Review on shilajit used in traditional Indian medicine

Ethnopharmacological relevance

Shilajit is a multi-component natural occurring mineral substance used in Ayurveda and Siddha systems of medicine which originated in India. Its source can be traced to the mountainous regions, where the hilly tribes first identified its beneficial use. Shilajit is aptly referred to as ‘rasayana’/‘rasayanam’ in Ayurveda and Siddha literature which means rejuvenator because it prevents ailment and enhances the quality of life.

Materials and Methods

An attempt has been put forth to review shilajit pertaining to its origin, synonyms, varieties, physical properties, chemical constituents, therapeutic properties and important biological properties to affirm its rasayana property. All relevant information on shilajit was collected from classical texts including pharmacopoeias, formularies, etc. Moreover, select doctoral thesis from Banaras Hindu University, Varanasi and Gujarat Ayurved University, Jamnagar were also scanned. Published papers on shilajit were collected from important databases for biomedical sciences. Amongst, the various biological properties of shilajit, antioxidant activity and immuno-modulatory activity were focused as it is closely related to its rasayana potential.

Results

This review finds that shilajit is used in twenty Sastric formulations and twenty-four proprietary drugs for extraneous indications. Even-though, there is a long history of use of shilajit in traditional Indian materia medica, shilajit unfortunately lacks scientific evaluation and systematic documentation. In vivo antioxidant activity of shilajit has been studied at an irrelevant dose and without using a positive control. The immuno-modulatory activity does not stand the test of critical assessment and currently may be considered as unproven.

Conclusion

Based on the earlier studies, the bioactivity of shilajit lacks substantial evidence. Nevertheless, further studies are imperative to overcome the lacuna in establishing the antioxidant property of shilajit and more specific assays are needed to vouch shilajit as an immuno-modulator which may be of use to establish its rasayana potential.     

Generation and function of immunosuppressive human and murine CD8+ T cells by transforming growth factor-β and retinoic acid

The intestinal immune system is constantly challenged by foreign antigens and commensal bacteria. Therefore, proper control of the intestinal microenvironment is required. One important arm of this regulatory network consists of regulatory T cells. In contrast to CD4(+) Foxp3(+) regulatory T cells, which have been well characterized, immunomodulatory CD8(+) T cells that express Foxp3 are less well defined in terms of their generation and function. Failures of these regulatory mechanisms contribute to the development of inflammatory bowel disease. In this study we demonstrate that the frequency of CD8(+) Foxp3(+) T cells is reduced in the peripheral blood of patients with ulcerative colitis. As these cells might play a currently underestimated role in the maintenance of intestinal homeostasis, we have investigated human and murine CD8(+) Foxp3(+) T cells generated by stimulating naive CD8(+) T cells in the presence of transforming growth factor-β and retinoic acid, mediators that are abundantly produced in the intestinal mucosa. These CD8(+) Foxp3(+) fully competent regulatory T cells show strong expression of regulatory molecules CD25, Gpr83 and CTLA-4 and exhibit cell-cell contact-dependent immunosuppressive activity in vitro. Our study illustrates a previously unappreciated critical role of CD8(+) Foxp3(+) T cells in controlling potentially dangerous T cells and in the maintenance of intestinal homeostasis.     

The Western model of integrative oncology — the contribution of Chinese medicine

<正>Western integrative oncology(IO) combines conventional mainstream medicine with complementary and alternative medicine(CAM) for the care of cancer patients.Since it includes patient orientation and the holistic approach of many CAM options,IO offers not only preventive measures,but also a wide spectrum of treatment modalities for all stages of illness,from the acute phases through the rehabilitation period.Many therapeutic methods of IO are supported by scientific evidence,for example,dietary and nutritional counseling,exercise,and mind-body medicine,among others.IO also includes therapeutic interventions of traditional Chinese medicine(TCM).At present acupuncture,qigong,and foot massage play an important role in the Western care of cancer patients.However,unlike in China, in Western countries herbal remedies are usually only used during those periods in which chemotherapy is not applied in order to avoid herb-drug interactions.Instead, acupuncture is widely used to manage the side-effects that often accompany chemotherapy.This paper focuses on the role of Chinese medicine in Western IO and reviews the scope and limitations of IO in the care of cancer patients today.The future challenges of IO will also be discussed in this paper.     

MR colonography without bowel purgation for the assessment of inflammatory bowel diseases: diagnostic accuracy and patient acceptance

BACKGROUND: The purpose of this pilot study was to assess the diagnostic accuracy of MR colonography (MRC) without bowel cleansing regarding its ability to quantify inflammatory bowel disease (IBD). In addition, patient acceptance was compared with conventional colonoscopy (CC). METHODS: In all, 29 patients with IBD (17 ulcerative colitis; 12 Crohn's disease) were included. While CC was performed after bowel cleansing as the gold standard, MRC was based on a fecal tagging technique and performed 48-72 hours prior to CC. The presence of inflammation in each of 7 ileocolonic segments was rated for every procedure. Patients evaluated both modalities and dedicated aspects of the examination according to a 10-point-scale (1 = good, 10 = poor acceptance). Furthermore, preferences for future examinations were investigated. RESULTS: Inflammatory segments were found by means of CC in 23 and by MRC in 14 patients. Overall sensitivity and specificity of MRC in a segment-based detection were 32% and 88%, respectively. Concerning severely inflamed segments, sensitivity increased to 53% for MRC. Overall acceptance of CC was significantly higher compared to MRC (mean value (mv) for MRT = 6.0; CC = 4.1; P = 0.003). For MRC, the placement of the rectal tube (mv = 7.3), and for CC bowel purgation (mv = 6.5), were rated as the most unpleasant. A total of 67% of patients voted for CC as the favorable tool for future examinations. CONCLUSIONS: The presented data indicate that 'fecal tagging MRC' is not suitable for an adequate quantification of inflammatory diseases of the large bowel. Furthermore, overall acceptance of endoscopic colonoscopy was superior to MRC.