A Laconic Review on Potential Herbals as Antiasthmatic Agents

 

Shubham Verma¹, Simranpreet Kaur¹, Jugnu Goyal², Shammy Jindal³, Kamya Goyal¹*

¹ISF College of Pharmacy, Moga, Punjab, India.

²Swami Dayanand Institute of Pharmaceutical Sciences, UHS, Rohtak, Haryana, India.

³ISF College of Pharmacy, Moga, Punjab, India.

 

ABSTRACT:

Asthma is a condition in which a person's airways become inflamed, narrowed, swollen, and produce excessive mucus, making it difficult to breathe due to some allergens such as pollen, dust mites, mould spores, pet dander, particles of cockroach waste etc. The word "asthma" originates from the Greek meaning short of breath, meaning that any patient with breathlessness was asthmatic. The term was refined in the latter part of the 19^th Century with the publication of a treatise by Henry Hyde Salter entitled "On Asthma and its Treatment". Asthma is a common condition diagnosed in as many as 25% of Scottish children by the age of 11 years. Childhood asthma is heterogeneous in terms of severity. In traditional system of medicines, plants herbs like ginger, Echinacea, garlic etc. are used in the treatment of asthma. Medicinal plants have been known for millennia and are highly esteemed all over the world as a rich source of therapeutic agents for the prevention of diseases and ailments. The importance of herbal medicine in the treatment of asthma is indisputable. This review highlights the etiology of asthma and few plants which are known to show antiasthmatic activity which are popular in traditional system of medicine.

 

 

 

INTRODUCTION:

Asthma is a common respiratory disease worldwide. It clinically manifests as wheezing, nocturnal cough, shortness of breath, chest tightness, and variable expiratory airflow limitation. Asthma is the most common chronic disease among children. Asthma is believed to be a chronic disease caused by the separate responses of innate and adaptive immunity to allergens; however, this concept has changed based on reports of ILC2. ILC2 are innate cells that can produce allergic cytokines without the need of adaptive T cell and B cell products.^1,2

 

 

 

Various research studies indicates that airway hyper responsiveness is important in the pathogenesis of asthma and the level of airway hyper responsiveness usually correlates with the clinical severity of asthma.

 

It is based on the presence and absence of an underlying immune disorder asthma may be classified as^3,4

a.        Extrinsic Asthma: It is a condition in which asthmatic episode is initiated by type I hypersensitive reaction induced by an exposure to an extrinsic antigen.

b.       Intrinsic Asthma: It is a conditionin which the triggering mechanisms are non- immune and stimuli that have little or no effect in normal subjects can trigger bronchospasm.

 

Bronchial asthma is a common chronic inflammatory disease of airways characterized by variable and recurring symptoms, reversible airflow, obstruction and bronchospasm. Asthma in Children is not a different disease from asthma in adults, but children do face unique challenges. Asthma in children is a leading cause of emergency, with departmental visitsand occasional hospitalizations.⁵

 

Conventional drugs applied in the treatment of asthma may notcure the patients completely. The treatment is very long, and patients are worried about its side effect. As a result, Complementary and Alternative Medicine (CAM) is graduallyused in asthma treatment. Alternative medicine methods are being natural, non-invasive, effective. As previous positive experiences and personal beliefs it has been shown that the leading causes of CAM are used in patients with asthma.⁶

 

PATHOPHYSIOLOGY OF ASTHMA:

Bronchial asthma is characterized pathologically by an infiltration of eosinophils into the airway submucosa. Eosinophil activation results in the secretion of an array of highly charged cytotoxic cationic proteins such as major basic protein, and is believed to play a central role in the etiology of this disease by inducing damage to the airway epithelium ⁷. The pathophysiology of asthma involves the development of acute and chronic inflammation in respiratory tract. It results in narrowing the bronchial tubesby increasing vascular permeability and producing edema, and airway smooth muscle contraction.⁸

 

 

 

Air pollution and the cause of asthma are also less clear; however, there is a relationship between smoking and the increasing risk of asthma⁸. Through research it is proved that obesity has a positive linear relationship between asthma and increased BMI⁹. More research needs to be done to have a clearer picture of the multifactorial disease.

