Recent Articles on Andrographis sp.

andrographis and diabetes

J Ethnopharmacol. 2006 Apr 21;105(1-2):196-200. Epub 2005 Nov 18.Click here to read Links

Anti-diabetic potentials of Momordica charantia and Andrographis paniculata and their effects on estrous cyclicity of alloxan-induced diabetic rats.

Thomas Jefferson University, Department of Neurosurgery, Farber Institute for Neurosciences, Philadelphia, Pennsylvania 19107, USA. bsr103@jefferson.edu

Momordica charantia and Andrographis paniculata are the commonly used herbs by the diabetic patients in Pampanga, Philippines. While the anti-diabetic potential of Momordica charantia is well established in streptozocin- or alloxan-induced diabetic animals, the anti-diabetic potential of Andrographis paniculata in alloxan-induced diabetic rat is not known. Neither the effects of these herbs on estrous cyclicity of alloxan-induced diabetic rats are elucidated. Thus, in these experiments, Momordica charantia fruit juice or Andrographis paniculata decoction was orally administered to alloxan-induced diabetic rats. Rats that were treated with Momordica charantia and Andrographis paniculata had higher body weight (BW) compared with diabetic positive control (P <>

PMID: 16298503 [PubMed - indexed for MEDLINE]

2: J Ethnopharmacol. 2004 Dec;95(2-3):205-8.Click here to read Links

Screening for antihyperglycaemic activity in several local herbs of Malaysia.

School of Bioscience and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600 Bangi, Selangor, Malaysia.

Screening of aqueous extract of Phyllantus niruri (PL), Zingiber zerumbet (ZG), Eurycoma longifolia (TA-a and TA-b) and Andrographis paniculata (AP) to determine their blood glucose lowering effect were conducted in normoglycaemic and Streptozotocin-induced hyperglycaemic rats. Significant reduction in blood glucose level at 52.90% was shown when hyperglycaemic rats were treated with 50 mg/kg body weight (BW) aqueous extract of AP. This effect is enhanced when freeze-dried material was used, where 6.25 mg/kg BW gave 61.81% reduction in blood glucose level. In the administration of TA-a and TA-b, positive results in hyperglyacaemic rats were only obtained when 150 mg/kg BW of the aqueous extract was used. No significant reduction in blood glucose level were shown in hyperglycaemic rats treated with PL and ZG at all concentrations used (50, 100 and 150 mg/kg BW). In normoglycaemic rats, no significant reduction was noted when all the same extracts were used.

PMID: 15507337 [PubMed - indexed for MEDLINE]

3: Planta Med. 2003 Dec;69(12):1075-9.Click here to read Links

Antihyperglycemic effect of andrographolide in streptozotocin-induced diabetic rats.

Department of Pharmacology, College of Medicine, National Cheng Kung University, Tainan City, Taiwan.

The antihyperglycemic action of andrographolide, an active principle in the leaves of Andrographis paniculata (Burm. f.) Nees, was investigated in streptozotocin-induced diabetic rats (STZ-diabetic rats). Oral treatment of andrographolide decreased the plasma glucose concentrations of STZ-diabetic rats in a dose-dependent manner. Similar treatment with andrographolide also decreased the plasma glucose in normal rats and the maximal effect was more marked than that in STZ-diabetic rats. Andrographolide at the effective dose (1.5 mg/kg) significantly attenuated the increase of plasma glucose induced by an intravenous glucose challenge test in normal rats. In the isolated soleus muscle of STZ-diabetic rats, andrographolide enhanced the uptake of radioactive glucose in a concentration-dependent manner. Moreover, the mRNA and protein levels of the subtype 4 form of the glucose transporter (GLUT4) in soleus muscle were increased after repeated intravenous administration of andrographolide in STZ-diabetic rats for 3 days. These results suggest that andrographolide can increase the glucose utilization to lower plasma glucose in diabetic rats lacking insulin.

PMID: 14750020 [PubMed - indexed for MEDLINE]

4: Acta Pharmacol Sin. 2000 Dec;21(12):1157-64.Links

Anti-diabetic property of ethanolic extract of Andrographis paniculata in streptozotocin-diabetic rats.

Department of Pharmacology, Faculty of Medicine, National University of Singapore, Singapore 117597, Singapore.

