Chemical Compositions of Metals in Bhasmas and Tibetan Zuotai Are a Major Determinant of Their Therapeutic Effects and Toxicity

Abstract

Minerals are alchemically processed as Bhasmas in Ayurvedic medicines or as Zuotai in Tibetan medicines. Ayurveda is a knowledge system of longevity and considers the mineral elixir made from “nature” capable of giving humans perpetual life. Herbo-metallic preparations have a long history in the treatment of various diseases in India, China, and around the world. Their disposition, pharmacology, efficacy, and safety require scientific evaluation. This review discusses the Bhasmas in Ayurvedic medicines and Zuotai in Tibetan medicines for their occurrence, bioaccessibility, therapeutic use, pharmacology, toxicity, and research perspectives. A literature search on Mineral, Bhasma, Ayurvedic medicine, Zuotai, Tibetan medicine, and Metals/metalloids from PubMed, Google and other sources was carried out, and the relevant papers on their traditional use, pharmacology, and toxicity were selected and analyzed. Minerals are processed to form Bhasma or Zuotai to alter their physiochemical properties distinguishing them from environmental metals. The metals found in Ayurveda are mainly from the intentional addition in the form of Bhasma or Zuotai. Bhasma and Zuotai are often used in combination with other herbals and/or animal-based products as mixtures. The advanced technologies are now utilized to characterize herbo-metallic preparations as Quality Assurance/Quality Control. The bioaccessibility, absorption, distribution, metabolism, and elimination of herbo-metallic preparations are different from environmental metals. The pharmacological basis of Bhasma in Ayurveda and Zuotai in Tibetan medicines and their interactions with drugs require scientific research. Although the toxic potentials of Bhasma and Zuotai differ from environmental metals, the metal poisoning case reports, especially lead (Pb), mercury (Hg), and arsenic (As) from inappropriate use of traditional medicines, are increasing, and pharmacovigilance is desired. In risk assessment, chemical forms of metals in Bhasma and Zuotai should be considered for their disposition, efficacy, and toxicity.

Zuotai (β-HgS)-containing 70 Wei Zhen-Zhu-Wan (Rannasangpei) differs from mercury chloride and methylmercury on hepatic cytochrome P450

“…Minerals (metals) in traditional medicines are the matter of debate on their e cacy and toxicity potentials [7,20]. In the present research, we examined the effects of β-HgS-containing Zuotai and Zuotaicontaining 70W on hepatic CYP 1-4 and CYP-7 families, and their corresponding nuclear receptors, compared to HgCl 2 and MeHg at both mRNA and protein levels.…”

“…The Tibetan medicine has thousand years of history and is still used in the world today for a variety of diseases, including liver diseases [1][2][3][4][5][6]. Herbal-metallic preparations are believed to assist the delivery of drugs to the target, contribute to therapeutic effects, and reduce toxicity [7,20]. 70W is one of famous Tibetan medicines listed in the 2015 Edition of Chinese Pharmacopoeia in the treatment of various diseases [3][4][5][6][7].…”

“…Herbal-metallic preparations are believed to assist the delivery of drugs to the target, contribute to therapeutic effects, and reduce toxicity [7,20]. 70W is one of famous Tibetan medicines listed in the 2015 Edition of Chinese Pharmacopoeia in the treatment of various diseases [3][4][5][6][7]. We have shown that 70W is effective against CCl 4 -induced liver injury [11] and protected LPS plus MPTP-induced neurotoxicity in mice [8], and the present study further demonstrated that the hepatoprotective effects of 70W is not due to the inhibition of CYP450 to reduce CCl 4 bioactivation, rather than due to activation of the Nrf2 antioxidant pathway [11].…”

“…Zuotai is included in 70W in a small amount [2][3][4]8]. The chemical speciation, spatial distribution of mercury from Zuotai are different from that of HgCl 2 [7,18], resulting in differential toxicity when compared to environmental mercury compounds (HgCl 2 and MeHg) in experimental animals and cultured human cells [24][25][26][27][29][30][31]. In patients taking Zuotai-containing Tibetan medicines, mercury toxicity to the liver and kidney was mild, tolerable and reversible [10,[21][22][23].…”

“…We have recently reviewed the relevant literature and indicated that chemical compositions of minerals (metals) are a major determinant of their therapeutic effects and toxicity in Tibetan medicines [7]. 70W…”