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(GIST OF SCIENCE REPORTER) Anti-inflammatory Activity of Medicinal Plants

[April-2022]

The spontaneous defense response of a human body tissue to any kind of injury is ‘inflammation’. Inflammation is also the body’s defense response to stimuli such as allergens. The primary indicators of inflammation are redness, pain, warmth, stiffness, and swelling.
Conventional treatment for controlling and suppressing inflammations includes Steroidal Anti-inflammatory Drugs (SAIDs), Nonsteroidal Anti-inflammatory Drugs (NSAIDs), and immunosuppressants.
However, long-term usage of these medications is often associated with undesirable side effects, which include gastrointestinal lesions, cardiovascular complications, liver damage, and renal failure.
Some plants also synthesise a wide variety of phytochemicals that have been shown to impart anti-inflammatory activity.

Turmeric (Curcuma longa)

Several clinical trials have shown the anti-inflammatory action of turmeric. The bioactive compound responsible for this effect is the yellow-coloured component curcumin. Clinical studies suggest that curcumin is as effective as phenylbutazone in treating inflammation of rheumatoid arthritis and reducing joint swelling and morning stiffness.
The effectiveness of curcumin has been reported in patients with gastric ulcers and irritable bowel syndrome treatment. Curcumin is also shown to be beneficial in ameliorating ulcerative colitis and psoriasis.

Ginger (Zingiber officinale)

Ginger extract has beneficial effects on inflammatory disorders, depending on the quantity of consumption. In mice it has been shown to elevate the tumour necrosis factor in peritoneal cells; long-term consumption of ginger extract is found to reduce proinflammatory markers.
Treatment with ginger extract in type 2 diabetic patients for two months reduced serum level of TNF- and high-sensitivity C-reactive Protein (hs-CRP). Ginger is reported to be efficacious in patients with osteoarthritis, the relief in pain being comparable to Diclofenac (100 mg).
The anti-inflammatory efficacy of ginger extract was also comparable to Ibuprofen and Indomethacin in Osteoarthritis patients. Ginger powder also showed an ameliorative effect in musculoskeletal and rheumatism patients.

Borage (Borago officinalis)

The anti-inflammatory effect of borage oil in rheumatoid arthritis is established. Borage plant is known to elevate prostaglandin levels by virtue of its high (25%) gamma-linoleic acid (GLA). Anti Rheumatoid arthritis potential of borage seed oil was seen with 1.4 g and 2.8 g/day for 6 months in these patients. Similarly, the anti-inflammatory effect of borage oil has been observed in patients with atopic dermatitis in multiple clinical trials.

Evening Primrose (Oenothera biennis)

In addition to GLA, tetracosanol, and ferulic acid, which are the active components of evening primrose oil that suppress proinflammatory markers, this oil also has sterols such as -Sitosterol and Campesterol that have been shown to exert an effective anti-inflammatory effect. The effectiveness of evening primrose oil has been clinically assessed in multiple sclerosis (a chronic inflammatory disorder) patients. In rheumatoid arthritis patients, improvement of health, remission in morning stiffness, and reduction in the usage of NSAIDs has been observed.

Indian ginseng (Ashwagandha: Withania somnifera)

Withaferin A is the most widely distributed steroidal lactone present in the root extracts of Ashwagandha (Withania somnifera) and has been shown to inhibit inflammation in rheumatoid arthritis and osteoarthritis. It has been shown to slow down the progression of rheumatoid arthritis.

Devil’s Claw (Harpagophytum procumbens)

Root extract of Devil’s claw plant also has anti-inflammatory potency and has been found effective in osteoarthritis remission in clinical trials.

Stinging nettle (Urtica dioica)

Stinging nettle leaf (50 mg), when combined with NSAIDs (50 mg Diclofenac), has a synergistic anti-inflammatory effect in acute arthritis patients. Topically applied nettle
leaf was effective in osteoarthritis of thumb, with significant alleviation in pain, stiffness, and anti-inflammatory effect. Leaf extract of nettle leaf has also shown anti-inflammatory potential in allergic rhinitis.

Cat’s claw (Uncaria tomentosa)

The anti-inflammatory efficacy of the plant of Cat’s claw in osteoarthritis patients is indicated by significant remission of knee inflammation after 4 weeks. Twenty-four-week treatment with purified extract of Cat’s claw also alleviates pain, swelling, and tenderness of joints in Rheumatoid arthritis and respiratory inflammation.

Olibanum (Boswellia serrata)

Efficacy of Boswellia serrata extract has been shown in osteoarthritis patients as indicated by alleviation in the frequency of joint swelling and pain. Similarly, a significant reduction in morning stiffness and reduced dependence on NSAID has been observed in rheumatoid arthritis patients also. B.serrata treatment also ameliorated collagenous colitis, an Inflammatory Bowel Disease (IBD) in a clinical trial. The combination of B. serrata with turmeric has been effective in relieving symptoms of asthma in patients.

Dog rose (Rosa canina)

Treatment of osteoarthritis patients with R. canina plant’s seed has shown reduction in pain and stiffness and a significant reduction in CRP (an index of inflammation). The ethanol extract of Rosa canina fruit has also shown anti-inflammatory effects.

Rosemary (Rosmarinus officinalis)

Treatment with rosemary extract for 4 weeks in patients with osteoarthritis and rheumatoid arthritis produced a significant decrease in inflammation.
The anti-inflammatory potential of rosemary is also supported by its gastroprotective action better than Omeprazole against gastric ulcers. Topical application of rosemary is reported to be effective as an anti-inflammatory in wound healing in mice.

Sage (Salvia officinalis)

Anti-inflammatory activity of sage leaves is attributed to the diterpene components carnosol and carnosic acid. Chloroform extract of sage leaves has also shown anti-inflammatory effects in mice.

Indian gooseberry (Emblica officinalis)

Both fruits and leaves of Emblica are traditionally used in anti-inflammatory and antipyretic treatment in subtropical and tropical countries ─ China, India, Indonesia, and the Malay Peninsula.
Anti-inflammatory effect of the phenolic compounds from Emblica fruit has been seen in both acute and chronic inflammatory animal models.

Blackcurrant (Ribes nigrum)

Blackcurrant seed oil treatment for 6 weeks has been shown to reduce morning stiffness in Rheumatoid arthritis patients and treatment for 24 weeks resulted in a reduction of clinical symptoms of the disease.

Avocado (Persea americana/Glycine max.)

In Osteoarthritis patients treated with Avocado-soybean unsaponifiables along with NSAIDs, along with considerable reduction in pain and disability, around 50% reduction in NSAID requirement has been observed in a majority of patients.

Olive oil has been demonstrated to modulate the synthesis of compounds that participate in inflammation, and to reduce the risk of coronary heart disease in healthy individuals as well as in metabolic syndrome patients. Olive oil intake is also found to accelerate wound healing in burn wound patients.
Herbal medicines constitute an important component of complementary medicines. Although there are numerous studies on natural compounds and herbal medicines, the positive outcome is sometimes inconsistent due to limitations of the study design. Therefore, further evidence based studies and meta-analyses would perhaps generate more clear information on the anti-inflammatory potential of medicinal plants.