Tinospora cordifolia

Tinospora cordifolia گلو

Tinospora cordifolia is an herb used in UNANI to enhance vitality. It is being researched for a variety of health effects, including its effect on diabetes, glucose metabolism, inflammation, immune system support, and neurology which is known by the common names heart-leaved moonseed, guduchi and giloy, is an herbaceous vine of the family  Menispermaceae  indigenous to the tropical areas of India, Myanmar, and Sri Lanka 

   It is an important drug of Indian Systems of Medicine (ISM) and used in medicines since times immemorial. The drug is well known Indian bitter and prescribed in fevers, diabetes, dyspepsia, jaundice, urinary problems, skin diseases and chronic diarrhea and dysentery. It has been also indicated useful in the treatment of heart diseases, leprosy, helmenthiasis and rheumatoid arthritis. The starch obtained from the stem known as “Sat-Giloy” is highly nutritive and digestive and used in many diseases. During last two decades, the drug has been subjected to extensive phytochemical, pharmacological and clinical investigations and many interesting findings in the areas of immunomodulation, anticancer activity, liver disorders and hypoglycemic are reported. The plant is distributed throughout the tropical region of India up to 1,200 m above sea level from Kumaon to Assam, in north extending through West Bengal, Bihar, Deccan, Konkan, Karnataka and Kerala. It is a fairly common plant of deciduous and dry forests, growing over hedges and small

Tinospora cordifolia supplementation improves the ability of macrophages, an immune system cell, to consume their targets, though this effect is not immunostimulatory. Supplementation can also ward off allergies. One study suggests Tinospora cordifolia is as potent as Spirulina  as an anti-allergic supplement.

Preliminary evidence suggests Tinospora cordifolia may provide benefits for people with diabetes. Supplementation of Tinospora cordifolia can reduce the body’s absorption of sugar-derived carbohydrates, and it may also play a role in reducing the pathologies associated with diabetes, like retinopathy and nephropathy. There is currently no human evidence for these effects.

Tinospora cordifolia may be a monoamine oxidase (MAO) inhibitor, which means it may raise catecholamine levels. The plant may also contain phytoandrogen, which means it can protect against DNA damage induced by the environment and radiation therapy. Finally, Tinospora cordifolia may have Adaptogen-like properties.

Venicular names

Sanskrit: guduchi, amrta,

 Punjabi: گلو (Giloy),

 Tamil:  (Shindilakodi),

 Malayalam: (Amruthu, Chittamruthu),

 Kannada: (Amrutha balli)

 Hindi:giloy (गिलोय), guruc (गुरुच), gurcha,

 Gujarati: galac, garo,

 Bengali: Gulancha,

 Marathi: Guduchi (गुडूची), Gulvel

 Odia: Guluchi,

 Myanmar: Nepali: Gurjo (गुर्जो). Konkani

Botanical description  

Tinospora cordifolia commonly named as “Giloy” in Unani belonging to family Menispermaceae is a genetically diverse, large, deciduous climbing shrub with greenish yellow typical flowers, found at higher altitude.In racemes or racemose panicles, the male flowers are clustered and female are solitary. The flowering season expands over summers and winters. A variety of active components derived from the plant like alkaloids, steroids, diterpenoid lactones, aliphatics, and glycosides have been isolated from the different parts of the plant body, including root, stem, and whole plant. Recently, the plant is of great interest to researchers across the globe because of its reported medicinal properties like anti-diabetic, anti-periodic, anti-spasmodic, anti-inflammatory, anti-arthritic, anti-oxidant, anti-allergic, anti-stress, anti-leprotic, anti-malarial, hepatoprotective, immunomodulatory and anti-neoplastic activities. In this review, we focus our attention to: It is a large, deciduous extensively spreading climbing shrub with several elongated twining branches. Leaves simple, alternate, exstipulate, long petioles up to 15 cm long, roundish, pulvinate, both at the base and apex with the basal one longer and twisted partially and half way around. Lamina broadly ovate or ovate cordate, 10–20 cm long or 8– 15 cm broad,

Uses in Indigenous Systems of Medicine

In Unani System, mostly “Sat Giloe” is incorporated in the preparations. “Arq Giloe” prepared from the fresh plant is considered a febrifuge, while “Arq Maul Laham Mako-kashiwala” is a general tonic.

