Andrographis Paniculata (King of Bitters)

Andrographis paniculata, also known in the Netherlands as Indian gentian, is a one-year herb that originated in India and Sri Lanka and has been used for centuries in Ayurveda and Chinese and Thai herbal medicine. In India, the herb is better known as kalmegh and is mainly used in the treatment of digestive problems and fever because of the bitter substances present. Due to its alleged antiparasitic and antimicrobial properties, andrographis was widely used in the treatment of syphilis, malaria, swollen lymph nodes and abscesses in China and India. Before antibiotics became widely available, andrographis was also used in many other cultures to treat syphilis. Nowadays, the standardized extract of Andrographis paniculata is also gaining popularity in Scandinavia as a remedy against upper respiratory tract infections and flu. Test Test One of the most important active ingredients of andrographis is andrographolide, a diterpeen lacton with a very bitter taste. Furthermore, the herb contains other diterpeen lactones, including 14-deoxy-11,12-dehydroandrographolide and neoandrographolide, polyphenols and flavonoids. Several studies have shown that andrographis has immune-enhancing and anti-inflammatory qualities. As an anti-inflammatory, andrographolide in vitro blocks the binding of NF-κB to DNA and thus the expression of various anti-inflammatory proteins, such as COX-2. It also reduces the production of nitrogen oxide (NO) in mitochondria, either by accelerating the breakdown of the nitrogen producing protein iNOS (inducible nitrogen oxide synthase), or by suppressing the expression of this protein. Neoandrographolide also appears to suppress the formation of nitrogen oxide in vitro and ex-vivo. Andrographis extract and the diterpeen lactones 14-deoxyandrographolide and 14-deoxy-11,12-didehydroandrographolide promote in vitro vasorelaxation by inhibiting the inflow of calcium. Both the whole extract of Andrographis paniculata and andrographolide increase the activity of NK cells, increase the production of interleukin-2 (IL-2) and interferon gamma (IFN-γ) and lower the values of anti-inflammatory cytokines, such as IL-1β, IL-6 and TNF α, both in healthy animals and in animals with tumors. A literature study has shown that andrographolide can inhibit the growth of breast, liver and prostate tumours in humans. In addition, andrographolide has neurprotective, antistress and antidiabetic properties, according to various in vitro and animal studies. In a study with rats, andrographolide protected brain tissue after a stroke, including by suppressing NF-κB and the activation of microglia. In a recent literature study, andrographolide is identified as potentially interesting in the prevention and treatment of metabolic syndrome. Andrographis, both alone and in combination with artemisinin or chloroquine, is effective in warding off and killing mosquitoes that transmit malaria (e.g. Plasmodium falciparum and Anopheles stephensi). Andrographis also turns out to be a powerful antioxidant that inhibits in vitro formation of superoxide and hydroxyl radicals and inhibits lipid peroxidation. In mice, andrographis also inhibits the formation of superoxide radicals. In mice with liver fibrosis due to prolonged use of acetaminophen, andrographolide can reduce oxidative stress in the liver and the formation of reactive oxygen compounds (ROS) in hepatic stellaat cells. ROS activates hepatic stellaat cells, turning them into myofibroblasts that multiply and produce excessive scar tissue. The activation of stellaat cells is seen as the most important step in the onset of liver fibrosis and andrographolide appears to have an inhibitory effect on this process. Furthermore, andrographolide, andrographoside and neoandrographolide mice protect against hepatotoxicity (property of certain substances, including drugs, which allows them to damage the liver). The latter two proved to be even as effective as the well-known liver protector silymarin. A Chilean study of mice with non-alcoholic steatohepatitis shows that andrographolide improves inflammatory processes and fibrosis and reduces the activation of inflammatory neuroses. Inflammasomes are cytoplasmic protein complexes that regulate the activity of the enzyme caspase-1 and thus produce anti-inflammatory cytokines, such as IL-1β. Previously, scientists at the University of Ghent had already found that the activity of a specific inflammatory genome (NLRP3) and the resulting secretion of IL-1β plays an important role in the onset and progression of rheumatoid arthritis. IL-1β is highly responsible for the breakdown of cartilage in rheumatoid arthritis. Andrographolide could therefore also have a beneficial effect in this disease. Indeed, a Chinese study of mice and synovial fibroblasts of people with rheumatoid arthritis shows a protective effect of andrographolide. Andrographolide reduces the severity of arthritis and joint damage and inhibits both in vitro and in vivo production of IL-1β and IL-6. In a prospective randomized placebo-controlled trial, 60 patients with active rheumatoid arthritis received 100 mg of a standardized andrographis extract three times a day. After 14 weeks, the sensitivity and swelling of the joints were significantly reduced. Also, the intensity of joint pain was less, albeit not statistically significant. An extract of Andrographis paniculata also appears to have a beneficial effect on ulcerative colitis. In a Chinese double-blind randomized trial, 120 patients with mild to moderately active ulcerative colitis received 400 mg of Andrographis extract three times a day for 8 weeks, or 1,500 mg of the anti-inflammatory mesalazine three times a day. The clinical response was mapped every other week and a colonoscopy was performed after the intervention. After 8 weeks, 76% of patients in the Andrographis group had improvements and 21% were fully in remission. Similar results were found in the mesalazine group: 82% and 16% respectively. The colonoscopy also showed that andrographis extract is as effective in the treatment of collitis ulcerative as mesalazine. Flu and cold As mentioned earlier, andrographis is successfully deployed against upper respiratory tract infections and flu. In a Swedish study of 50 patients