AYU (An International Quarterly Journal of Research in Ayurveda)

PHARMACOLOGICAL STUDY
Year
: 2015  |  Volume : 36  |  Issue : 4  |  Page : 421--424

In vitro thrombolytic activity of Dhamasa (Fagonia arabica Linn.), Kushta (Saussurea lappa Decne.), and Guduchi (Tinospora cordifolia Thunb.)


Shweta Chaudhary1, Pawan Kumar Godatwar2, Reetu Sharma2,  
1 Lecturer, Department of Roga Nidana and Vikriti Vijnana, Aligarh Unani and Ayurvedic Medical College, Aligarh, UP, India
2 Department of Roga Nidana and Vikriti Vigyan, National Institute of Ayurveda, Jaipur, Rajasthan, India

Correspondence Address:
Pawan Kumar Godatwar
Department of Roga and Vikriti Vigyan, National Institute of Ayurveda, Madhav Vilas Palace, Amer Road, Jaipur - 302 002, Rajasthan
India

Abstract

Introduction: Thrombotic disorders are among the major fatal conditions affecting the society. Treatment modalities used for such disorders are either surgical interventions or use of drugs such as urokinase, streptokinase (SK), or tissue plasminogen activators to dissolve the blood clots. These modalities have their own limitations and side effects apart from being expensive. There is a need for safer and cost effective antithrombolytic agents. Aim: To evaluate in vitro thrombolytic property of Dhamasa (Fagonia arabica Linn.), Kushta (Saussurea lappa Decne.), and Guduchi (Tinospora cordifolia Thunb.) plant extract. Materials and Methods: Venous blood drawn from 20 healthy volunteers was allowed to form clots which was weighed and treated with the extract of test plant materials to disrupt the clots. Weight of clot after and before treatment provided a percentage of clot lysis. SK was used as a positive and water as a negative control. Statistical Analysis Used: The significance between % clot lysis of five groups by means of weight difference was tested by the one-way ANOVA. Results: Clot lysis observed were 68.06%, 14.85%, 25.01%, 92.54%, and 3.00% for Dhamasa, Kushta, Guduchi, SK, and distilled water, respectively. Conclusion: Herbal extracts possess thrombolytic properties and lyse blood clots in vitro.



How to cite this article:
Chaudhary S, Godatwar PK, Sharma R. In vitro thrombolytic activity of Dhamasa (Fagonia arabica Linn.), Kushta (Saussurea lappa Decne.), and Guduchi (Tinospora cordifolia Thunb.).AYU 2015;36:421-424


How to cite this URL:
Chaudhary S, Godatwar PK, Sharma R. In vitro thrombolytic activity of Dhamasa (Fagonia arabica Linn.), Kushta (Saussurea lappa Decne.), and Guduchi (Tinospora cordifolia Thunb.). AYU [serial online] 2015 [cited 2022 Sep 24 ];36:421-424
Available from: https://www.ayujournal.org/text.asp?2015/36/4/421/190697


Full Text

 Introduction



Thrombosis is defined as “hemostasis in the wrong place,” and is a major cause of morbidity and mortality. Arterial thrombosis is a common cause of myocardial infarction, ischemic stroke, and limb gangrene whereas venous thrombosis leads to deep vein thrombosis which can be complicated by the post thrombotic syndrome, and pulmonary embolism, chronic thrombo-embolism, pulmonary hypertension.[1] Number of other condition that can arise according to the location of the thrombus and the organs affected. The major risk factors for such thrombotic disorders are acquired disorders of hyper-coagulation, others being the exogenous factors such as surgery, hospitalization, immobility, trauma, pregnancy and the puerperium, and endogenous factors such as cancer, obesity.[2]

Current treatment modalities of thrombotic disorders include surgical interventions or use of drugs such as alteplase, anistreplase, streptokinase (SK), urokinase, and tissue plasminogen activators.[3] These modalities are costly as well as have serious side-effects which may be life threatening such as intracranial haemorrhage,[4] spontaneous pulmonary haemorrhage,[5] and angioedema.[6] Moreover, these drugs are not used in patients who have undergone surgery or those with a history of nervous lesions, gastrointestinal bleeding, or hypertension.[7] There is a need for safer and cost effective anti-thrombolytic agents. In order to find the blood thinning agents this work was conceived as it is known that herbal products are often perceived as safe because they are “natural.”[8] This study aims to investigate the multiple solvent extracts of the three medicinal plants viz., Dhamasa (Fagonia arabica Linn.), Kushta (Saussurea lappa Decne.), and Guduchi (Tinospora cordifolia Thunb.) for their clot lysis (thrombolytic activity) by using thrombolytic in vitro model.

