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REVIEW ARTICLE

 

Indian Medicinal Plants Used for Treatment of Rheumatoid Arthritis

 

Shyama S. Kumar1, Divya Bhosle1, Akshay Janghel1, Shraddha Deo1, Parijeeta Raut1,

Chetan Verma1, Mukta Agrawal1, Nisha Amit2, Mukesh Sharma1, Tapan Giri3, D. K. Tripathi1, Ajazuddin1, Amit Alexander1*

1Rungta College of Pharmaceutical Sciences and Research, Kohka-Kurud Road, Bhilai, Chhattisgarh, India, 490024

2Ex-employee, Kalyan PG College, Sector 7, Bhilai, Chhattisgarh, India.

3NSHM College of Pharmaceutical Technology, NSHM Knowledge Campus, Kolkata Group of Institutions, 124 BL Saha Road, Kolkata-700053, West Bengal, India.

*Corresponding Author E-mail: itsmeamitalex@gmail.com

 

ABSTRACT:

Rheumatoid arthritis (RA) is an autoimmune disease of unknown etiology and is mainly characterized by the progressive erosion of cartilage leading to chronic polyarthritis and joint distortion. Although the exact pathogenesis of the disease has yet not been elucidated, however, studies suggest that cellular proliferation of synoviocytes result in pannus formation which damages the cartilage and bone. Recent reports also support the role of free radicals in its pathogenesis. Apart from the conventional treatment strategies using nonsteroidal anti inflammatory drugs, disease modifying antirheumatic drugs and glucocorticoids, newer and safer drugs are continuously being searched, as long term usage of these drugs have resulted in adverse effects. Alternative medicine provides another approach for treatment of RA and currently a number of medicinal plants are under scientific evaluation to develop a novel drug. There is a dire need to investigate the complete therapeutic potential and adverse effects, if any, of these herbals for providing newer and safer treatment options with minimum side effects. In this paper we have tried to explore various Indian ancient Ayurvedic, Unani and Tibet, as also some Chinese and Korean, herbals for their potential to treat RA.

 

KEYWORDS: Rheumatoid arthritis, joint distortion, herbal drugs, therapeutic potential, alternative medicine.

 

 


INTRODUCTION:

Rheumatoid arthritis (RA) is a long-term disease that leads to inflammation of the joints and surrounding tissues. It is an auto immune disease. This means the body's immune system mistakenly attacks healthy tissue in the joints (fig. 1). Over time, RA can cause the joints to become deformed. Rheumatoid arthritis sometimes can affect other organs of the body such as the skin, eyes, lungs and blood vessels. RA is more prevalent among women than men, and usually develops in the fourth and fifth decades of life, with 80% of the total cases occurring between the ages of 35 and 501.

 

 

Received on 28.04.2015       Modified on 27.05.2015

Accepted on 30.05.2015      © RJPT All right reserved

Research J. Pharm. and Tech. 8(5): May, 2015; Page 597-610

DOI: 10.5958/0974-360X.2015.00099.2

 

Many patients look for complementary and alternative medicine (CAM) options in coping with this debilitating disease. Research has indicated that people suffering from chronic pain, as in RA, and those dissatisfied with current treatment are very likely to seek alternative treatments, and an estimated 60–90% of persons with arthritis use CAM2. Among the most widely used treatments are chiropractic and herbal therapies. This growing interest in alternative medical practices clearly indicates the need for more thorough investigation into the safety and efficacy of CAM.

 

 

 

 

 

 

 


http://images.wisegeek.com/diagram-depicting-rheumatoid-arthritis.jpg

Figure 1: Rheumatoid arthritis; Healthy and arthritic joints.

 

 


Signs and Symptoms

Tender, warm, swollen joints. Morning stiffness that may last for hours Firm bumps of tissue under the skin on arms  Fatigue, fever and weight loss. As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur in the same joints on both sides of your body3.

 

Rheumatoid arthritis signs and symptoms may vary in severity and may even come and go. Periods of increased disease activity, called flares, alternate with periods of relative remission when the swelling and pain fade or disappear. Over time, rheumatoid arthritis can cause joints to deform and shift out of place. Firm lumps, called rheumatoid nodules, which grow beneath the skin in places such as the elbow and hands4.

 

Causes

Rheumatoid arthritis occurs when immune system attacks the synovium the lining of the membranes that surround the joints the resulting inflammation thickens the synovium, which can eventually destroy the cartilage and bone within the joint. The tendons and ligaments that hold the joint together weaken and stretch. Gradually, the joint loses its shape and alignment.