 

To diagnose asthma, clinicians can do a variety of tests such as expiratory airflow limitation, documentation of reversible obstruction, and rule out any exclusion of an alternative diagnosis. Assessing the patient’s obstruction via spirometry and checking for a reversible change after a bronchodilator is suggestive for the diagnosis of asthma. By using spirometry, physicians can diagnose asthma as well as the severity of obstruction¹⁰.

 

HERBAL DRUGS USED FOR ASTHMA TREATMENT:

Though the large numbers of drugs are available for the treatment of asthma, the relief offered by them is mainly symptomatic and short lived. Moreover the side effects of these drugs are also quite disturbing. Recently there has been a shift in universal trend from synthetic to herbal medicine, which we can say ‘Return to Nature’. Medicinal plants have been known for millennia and are highly esteemed all over the world as a rich source of therapeutic agents for the prevention of diseases and ailments¹¹.

 

Table 1: brief review of antiasthmatic plants

Plants	Family	Part used	Chemical constituents	Mechanism of action	Ref.
Achyranthes aspera	Amaranthaceae	Fruit	Saponin C Saponin D	Mast cell stabilizer	12
Allium cepa	Liliaceae	Bulb	Quercetin	Mast cell stabilizer, LOX inhibitor, PAF inhibitor, COX inhibitor	12, 13
Adhatoda vasica	Acanthaceae	Leaves, root	Alkaloids	Bronchodilator Anti-anaphylactic	14, 15
Albizzia lebbeck	Leguminosae	Bark	Alkaloids, tannins, flavonoids,	Bronchodilator Mast cell stabilizer Inhibits action of histamine, Ach and 5-HT	16, 17
Boswellia serrata	Burseraceae	Root	Boswellin, Boswellic acid	Inhibits leukotriene biosynthesis	18
Balanites roxburghii	Simarubaceae	Stem bark	Alkaloids	Bronchodilator  Mast cell stabilizer	19
Clerodendron phlomidis	Verbenaceae	Leaves	Flavonoids, terpenoids, steroids	Antihistaminic Mast cell stabilizer	20
Centipeda minima	Compositae	Whole plant	Pseudoguainolide, sesquiterpene, lactone, flavonoids	Antiallergic	21
Ephedra gerardiana	Ephedraceae	Stem	Ephedrine	Bronchodilator	22
Eucalyptus globules	Myrtaceae	Leaves	Volatile oil	Anti-inflammatory	23
Glycyrrhiza glabra	Leguminosae	Root	Glycyrrhizinic acid	Antihistaminic Antiallergic	24, 25
Hedychium spicatum	Zingiberaceae	Rhizome	Sitosterol, Volatile oil	Anti inflammatory	26, 27
Inula racemosa	Asteraceae	Roots	nulin, sesquiterpenelactone- alantolactone	Antihistaminic	28
Moringa oleifera	Morangaceae	Seed	Tannins, steroids, triterpenoids, flavonoids, alkaloids, saponins	Antihistaminic	29
Nigella sativa	Ranunculaceae	Seed	Volatile oil, fatty acid	Bronchodilator	30
Ocimum sanctum	Labiateae	Leaves	Ursolic acid	Mast cell stabilizer	30
Picorrhiza kurroa	Scrophulareaceae	Roots	Picorrhizin	Antihistaminic	30
Passiflora incarnata	Passifloraceae	Leaves	Benzoflavone	Bronchodilator	31
Solanum xanhocarpum	Solanaceae	Flower	Phyto-sterol, alkaloids, flavonoooids, Steroids	Antihistaminic Mast cell stabilizer	32
Terminalia belerica	Combrataceae	fruits	Beta sitosterol, Gallic acid, ellagic acid, glycoside	Mast cell stabilizer	33
Tinospora cordifolia	Mensipermaceae	Stem	Alkaloids	Antihistaminic Mast cell stabilizer	34
Tamarindus indica	Caesalpiniaceae	leaves	Flavone, Glycosides	Brochodialator Antihistaminic Anti-inflammatory	35

 

CONCLUSION:

Asthma is a common disease ofrespiratory system worldwide. It clinically manifests as wheezing, nocturnal cough, shortness of breath, chest tightness, and variable expiratory airflow limitation. Many synthetic drugs are used to treat asthma, but they are not completely safe for long term use. Scientifically explored exhaustive reports published in Indian and international journals suggest the importance of herbal medicine in the treatment of asthma is indisputable.Ongoing research worldwide has provided valuable clues regarding the precise mechanism of action of these herbal alternatives and these herbs, have shown interesting results in various target specific biological activities such as bronchodilation, anti-anaphylactic, anti-inflammatory, anti-allergic and inhibition of mediators.

