Arthritis
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Transcript of Arthritis
Presented by
Dr. Sudhakar Kokate
Director PPRC, India
About disease
∞ Inflammation of a joint characterised by pain,
swelling and limitation of a joint movement
∞ Osteo-arthritia (OA)
– Knee and hip…debilitating disease affected
– More in women than male
– Increases with ageing
PPRC/INDIA 01
About disease
∞ Rheumatoid arthritis (RA)
- Most common disease
- Affects 1% of world population
- Involves many joints
PPRC/INDIA 02
About disease
PPRC/INDIA 03
Drugs in Practice
∞ Non-steroidal anti-inflammatory drugs
(NSAIDS)
…. For symptomatic treatment of
OA and RA
Side effects risk in use
- many limitations
PPRC/INDIA 04
Side effects of NSAIDS drugs
∞ Propensity to cause stomach ulcers
- GI bleeding
- Perforations
∞ New cox – 2 drugs
- Long term use may increase the risk
of stroke and heart attack
PPRC/INDIA 05
∞ USFDA withdrawn from market
∞ Biologics drugs
(Anti-bodies for IL-1, IL-6, TNF-ɑ)
Benefits:
- Reduce inflammation
- Joint destruction
PPRC/INDIA 06
Side effects of NSAIDS drugs
Disadvantages
∞ Not effective universally
∞ Higher costs
∞ Severe side effects as life – threatening
infections
∞ Increases risk of malignances
PPRC/INDIA 07
Emerging CAM therapy
∞ CAM: Complementary and Alternative
Medicine
∞ Use of accu-puncture
∞ 60-90% of dissatisfied patients use this
therapy
PPRC/INDIA 08
Symptoms of Arthritis
∞ Caused due to the aggravation of vata
(air) dosha and accumulation of Ama
(toxins) gets deposited in the weak areas
of the body
∞ Weak digestion, constipation, overeating
and little physical activity
PPRC/INDIA 09
Osteoarthritis
∞ Most common joint disease
∞ Women >55 yrs age affected
∞ 12% incidences of Osteoarthritis in India
∞ Condition of synovial joints characterised
by cartilage loss with peri-articular
response
PPRC/INDIA 10
Emerging new trends
in
the development
of
PhytoDrugs
In
Arthritis PPRC/INDIA 11
Ashwagandha Withania somnifera
PPRC/INDIA 12
Withania somnifera
• The root contains traces of an essential oil
• It is effective in the treatment of rheumatic
infections
• The water soluble portion of the root extract
contains indefinite amorphous substances and a
quantity of sugar
PPRC/INDIA 13
Ajwain Trachyspermum ammi
PPRC/INDIA 14
Trachyspermum ammi
• The seeds are used as a household remedy for
indigestion, colic, diarrhoea, flatulence and asthma
• In arthritis it is quite effective
• Ref. The Ayurvedic Pharmacopoeia of India, New
Delhi Part I, Vol. I, II
• Waltis T.E. - Textbook of Pharmacogney PPRC/INDIA 15
Alfalfa Medicago sativa
PPRC/INDIA 16
Medicago sativa
• It contains 1-canavanine, an amino acid causes
curing properties against joint pain
PPRC/INDIA 17
Angelica Angelica archangelica
PPRC/INDIA 18
Angelica archangelica
• It is used in European folk medicine
• Western variety has 12 anti-inflammatory
constituents, 10 anti-spasmodic constituents and 5
anodyne ones
• Chinese species is sold in North America in the
name of dang guei or dang quai
PPRC/INDIA 19
Black cohosh Cimicifuga racemosa
PPRC/INDIA 20
Cimicifuga racemosa
• There are five species worldwide that have been
used to treat rheumatism
• It contains aspirin-like substances and the root of
the plant is very beneficial
• Other anti-inflammatory and anti-spasmodic
constituents
PPRC/INDIA 21
Celery Apium graveolens
PPRC/INDIA 22
Apium graveolens
• Eating raw or cooked celery seeds or large amount
of this plant to treat rheumatism arrived in North
America
• Celery is rich in minerals
• 1 cup of celery contains 350 mg of potassium
PPRC/INDIA 23
Chaparral Larrea tridentata
PPRC/INDIA 24
Larrea tridentata
• It is widely promoted in health food-stores as a
treatment for arthritis
• Externally as a wash or internally as a tea