 

Physiology

There is usually a "trigger," such as an infection or environmental factor, which activates the genes. When the body is exposed to this trigger, the immune system responds inappropriately. Instead of protecting the joint, the immune system begins to produce substances that attack the joint. This leads to the development of rheumatoid arthritis. The normal joint lining is very thin and it has very few blood vessels in it but in the rheumatoid arthritis joints lining is very thick and crowded with the white blood cells. The white blood cells secrete chemical substances like interleukin-1 (IL-1) and tumor necrosis factor alpha (TNF-alpha) that produce pain, joint swelling and joint damage. Cytokines like IL-17, IL-18, RANKL stimulate synovial fibroblasts and chondrocytes in the nearby articular cartilage to secrete enzymes that degrade proteoglycan and collagen, leading to tissue destruction (fig. 2)5. In rheumatoid arthritis the synovial membranes become thickened and cartilages are eroded, the synovial membrane invades the space between the joints and whole joint is swollen and become painful on movement 6.

 

 

http://newarthritistips.com/wp-content/uploads/2014/11/stages-of-rheumatoid-arthritis.png

Figure 2: Stages of rheumatoid arthritis

 

Use of herbal drugs for treatment of RA

In earlier centuries natural product extracts, particularly those derived from botanical species, provided the main source of folk medicines. However, in the latter part of the nineteenth century, biologically-active organic molecules began to be isolated in relatively pure form for medicinal use. For example, salicylic acid, the precursor of aspirin, was isolated in 1874 from willow bark.

There are numerous other examples. There are many synthetic drugs that are being used as standard treatment for rheumatoid arthritis but they have adverse effect that can compromise the therapeutic treatment so these adverse effects increase the chances for the use of herbal plants for the rheumatoid arthritis treatment.

 

This paper reviews of some of the common herbs that have a history of human use and their anti-inflammatory or anti-arthritic properties. Traditionally herbal plants are used both internally and externally both. Abundant number of herbal drugs is available which are used to reduce chronic joint inflammation.

 


Table 1:  Name, chemical constituents and uses of herbal drugs used for treatment of RA

S. no.

Name of plant

Chemical constituents

Uses

References

1.

Myrobalan

Arjunglucoside, trans-cinnamic acid, triethyl ester of chebulic acid, arjunic acid, arjungenin, daucosterol

In the treatment of asthma, sore throat, vomiting, hiccough, diarrhea, dysentery, bleeding piles, ulcers, and gout, heart and bladder diseases.

7,8

2.

Black pepper

Piperene, sabinene, pinene, terpene, limonene, mercene, camphene, carypophylline, alpha-phellandrene, alpha-pinene, beta-pinene, beta-bisbolene, beta-farnesene, linalool, terpene-4-ol, thujone.

Anti-inflammatory, carminative, anti-flatulent, pyridoxine, riboflavin, thiamin and niacin.

9,10

3.

Ginger

 Gingerols, bisabolene, zingiberine, zingiberol, sesquiphellandrene, curcumene, 6dehydrogingerdione, galanolactone, gingesulphonicacid, alpha curcumin, alpha farnesene.

Anti-emetic, chemo-protective, anti-viral, anti-inflammatory, anti-nauseant, and anti-ulcerogenic, migraine

11,12,13

4.

Tinospora gulancha

Tinocardifolin, columbin, colombine, picroretin, and tinocardifolioside, tinosponone, tinocardioside, cordioside.

Jaundice, diabetes, and rheumatoid arthritis, antineoplastic, antioxidant, hepatoprotective, hypolipidemic.

14,15,16

5.

Deodar cedar

 Himachalene, β-himachalene, himachalol, allohimachalol, himadarol, isocentdarol and centdarol, 9-hydroxy-dodecanoic acid, ethyl laurate, ethyl stearate, 3-beta-hydroxy-oleanolic acid methyl ester, beta-sitosterol, shikimic acid, methyl coniferin.

Carminative, diaphoretic, diuretic, pulmonary and urinary disorders, rheumatism, piles, kidney stones, insomnia, diabetes etc.

17,18,19,20

6.

Indian bay leaf

Geraniol, beta-pinene, camphene, beta-caryophyllene, cinnamaldehyde, limonene, p-cymene, alpha-pinene, eugenol.

Carminative, anti-flatulent, diuretic, anorexia, bladder disorder, coryza, nausea

21,22,23,24

7.

Aginbuti

Hentriacontine, dotriacontanol, betulinic-acid, lupeol, ellagic acid, quercetin,  lawsone, β-sitostero, ellagic acid.

Anti-arthritic, anti-inflammatory, laxative, rubifacient, hypothermic, hypertensive, antiurolithiasis, antibacterial.

25,26,27,28,29

8.

Indian mallow

Stigmasterol, riboflavin, adenine, scoparone, scopoletin, p-coumaric acid, scoparone, scopoletin, sitosterol, syringaldehyde, thymine, vanillic acid.

Lung ailments, cold and fever, tuberculosis, bronchitis, urinary tract infection, gout, tooth ache, anti- arthritic.

30,31

9.