AIM: To investigate the anti-diabetic effect of a crude ethanolic extract of Andrographis paniculata in normal and streptozotocin (STZ)-induced diabetic rats. METHODS & RESULTS: Oral administration of the extract at different doses (0.1, 0.2, and 0.4 g/body weight) significantly reduced the fasting serum glucose level in STZ-diabetic rats compared to the vehicle (distilled water), but not in normal rats. This effect was dose-dependent. A similar result was seen with metformin (0.5 g/body weight). In the glucose tolerance test, an oral administration of the extract at the same doses suppressed the elevated glucose level in normal and diabetic rats, as did metformin. The effects were also dose-respondent. In the long-term experiment, the extract (0.4 g/body weight), metformin (0.5 g/body weight), and vehicle were given twice daily to diabetic rats for 14 d. On d 15, fasting serum glucose levels were found to be significantly lower in the extract- and metformin-treated groups (P <>

PMID: 11603293 [PubMed - indexed for MEDLINE]

5: Clin Exp Pharmacol Physiol. 2000 May-Jun;27(5-6):358-63.Click here to read Links

Antihyperglycaemic and anti-oxidant properties of Andrographis paniculata in normal and diabetic rats.

Department of Pharmacology, Faculty of Medicine, National University of Singapore, Singapore.

1. Oxidative stress is believed to be a pathogenetic factor in the development of diabetic complications. In the present study, we investigated the ethanolic extract of the aerial parts of Andrographis paniculata for antihyperglycaemic and anti-oxidant effects in normal and streptozotocin-induced type I diabetic rats. 2. Normal and diabetic rats were randomly divided into groups and treated orally by gavage with vehicle (distilled water), metformin (500 mg/kg bodyweight) or the extract (400 mg/kg bodyweight), twice a day for 14 days. 3. At the end of the 14 day period, the extract, like metformin, significantly increased bodyweight (P <>

PMID: 10831236 [PubMed - indexed for MEDLINE]

Andrographis paniculata and Swertia chirata

Both in Ayurveda and Unani, Andrographis paniculata is confused with 'Chitetta' (Swertia chirata), but both are different plants.



Swertia Chirata

Botanical Name : SWERTIA CHIRATA



Family Name : GENTIANACEAE



Common Name : CLEARING NUT TREE, BITTER STICK, CHIRETTE INDIEN, DOWA I PECHISH,INDIAN GENTIAN,



Part Used : Seeds



Habitat : Found in the temperate Himalayas at altitudes of 1,200-3,000 m. from Kashmir to Bhutan and in the Khasi hills in Meghalaya at 1,200-1,500 m.



Uses : According to Ayurveda, this herb is a bitter tonic, stomachic. It is useful in liver disorders, eyes, heart. A strongly bitter tonic it is an excellent remedy for a weak stomach, especially when this gives rise to nausea, indigestion and bloating and it has also been shown to protect the liver.



It is best known as the main ingredient in Mahasudarshana churna, a remedy containing more than 50 herbs. It also contains xanthones which are reputedly effective against malaria and tuberculosis, and also amarogentin, a glycoside that may protect the liver against carbon tetrachloride poisoning.



The whole plant is an exthis herb is an excellent drug for intermittent fevers, skin diseases intestinal worms, bronchial asthma, burning of the body, regulating the bowels.



Chiretta, or chirayta, consists of the dried plant, Swertia Chirata, Buch.-Ham. (N.O. Gentianeae), an erect annual herb, indigenous to the mountainous districts of Northern India. The drug is also official in the U.S.P. When the flowering is well advanced the entire plant is collected, dried, and packed into bundles, which are sometimes compressed before exportation. The drug consists chiefly of the stem, which is of a dark purplish-brown colour, quite glabrous, and contains a large continuous pith. In the upper part it branches freely, bearing numerous fruits and flowers, together with a few opposite leaves with prominent curving lateral veins. The fruits are bicarpellary but unilocular, and contain numerous minute brownish seeds. The root is short, stout, and oblique. All parts of the drug have an intensely bitter taste. Various other species of Swertia (e.g., S. angustifolia, Buch.-Ham. (more); S. alata, Royle (more); S. trichotoma, Wall. (more)) have been found mixed with or substituted for chiretta. From these the genuine drug may be distinguished by its dark colour, intensely bitter taste, and continuous pith. Andrographis Paniculata, Nees (more), which has been offered as chiretta, has dark green stems with numerous slender erect opposite branches, few lanceolate green leaves, and a fibrous root. The roots of Rubia cordifolia, Linn. (more), are also occasionally mixed with chiretta; they are readily distinguished by their purple colour.



