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This review for the first time summarizes these results, with emphasis on published observations. Furthermore, the possible mechanisms responsible for the beneficial effects and lacunas in the existing knowledge that need to be bridged are also discussed.
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Ayurvedic texts describe many formulations for different ailments. Triphala Guggulu (TG) is reputed for treating inflammatory conditions. These formulations have been considered complementary medicine or alternative to conventional medicines across the globe. These complex polyherbal formulations need science-based approach toward manufacturing process and chemical standardization.
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Triphala, a mixture of Emblica officinalis, Terminalia chebula, and Terminalia bellirica, containing ingredients from plant origin, is often prone to microbial contamination. A high level of microbial contamination was observed in Triphala samples obtained from different sources. On gamma radiation processing, a sharp decline in log CFU was observed with increasing radiation dose and a complete decontamination at 5 kGy. Average D10 value for total aerobic and fungal counts were observed to be 0.55 +/- 0.073 kGy and 0.94 +/- 0.043 kGy, respectively. Water extracts of irradiated samples showed linearly increasing concentration of gallic acid (3.3 to 4.5 times), total phenolic contents (2.16 to 2.87 times), and antioxidant properties with increasing radiation dose up to 25 kGy. The increase could be attributed to easy release of active ingredients from their radiation degraded complex forms. Aflatoxin B(1) and ochratoxin could not be detected in the samples. Gamma-radiation dose up to 5 kGy could be safely used to hygienize Triphala.
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This study sought to explore the mechanism of anti-inflammatory effect of triphala in lipopolysaccharide (LPS)-stimulated RAW 264.7 macrophages and in adjuvant-induced arthritic rats. In stimulated RAW 264.7 cells, triphala (100-300 μg/ml) significantly suppressed production of inflammatory mediators (e.g. TNFα, IL-1β, IL-6, MCP-1, VEGF, NO, PGE2), intracellular free radicals and release of lysosomal enzymes (e.g. acid phosphatase, β-galactosidase, N-acetyl glucosamindase and cathepsin D) in a dose-related manner. With triphala, mRNA levels of genes for pro-inflammatory TNFα, IL-1β, IL-6 and MCP-1, inflammatory iNOS and COX-2 enzymes and NF-κBp65 were down-regulated in the stimulated cells; in contrast, there was up-regulation of heme oxygenase-1 (HO-1) expression. Western blot analyses revealed that triphala suppressed the protein expression of NF-κB p65 and p-NF-κB p65 in the stimulated cells, which subsequently reduced over-expression of TNFα, IL-17, iNOS and COX-2 in a manner similar to that observed with BAY 11-7082, an IκB kinase inhibitor. Immunofluorescence analysis revealed inhibition of p-NF-κB p65 nuclear translocation and COX-2 protein expression caused by triphala. Consistent with these findings, the animal studies presented confirmed that triphala exhibited anti-inflammatory effects in a rat adjuvant-induced arthritis model by reducing of inflammatory mediator (e.g. IL-17, COX-2 and RANKL) expression via inhibition of NF-κB activation. Taken together, the results here demonstrated that triphala has potential anti-inflammatory applications that could be used for the treatment of inflammatory disorders, including rheumatoid arthritis.
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Prostate cancer is one of the most commonly diagnosed solid malignancies among US men. We identified gallic acid (GA) as a major bioactive cytotoxic constituent of a polyherbal Ayurvedic formulation - triphala (TPL). Both TPL and GA were evaluated on (AR)(+) LNCaP prostate cancer and normal epithelial cells.
Herbal products from Ayurveda were always in the forefront in providing leads to new drug discovery. Triphala, an ancient Ayurvedic herbal formulation comprises of equal portions of Amalaki, Bibhitaki and Haritaki and is used extensively for constipation, as an anti-inflammatory, analgesic, anti-arthritic, hypoglycemic and an anti-aging agent.
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The triphala group showed a 17% and 44% reduction, while the chlorhexidine group showed 16% and 45% reduction at the end of 48 h and 7 days (P < 0.001). The reduction in CFUs/ml seen in triphala group closely paralleled that of chlorhexidine group.
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Herbal combination of Itrifal Saghir (triphala) has been widely used in traditional medicine. And brings health benefits such as antioxidant effect and scavenger of hydroxyl radicals and nitric oxide radicals activity and substantiated in traditional medicine a anti-obesity.
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LSP (a part of IAYT) is a safe and useful procedure for patients with essential hypertension. LSP with triphala is more useful.
