Antiarthritic Activity of a Standardized, Multiherbal, Ayurvedic Formulation containing Boswellia serrata: In Vitro Studies on Knee Cartilage from Osteoarthritis Patients

Abstract

A validated in vitro model of cartilage damage and published data were used showing that this model measures the chondroprotective and antiinflammatory effects of different antiarthritic drugs. In this report, this model was used to evaluate the effects of a new antiarthritic Ayurvedic formulation containing Zingiber officinale root, Tinospora cordifolia stem, Phyllanthus emblica fruit and oleoresin of Boswellia serrata. Glucosamine sulphate was used as a positive control in the study. Aqueous extracts of each drug were tested on explant cultures of knee cartilage obtained from osteoarthritis patients undergoing knee replacement surgery. The new formulation caused a sustained and statistically significant inhibition in the release of glycosaminoglycans and aggrecan by cartilage explants from these patients. This formulation also induced a transient antiinflammatory effect as measured by a reduction in the levels of nitric oxide released by explants. Furthermore, the data strongly suggest that oleoresin of B. serrata plays a crucial role in the chondroprotective and antiinflammatory activity of this formulation. In summary, this report provides the first, direct, in vitro biochemical evidence of anti-arthritic activity a new Ayurvedic formulation. This formulation significantly reduced damage of articular knee cartilage from chronic osteoarthritis patients.

A pilot, randomized, double‐blind, placebo‐controlled trial to assess the safety and efficacy of a novel Boswellia serrata extract in the management of osteoarthritis of the knee

“…In this context, Panahi et al () have shown that curcuminoids significantly reduce WOMAC, VAS, and Lequesne's pain functional index scores and concluded that curcuminoids also represent an effective and safe alternative treatment for OA. Earlier studies using knee cartilage at in vitro conditions demonstrated the anti‐arthritic effects of an Ayurvedic formulation containing Zingiber officinale root, Tinospora cordifolia stem, Phyllanthus emblica fruit, and oleoresin of B. serrata (Sumantran et al, ). Specifically, oleoresin of B. serrata was shown to play a crucial role in the chondroprotective and anti‐inflammatory activity in OA patients (Sumantran et al, ).…”

“…Earlier studies using knee cartilage at in vitro conditions demonstrated the anti‐arthritic effects of an Ayurvedic formulation containing Zingiber officinale root, Tinospora cordifolia stem, Phyllanthus emblica fruit, and oleoresin of B. serrata (Sumantran et al, ). Specifically, oleoresin of B. serrata was shown to play a crucial role in the chondroprotective and anti‐inflammatory activity in OA patients (Sumantran et al, ). An earlier study using a triterpene‐rich extract of Vitellaria paradoxa against OA showed a decrease in tumor necrosis factor alpha and a cartilage degradation marker CTX‐II (Cheras, Myers, Paul‐Brent, Outerbridge, & Nielsen, ).…”

“…No clinically significant abnormal lab values were identified, and no statistically significant changes in the vitals were observed from the baseline to the final visits. Although few high values were reported, they were categorized as "not clinically significant" by the study investigator owing to their marginal borderline values from the lab (Sumantran et al, 2011). Specifically, oleoresin of B. serrata was shown to play a crucial role in the chondroprotective and anti-inflammatory activity in OA patients (Sumantran et al, 2011).…”

Phytomedicine in Joint Disorders

“…A BS preparation enriched in active principles was able to hinder cartilage breakdown by metalloproteinase-3 (MMP-3) and to block Intercellular Adhesion Molecule 1 (ICAM-1) and thereby the inflammatory reaction [21]. In another study a B. frereana preparation decreased the synthesis/ activation of several inflammation-related mediators and enzymes (MMP-9 and MMP-13, cycloxygenase-2, nitric oxide, prostaglandin E2), thus thwarting collagen and cartilage dissolution [22].A poly-herbal formulation containing Zingiber officinale root, Tinospora cordifolia stem, Phyllanthus emblica fruit and oleoresin of BS has been shown to halt cartilage degradation in the knee (decreased release of glycosaminoglycans and aggrecan) associated with antiinflammatory activity (as assessed by lower levels of nitric oxide) [23]. Another combination including three herbs (Uncaria tomentosa, Boswellia spp., Lepidium meyenii) and an aminoacid (L-leucine) has been shown to hamper inflammation and protect the articular cartilage.…”

Meniscal tear as potential steering factor for inflammation may aggravate arthritis: two case reports

“…Chondroitin sulfate was used as a standard [3]. The GAG levels were expressed as microgram equivalents of chondroitin sulfate per milliliter of SF.…”