Constituents.—The plant contains the two bitter principles, ophelic acid and chiratin. The latter occurs in the larger proportion, and yields, by boiling with hydrochloric acid, chiratogenin and ophelic acid, but no sugar. Neither ophelic acid nor chiratin has been obtained in crystals.



Action and Uses.—Chiretta owes its action to its bitterness; it is used in dyspepsia to improve the appetite. At one time it was believed to exert a specific action upon the liver, but there is no evidence to confirm this. It is usually administered in the form of infusion. The preparations of chiretta are without tannin, and may, therefore, be prescribed with iron. Chiretta and kreat (Andrographis) are active ingredients of many advertised bitters. Chiratin has been used in powder form, diluted with milk sugar, but the liquid preparations of chiretta are usually preferred.

andrographis clinical trials

1: Explore (NY). 2006 Jan;2(1):25-9. Links

Andrographis paniculata for the treatment of upper respiratory infection: a systematic review by the natural standard research collaboration.

Continuum Center for Health and Healing, New York, NY, USA. bkligler@bethisraelny.org

PMID: 16781605 [PubMed - indexed for MEDLINE]

2: Am J Health Syst Pharm. 2006 Jan 1;63(1):33-9.Click here to read Links

Complementary and alternative medicine for upper-respiratory-tract infection in children.

College of Pharmacy, The Ohio State University, Columbus, OH 43210-1291, USA.

PURPOSE: Evidence on the efficacy and safety of complementary and alternative medicine (CAM) for the prevention and treatment of upper-respiratory-tract infection (URTI) in children is reviewed. SUMMARY: A search of the literature to June 2005 identified six clinical trials examining the use of herbal medicines and nine trials of other CAM therapies. All articles were critically evaluated for adherence to standards of efficacy and safety research. Echinacea did not reduce the duration and severity of URTI. Andrographis paniculata or echinacea decreased nasal secretions (p < p =" 0.008)." p =" 0.04)" p =" 0.03)">

PMID: 16373463 [PubMed - indexed for MEDLINE]

3: Phytomedicine. 2005 Jun;12(6-7):403-9. Links

A phase I clinical study of Andrographis paniculata fixed combination Kan Jang versus ginseng and valerian on the semen quality of healthy male subjects.

Republican Medical Scientific Centre of Dermatology and Diseases Disseminated by Sexual Contacts, Yerevan, Armenia.

The safety of different doses of Kan Jang--a fixed combination of Andrographis paniculata special extract (SHA-10) and Acanthopanax senticosus--compared to two extensively used medicinal plants, Valeriana officinalis and Panax ginseng in the form of standardized extracts, has been examined. A phase I clinical study was designed to evaluate the effect on semen quality of healthy males in terms of spermatogenesis and quality of semen. The results of the study revealed no significant negative effect of Kan Jang on male semen quality and fertility, but rather a positive trend with respect to the number of spermatozoids in the whole ejaculate, the percentage of active (normokinetic) forms of spermatozoids, and fertility indexes, together with a decrease in the percentage of inactive (diskinetic) forms of spermatozoids. In the group receiving ginseng, no significant negative effects on the fertility parameters were revealed and there was a clear decrease in the percentage of diskinetic forms of spermatozoids. Subjects receiving valerian showed a temporary increase in the percentage of normokinetic spermatozoids and a decrease in diskinetic forms, but these changes had no effect on fertility indices. The results indicate that Kan Jang, ginseng and valerian are safe with respect to effects on human male sterility when administered at dose levels corresponding to approximately 3 times the human daily dose.

PMID: 16008115 [PubMed - indexed for MEDLINE]

4: J Herb Pharmacother. 2003;3(1):77-93. Links

A randomized, controlled study of Kan Jang versus amantadine in the treatment of influenza in Volgograd.

Volgograd Outpatient Clinic, Department of Outpatient Therapy.

Two randomized, parallel-group clinical studies with a verum and a control group were performed to investigate the effect of a standardized extract (SHA-10) of Andrographis panaiculata (N.) fixed combination Kan Jang in the treatment of diagnosed influenza viral infection. The pilot study was performed on 540 patients with 71 Kan Jang-treated patients with the second phase conducted enrolling 66 patients. The differences in the duration of sick leave and frequency of post-influenza complications indicate that the Kan Jang phytopreparation not only contributes to quicker recovery, but also reduces the risk of post-influenza complications. Kan Jang was well tolerated by patients.