The Ayurvedic drug Guduchi or Amrita is mentioned in various classical texts of Ayurvedic System of Medicine, viz. Charak, Sushrut and Ashtang Hridaya and other treaties like Bhava Prakash and Dhanvantari Nighantu under other various names, viz. Amara, Amritvalli, Chinnarrhuha, Chinnodebha and Vatsadani etc

. In Sushurta Samhita, it is mentioned under “Tikta-Saka Varga” and claimed to be useful in treating Kustha (leprosy), Maha-jvara (a kind of fever), Svasa (asthma) and Aruchi (anorexia). In other treaties i.e. Charak Samhita and Ashtang Hridaya, it has been indicated in diseases like Kamala (jaundice), Jvara (fever) and Vat Rakta (gout), etc.. In Bhava Prakash, it is considered as a bitter tonic, astringent, diuretic and potent aphrodisiac and curative against skin infections, jaundice, diabetes and chronic diarrhoea and dysentery. In Dhanvantari Nighantu, its medicinal properties are mentioned for cure of bleeding piles, promoting longevity, curing itching and erysipelas. The drug also caught the attention of European physicians in India as a specific tonic, antiperiodic and for its diuretic properties and it was included in the Bengal Pharmacopoeia of 1868

T. cordifolia is mentioned in Ayurvedic literature as a constituent of several compound formulations used in general debility, dyspepsia, fever and urinary diseases. Some of the important formulations are: 

Uses in folk and tribal medicine

T. cordifolia finds a special mention for its use in tribal or folk medicine in different parts of the country. Some of the important uses mentioned are given below:

The tribals Baiga, living in the interior areas of Naugarh and Chakia Block of Varanasi district, Uttar Pradesh make the paste of stem of the Guduchi (T. cordifolia) and the roots of Bhatkatiaya (Solanum surattense). The pills are prepared and used in the treatment of fever for three days¹⁸.

The tribals of Bombay and its neighbouring areas and the fishermen along the sea coast use T. cordifolia as drug in the treatment of fever, jaundice, chronic diarrhoea and dysentery¹⁹.

The tribals of Khedbrahma region of North Gujarat use the plant in their day-to-day life as food or medicine. They use powdered root and stem bark of T. cordifolia with milk for the treatment of cancer; decoction of root is used for the cure of dysentery and diarrhoea and decoction of old stems is preferred in the treatment of periodic fever.

Decoction of stem is administered orally by the people of Jammu (J & K) and Bigwada (Rajasthan) for the treatment of fever.

The inhabitants of Bhuvneshwar (Orissa) use the warm juice of root of T. cordifolia orally for the treatment of fever.

Juice or decoction of leaves is administered orally with honey in fever by the local people of Patiyala (Punjab).

The Muslim tribals of Rajouri, Jammu (Tawi) comprising Gujjar and Backwals used the plant in bone fracture.

In Dahanu forest division of Maharashtra, tribal races, viz. Agaris, Bhils, Dhodias, Dublas, Khakaris, Rimoshis, Thakurs, Vardaris, Vagharis and Varlis use the stem decoction with cold or hot water (about 3-4 gm) in morning in an empty stomach as a tonic in general debility.

Shirt of child is dyed in juice of Guduchi and worn in balashosha (emaciation in children) by the inhabitants of Banka (Bihar)

Powder of Terminalia chebula (Haritaki), Tinospora cordifolia (Amrita) and Trachyspermum ammi (Ajwain) in equal quantity is administered orally, once daily early morning with salt for the treatment of cough Decoction of these drugs is also to be taken in dose of 50 ml for the treatment of Kasa (cough) by the people of Dhurala (Haryana) 

Two drops of leaf juice of allied species of Guduchi (T. sinensis) is dropped in the ear for the treatment of pain in ear by the local people of Patiyala (Punjab)

Paste of Guduchi (T. cordifolia) and 5 seeds of Krishna marich (Piper nigrum) is administered orally once daily in morning in leucorrhoea by the local women of Arjunpura (Rajasthan).

The inhabitants of Badala (U.P.) take the juice of stem orally with honey for the treatment of (Asthma).

Decoction of stem is administered orally in case of twak-roga (skin disease) by the people of  Dehrabara Kolaras, Sivpuri District of M.P.