Teak

Astectoquinone, 5-hydroxylapachol, tectol, betulinic acid, betulinic aldehyde, squalene, acetovanillone, e-isofuraldehyde, evofolin, syringaresinol, medioresinol, balaphonin, lariciresinol, zhebeiresinol, 1- hydroxypinoresinol

Antibacterial, anti-oxidant, anti-asthamatic, analgesic, anti-fungal, anti tumor, anti inflammatory.

32,33

10.

Shallaki

Boswellic-acid, p-cymene-limonene,terpinolene ,bornyl acetate, p-cymene-limonene,terpinolene ,bornyl acetate, β-eudesmene α-phellandrene ,γ-murolene, terpinene ,valencene ,s-cis-sabinol.

Inflammatorydiseases, osteoarthritis, cervical spondylosis, ankylosing spondylitis.

34

11.

Chanka piedra

Brevifolin,butyrolactone, dibenzyl,butyrolactone, 24-isopropyl,corilagin,cymene,deca-trans-2-cis-4-dienamide.

Asthma, anemia, astringent, conjunctivitis, bronchitis, cough, dropsy, diarrhoea, diabetes, dysentery, eye disorders, galactagogue, jaundice, hepatitis, menorrhagia, leucorrhea,

35

12.

Clearing nut tree

Diaboline, isomotiol, sitosterol, stigmasterol, compesterol norharmane, akuammidine, loganin, mannose, sucrose, arachidonic, lignoceric, linoleic, oleic, palmitic acid.

Microbial infections, diarrhea and diabetes, anti-microbial,analgesic,anti- inflammatory,anti-nociceptive, hepato-protective and anti-diarrhoel activity

36,37

13.

Bachelor’s button

Parthenolide, eudesmanolides ,germacranolides,guaianolides, epicanin,epoxyartemorin, 1-beta-hydroxyarbusculin,3-beta-hydroxycostunolide.

Anticancer, cardio tonic, antispasmodic, an emmenagogue, anti-inflammatory activity, anti-cancer activity, migraine, headache.

38

14.

Ram tulsi

Thymol, gratissimol, pentoses, hexoses, uronic acid, eugenol,cis-ocimene,trans-ocimene,pinene, eugenol, 1,8 cineole, linalool, methyl chavicol , methyl eugenol.

Anti-nociceptive, relaxant.

39

15.

Morning glory

Tetradecanyl palmitate, stigmasteryl phydroxycinnamate, hexadecanyl p-hydroxycinnmate, palminate, stearic, linoleic, oleic acid, myristoleic, myristic, palmitic, nonadecanoic.

Antibacterial, anti-convulsant, anti-inflammatory, hypoglycemic, immune-modulatory, central nervous system activity.

 

40

 


Myrobalan

Biological Name: Terminalia chebula Retz.

Common Name: Haritaki.

Family: Combretaceae.

Terminalia chebula Retz is called the ‘King of Medicine’ in Tibet and is always listed at the top of the list of ‘Ayurvedic Materia Medica’ because of its extraordinary power of healing. T. chebula has been extensively used in Ayurveda, Unani and Homoeopathic medicine and has become a cynosure of modern medicine. The health benefits may be credited to the presence of the various phytochemicals like polyphenols, terpenes, anthocyanins, flavonoids, alkaloids and glycosides. The hydroalcoholic extract of T. chebula produce significant inhibition of joint swelling. 7

 

 

 

 

 

Chemical constituents

It contains arjunglucoside, trans-cinnamic acid, triethyl ester of chebulic acid, arjunic acid, arjungenin, daucosterol (Fig. 3).

 

Uses

The whole plant possesses high medicinal value and traditionally used for the treatment of various ailments for human beings. Some of the folklore people used this plant in the treatment of asthma, sore throat, vomiting, hiccough, diarrhea, dysentery, bleeding piles, ulcers, and gout, heart and bladder diseases. 8

 

The plant has been demonstrated to possess multiple pharmacological and medicinal activities, such as antioxidant, antimicrobial, antidiabetic, hepatoprotective, anti-inflammatory, antimutagenic, antiproliferative, radio protective, cardio protective, antiarthritic, anticaries, gastrointestinal motility and wound healing activity.

 


http://s3.amazonaws.com/readers/2011/07/06/phyllanthusemblicafr_1.jpg       arjungenin terminalia chebula.pngarjunglucoside terminalia chebula.png     

MYROBALAN                                          Arjunjenin                                    Arjunglucoside                     

daucosterol.gif            Arjunic-acid-CFN98397 terminalia chebula.jpg    http://www.mpbio.com/images/product-images/molecular-structure/02101243.png

  Daucosterol                                            Arjunic acid                         Trans-cinnamic acid

Figure 3: Chemical constituents of Myrobalan

 

 

 

Black Pepper


Biological Name: Piper Nigrum linn.

Common Name: Pepper.

Family: Piperaceae.

