anti-arthritic effects of the methanol extract of Cissus Pentagona roxb and Thunbergia Grandiflora roxb The Pharma innovation Journal 2015;4(4):39-42.
- Narendra K., Josh DSD S., Prasad M.S et al: In vitro and In vivo Anti-inflammatory efficiency of Trichodesma Indica Linn. Leaf extract. Journal of Pharmaceutical and Scientific Innovation 2015;4(6):
- Panchala A.H., Patelb R.K et al: Anti-arthritic and syergetic activity of wedeliaCaledulacea With methotrexate in adjuvant induced Arthritis with cardioprotective activity in Pharmacologyonline2011;3:175-187.
- Jayaprakasam R and Ravi T.K: Evaluation of anti arthritic activity of the root extract of
- Acalypha indica linn. Using in vitro techniques. International journal of Phytopharmacy 2012;2 (6):169-173.
- Kumar S. and Kumar V: Invitro Antiarthritic Activity of isolated fractions from methanolic Extract of asystasia dalzelliana leaves. Asian Journal of Pharmaceutical and Clinical Research 2011;4(3):5253.
- FunkL., Frye J.B.et al: Anti-Arthritic Effects and Toxicity of the Essential Oils of Turmeric Curcuma longa L. J Agric Food Chem. 2010; 58(2): 842–849.
- Rathi B., Bodhankar S.et at: Ameliorative Effects of a Polyphenolic Fraction of Cinnamomum zeylanicum L. Bark in Animal Models of Inflammation and Arthritis. Sci Pharm. 2013; 81:567–589.
- Vetal S.A, Bodhankar S.L et al: Anti-inflammatory and anti-arthritic activity of type-A procyanidine polyphenols from bark of Cinnamomum zeylanicum in rats. Food Science and Human Wellness 2013;2: 59–67.