Chemical Constituents

The plant T. cordifolia has been subjected to chemical investigations extensively and a number of chemical constituents belonging to the different groups, viz. terpenoids, alkaloids, lignans, steroids have been reported. Some of the important constituents reported so far are:

Therapeutic Applications

 Anti-cancer/anti-tumour activity:

 Administration of T. cordifolia stem methanolic extract to BALB/c mice (200 mg/kg, i.p. daily for 5 days) increased the total white blood cell count significantly (P<0.001). It also increased bone marrow cellularity  and a-esterase positive cells  in bone marrow indicating increased maturation of stem cells.Treatment with plant significantly inhibited OTA-induced suppression of chemotactic activity and production of IL-1 and TNF-a by macropahges. One of the compounds, NII-70, isolated from T. cordifolia, has been found to activate the macrophages and induced production of IL-12 and TNF-a and antigen specific Th₁ response; NII-70 also induces production of nitric oxide by macrophages and has shown therapeutic effect against Leishmania infection and tumour implant in experimental animals.

Anti-HIV activity

 TCE has been shown to demonstrate a decrease in the recurrent resistance of HIV virus thus improving the therapeutic outcome. Anti-HIV effects of TCE was revealed by reduction in eosinophil count, stimulation of B lymphocytes, macrophages and polymorphonuclear leucocytes and hemoglobin percentage thus, revealing its promising role of application in management of the disease.

Anti Diabetic and Hyperglycaemic activity:

Alcoholic extracts of the stem showed activity against E.coli. Effect on fasting blood sugar, glucose tolerance and against equieprine induced hyperglycemia have been studied. The aqueous and alcoholic extract caused reduction in the fasting blood sugar, which have been interpreted as indicating some indirect action of the drug on carbohydrate metabolism. Similarly, glucose tolerance had increased in the beginning but the deterioration in tolerance occurred after one month. It has been suggested that the action of the drug is due to its favourable effects on the endogenous insulin secretion, glucose uptake inhibition of peripheral glucose release^. The extract caused an increase in body weight, total haemoglobin and hepatic hexokinase. The root extract also lowers hepatic glucose-6-phosphatase and serum acid phosphatase, alkaline phosphatase, and lactate dehydrogenase in diabetic rats. Thus TCREt has hypoglycaemic and hypolipidaemic effect.Histological studies of pancreas did not reveal any evidence of regeneration of ß-cells of islets of Langerhance. The possible mode of action of the drug has been discussed projecting a hypothesis related to control of glucose metabolism⁶¹.

 Anti-inflammatory activity:

The decoction of T. cordifolia showed anti-inflammatory activity.The effect of extract of stem of T. cordifolia was studied on the contractile response due to various agonists  The possible mechanism of antagonistic action of T. cordifolia has been discussed in the light of involvement of various autocoids in the pathophysiology of clinical joint inflammation. The mechanism of potentiating effects of T. cordifolia on NA induced responses is suggested to be due to an uptake blocking effect of T. cordifolia or to an inhibition of metabolism by COMT since MAO inhibition would also produce potentiation of 5-HT responses.

  Antioxidant activity:

Antioxidant activity and amelioration of cyclophosphamide-induced toxicity has been reported. It has an amelioratic effect in aflotoxicosis of duck.

Anti-stress activity:

Ethanol extract of T. cordifolia at the dose of 100 mg/kg exhibited significant anti-stress activity in all the parameters studied, compared with diazepam at the dose of 2.5 mg/kg.

 Anti Ulcer activity:

The ethanol extract of the root of T. cordifolia was observed to induce a marked protective action against restrain stress induced ulcerization. The activity was comparable to that of diazepam.

  Digestive activity

The antiamoebic effect of a crude drug formulation containing T. cordifolia against Entamoeba histolytica was studied. There were varying degrees of inhibition of the enzymes, viz. DNase, RNase, aldolase, alkaline phosphatase, acid phosphatase, -amylase and protease activities of crude extracts of axenically cultured amoebae.

 Anti-arthritic, anti-osteoporotic effects

Single or synergistic formulations of Tinospora cordifolia with Zingiber officinale has been used in rheumatoid arthritis treatment in traditional medicine. Tinospora cordifolia have been reported to affect the proliferation, differentiation and mineralization of bone like matrix on osteoblast model systems in vitroand hence finds potential application as an anti-osteoporotic agent. Alcoholic extract of Tinospora cordifolia have been shown to stimulate the growth of osteoblasts, increasing the differentiation of cells into osteoblastic lineage and also increasing the mineralization of bone like matrix. Ecdysteroids isolated from the plant have been reported of protein anabolic and anti-osteoporotic effects in mammals.