 

REFERENCES:

1.      Artis D, Spits H. The biology of innate lymphoid cells. Nature. 2015; 517:293–301.

2.      Eberl G, Colonna M, Di Santo JP, McKenzie AN. Innate lymphoid cells. Innate lymphoid cells: a new paradigm in immunology. Science. 2015;348:aaa6566.  

3.      Holgate ST, Polosa R. Treatment strategies for allergy and asthma. Nat Rev Immunol. 2008; 8:218–230

4.      Tattersfield AE, Knox AJ, Britton JR, Hall IP. Asthma. Journal of Lancet. 2002; 360:1313–1322.

5.      Schuijs, M.J.; Willart, M.A.; Hammad, H.; Lambrecht, B.N. Cytokine targets in airway inflammation. Curr. Opin. Pharmacol. 2013, 13, 351–361.  

6.      Chabra, R.; Gupta, M. Allergic and Environmental Induced Asthma; StatPearls Publishing LLC.: Treasure Island, FL, USA, 2020.  

7.      Christopher EB, Peter B, Fiona AS, Stephen TH, Andrew J W, Ian DP. Mast-cell infiltration of airway smooth muscle in asthma. New Eng J Med 2002; 33; 1699-1705.

8.      Gregory GK, Peter DP, Chun YS. The mechanics of exaggerated airway narrowing in asthma the role of smooth muscle. Respiration Physiology 1999; 118:1-13.

9.      Sundeep SS, Mamudipudi TK, Anthony PS, Stephen TH. The anti-inflammatory effects of leukotriene-modifying drugs and their use in asthma. Chest 2001; 119:1533-1546

10.   Gold WM, Koth LL. Chapter 25. Pulmonary function testing. In: Broaddus VC, Mason RJ, Ernst JD, King TE, Lazarus SC, Murray JF, et al., editors. Murray and Nadel's textbook of respiratory medicine. 6th ed. Philadelphia: Saunders/ Elsevier; 2015. pp. 407–435.e18. [Google Scholar]

11.   Sharma A, Shanker C, Tyagi L, Singh M, Rao CV. Herbal medicine for market potential in India: An Overview. Academic Journal of Plant Sciences. 2008; 1(2): 26-36.

12.   Rastogi RP, Mehrotra BN, Compendium of indian medicinal plants, 1st Edition, Vol 3, CDRI Lucknow and PID New Delhi, 1980-1984; 10, 224, 294, 376

13.   Chaudhari RD (Ed.). Pharmacological classification of medicinal herbs, Herbal Drug industry, Eastern Publishers, New Delhi, 1st Edition, 2004; 61.

14.   Paliwa JK, Dwiwedi AK, Singh S. Pharmacokinetics and insitu absorption studies of a new antiallergic compound 73/602 in rats, Int. J. Pharm. 2000;197(1-2): 213-220

15.   Evans WC. Trease and Evans Pharmacognosy, 15th edn, WB Saunders Company Ltd., London, 2003; 299, 471, 485

16.   Tripathi RM, Das PK. Studies on antiasthmatic and anti anaphylactic activity of Albizzia lebbeck Ind. J. Pharmacol 1977, 9(3):189-194

17.   Tripathi RM, Sen PC, Das PK Studies on the mechanismof action of Albizzia lebbeck, an indigenous drug used in the treatment of atopic allergy, J Ethnopharmacol.1979,1, 1385-1396.