 It is the fruit of the black pepper plant from the Piperaceae family and is used as both a spice and a medicine. The     chemical piperine, which is present in black pepper, causes the spiciness. It is native to Kerala, the southern state of India

 

Chemical constituents

It consists of piperene, an amine alkaloid, which gives strong spicy pungent character to the pepper. It also contains numerous monoterpenes hydrocarbons such as sabinene, Pinene, terpene, limonene, mercene, camphene, carypophylline, alpha-phellandrene, alpha-pinene, beta-pinene, beta-bisbolene, beta-farnesene, linalool, terpene-4-ol, thujone (Fig. 4) 9 .

 

Uses

Peppers have been in use since centuries for its anti-inflammatory, carminative, anti-flatulent properties10 Black peppercorns contain a good amount of minerals like potassium, calcium, zinc, manganese, iron, and magnesium.Manganese is used by the body as a co-factor for the antioxidant enzyme, superoxide dismutase. Peppers are an excellent source of many vital B-complex groups of vitamins such as Pyridoxine, riboflavin.

 

 


                                 

 BLACK PEPPER                                                                           Beta-bisbolene                Camphene              Alpha-pinene       

            

     Terpene-4-ol                                     Limonene                Beta farnesene                                 Linalool                                                         

Figure 4: Chemical constituents of Black Pepper

 

 

 


 

Ginger

Biological Name: Zingiber officinale.

Common Name: Ginger root.

Family: Zingiberaceae.

The rhizomes of ginger are used as spice in food and beverages and in traditional medicine as carminative, antipyrexia of waist pain rheumatism and bronchitis. It is used for the treatment of gastrointestinal disorders and piles. 11

 

Chemical constituents

It contains sesquiterpenes and phenolic compounds shogaols, gingerols  bisabolene, zingiberine, zingiberone sesquiphellandrene. It also cantains curcumene, 6dehydrogingerdione, galanolactone, gingesulphonicacid, zingerone, geraniol, neral, gingerglycolipids,  curcumin, alpha farnesene (Fig. 5)13.

 

Uses

It has anti-emetic, chemo-protective, anti-viral, anti-inflammatory, anti-nauseant, and anti-ulcerogenic.12 It is also used in treatment of migraine. Ginger improves the absorption and assimilation of essential nutrients in the body.Ginger clears the microcirculatory channels of the body.

 

 


 

         

    GINGER                                                  Zingiberine                                     Zingiberol

      

  Shogaol                                                          Gingerol                                           Beta-sesquiphellandrene

              

 Zingerone            Galanolactone             Bisabolene                       Alpha- farnesene

Figure 5: Chemical constituents of  Ginger


 

    

 

 

Tinospora gulancha

Biological Name: Tinospora cordifolia linn

Common Name: Guduchi

Family: Menispermaceae

Tinospora cordifolia commonly named as “Guduchi” in Sanskrit belonging to family Menispermaceae is a genetically diverse, deciduous climbing shrub with greenish yellow typical flowers, found at higher altitude. It’s immunomodulatory property used as an adjuvant therapy in diabetic patients with foot ulcers, T. cordifolia produce significant anti-inflammatory effect in both acute and subacute inflammation. T. cordifolia was found to be more effective than acetylsalicylic acid in acute inflammation14.

Chemical constituents

It consist of tinocardifolin, columbin, colombine, picroretin and tinocardifolioside, tinosponone, tinocardioside, cordioside (Fig.6) 15.

 

Uses                                                                                                         

Tinospora cordifolia is used in the Indian Ayurvedic system of medicine for the treatment of jaundice, diabetes, and rheumatoid arthritis, and is also used as an immunostimulant16. Experiments have examined its antineoplastic, antioxidant, hepatoprotective, hypolipidemic, and immunologic properties.


 

 

  TINOSPORA GULANCHA              Tinosponone                    Tinocordioside               Tinocordifolin                            Columbin

 

Figure 6: Chemical constituents of Tinospora gulancha

 


Deodar cedar

Biological Name: Cedrus deodara.

Common Name: Deodar cedar, Himalayan cedar.

Family: Pinaceae

Cedrus deodara (Roxb.), belonging to the family Pinaceae (Hindi-Marathi Deodar; Sanskrit-Devadaru; English-Cedar) is  graceful, ornamental evergreen tree growing extensively on the slopes of the Himalayas. C. Deodar forests are common from Kashmir, especially krishnaganga, kishtwar and Jhelum, to Garhwal.17The wood of C. deodara has been used since ancient days in Ayurvedic medical practice for the treatment of inflammations and rheumatoid arthritis.

 

Chemical constituent

The principle constituents of the oil are sesquiterpenes i.e., α- himachalene (12.5%) and β-himachalene (43%) associated with them are sesquiterpene alcohols himachalol, allohimachalol, himadarol, isocentdarol and centdarol.18 Some compounds isolated from the pine needles of cedrus deodara are 9-hydroxy-dodecanoic acid, ethyl laurate, ethyl stearate, 3-beta-hydroxy-oleanolic acid methyl ester, beta-sitosterol, shikimic acid, methyl coniferin, ferulic acid, beta-glucoside. Cedeodarin (6-methyltaxifolin), dihydromyricetin, cedrin (6-methyldihydromyrecetin) and cedrinoside are also isolated from cedar wood.19,20 (Fig.7).

