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Author: Dr. Manajit Bora,, Research Officer (Pharmacology), Central Ayurveda Research Institute, Guwahati
India
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Chandigarh, August 18, 2022:
Hyperlipidemia is a condition of lipoprotein synthesis characterized by elevated cholesterol and triglyceride levels in the blood, which can be attributed to Medo Roga in Ayurveda Hyperlipidemia has been positioned as one of the most serious threat factors adding to the predominance and seriousness of coronary heart diseases resulting in death.
Many modern drugs namely fibrates, statins, bile acid sequestrants, inhibitors of cholesterol absorption have been used for treating hyperlipidemia. The modern pharmacological therapy for hyperlipidemia is effective but causes various adverse reactions and is also expensive. Treatments using medicinal plants are therefore, being explored in recent times as an alternative therapy. World Health Organization (WHO) has recorded nearly 21,000 medicinal plants, which are utilized for treating a variety of diseases in humans as well as animals. Among these, 2,500 species of medicinal herbs are distributed in India.
Pharmacological studies showed that Ayurvedic herbs namely garlic (Allium sativum L.), Aswagandha (Withania somnifera L.), Apamarga (Achyranthes aspera L.), Bhringaraja (Eclipta alba L. Hassk.), Guggulu (Commiphora mukul [Hook. ex Stocks] Engl.), Kalonji (Nigella sativa L.), Bael (Aegle marmelos L.), Khadira (Acacia catechu (L.f.) Willd.), Ghritkumari (Aloe barbadensis Mill./Aloe vera L.), Shatavari (Asparagus racemosus Willd.), Palasha (Butea monosperma (Lam.) Taub.), Amlatas (Cassia fistula L.), Bhringaraja [Eclipta prostrata / Eclipta alba (L.) Hassk.], Sunthi (Zingiber officinale Roscoe), Rasona (Allium sativa L.), Pippali (Piper longum), Haritaki (Terminalia chebula Retz.), Bibhitaki (Terminalia bellirica (Gaertn.) Roxb. etc. are effective for the treatment hypercholesterolemia. Phytoconstituents present in these Ayurvedic herbs like alkaloids, tannins, saponins, emodins, ferric chloride, phenolics, and volatile oils exhibit potential anti-cholesterol activity by reducing the exogenous cholesterol absorption and endogenous cholesterol synthesis.
Studies showed that various phytochemicals present in Ayurvedic herbs decreased HMG-CoA reductase activity, which helps in reducing endogenous cholesterol synthesis, activated lipids, lecithin-cholesterol acyltransferase, and also increases HDL-C in the blood. Phytosterols present in Ayurvedic herbs can bind to cholesterol and prevent its absorption resulting in decreased total serum cholesterol.
It has been reported that saponins precipitate cholesterol from micelles and interfere with the hepatic circulation of bile acids, making it unavailable for intestinal absorption; this forces the liver to produce more bile from serum cholesterol. This leads to a decline in serum cholesterol levels. Saponins also lower the plasma LDL-C levels through an increased turnover of LDL-C to hepatic tissue, which is then converted to bile acids.
It is also reported to lower triglycerides by inhibiting pancreatic lipoprotein lipase. The lipid-lowering effect of alkaloid berberine appears to be mainly due to stabilization of the hepatic LDLC receptor by exracellular signal- regulated kinase dependent mechanism and also by increasing transcriptional activity of the low density lipoprotein receptor (LDLR) promoter by the c-Jun N-terminal kinase pathway.
Moreover, berberine induces decreased transcription of the proprotein convertase subtilisin/kexin type 9 (PCSK9) gene, where PCSK9 post-transcriptionally down regulates the LDLR by binding to the receptor’s EGF repeat A on the cell surface and shuttling the LDLR to the lysosomes for degradation. The lipid-lowering activity of Allium sativum might be due to inhibition of hepatic cholesterol biosynthesis, activation of tissue lipases, SOD, CAT and its bioactive compounds like typical alkaloids, S-allyl cysteine sulfoxide. Fresh Guggulu produced pronounced anti-hyperlipidaemic effect than the old one due to the presence of higher concentrations of Z-guggulsterone and E-guggulsterone.
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