PMID: 15277072 [PubMed]

5: Planta Med. 2004 Apr;70(4):293-8.Click here to read Links

Andrographis paniculata in the treatment of upper respiratory tract infections: a systematic review of safety and efficacy.

Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, Exeter, UK. Jo.Thompson-Coon@pms.ac.uk

Acute respiratory infections represent a significant cause of over-prescription of antibiotics and are one of the major reasons for absence from work. The leaves of Andrographis paniculata (Burm. f.) Wall ex Nees (Acanthaceae) are used as a medicinal herb in the treatment of infectious diseases. Systematic literature searches were conducted in six computerised databases and the reference lists of all papers located were checked for further relevant publications. Information was also requested from manufacturers, the spontaneous reporting schemes of the World Health Organisation and national drug safety bodies. No language restrictions were imposed. Seven double-blind, controlled trials (n = 896) met the inclusion criteria for evaluation of efficacy. All trials scored at least three, out of a maximum of five, for methodological quality on the Jadad scale. Collectively, the data suggest that A. paniculata is superior to placebo in alleviating the subjective symptoms of uncomplicated upper respiratory tract infection. There is also preliminary evidence of a preventative effect. Adverse events reported following administration of A. paniculata were generally mild and infrequent. There were few spontaneous reports of adverse events. A. paniculata may be a safe and efficacious treatment for the relief of symptoms of uncomplicated upper respiratory tract infection; more research is warranted.

PMID: 15095142 [PubMed - indexed for MEDLINE]

6: Phytother Res. 2004 Jan;18(1):47-53.Click here to read Links

Comparative controlled study of Andrographis paniculata fixed combination, Kan Jang and an Echinacea preparation as adjuvant, in the treatment of uncomplicated respiratory disease in children.

Research Institute of Pharmacology of Volgograd Medical Academy, Volgograd, Russia.

A three-arm study comparing the efficacy of Kan Jang, a fixed herbal combination containing standardized Andrographis paniculata (N.) SHA-10 extract, with Immunal, a preparation containing Echinacea purpurea (L.) extract, in uncomplicated common colds was carried out in 130 children aged between 4 and 11 years over a period of 10 days. The study was designed as an adjuvant treatment of Kan Jang and Immunal with a standard treatment. The patients were assigned to one of the three groups. In control group C; 39 patients received only standard treatment. Kan Jang and Immunal were used as an adjuvant to this therapy in the other two groups. Adjuvant group A; 53 patients treated with Kan Jang tablets concomitant to standard treatment, and adjuvant control group B; 41 patients treated with concomitant Immunal. It was found that the adjuvant treatment with Kan Jang, was significantly more effective than Immunal, when started at an early stage of uncomplicated common colds. The symptoms of the disease were less severe in the Kan Jang group. The effect of Kan Jang was particularly pronounced in two objective parameters, amount of nasal secretion g/day and nasal congestion. Kan Jang also accelerated the recovery time, whereas Immunal did not show the same efficacy. The use of standard medication was significantly less in the Kan Jang adjuvant group than in either the Immunal or standard treatment group. Kan Jang treatment was well tolerated and no side effects or adverse reactions were reported. Copyright 2004 John Wiley & Sons, Ltd.

PMID: 14750201 [PubMed - indexed for MEDLINE]

7: J Clin Pharm Ther. 2004 Feb;29(1):37-45.Click here to read Links

Andrographis paniculata in the symptomatic treatment of uncomplicated upper respiratory tract infection: systematic review of randomized controlled trials.

Department of Pharmacy, Faculty of Pharmacy, Silpakorn University, Nakhon-Pathom, Thailand. nalinee@email.pharm.su.ac.th

OBJECTIVE: To assess the efficacy of Andrographis paniculata in the symptomatic treatment of uncomplicated upper respiratory tract infection. METHODS: Systematic review of the literature and meta-analysis of randomized controlled trials. Mean difference in the reduction in symptom severity scores between treatment and control groups was calculated to obtain an overall estimate of effect. RESULTS: Four studies met our inclusion criteria and were reviewed. A total of 433 patients reported in three trials were included in the statistical analysis. Andrographis paniculata fixed combination with Acanthopanax senticosus was more effective than placebo. The mean difference was 2.13 points (95% CI 1.00-3.26 points, P=0.0002) on the symptom severity score. The difference in effects between A. paniculata and placebo was 10.85 points (95% CI 10.36-11.34 points, P<0.0001)>

PMID: 14748896 [PubMed - indexed for MEDLINE]

8: Vestn Otorinolaringol. 2003;(3):48-50. Links

[Effectiveness of using the drug Kan-Yang in children with acute respiratory viral infection (clinico-functional data)]

[Article in Russian]

A randomized trial of the effectiveness of the preparation Kan-Yang (Sweden) consisting of andrographis and eleutherococcus extracts was performed in 53 children with acute respiratory viral infection (ARVI). 40 ARVI children given conventional treatment served control. It is shown that in early acute noncomplicated respiratory disease Kan-Yang tablets relieves considerably the treatment course and promoted cure in good tolerance.