 

Uses

Deodar cedar is carminative, diaphoretic, diuretic and expectorant. A decoction of the wood is used in the treatment of fevers, flatulence, pulmonary and urinary disorders, rheumatism, piles, kidney stones, insomnia, diabetes etc. It is used as an antidote to snake bites. The plant yields a medicinal essential oil by distillation of the wood, it is used in the treatment of phthisis, bronchitis, and skin eruptions. A resin obtained from the wood is used externally to treat bruises, skin diseases and injuries to joints.


 

                         

        DEODAR CEDAR                                                  Alpha-himachalene        Beta-himachalene                    Alpha-terpineol

 

                                          

           Himachalol                            Isopimaric acid                                         Taxifolin                                           Linalool

Figure 7: Chemical constituents of  Deodar cedar


 

Indian Bay Leaf

Biological Name: Cinnamomum tamala    

Common Name: Tamala cassia

Family: Lauraceae

Cinnamomum tamala is found in himalayan region is a promising medicinal plant species.  It is used in traditional indian  system of medicine.

 

Chemical constituents

Cinnamomum tamala consist of geraniol, beta-pinene, camphene, beta-caryophyllene, Cinnamaldehyde, limonene, p-cymene, alpha-pinene, eugenol (Fig. 8) 21,22.

 

Uses

Essential oils of Cinnamomum tamala are used as carminative, anti-flatulent, diuretic. Ayurveda it is described to be used in treatment of anorexia, bladder disorder, coryza, nausea 23.. It is used in treatment of rheumatism, it’s essential oil possess anti-microbial and anti-bacterial property. Bark and leaf used as tea and spice due to its aromatic smell. In Kashmir, fresh leaf is used as betel leaf24. Oil is used in the treatment of stress-related conditions such as  headache  insomnia  nervous tension  muscles and joints complications  arthritis  inflamed joints  muscular pains  rheumatism sprains  benefits the digestion.

 


             

INDIAN BAY LEAF                                                 Beta-pinene                              camphene                          limonene                       

                                                                                                                    Geraniol                                                 P-cymene                                            Cinnamaldehyde                                 Alpha-pinene

 

Figure 8: Chemical constituents of Indian bay leaf


 

Aginbuti

Biological Name: Ammania baccifera Linn

Common Name: Acrid weed, Tooth cup

Family: Lythraceae

An erect or sub erect herb, 15-20 cm high, sometimes more. Leaves oblong or narrow-elliptic, usually opposite, cauline ones opposite or alternate, 2.5-6.2 cm long. Flowers small, in dense axillary clusters or loose, but short cymes25.

 

Chemical constituents

It contains hentriacontine, dotriacontanol, betulinic-acid, lupeol, ellagic acid, quercetin, and lawsone. The plant is also reported to contain tetralone derivatives i.e. (-)-(4R)-Hydroxy-1-tetralone, (-)-(4S)-acetoxy-1-tetralone, (-)-(4S)-hydroxy-1-tetralone-4-O-β-D-glucoside, β-sitosterol and β-sitosterol-β-D-glucoside,ellagic acid (Fig. 9) 26-28.

 

Uses

It has anti-arthritic, anti-inflammatory potential, an appetizer, and stomachic and is useful in treating biliousness the leaves are beneficial for removing phlegm from the lungs and trachea29. The leaves are acrid and find application in folk medicine for the treatment of rheumatic pain, as laxative, rubifacient and external remedy for ring worm. This plant possess hypothermic, hypertensive, antiurolithiasis, antibacterial and CNS depressant activities.


 

     

   AGINBUTI                                                        Ellagic acid                Dotriacontanol             Hentriacontane

        

1-Tetralone                  Lawsone           Quercetin                   Beta-sitosterol                                         Lupeol

Figure 9: Chemical constituents of  Aginbuti


 

Indian Mallow

Biological Name: Abutilon indicum

Common Name: Abutilon

Family: Malvaceae

It is a perennial shrub, softly tomentose and up to 3 m in height. The plant is found in India, Sri Lanka, topical regions of America.  It is found as a weed in sub-Himalayan tracts, hills up to 1200 m and in hotter parts of India.

 

Chemical constituents

It consist of stigmasterol, riboflavin, adenine, scoparone, scopoletin, and p-coumaric acid, Scoparone, scopoletin, sitosterol, syringaldehyde, thymine, vanillic acid etc (Fig. 10)30,31.

 

Uses

It is used in treatment of lung ailments, cold and fever, tuberculosis, bronchitis, urinary tract infection, gout, tooth ache, anti- arthritic. It is sweet, cooling, digestive, laxative, expectorant, diuretic, astringent, analgesic, anti-inflammatory. It is useful in gout, tuberculosis, ulcers, bleeding disorders, and worms. Decoction used in toothache and tender gums. Demulcents of leaves are locally applied to boils and ulcers. Roots are prescribed in fever, chest affection and urethrities.