Anti-microbial activity

The methanol extracts of Tinospora cordifolia have been reported to have potential against microbial infections. The anti-bacterial activity of Tinospora cordifolia extracts has been assayed against Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Proteus vulgaris, Salmonella typhi, Shigella flexneri, Salmonella paratyphi, Salmonella typhimurium, Pseudomonas aeruginosa, Enterobacter aerogene, and Serratia marcesenses (Gram-positive bacteria). In mice models, TCE has been reported to function in bacterial clearance and improved phagocytic and intracellular bactericidal capacities of neutrophils.TCE has been reported of immunostimulant properties on macrophages. 

Hypolipidaemic activity

The hypolipidaemic effect of an aqueous extract of roots was evaluated. The root extract at a dose of 5.0 g/kg body weight showed highest hypolipidaemic effect. The effect at the dose of roots at 2.5 and 5.0 g/kg body weight was better than glibenclamide. Insulin restored all the parameters to near normal values. Aqueous extract of T. cordifolia roots when administered (2.5 and 5.0 g/kg body weight) for 6 weeks, resulted in a significant reduction in serum and tissue cholesterol, phospholipids and free fatty acids

Immunobiological activities

The water and ethanol extracts of stem of T. cordifolia inhibit immunosuppression produced by cyclophosphamide. The ethanol extract of stem of the plants inhibits cyclophosphamide-induced anemia.Their proliferation did not require macrophages. The immunobiological activity of ethanolic extract was investigated on delayed type hypersensitivity, It appear that T. cordifolia improves the phagocytic function without effecting the humoral or cell mediated immune system. The activity of a crude extract formulation containing T. cordifolia and other plant drugs was evaluated in experimental amoebic liver abscess in golden hamsters and in immunomodulation studies. In clinical studies, it also showed immunosuppression on obstructive jaundice patients

 Liver disorders:

The drug was also studied against the hepatic damage induced by a standard hepatotoxin – carbon tetra chloride (CCl₄). Though acute damage was aggravated by T. cordifolia, it was proved to be effective in preventing fibrous changes and promoting regeneration by paranchymal tissue. It was found that HPN-12 is an effective drug against CCl₄ induced liver damage.

In clinical studies 20 patients of infective hepatitis were selected on the basis of clinical and biochemical findings. Four tablets (500mg each) thrice in a day, orally with fresh water were given to the patient for 4 weeks. Comparison between before and after treatment of those patients (N=20) were showed that drug T. cordifolia (Guduchi) played an important role in relieving the symptoms as well as normalization of altered liver function test.

Urinary calculi:

The water extract of the stem of T. cordifolia was experimentally evaluated for dissolution of urinary calculi.

 

 Uremia

Pharmacological and clinical study of T. cordifolia was undertaken and its role in uraemia elicited. The water extract produced marked but transient fall in B.P. along with bradycardia and increased force of ventricular contraction in dogs and diuresis in rats. It significantly decreases blood urea levels in uremic dogs and patients.

Post menopausal syndrome

Clinical evaluation of a non-hormonal drug minofil containing T. cordifolia along with other plant drugs was done in women of post-menopausal syndrome. Breast discomfort, nausea and fluid retention was observed in 22% (7 cases) with estriol and almost no side effect was observed with minofil. However, long term follow up is required before universal use in post menopausal syndrome.

Effects on other diseases

A dose dependent reduction in infarct size and in lipid peroxide levels of serum and heart tissue were observed with the prior treatment of Tinospora cordifolia. The activation of macrophages by cytotoxic T cells leads to increase in GM-CSF which leads to leucocytosis and improved neutrophil function. Octacosanol isolated from Tinospora cordifolia inhibits proliferation of endothelial cells and Ehrlich ascites tumor cells, The in vivo administration of alcoholic extract of Tinospora cordifolia has been reported to increase bone marrow derived macrophages (BMDM) in bearing Dalton's lymphoma (DL). 

Toxicity

No significant information on side effects is available so far. Nothing conspicuous has been done as yet in this aspect although many experiments have already been conducted on this plant. According to UNANI, herbs are taken in combination with other herbs with the opposing effect of the other or to enhance the particular effect of one herb with the help of the other.

 

Safety Aspects

The drug is traditionally considered to be safe in the dosage