PMID: 12847809 [PubMed - indexed for MEDLINE]

9: Phytomedicine. 2003 May;10(4):271-85. Links

Double-blind, placebo-controlled, randomized, pilot clinical trial of ImmunoGuard--a standardized fixed combination of Andrographis paniculata Nees, with Eleutherococcus senticosus Maxim, Schizandra chinensis Bail. and Glycyrrhiza glabra L. extracts in patients with Familial Mediterranean Fever.

Republican Children's FMF Center, Yerevan State Medical University, Yerevan, Armenia.

Double blind, randomized, placebo controlled pilot study of ImmunoGuard--a standardized fixed combination of Andrographis paniculata Nees., Eleutherococcus senticosus Maxim., Schizandra chinensis Bail., and Glycyrrhiza glabra L. special extracts standardized for the content of Andrographolide (4 mg/tablet), Eleuteroside E, Schisandrins and Glycyrrhizin, was carried out in two parallel groups of patients. The study was conducted in 24 (3-15 years of both genders) patients with Familial Mediterranean Fever (FMF), 14 were treated with tablets of series A (verum) and 10 patients received series B product (placebo). The study medication was taken three times of four tablets daily for 1 month. Daily dose of the andrographolide--48 mg. The primary outcome measures in physician's evaluation were related to duration, frequency and severity of attacks in FMF patients (attacks characteristics score). The patient's self-evaluation was based mainly on symptoms--abdominal, chest pains, temperature, arthritis, myalgia, erysipelas-like erythema. All of 3 features (duration, frequency, severity of attacks) showed significant improvement in the verum group as compared with the placebo. In both clinical and self evaluation the severity of attacks was found to show the most significant improvement in the verum group. Both the clinical and laboratory results of the present phase II (pilot) clinical study suggest that ImmunoGuard is a safe and efficacious herbal drug for the management of patients with FMF.

PMID: 12809357 [PubMed - indexed for MEDLINE]

10: Phytomedicine. 2002 Oct;9(7):589-97. Links

A double blind, placebo-controlled study of Andrographis paniculata fixed combination Kan Jang in the treatment of acute upper respiratory tract infections including sinusitis.

Erebuni, Medical Centre, Yerevan, Armenia.

A double blind, placebo-controlled, parallel-group clinical study was carried out to evaluate the effect of an Andrographis paniculata (N.) extract SHA-10 fixed combination, Kan Jang, in the treatment of acute upper respiratory tract infections, including sinusitis. Ninety-five individuals in the treatment group and 90 individuals in the placebo group completed the study according to the protocol. The medication was taken for 5 days. Temperature, headache, muscle aches, throat symptoms, cough, nasal symptoms, general malaise and eye symptoms were taken as outcome measures with given scores. The total score analysis showed a highly significant improvement in the verum group versus the placebo. This result applied to the group as a whole and to the sinusitis subgroups. The individual symptoms of headache and nasal and throat symptoms together with general malaise showed the most significant improvement while cough and eye symptoms did not differ significantly between the groups. Temperature was moderately reduced in the verum group. It can be concluded that Kan Jang has a positive effect in the treatment of acute upper respiratory tract infections and also relieves the inflammatory symptoms of sinusitis. The study drug was well tolerated.

PMID: 12487322 [PubMed - indexed for MEDLINE]

11: Prim Care. 2002 Jun;29(2):231-61. Links

Respiratory and allergic diseases: from upper respiratory tract infections to asthma.