                              

   INDIAN MALLOW                                        Thymine              Syringaldehyde              Stigmasterol             Scoparone

 

  

                                Scopoletin                          Vanillic acid                   P-coumaric acid        Adenine     Riboflavin

Figure 10: Chemical constituents of  Abutilon indicum

 


Teak

Biological Name: Tectona grandis linn.

Common Name: Sagon

Family: Verbanaceae

The plant Tectona grandis is probably the most widely cultivated high value hardwood (HVH) in the world and is native to India and Myanmar and South- East Asian countries. It is now one of the most important species of tropical plantation forestry. The whole plant is medicinally important and many reports claim to cure several diseases according to Indian traditional system of medicines.

 

Chemical constituents

Several phytochemicals like alkaloids, glycosides, steroids,  saponins, steroids, flavonoids, proteins and carbohydrates have been reported in Tectona grandis .Secondary metabolites such astectoquinone, 5-hydroxylapachol, tectol, betulinic acid, betulinic aldehyde, squalene,  are found in plants. Acetovanillone, E-isofuraldehyde, Evofolin, syringaresinol, medioresinol, balaphonin, lariciresinol, zhebeiresinol, 1- hydroxypinoresinol together with two new compounds Tectonoelin A and Tectonoelin B are present in leave (Fig.11) 32.

 

Uses

It has antibacterial, anti-oxidant, anti-asthamatic, analgesic, anti-fungal, anti tumor, anti inflammatory and anti metastatic, anti pyretic, anti-ulcer activity.Studies indicates that T. grandis Linn. may prove to be useful in insulin resistance owing to its antioxidant activity and ability to increase the glucose uptake. Aqueous extract of leaves of T. grandis Linn. showed the acute diuretic activity.


 

                                  

   TEAK                                                                     Dehydroxy-alpha-lapachone     Dehydro-alpha-lapachone    Beta-lapachone

     

   Betulinic acid                             Lariciresinol                                          Tectol                               Beta-sitosterol

Squalene                                           Evofolin                                        Lapachol

Figure 11: Chemical constituents of  Teak


 

Shallaki

Biological Name: Boswellia serrata

Common Name: Salai guggul

Family: Burseraaceae

Resin of Boswellia species has been used as incense in religious and cultural ceremonies and in medicines since time immemorial. Boswellia serrata (Salai/ Salai guggul), is a moderate to large sized branching tree of family Burseraceae (Genus Boswellia), grows in dry mountainous regions of India, Northern Africa and Middle East. Oleo gum-resin is tapped from the incision made on the trunk of the tree and is then stored in specially made bamboo basket for removal of oil content and getting the resin solidified. After processing, the gum-resin is then graded according to its flavour, colour, shape and size.

 

 

Chemical constituents

It contains essential oil, gum and resin. It’s essential oil consists of monoterpenes, diterpenes and sesquiterpenes.  Resin portion mainly composed of pentacyclic triterpene acid of which boswellic-acid is the active moiety. Essential oil fraction of n-hexane extract of Salai guggul contains esters (62.1%), alcohol (15.4%), monoterpenes (9.9%) and diterpenes (7.1%) (28). It’s leaves contains P-Cymene-Limonene,Terpinolene ,Bornyl acetate ,α-Pinene ,α-Thujone ,α-Phellandrene (Fig.12)33.

 

Uses

The gum resin from Boswellia serrata, i.e. frankincense, has been used as medicine for the treatment of inflammatory diseases. Rheumatoid arthritis, osteoarthritis, cervical spondylosis, ankylosing spondylitis. Besides being an effective anti-inflammatory, boswellia can be an effective painkiller and may prevent the loss of cartilage.


           

      SHALLAKI                                                  Glucoronic acid       Digitoxose                   Serratol                       Alpha cubebene

                 

       Beta bourbonene                          Methyl-chavicol               P-cymene                    Bornyl acetate                Alpha terpineol

Figure 12: Chemical constituents of Shallaki


 

Chanka piedra

Biological Name: Phyllanthus niruri

Common Name: Chalmeri

Family:  Euphorbiaceae

The herb P.niruri is a widespread tropical plant found in coastal areas. It grows along the bunds and ridges in cultivated fields. The plant grows to a height of 15-60 cm. The leaves are small close to each other, arranged in two rows so that the branches resemble compound leaves.

 

Chemical constituents

Ascorbic Acid, Astragalin, Brevifolin, Butyrolactone, dibenzyl, Butyrolactone, trans-2-(3-4-dimethox y-benzyl)-3-(3-4- methylenedioxy-benzyl), Catechin, (+)Catechin, epi: (-) Cholesterol, 24-isopropyl, Corilagin, Cymene, Deca-trans-2-cis-4-dienamide, Dotriacontanoic Acid, Ellagic Acid, Eriodictyol-7-o-alpha-l-rhamnoside, Estradiol, Fisetin-41-o-beta-d-glucoside, Gallic acid (Fig.13)34.