with a cold, a standardized andrographis extract was found to reduce subjective symptoms, the duration of complaints and the period of absenteeism. Favourable results were also found in a larger-scale Chilean study. Of a group of 158 cold men and women, one half received 1,200 mg of andrographis extract (5% andrographolide) daily for five days and the other half received a placebo. Prior to and on day 2 and 4 of the intervention, the patients reported the severity of their cold symptoms. After two days, the intensity of a number of symptoms (fatigue, insomnia, sore throat and nasal secretion) in the andrographis group decreased significantly compared to the placebo group. By day 4, the severity of these symptoms had decreased significantly and the earache was also greatly reduced. A review of seven double-blind studies involving a total of 896 participants shows that andrographis is a safe and effective means of reducing the severity of upper respiratory tract infections. There is also evidence that andrographis could prevent a cold. During the winter season, 107 students (age 18 years) received 200 mg of andrographis extract (5.6% andrographolide) or a placebo for three months. During this period, they were checked once a week by a doctor for the on- or absence of cold symptoms. After a month, there was no difference between the two groups in terms of preventing colds. After three months, however, there was a difference: in the andrographis group, 30% of students (16 of the 54) had a cold while 62% of students (33 out of 53) in the placebo group had had a cold. According to the researchers, andrographis can halve the risk of a cold in winter. In high doses, andrographis is also found to have a beneficial effect on strep throat. In a Thai study, 152 adult patients with strep throat received 3 g of andrographis, 6 g of andrographis or acetaminophen daily for a week. The characteristics of the patients at the start of the study were the same in each group. After three days, the effectiveness of acetaminophen and the high dosage of andrographis in terms of fever and sore throat was found to be significantly greater than the lower dose of andrographis. After a week of intervention, the effectiveness was no different. In vitro research shows that a specific andrographolide lacton (14-deoxy-11,12-dehydroandrographolide; DAP) antiviral activity is deployed against the H5N1 influenza A virus. DAP inhibits the replication of H5N1 and curbs the core exports of viral ribonucleoprotein complexes. Furthermore, DAP can curb the increased expression of anti-inflammatory cytokines and chemokines increased by H5N1. Multiple in vitro and in vivo studies show a broad antiviral effect of andrographolide in influenza A, hepatitis B and C, herpes simplex, Epstein-Barr, HIV, human papillomavirus and dengue fever, among others. Antimicrobial action Scientists at the Universiti Malaysia Kelantan have studied the antimicrobial and antioxidant abilities of andrographolide. Andrographolide inhibited in vitro growth of strains of Stafylococcus aureus, Streptococcus thermophilus, Bacillus subtilis, Escherichia coli, Mycobacterium smegmatis, Klebsiella pneumonia and Pseudomonas aeruginosa,but was not effective against the yeasts Candida albicans and Saccharomyces cerevisiae. In addition, andrographolide proved to be a modest free radical catcher. Many bacterial species have a communication mechanism called quorum sensing. Quorum sensing means that bacteria can 'perceive' the population density of their species using excreted signaling molecules and adapt their gene expression accordingly. For example, pathogenic bacteria in the body can increase in number without causing damage, until they switch to a more aggressive appearance at a certain population density. Quorum sensing therefore plays an important role in the regulation of virulence factors of pathogenic bacteria, such as the formation of biofilms and the excretion of toxins. In an Indian in vitro study, andrographolide quorum sensing of Pseudomonas aeruginosa and the formation of biofilms were found to prevent. In addition, andrographolide developed anti-inflammatory activities in macrophages infected with Pseudomonas aeruginosa. Other in vitro research shows that andrographolide also inhibits quorum sensing of Escherichia coli in chickens. This bacterium causes sepsis by invading pneumocytes and breaking the air-blood barrier. Andrographolide reduces the activity and release of virulence factors and damage to pneumocytes. Lyme disease Many of the properties of Andrographis paniculata described above make this herb an important tool in the treatment of Lyme disease. Andrographis is considered one of the first designated herbs for lowering or even eliminating the load of Borrelia burgdorferi-spirochtes in the body, supporting the congenital immune function in the response to borrelia infection and treating certain symptoms of Lyme disease. Before the advent of antibiotics, andrographis was often used in the treatment of syphilis. Treponema pallidum, the bacterium that causes syphilis, is like Borrelia burgdorferi a spirocheet. Special application Mediterranean Fever (Familial Mediterranean Fever; FMF) is a rare genetic disorder for which the gene MEFV is responsible. This gene produces the protein pyrine, which plays a role in controlling inflammatory processes. In FMF, the MEFV gene has mutated, which means that the control over inflammatory processes is not successful. FMF patients have repeated fever attacks that may be accompanied by abdominal pain, chest pain, joint pain and swelling. The disease mainly affects people from mediterranean or Middle Eastern backgrounds. In a small-scale study, 24 FMF patients aged 3-15 years received an herbal combination of Andrographis paniculata, Siberian Gingseng, pepperber and liquorice (48 mg andrographolide per daily dose) or a placebo. After one month, the controlling physicians saw a significant improvement in frequency, duration and severity of seizures in the treatment group compared to the placebo group. Patients in the treatment group reported significant improvements in symptoms such as abdominal or chest pain, fever, muscle pain, wound-like redness and arthritis. (WD) Sources

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