Division of Wellness and Chronic Illness, Department of Family Medicine, University Hospital and Medical Center, Health Sciences Center, State University of New York at Stony Brook, Stony Brook, NY 11794-8461, USA. rjaber@notes.cc.sunysb.edu

Patients with asthma and allergic rhinitis may benefit from hydration and a diet low in sodium, omega-6 fatty acids, and transfatty acids, but high in omega-3 fatty acids (i.e., fish, almonds, walnuts, pumpkin, and flax seeds), onions, and fruits and vegetables (at least five servings a day). Physicians may need to be more cautious when prescribing antibiotics to children in their first year of life when they are born to families with a history of atopy. More research is needed to establish whether supplementation with probiotics (lactobacillus and bifidobacterium) during the first year of life or after antibiotic use decreases the risk of developing asthma and allergic rhinitis. Despite a theoretic basis for the use of vitamin C supplements in asthmatic patients, the evidence is still equivocal, and long-term studies are needed. The evidence is stronger for exercise-induced asthma, in which the use of vitamin C supplementation at a dosage of 1 to 2 g per day may be helpful. It is also possible that fish oil supplements, administered in a dosage of 1 to 1.2 g of EPA and DHA per day, also may be helpful to some patients with asthma. Long-term studies of fish oil and vitamin C are needed for more definite answers. For the patient interested in incorporating nutritional approaches, vitamin C and fish oils have a safe profile. However, aspirin-sensitive individuals should avoid fish oils, and red blood cell magnesium levels may help in making the decision whether to use additional magnesium supplements. Combination herbal formulas should be used in the treatment of asthma with medical supervision and in collaboration with an experienced herbalist or practitioner of TCM. Safe herbs, such as Boswellia and gingko, may be used singly as adjuncts to a comprehensive plan of care if the patient and practitioner have an interest in trying them while staying alert for drug-herb interactions. No data on the long-term use of these single herbs in asthma exist. For the motivated patient, mind-body interventions such as yoga, hypnosis, and biofeedback-assisted relaxation and breathing exercises are beneficial for stress reduction in general and may be helpful in further controlling asthma. Encouraging parents to learn how to massage their asthmatic children may appeal to some parents and provide benefits for parents and children alike. Acupuncture and chiropractic treatment cannot be recommended at this time, although some patients may derive benefit because of the placebo effect. For patients with allergic rhinitis, there are no good clinical research data on the use of quercetin and vitamin C. Similarly, freeze-dried stinging nettle leaves may be tried, but the applicable research evidence also is poor. Further studies are needed to assess the efficacy of these supplements and herbs. Homeopathic remedies based on extreme dilutions of the allergen may be beneficial in allergic rhinitis but require collaboration with an experienced homeopath. There are no research data on constitutional homeopathic approaches to asthma and allergic rhinitis. Patients with COPD are helped by exercise, pulmonary rehabilitation, and increased caloric protein and fat intake. Vitamin C and n-3 supplements are safe and reasonable; however, studies are needed to establish their efficacy in COPD. On the other hand, there are convincing data in favor of N-acetyl-cysteine supplementation for the patient with COPD at doses ranging between 400 and 1200 mg daily. Red blood cell magnesium levels may guide the use of magnesium replacement. The use of L-carnitine and coenzyme Q10 in patients with COPD needs further study. The addition of essential oils to the dietary regimen of patients with chronic bronchitis is worth exploring. Patients with upper respiratory tract infections can expect a shorter duration of symptoms by taking high doses of vitamin C (2 g) with zinc supplements, preferably the nasal zinc gel, at the onset of their symptoms. Adding an herb such as echinacea or Andrographis shortens the duration of the common cold. The one study on Elderberry's use for the flu was encouraging, and the data on the homeopathic remedy Oscillococcinum interesting, but more studies should be performed. Saline washes may be helpful to patients with allergic rhinitis and chronic sinusitis. Patients also may try the German combination (available in the United States) of elderberry, vervain, gentian, primrose, and sorrel that has been tested in randomized clinical trials. Bromelain is safe to try; the trials of bromelain supplementation were promising but were never repeated. The preceding suggestions need to be grounded in a program based on optimal medical management. Patients need to be well educated in the proper medical management of their disease and skilled at monitoring disease stability and progress. Asthmatic patients need to monitor their bronchodilator usage and peak flow meter measurements to step up their medical treatment in a timely manner, if needed. Patients welcome physician guidance when exploring the breadth of treatments available today. A true patient-physician partnership is always empowering to patients who are serious about regaining their function and health.

PMID: 12391710 [PubMed - indexed for MEDLINE]

12: Drug Deliv. 2000 Oct-Dec;7(4):209-13. Links

Targeting of liposomal andrographolide to L. donovani-infected macrophages in vivo.

Biomembrane and Medicinal Chemistry Division, Indian Institute of Chemical Biology, Calcutta.