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Triphala is categorized as rejuvenator and traditionally been used in various gastric disorders including intestinal inflammation. The aim of present study was to examine the comparative gastroprotective effects of Triphala formulations against experimental gastric ulcer in rats to substantiate its traditional claim. Gastric ulcer was induced by water immersion plus stress-induced ulcers in rats. The drug effects were assessed by studying macroscopic gross injury and stomach tissue biochemical parameters. Triphala unequal formulation and Chinnodbhavadi kwath showed significant antiulcer activity and this is evident from reduction of ulcer index, lipid peroxidation and hydroxyl radical levels and concomitantly raised levels of catalase and superoxide dismutase. Though similar kind of activity was observed in Triphala equal formulation the magnitude was much less. Further, Chinnodbhavadi kwath significantly increased the glutathione and ATPase level but Triphala equal formulation significantly increased glutathione level only. Based on the data generated, it is suggested that among the three formulations studied, Chinnodbhavadi kwath and Triphala unequal formulations provides significant protection in gastric ulcer as compared to Triphala equal formulation.
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Functional constipation is one of the most common gastrointestinal symptoms across the globe. Its high prevalence rate, economic burden, and adverse implications on the quality of life make constipation a major public health issue. Though various treatment options are available for the management of constipation, evidence for their efficacy and safety are limited. An open-label, prospective, interventional, and exploratory clinical trial was carried out to evaluate the efficacy and safety of "TLPL/AY/01/2008" in 34 patients suffering from functional constipation. "TLPL/AY/01/2008" is an Ayurvedic proprietary polyherbal formulation in powder form, containing Isabgol husk, Senna extract, and Triphala extract. Administration of "TLPL/AY/01/2008" for 14 days showed a significant increase in mean weekly bowel movements from 10.19 ± 05.64 to 18.29 ± 05.72 (P<0.05). The mean average time spent on toilet for bowel evacuation reduced significantly from 11.02 ± 05.43 minutes (baseline value) to 08.70 ± 04.72 minutes on day 14 (P<0.05). Mean stool form score assessed on Bristol stool form scale was improved from 02.97 ± 00.48 (baseline value) to 04.61 ± 00.84 (P<0.05) on day 14. A significant improvement (P<0.05) was also noted in straining during defecation, sensation of incomplete evacuation, sensation of anorectal blockage, and other associated symptoms of functional constipation. The significant improvement in most of the above symptoms was endured for a post-treatment observatory period of one week. All the study patients showed an excellent tolerability to the study drug. These findings suggest that "TLPL/AY/01/2008" is an effective, safe, and non-habit-forming herbal laxative formulation for the management of constipation. Comparative clinical studies with larger sample size would be able to confirm the above findings.
In this study, Triphala exhibited better antimicrobial activity against E. faecalis compared to 0.5 and 1% NaOCl (P<0.05).
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A controlled, randomized, double-blind, crossover clinical trial was designed. Thirty subjects underwent four consecutive experimental phases with four treatments: Triphala, Hi Ora, Chlorhexidine and Colgate Plax. On the day of study, the subjects discontinued all other oral hygiene habits and were randomly assigned for treatment with the experimental mouthwash. Each experimental phase was preceded by a 28-day washout period. Plaque formation was recorded after one undisturbed day.
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Bromobenzene treatment resulted in significant (P< 0.05) decreases in the activities of antioxidant enzymes such as catalase, superoxide dismutase, glutathione-S-transferase and glutathione peroxidase as well as total reduced glutathione. There was a significant (P< 0.05) increase in lipid peroxidation in kidney tissue homogenates. There were significant (P< 0.05) reductions in the levels of serum total protein and albumin as well as significant (P< 0.05) increases in serum creatinine, urea and uric acid. The oral administration of two different doses (250 and 500 mg/kg) of Triphala in bromobenzene-treated rats normalized the tested parameters. The histopathological examinations of kidney sections of the experimental rats support the biochemical observations.
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Terminalia species are a rich source of tannins. Many preparations of these species are used in traditional medicine and have many different ethnobotanical applications. A simple UHPLC method was developed for the simultaneous analysis of such hydrolysable tannins and triterpene saponins from the fruit rinds of different species of Terminalia (T. chebula, T. arjuna, T. bellirica) and Phyllantus emblica. A separation by LC was achieved using a reversed-phase column and a water/acetonitrile mobile phase, both containing formic acid, using a gradient system and a temperature of 40°C. Eight hydrolysable tannins (gallic acid, gallic acid methyl ester, corilagin, chebulagic acid, 1,2,3,6-tetra-O-galloyl-β-D-glucose, ellagic acid, chebulinic acid, and 1,2,3,4,6-penta-O-galloyl-β-D-glucose) and six triterpene saponins (arjunglucoside-I, arjunglucoside-III, chebuloside II, bellericoside, arjunetin, and arjunglucoside-II) could be separated within 20 minutes. The wavelength used for detection with the diode array detector was 254 and 275 nm for tannins and 205 nm for triterpene saponins. The method was validated for linearity, repeatability, limits of detection, and limits of quantification. The developed method is economical, fast, and especially suitable for quality control analysis of tannins and triterpene saponins in various plant samples and commercial products of Terminalia.