 Materials and Methods



The whole dry plant of Dhamasa, dry bark of Kushta, and dry stem of Guduchi were collected from the local market and were identified and authenticated by experts of the Department of Dravyaguna, National Institute of Ayurveda, Jaipur. The plants were cleaned, powdered and dried up in the hot air oven to remove the moisture content. The multiple solvent (methanol: Isopropyl alcohol: Acetone 100 ml each) extraction procedure was used to prepare extract by using Soxhlet apparatus. The extract was dried in the hot air oven and weighed to find out the percentage of extract formed from the dried powder.

About 100 mg of the extract thus formed was suspended in 10 ml distilled water (DW) and the suspension was shaken vigorously on a vortex mixer. The suspension was kept overnight and decanted to remove the soluble supernatant. Supernatant was filtered through a 0.22 µ syringe filter and was used to check clot lysis. An in vitro thrombolytic model was used to check the clot lysing effect of aforesaid three plants. SK was used as a positive control and DW as a negative control.

Clot lysis

Experiment for clot lysis was carried as reported earlier.[9] In brief, 2.5 ml venous blood drawn from healthy volunteers was distributed in five different pre-weighed sterile micro-centrifuge tubes (0.5 ml/tube) and incubated at 37°C for 45 min. After clot formation, serum was completely removed (aspirated out without disturbing the clot formed) and each tube having clot was again weighed to determine the clot weight (clot weight = weight of clot containing tube − weight of tube alone).

As a standard control, 100 μl of SK and as a non-thrombolytic control, 100 μl of DW along with 100 μl of each samples were separately added to the micro-centrifuge tubes. All the tubes were then incubated at 37°C for 90 min and observed for clot lysis. After incubation, fluid released was removed and tubes were again weighed to observe the difference in weight after clot disruption. Difference obtained in weight taken before and after clot lysis was expressed as percentage of clot lysis. The experiment was repeated 20 times with the blood samples of 20 volunteers.

Statistical analysis

Data are expressed as mean ± standard error of the mean. The significance between % clot lysis by SK, DW, test plants by means of weight difference was tested by the one-way ANOVA by using Instat GraphPad version 5.01 (GraphPad Software, Inc., La Jolla, CA, USA).

 Results



Addition of 100 μl SK, the standard control to the clots along with 90 min of incubation at 37°C, showed 92.54% ±1.25% clot lysis. Clots when treated with 100 μl sterile DW (negative control) showed only negligible clot lysis (3.00% ±0.597%). The mean difference in clot lysis percentage between positive and negative control was very significant (P < 0.001). After treatment of clots with 100 μl of Dhamasa (F. arabica), Guduchi (T. cordifolia), Kushta (S. lappa) clot lysis, i.e. 68.06% ±3.53%, 25.01% ±2.11%, 14.85% ±1.37%, respectively, was obtained. When compared with the negative control (water) the mean clot lysis % difference of Dhamasa and Guduchi was significant (P < 0.001 in both) but mean clot lysis % difference of Kushta was not found to be significant (P < 0.01). When compared with the positive control (SK) the mean clot lysis % difference of all the three test plants was significant (P < 0.001 in all). Statistical representation of the effective clot lysis percentage by test plants, positive thrombolytic control (SK), and negative control (sterile DW) is tabulated in [Table 1]. Between group comparisons of percentage clot lysis is tabulated in [Table 2].{Table 1}{Table 2}

 Discussion



In earlier study, thrombolytic effect of Dhamasa has been reported so it was selected to confirm the reported findings.[10]Guduchi has been mentioned as best in “Shonitavibandhprashmana” (one that removes obstruction in blood) in Agrya Prakarana by Acharya Charaka.[11]Kushta has been mentioned by Sushruta during description of Rakta mokshana (blood-letting). Sushruta says that in the process of Rakta mokshana if the bleeding does not occur due to clot formation then area should be rubbed by the powdered form of some drugs. Kushta is one among the drug mentioned to facilitate bloodletting.[12] Textual references suggest that Guduchi and Kushta have thrombolytic property and so they were screened for their thrombolytic activity in the present study.