Despite the rapid development in medicinal and pharmaceutical technology, the targeting of drugs to phagocytic cells in macrophage-related diseases still remains a major unsolved problem. By using the mannosyl-fucosyl receptors on macrophages, attempts were made to target antileishmanial drugs encapsulated in mannosylated or fucosylated liposomes to treat experimental leishmaniasis in the hamster model. Mannosylated liposomes were found to be more potent in delivering antileishmanial drugs to phagocytic cells. Liposomes loaded with an indigenous drug, andrographolide, a labdane diterpenoid isolated from Indian medicinal plant Andrographis paniculata, were prepared and tested against experimental leishmaniasis in a hamster model. Mannosylated liposomes loaded with the drug were found to be most potent in reducing the parasitic burden in the spleen as well as in reducing the hepatic and renal toxicity. In addition, mannosylated drug-loaded liposome-treated animals showed a normal blood picture and splenic tissue histoarchitecture when compared with those treated with free drug or regular liposomal drug. Such a drug-vehicle formulation may be considered for clinical trials.

PMID: 11195427 [PubMed - indexed for MEDLINE]

13: Phytomedicine. 2000 Oct;7(5):341-50. Links

Double-blind, placebo-controlled pilot and phase III study of activity of standardized Andrographis paniculata Herba Nees extract fixed combination (Kan jang) in the treatment of uncomplicated upper-respiratory tract infection.

Hallehalsan, Clinic, Ulricehamn, Sweden. jan.melchior@swipnet.se

Two randomized double-blind, placebo-controlled parallel group clinical trials were performed to investigate the effect of a standardized extract (SHA-10) of Andrographis paniculata fixed combination (Kan jang) in the treatment of uncomplicated upper-respiratory tract infections. 46 patients in the pilot study and 179 patients in the phase III study completed the study according to the protocol. Medication was taken three times daily for a minimum of 3 days and a maximum of 8 days for the pilot study, and for exactly three days in the phase III study. The primary outcome measures in the patients self-evaluation were: related to pain in the muscle, cough, throat symptoms, headache, nasal symptoms and eye symptoms and temperature. The physician's fixed score diagnosis was based mainly on sign/symptoms: ears, nose, oral cavity, lymph glands-tonsils and eyes. The total symptom score showed a tendency toward improvement in the pilot study (p = 0,08), while both the total symptom score and total diagnosis score showed highly significant improvement (p < or =" 0.0006">

PMID: 11081985 [PubMed - indexed for MEDLINE]

14: Phytother Res. 2000 Aug;14(5):333-8.Click here to read Links

A phase I trial of andrographolide in HIV positive patients and normal volunteers.

Bastyr University Research Institute, Bastyr University, Washington 98028, USA. carlo@bastyr.edu

A phase I dose-escalating clinical trial of andrographolide from Andrographis paniculata was conducted in 13 HIV positive patients and five HIV uninfected, healthy volunteers. The objectives were primarily to assess safety and tolerability and secondarily to assess effects on plasma virion HIV-1 RNA levels and CD4(+) lymphocyte levels. No subjects used antiretroviral medications during the trial. Those with liver or renal abnormalities were excluded. The planned regimen was 5 mg/kg bodyweight for 3 weeks, escalating to 10 mg/kg bodyweight for 3 weeks, and to 20 mg/kg bodyweight for a final 3 weeks. The trial was interrupted at 6 weeks due to adverse events including an anaphylactic reaction in one patient. All adverse events had resolved by the end of observation. A significant rise in the mean CD4(+) lymphocyte level of HIV subjects occurred after administration of 10 mg/kg andrographolide (from a baseline of 405 cells/mm(3) to 501 cells/mm(3); p = 0.002). There were no statistically significant changes in mean plasma HIV-1 RNA levels throughout the trial. Andrographolide may inhibit HIV-induced cell cycle dysregulation, leading to a rise in CD4(+) lymphocyte levels in HIV-1 infected individuals. Copyright 2000 John Wiley & Sons, Ltd.

PMID: 10925397 [PubMed - indexed for MEDLINE]

15: Phytomedicine. 1999 Oct;6(4):217-23. Links

Use of visual analogue scale measurements (VAS) to asses the effectiveness of standardized Andrographis paniculata extract SHA-10 in reducing the symptoms of common cold. A randomized double blind-placebo study.

Facultad de Medicina, Universidad de Chile, Santiago, Chile.