PPRC/INDIA 25
Cat’s claw Uncaria tomentosa, Uncaria guianensis
PPRC/INDIA 26
Uncaria tomentosa, Uncaria guianensis
• This plant contains oxindole alkaloids tannis,
quinoxic acid glycosides, flavonoids and sterols
• Extract of this herb is effective in arthritis
PPRC/INDIA 27
Devdaru Cedrus deodara
PPRC/INDIA 28
Cedrus deodara
• It is acute and pungent in action
• This is one of the most useful drug
• It is used in combination with other anti-pyretics
PPRC/INDIA 29
Ginseng liquor Panax quinquefolius
PPRC/INDIA 30
Panax quinquefolius
• It contains ginsenosides which has a variety of
pharmacological actions
• It handles a wide variety of stresses effective in
rheumatism
PPRC/INDIA 31
Garlic Allium sativum
PPRC/INDIA 32
Allium sativum
• It possesses anti-inflammatory anti-arthritic, hypo-
lipidemic, anti-coagulant, hypo-proteomic, hypo-
cholesterolemic, anti-bacterial, anti-fungal, anti-
hypersensitive and hypo-glycaemic action
PPRC/INDIA 33
Gandhaprasarini Paederia foetida
PPRC/INDIA 34
Paederia foetida
• This plant exhibits disease modifying anti-
rheumatic activity
• It also helps in treating inflammatory disorders
PPRC/INDIA 35
Ginger Zingiber officinale
PPRC/INDIA 36
Zingiber officinale
• Chromatographic fraction results showed that most
of the fractions containing gingerols / gingerol
derivatives were excellent inhibitors of LPS-induced
PGE-2 production
• Ginger extract when administered daily for 4 weeks
caused significant reduction in PGE-2 levels in rats
PPRC/INDIA 37
Green tea Camellia sinensis
PPRC/INDIA 38
Camellia sinensis
• One of the most commonly consumed beverages in
the world with no side-effects
• Sufficient experimental proof on the effect of
Green tea’s anti-inflammatory and chondro-
protective properties at molecular level
PPRC/INDIA 39
Hop tea Humulus lupulus
PPRC/INDIA 40
Humulus lupulus
• It contains 32 constituents that have anti-
inflammatory activities
• 10 out of them may act as sedative
• It is popular remedy for rheumatism
PPRC/INDIA 41
Karpura Cinnamomum camphora
PPRC/INDIA 42
Cinnamomum camphora
• When applied on the affected area camphor may
redden the skin and produce a warm sensation
• When rubbed into painful, stiff joints, ligaments
and muscles, it provides soothing “camphor-ice”
relief
PPRC/INDIA 43
Pepper Piper nigrum
PPRC/INDIA 44
Piper nigrum
• As an external application, it dilates the superficial
vessels and acts as a counter-irritant
• It is used as an analgesic liniment for myalgia and
rheumatic pains
PPRC/INDIA 45
Liquorice Glycyrrhiza glabra
PPRC/INDIA 46
Glycyrrhiza glabra
• It acts on the body without any harmful side-effects
• It has significant anti-inflammatory and anti-allergy
activity
• It has been historically in the treatment of
inflammation, allergy and asthma
PPRC/INDIA 47
Mustard plaster Brassica alba, Brassica juncea
PPRC/INDIA 48
Brassica alba, Brassica juncea
• Popular counter-irritant treatment for arthritis
• Active principle – allyl-isothiocyanate
• Crush the seeds in grinder, moisten the mixture
with vinegar and sprinkle the flour. Spread mixture
on cloth and place it on skin for > 20 mins. After
removal, wash the affected area
PPRC/INDIA 49
Pineapple Ananas comosus
PPRC/INDIA 50
Ananas comosus
• Active principle – “Bromelain” helps prevent
inflammation
• Athletic trainers recommend pineapple for athletes
to prevent and treat sports injury
• Bromelain help the body to get rid of immune
antigen complex compounds that are implicated in
arthritic conditions PPRC/INDIA 51
Rosemary Rosmarinus officinalis
PPRC/INDIA 52
Rosmarinus officinalis
• The leaves of this plant contain carnosal, oleanolic
acid rosmarinic acid and ursdic acid which acts as
an anti-inflammatory activity
PPRC/INDIA 53
Red pepper Capsicum sp.