Herbal preparations are used since ancient times to maintain health and to prevent and treat various ailments. Advancement in field of phytochemistry have paved path for identification and isolation of plant compounds for curing diseases. Presently, about 30% of the pharmaceuticals are prepared from plants worldwide.[13] Researches are going on extensively to find new alternative herbal drugs in various areas. Treatment of hyper coagulable state still remain a great challenge and to combat vascular diseases number of studies have been conducted by various researchers to find out the herbs and natural food sources and their supplements having antithrombotic effect.[7],[9],[13] SK is a widely used thrombolytic drug by the modern science but it can cause serious and life threatening side effects.[14] SK has its own complications like, bleeding which may be fatal with intracranial haemorrhage, it is also ineffective in individuals with anti-streptococcal and anti-prothrombin antibodies, and in patients who had multiple SK injections.[15],[16] All available thrombolytic agents still have significant shortcomings, including the need for large doses to be maximally effective, limited fibrin specificity and bleeding tendency.

Coagulation factor or natural anticoagulant factor levels influence the risk of venous thrombosis along with other risk factors such as ageing, obesity, protein C deficiency, etc. Oxidative stress, which is defined as an imbalance between pro-oxidant and antioxidant systems, can be both a cause and consequence of many vascular complications and serve as one of the biomarkers for these conditions.[17]F. arabica has been found to be beneficial in reducing oxidative stress by virtue of its antioxidant potential.[18] Different parts of F. arabica have also been used to cure various ailments, namely hematological, neurological, endocrinological, and inflammatory disorders.[19]T. cordifolia[20] and Saussurea lappa are also found to have good anti-oxidant activity.[21] These plants have properties which can help in preventing vascular diseases. The results of this study shows mild to moderate thrombolytic activity of test plants and so it gives an opportunity to explore their use in field of hypercoagulable state. These plants have Tikta/Katu (bitter/pungent) predominant Rasa (taste) and Ushna Virya (hot potency). Katu Rasa has property of “Shonitasanghata Bhinnati” (dissociates blood clots).[22]Tikta Rasa has Lekhana and Kleda, Meda, Shleshma Upshoshana properties which may help in lysis of formed thrombus in blood vessels.[23] It may be hypothesized that thrombolytic activity of these drugs might be due to above mentioned properties. In earlier studies also herbal medicines such as Hemidesmus indicus (L.) R. Br.,[24]Allium sativum L., [25]Zingiber officinale Roscoe.,[26]Ocimum sanctum L., Curcuma longa L., and Azadirachta indica A. Juss [27] have been shown to exert thrombolytic or fibrinolytic effects. Positive results give hope to develop drugs in future but there is need of extensive research to find out active constituents so that development of alternative novel thrombolytic drugs can be done.

 Conclusion



Dhamasa showed a significant percentage of clot lysis which is comparable with SK, a well-known thrombolytic drug. Guduchi and Kushta also showed mild thrombolytic activity. This study indicates possibility of finding novel thrombolytic drugs. However, there is need of thorough phytochemical and pharmacological research to discover their therapeutic potential. Once proved on scientific grounds these herbal preparations may be incorporated as thrombolytic agent for the improvement of the patients suffering from atherothrombotic diseases.

Financial support and sponsorship

National Institute of Ayurveda, Jaipur, Rajasthan, India.

Conflicts of interest

There are no conflicts of interest.