The objective of our study was to measure the effectiveness of Andrographis paniculata SHA-10 extract in reducing the prevalence and intensity of symptoms and signs of common cold as compared with a placebo. A group of 158 adult patients of both sexes completed the randomized double blind study in Valdivia, Chile. The patients were divided in two equal size groups, one of which received Andrographis paniculata dried extract (1200 mg/day) and the other a placebo during a period of 5 days. Evaluations for efficacy were performed by the patient at day 0, 2, and 4 of the treatment; each completed a self-evaluation (VAS) sheet with the following parameters: headache, tiredness, earache, sleeplessness, sore throat, nasal secretion, phlegm, frequency and intensity of cough. In order to quantify the magnitude of the reduction in the prevalence and intensity of the signs and symptoms of common cold, the risk (Odds Ratio = OR) was calculated using a logistic regression model. At day 2 of treatment a significant decrease in the intensity of the symptoms of tiredness (OR = 1.28; 95% CI 1.07-1.53), sleeplessness (OR = 1.71; 95% CI 1.38-2.11), sore throat (OR = 2.3; 95% CI 1.69-3.14) and nasal secretion (OR = 2.51; 95% CI 1.82-3.46) was observed in the Andrographis SHA-10 group as compared with the placebo group. At day 4, a significant decrease in the intensity of all symptoms was observed for the Andrographis paniculata group. The higher OR values were for the following parameters: sore throat (OR = 3.59; 95% CI 2.04-5.35), nasal secretion (OR = 3.27; 95% CI 2.31-4.62) and earache (OR = 3.11; 95% CI 2.01-4.80) for Andrographis paniculata treatment over placebo, respectively. It is concluded that Andrographis paniculata had a high degree of effectiveness in reducing the prevalence and intensity of the symptoms in uncomplicated common cold beginning at day two of treatment. No adverse effects were observed or reported.

PMID: 10589439 [PubMed - indexed for MEDLINE]

16: J Med Assoc Thai. 1991 Oct;74(10):437-42. Links

Efficacy of Andrographis paniculata, Nees for pharyngotonsillitis in adults.

Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok.

One hundred and fifty-two adult patients with pharyngotonsillitis were enrolled in the randomized double blind study to assess the efficacy of Andrographis paniculata. The patients were randomized to receive either paracetamol or 3 g/day of Andrographis paniculata or 6 g/day of Andrographis paniculata for 7 days. The baseline characteristics of the patients among the three groups were not different. The efficacy of paracetamol or high dose Andrographis paniculata was significantly more than that of low dose Andrographis paniculata at day 3 in terms of the relief of fever and sore throat. The clinical effects were not different at day 7. Minimal and self limiting side effects were found in about 20 per cent in each group.

PMID: 1797953 [PubMed - indexed for MEDLINE]

17: J Med Assoc Thai. 1990 Jun;73(6):299-304. Links

Undetectable anti-bacterial activity of Andrographis paniculata (Burma) wall. ex ness.

Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok.

Andrographis paniculata (Burma) Wall. ex Ness (AP) is a herbal medicine and has been used for therapy of upper respiratory tract infection (URI) as well as acute diarrhea with reported efficacy of 75-100 per cent. To investigate whether anti-bacterial activity was responsible for the reported therapeutic success of AP, we carried out a number of studies. The first study was a direct assay of anti-bacterial activity of AP suspended in water. The tested pathogens included Salmonella, Shigella, E.coli, gr. A Streptococci and S.aureus. Anti-bacterial activity was not demonstrable even in a solution containing 25,000 mg per litre of crude powder. The second was designed to detect serum bactericidal activity after oral intake of stem and leaves of AP. Ten healthy volunteers were enrolled in the study. They received a single oral dose of AP (1, 2, 3 and 6 g) in a randomized, cross-over manner. The washout period was one week. Blood samples were taken at 0, 1, 2, 4, 8 and 24 hours after ingestion. Serum bactericidal activity was assayed by agar diffusion technique using Bacillus spores and five strains of each pathogen (Shigella, Salmonella typhi, S.aureus and gr. A Streptococci) incubated for 24 hours. Again serum bactericidal activity was not detected in any of the sera tested. In a third study, ninety-six rats were daily fed with high doses of AP ranging 0.12-24 g per kg body wt. for six months before sacrifice. Antibacterial activity was still undetectable when lung parenchyma and liver tissue was placed on culture media containing bacteria tested. In conclusion, anti-bacterial activity of AP is undetectable in our study.

PMID: 2230623 [PubMed - indexed for MEDLINE]