 

Uses

Asthma, anemia, astringent, conjunctivitis, bronchitis, cough, dropsy, diarrhoea, diabetes, dysentery, eye disorders, galactagogue, gonorrhea, genitourinary disorders, jaundice, hepatitis, menorrhagia, leucorrhea, ringworm, oligogalactia, stomachic, scabies, tuberculosis, thirst, urogenital tract infections. P. niruri is used for the treatment of kidney stones. 


 

   

     CHANKA PIEDRA                                              Corilagin                         Hypophyllanthin              Ascorbic acid

  

Gallic acid                                Astragalin                      Brevifolin               Cholesterol                               Catechin

Figure 13: Chemical constituents used of Chanka piedra


Morning Glory

Botanical Name: Argyreia

Common Name: Elephant creeper

Family: Convolvulaceae

The Elephant Creeper is a very large climber whose length is over 8-10 meters. It bears stout stems that are covered with white woolly hairs. It belongs to the plant family Convolvulacea. The large alternate leaves are 7.5-30 cm. or more long, cordate, bright green on top but hairy and white beneath. The rose-purple, bell shaped flowers have a prominent white and hairy calyx. The round fruit 2cm. in diameter, with a short sharp point.

 

Chemical constituents:

The leaves contain flavonoids, quercetin and kaempferol root contain tetradecanyl palmitate, 5, 8-oxidotetracosan-10-one26 stigmasteryl phydroxycinnamate, hexadecanyl p-hydroxycinnmate and scopoletin. Seeds contain glycerides of palminate, stearic, linoleic, oleic acid, myristoleic, myristic, palmitic, nonadecanoic, eicosenoic, and heneicosanoic, behenic acids (Fig.14)35.

 

Uses

It has antibacterial, anti-convulsant, anti-inflammatory, anti-viral, anti-fungal, hepato- protective, Hypoglycemic, immune-modulatory, central nervous system activity, aphrodisiac activity. Promotes the flow of urine, relieves gonnorrhoea, strangury or painful urination and chronic ulcers. Rheumatism and nervous disorders. Wounds and skin diseases. Synovitis or inflammation of the synovial membrane.


 

       

      MORNING GLORY                               Behenic acid                                     Myristic acid                   Quercetin

                    

         Kaempferol                     Scopoletin                          Myristoleic acid                           Heneicosanoic acid

Figure 14: Chemical constituents of Morning glory

 

 

 


 

Clearing Nut Tree

Botanical Name: Strychonus potatorum linn.

Common Name: Nirmali

Family: Loganiaceae

Strychnos potatorum is a medium-sized, glabrous tree of height 1213 m. Stem is fluted and covered with black, thick, square to rectangular scales. Bark is 1.32 cm thick, black or brownish-black, corky, with very deep and narrow vertical, thin ridges, which easily break off. Branches are swollen at nodes. Leaves are about 57.5 cm long, nearly sessile, subcoriaceous, ovate or elliptic, acute, glabrous and shining, spuriously three or five nerved, with lateral nerves springing from the lower part of the mid rib, nearly reaching the tip36.

 

 

 

 

Chemical constituents

It consists of alkaloids, flavonoids, phenols, tannins, saponins. Alkaloids mainly diaboline, four triterpene i.e. isomotiol,       itosterol, stigmasterol and compesterol norharmane, akuammidine, nor-C-fluroiocuraine, ochrolifuanine, bis-nordihydrotoxiferine, 11-methoxy- henningsamine, 11-methoxy-12 hydroxydiabolin and 11-methoxydiabolin. Alkaloids-diaboline 9 and itsacetate10,  brucine, loganin, mannose, sucrose, arachidonic, lignoceric, linoleic, oleic, palmitic and stearic acids; steroids and triterpines6, βsitosterol, stigmasterol, oleanolic acid and its 3β-acetate, saponins containing oleanic acid11 (Fig.15)37.

 

Uses

It is used for treating several diseases like microbial infections, diarrhea and diabetes, It has anti-microbial, analgesic, anti-inflammatory, anti-nociceptive, anti-arthritic, anti-ulcerogenic, hepato-protective.


       

     CLEARING NUT TREE                   Carboxamide                        

    

                                                                                                     Diaboline                                     Norharmane

    

   Oleic acid                                                                                                      Stigmasterol

Figure 15: Chemical constituents of Clearing nut tree

 


 

Bachelor’s Button

Botanical Name: Tanacetum parthenium.

Common Name: Mid summer daisy.