18.   Gupta I, Gupta V, Parihar A, Gupta S, Ludtke R, Safeyhi H, Ammon HP. Effects of Boswellia serrata gum resin in patients with bronchial asthma: results of a double-blind, placebo-controlled 6-week clinical study. Eur. J. Med. Res. 1998; (11): 511-514

19.   Singh V, Tripathi P, Patel JR, Kori ML, Dixit VK, Preliminary phytochemical and antiasthmatic studies on stem bark of Balanites roxburghii planch. International Journal of Pharmaceutical and Clinical Research 2009,1(1):40-42

20.   Vadnere GP, Somani RS, Singhai AK. Studies on antiasthmatic activity of aqueous extract of Clerodendron phlomidis. Pharmacologyonline. 2007(1) :487-494

21.   Wu JB, Chun YT, Ebizuka Y, Sankawa V. Biologically active constituents of Centipeda minima: isolation of a new phenolin ester and the antiallergic activity of sesquiterpene lactones. Chem. Pharm. Bull.1985,33: 4091-4094

22.   Rastogi RP, Mehrotra BN. Compendium of Indian Medicinal Plants, 1st Edition, Vol 4, CDRI Lucknow and PID New Delhi, 1985-1989; 154, 246, 288, 315, 348, 360.

23.   23. Focho DA, Nkeng EAP, Fonge BA, Fongod AN, Muh CN, Ndam TW, Afegenui A. Diversity of plants used to treat respiratory diseases in Tubah, northwest region, Cameroon. African J. of Pharm. Pharmacol. 2009 Nov3(11): 573-580

24.   RP Rastogi, BN Mehrotra. Compendium of Indian Medicinal Plants, 1st Edition, Vol 4, CDRI Lucknow and PID New Delhi, 1985-1989; 154, 246, 288, 315, 348, 360.

25.   WC Evans. Trease and Evans Pharmacognosy, 15th edn, WB Saunders Company Ltd., London, 2003; 299, 471, 485.

26.   26. Chaturvedi GN, Sharma BD. Ethnobotnical survey of the plants used to treat asthma in Andhra Pradesh. Journal of research in Indian medicine. 1975;10(2):6

27.   Shekhar AV, Gandhi DN, Mohan Rao N, Rawal UD. An experimental and clinical evaluation of Antiasthmatic potentialities of Devadaru compound (Dc) Indian J Physiol Pharmacol. 2003 Jan.47(1): 101-107

28.   Srivastava S, Gupta PP, Prasad R, Dixit KS, Palit G, Ali B, Misra G, Saxsena RC. Evaluation of antiallergic activity (type I hypersensitivity) of Innula racemosa in rats. Indian J. Physiol. Pharmacol. 1999;29,89-95

29.   Agrawal B, Mehta A. Antiasthmatic activity of Moringa olifera Lam: A clinical study Indian J Pharmacol. 2009; 40(1): 28-31

30.   Doshi VB, Shetge VM, Mahashur AA, Kamat SR, Picrorrhiza kurroa in bronchial asthma. J. Postgrad. Med.1983; 29:89-95

31.   Dhawan K, Kumar S, Sharma A. antiasthmatic activity of the Methanol extract of leaves of Passiflora incarnata.Phytother. Res. 2003;17:821-22

32.   Vadnere GP, Gaud RS, Singhai AK. Evaluation of antiasthmatic property of Solanum xanthocarpum flowers extracts. Pharmacologyonline. 2008;1: 513-522

33.   Vyas BA, Vyas RB. Effect of ethanolic extracts of Allium sativum and Terminalia belerica on clonidine induced mast cell degranulation and clonidine and haloperidol induced catalepsy in mice. Int J Pharm Res 2009; 1(1): 41-44

34.   Nayampalli SS, Desai NK, Ainapure SS. Antiallergic properties of Tinspora cordifolia in animal models. Indian J. Pharmacol. 1986; 18:250-252

35.   Tayade PM, Ghaisas MM, Jagtap SA, Dongre SH. Antiasthmatic activity of methanolic extract of leaves of Tamarandus indica linn. Journal of pharmacy research.2009, 2(5):944-947

 

 

 

 

 

Received on 26.05.2023           Modified on 12.02.2024

Accepted on 15.07.2024   ©Asian Pharma Press All Right Reserved