References

1Freedman JE, Loscalzo J. Arterial and venous thrombosis. In: Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo, editors. Harrison's Principles of Internal Medicine. 19th ed., Ch. 142. Publisher- McGraw Hill. Available from: .[Last accessed on 2016 Feb. 01].
2Cushman M. Epidemiology and risk factors for venous thrombosis. Semin Hematol 2007;44:62-9.
3Collen D. Coronary thrombolysis: Streptokinase or recombinant tissue-type plasminogen activator? Ann Intern Med 1990;112:529-38.
4Rouf SA, Moo-Young M, Chisti Y. Tissue-type plasminogen activator: Characteristics, applications and production technology. Biotechnol Adv 1996;14:239-66.
5Awadh N, Ronco JJ, Bernstein V, Gilks B, Wilcox P. Spontaneous pulmonary hemorrhage after thrombolytic therapy for acute myocardial infarction. Chest 1994;106:1622-4.
6Cooper JP, Quarry DP, Beale DJ, Chappell AG. Life-threatening, localized angio-oedema associated with streptokinase. Postgrad Med J 1994;70:592-3.
7Naderi GA, Asgary S, Jafarian A, Askari N, Behagh A, Aghdam RH. Fibrinolytic effects of Ginkgo biloba extract. Exp Clin Cardiol 2005;10:85-7.
8Demrow HS, Slane PR, Folts JD. Administration of wine and grape juice inhibits in vivo platelet activity and thrombosis in stenosed canine coronary arteries. Circulation 1995;91:1182-8.
9Prasad S, Kashyap RS, Deopujari JY, Purohit HJ, Taori GM, Daginawala HF. Development of an in vitro model to study clot lysis activity of thrombolytic drugs. Thromb J 2006;4:14.
10Prasad S, Kashyap RS, Deopujari JY, Purohit HJ, Taori GM, Daginawala HF. Effect of Fagonia arabica (Dhamasa) on in vitro thrombolysis. BMC Complement Altern Med 2007;7:36.
11Shastri K, Chaturvedi GN, Commentator. Charaka Samhita of Agnivesha, Sutra Sthana, Ch. 25, Ver. 40. 1st ed. (Reprint). Varanasi: Chaukhambha Bharati Academy; 2003. p. 468.
12Acharya JT, editor. Sushruta Samhita of Sushruta, Sutra Sthana. Ch. 14, Ver. 35. 1st ed. Varanasi: Chaukhamba Surbharati Prakashan; 2008. p. 65.
13Anwar AK, Ashfaq M, Nasveen MA. Pharmacognostic studies of selected indigenous plants of Pakistan. Pakistan: Pakistan Forest Institute, Peshawar NWFP; 1979. p. 15-35.
14Sheehan FH, Braunwald E, Canner P, Dodge HT, Gore J, Van Natta P, et al. The effect of intravenous thrombolytic therapy on left ventricular function: A report on tissue-type plasminogen activator and streptokinase from the thrombolysis in myocardial infarction (TIMI phase I) trial. Circulation 1987;75:817-29.
15Buchalter MB, Suntharalingam G, Jennings I, Hart C, Luddington RJ, Chakraverty R, et al. Streptokinase resistance: When might streptokinase administration be ineffective? Br Heart J 1992;68:449-53.
16Puurunen M, Mänttäri M, Manninen V, Palosuo T, Vaarala O. Antibodies to prothrombin crossreact with plasminogen in patients developing myocardial infarction. Br J Haematol 1998;100:374-9.
17Kim YW, Byzova TV. Oxidative stress in angiogenesis and vascular disease. Blood 2014;123:625-31.
18Satpute R, Bhattacharya R, S Kashyap R, J Purohit H, Y Deopujari J, M Taori G, et al. Antioxidant Potential of Fagonia arabica against the chemical ischemia-induced in PC12 cells. Iran J Pharm Res 2012;11:303-13.
19Chopra RM, Handa KL, Kapur LD, Chopra IC. Indigenous Drugs of India. 2nd ed. New Delhi: Academic Publisher; 1982. p. 507.
20Goel HC, Prem Kumar I, Rana SV. Free radical scavenging and metal chelation by Tinospora cordifolia, a possible role in radioprotection. Indian J Exp Biol 2002;40:727-34.
21Saha AK, Md. Rahman R, Shahriar M, Saha SK, Azad NA, Das S. Screening of six ayurvedic medicinal plant extracts for antioxidant and cytotoxic activity. J Pharmacogn Phytochem 2013;2:181-8.
22Acharya YT, editor. Charaka Samhita of Agnivesha, Sutra Sthana, Ch. 26, Ver. 42(4). 1st ed. (Reprint). Varanasi: Chaukhambha Subharati Prakashana; 2011. p. 144.
23Acharya YT, editor. Charaka Samhita of Agnivesha, Sutra Sthana, Ch. 26, Ver. 42(5). 1st ed. (Reprint). Varanasi: Chaukhambha Subharati Prakashana; 2011. p. 144.
24Mary NK, Achuthan CR, Babu BH, Padikkala J.In vitro antioxidant and antithrombotic activity of Hemidesmus indicus (L) R. Br. J Ethnopharmacol 2003;87:187-91.
25Bordia A, Verma SK, Srivastava KC. Effect of garlic (Allium sativum) on blood lipids, blood sugar, fibrinogen and fibrinolytic activity in patients with coronary artery disease. Prostaglandins Leukot Essent Fatty Acids 1998;58:257-63.
26Verma SK, Bordia A. Ginger, fat and fibrinolysis. Indian J Med Sci 2001;55:83-6.
27Khan IN, Habib MR, Rahman MM, Mannan A, Sarker MM, Hawlader S. Thrombolytic potential of Ocimum sanctum L. Curcuma longa L. Azadirachta indica L. and Anacardium occidentale L. J Basic Clin Pharm 2011;2:125-7.