PPRC/INDIA 54
Capsicum sp.
• It interferes with pain perception
• It contains capsaicin salicylates and others
• These help to relieve arthritis
PPRC/INDIA 55
Sesame seeds Sesamum indicum
PPRC/INDIA 56
Sesamum indicum
• Chinese folk medicine to eat seeds
• ½ ounce of the seeds contain 4 gm of essential
fatty acids, 175 mg of calcium, 64 mg of
magnesium, 0.73 mg of copper
• Increased copper intake may be important during
arthritis attacks
• A rind ½ ounce of seeds & sprinkle on food PPRC/INDIA 57
Stinging nettle Urtica dioica
PPRC/INDIA 58
Urtica dioica
• Official remedy for rheumatism in Germany
• Most important herb to consider for treating early
onset arthritis
• Contains anti-inflammatory component similar to
that of steroid drugs
• Dose: 1 tablespoon juice thrice a day, freeze the
juice if needed PPRC/INDIA 59
Thunder god vine Tripterygium wilfordii Hook f.
PPRC/INDIA 60
Tripterygium wilfordii Hook f.
• It is a perennial vine-like plant that grows in
Southern China and Taiwan
• Root extract is for treatment of various auto-
immune and inflammatory diseases including RA
PPRC/INDIA 61
Turmeric Curcuma longa
PPRC/INDIA 62
Curcuma longa
• Curcumin, the yellow pigment of Turmeric has
significant anti-inflammatory action
• Curcumin – effective as cortisone in inflammation
• Dosage: 400-600 mg thrice a day
• Non-toxic dietary pigment quite useful in arthritis
• It is effective in liver infections PPRC/INDIA 63
Wild cucumber bark
PPRC/INDIA 64
Wild cucumber bark
• Best plant for treating rheumatism and arthritis
• It is to be taken in drinking alcohol or tea
PPRC/INDIA 65
Wild yam Dioscorea villosa
PPRC/INDIA 66
Dioscorea villosa
• Contains “Diosgenin” a steroid constituent with
anti-inflammatory properties
• Wild yam tea popular folk remedy for muscular
rheumatism
• Dosage: 1 ounce of wild yam root + 1 ginger root
= fill jar with boiling water – mixture at room
temp. Drink 2 – 3 cups / day PPRC/INDIA 67
Willow Salix spp.
PPRC/INDIA 68
Salix spp.
• Active principle: “Salicin”
• Pain relieving and anti-inflammatory properties
PPRC/INDIA 69
Wintergreen Gaultheria procumbens
PPRC/INDIA 70
Gaultheria procumbens
• Chief active principle: Methylsalicylate
• Dried herb is used
PPRC/INDIA 71
Yucca Yucca filamentosa
PPRC/INDIA 72
Yucca filamentosa
• To reduce arthritic pain
• Saponin extract of Yucca showed positive
therapeutic effect
• It decreases bacterial endotoxin absorption thus
reducing inhibition of cartilage synthesis
PPRC/INDIA 73
Thank you !!