Family: Asteraceae

The feverfew herb has a long history of use in traditional and folk medicine, especially among Greek and early European herbalists. The plant contains a large number of natural products, but the active principles probably include one or more of the sesquiterpene lactones known to be present, including parthenolide.  It has multiple pharmacologic properties, such as anticancer, anti-inflammatory, cardiotonic, antispasmodic, an emmenagogue, and as an enema for worms. Tanetin, a lipophilic flavonoid found in the leaf, flower, and seed of feverfew, blocks prostaglandin synthesis. Aqueous extracts do not contribute to feverfew's anti-inflammatory activity, but do prevent the release of arachidonic acid and inhibit in vitro aggregation of platelets stimulated by adenosine 5″-diphosphate (ADP) or thrombin38.

 

Chemical constituents

The most important biologically active principles are the sesquiterpenes lactones, the principal one being parthenolide.  In general there are 5 different types of sesquiterpenes lactones, which may be classified by chemical ring structures. It contains eudesmanolides, germacranolides, guaianolides. Germacranolide,  Artecanin,  artemorin,  balchanin, costunolide, 10-epicanin, epoxyartemorin, 1-beta-hydroxyarbusculin, 3-beta-hydroxycostunolide, 8-alpha-hydroxyestagiatin, 8-beta-hydroxyreynosin, 3secotanaparthenolideA,  secotanaparthenolide B, tanaparthin-alpha-peroxide (Fig. 16).

 

Uses

It has multiple pharmacologic properties, such as anticancer, cardio tonic, antispasmodic, an emmenagogue, and as an enema  for worms.It has anti-inflammatory activity, anti-cancer activity, migraine, headache.

 

Ram Tulsi

Botanical Name: Ocimum gratissimum linn.

Common Name: Wild basil

Family: Lamiaceae

Ocimum gratissimum Linn., a well-known plant is widely used in the treatment of various infections. In India, the plant is used for curing stomach ache, diarrhea and skin infections, but also in religious ceremonies and rituals, the leaves are used as laxative and consumed as tea. The use of essential oils is remarkable in medicine, including headaches, flu, fever, sore throat, ears or eyes. The seeds have laxative properties and are prescribed against gonorrhea. The aqueous leaves extract of Ocimum gratissimum has anti-nociceptive and anti-inflammatory effects. O. gratissimum inhibits the enzymes, cyclooxygenase function of PGHS and lipoxygenase.

Chemical constituents

Thymol, Gratissimol, Pentoses, hexoses, uronic acid and lipids. Alkaloids, tannins, flavonoids and oligosaccharides, Eugenol, cis-ocimene, trans-ocimene, pinene, camphor, germacrene-D, trans-carypohyllene, farnesene and l-bisabolene, bisaboline and thymol, p-cymene,  terpene and trans sabiene hydrate Eugenol, 1,8 cineole, linalool, methyl chavicol , methyl eugenol  linalool, limonene, caryophyllene, farnesene, terpineol, salinene, methyl isoeugeneol, Geraniol, -copaene, fenchone, cubenene, camphene, T-cadinol, -eudesmol, sabinene, myrcene39 (Fig.17).

 

Uses

The plant extracts can be used in relaxing intestinal muscles. The herbaceous plant has anti-nociceptive effects. It is effective in reducing blood glucose. It can reduce diabetes. It is helpful in preventing convulsions and seizures41-43.


      

   BACHELOR’S BUTTON                         Costunoli                   Manolide                                                    Artecanin

  

             Parthenolide                     Balchanin                                              Artemorin

Figure 16: Chemical constituents of Bachelor’s button

 


 

 


                       

  RAM TULSI                                                 Thymol                                 Eugenol                                         Geraniol

     

        Cubenene                          Pinene                                    Camphor                                         Alpha-farnesene                               

Figure 17: Chemical constituents of Ram tulsi


 

CONCLUSION:

The use of herbal medicine is widespread among patients as herbal plants represent a rich or prime source of highly effective conventional drugs for the treatment of arthritis. Although numbers of synthetic drugs are being used as standard treatment for rheumatoid arthritis but they have adverse effect that can compromise the therapeutic treatment. Unfortunately, there is still no effective known medicinal treatment that cures rheumatoid arthritis as the modern medicine can only treat the symptoms of this disease that means to relieve pain and inflammation of joints. With herbal medicines there is reduced risk of side effects and is cost effective. The use of herbal drugs in treatment of rheumatoid arthritis is an alternative and even effective method of treatment of chronic conditions with lesser or no side effects. From the above review it should be evident  that there are many medicinal plants that exert anti arthritic activity. This review makes an attempt to give scientific account of use of valuable medicinal plants in rheumatoid arthritis.

 

ACKNOWLEDGMENT:

The author wants to acknowledge the library of Rungta College of Pharmaceutical Sciences and Research, Kohka-Kurud road Bhilai, for providing necessary literature for the compilation of the work. The authors also want to thanks Shri Santosh Rungta, Chairman, Santosh Rungta Group of Institution for providing necessary facility and infrastructure for the completion of the work.

 

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