Ninety individuals with chronic generalized gingivitis were randomly assigned to three groups: 1) group I, placebo mouthwash; 2) group II, TRP mouthwash; and 3) group III, chlorhexidine (CHX) mouthwash. All individuals were instructed to rinse with their respective mouthwash twice daily. 1) Plaque index (PI); 2) gingival index (GI); 3) oral hygiene index-simplified (OHI-S); and 4) microbiologic colony counts were recorded at baseline and at 7, 30, and 60 days.
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Stress is one of the basic factors in the etiology of number of diseases. Cold-stress occurs when the surrounding temperature drops below 18 degrees C, the body may not be able to warm itself, and hence serious cold-related illnesses, permanent tissue damage and death may results. The present study was aimed to investigate the effect of Triphala (Terminalia chebula, Terminalia belerica and Emblica officinalis) against the cold stress-induced alterations in the behavioral and biochemical abnormalities in four different groups (saline control, Triphala, cold-stress and Triphala with cold-stress) of Wistar strain albino rats. In this study cold-stress (8 degrees C for 16 h/d/15 days) was applied and the oxidative stress was assessed by measuring the extent of lipid peroxidation (LPO) and the changes in corticosterone levels. Upon exposure to the cold-stress, a significant (P<0.05) increase in immobilization with decrease in rearing, grooming, and ambulation behavior was seen in open field. Following cold-exposure, significant increase in the LPO and corticosterone levels was observed. Oral administration of Triphala (1 g/kg/animal body weight) for 48 days significantly prevented these cold stress-induced behavioral and biochemical abnormalities in albino rats. The results of this study suggest that Triphala supplementation can be regarded as a protective drug against stress.
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Triphala is categorized as a rejuvenator and antioxidant-rich Ayurvedic herbal formulation and has traditionally been used in various gastric problems including intestinal inflammation. The aim of the present study was to examine the comparative enteroprotective effect of Triphala formulations against methotrexate-induced intestinal damage in rats. Triphala formulations were prepared by mixing equal (1:1:1) and unequal (1:2:4) proportions of Terminalia chebula Retz., Terminalia belerica (Gaertn.) Roxb. and Emblica officinalis Gaertn. Intestinal damage was induced by administering methotrexate (MTX) in a dose of 12 mg/kg, orally for 4 days to albino rats. The intestinal damage response was assessed by gross and microscopical injury, measuring the intestinal permeability to phenol red and tissue biochemical parameters. Triphala equal and unequal formulations at the dose of 540 mg/kg significantly restored the depleted protein level in brush border membrane of intestine, phospholipid and glutathione content and decreased the myeloperoxidase and xanthine oxidase level in intestinal mucosa of methotrexate-treated rats. In addition, Triphala unequal formulation showed significant decrease in permeation clearance of phenol red with significant attenuation in the histopathological changes, level of disaccharidase in brush border membrane vesicles and lipid peroxidation content of intestinal mucosa. Based on the data generated, it is suggested that Triphala unequal formulation provides significantly more protection than Triphala equal formulation against methotrexate-induced damage in rat intestine.
Three gallotannins (3-5) from Terminalia fruits acting as enhancers of both PPARα and PPARγ signaling increased insulin-stimulated glucose uptake without inducing the adipogenesis, with 1,2,3,6-tetra-O-galloyl-β-D-glucose (4) being the most effective in stimulating glucose uptake and 1,2,3,4,6-penta-O-galloyl-β-D-glucose (5) being most effective in increasing PPAR protein expression.
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Dushta Pratishyaya is the chronic stage of Pratishyaya, which occurs due to neglect or improper management of the disease Pratishyaya. In modern science, chronic sinusitis can be correlated with Dushta Pratishyaya on the basis of the signs, symptoms, complications, and prognosis. Changing lifestyles, rapid urbanization, and the increase in cases of antibiotic resistance are responsible for the rise in the prevalence of sinusitis. In the present clinical study, 37 patients were registered and were randomly divided into three groups: A, B, and C; of the 37 patients, 31 completed the full course of treatment. In group A, Trayodashanga Kwatha with Madhu was given orally; in group B, Pradhamana Nasya with Trikatu + Triphala Churna was administered; and in group C (combined group), Pradhamana Nasya was administered initially, followed by oral Trayodashanga Kwatha with Madhu. In group A, complete relief was observed in 10% of the patients; in group B, marked improvement was observed in 81.82% of patients; and in group C, marked relief was observed in 60% of patients. In comparison to other groups (Group A and Group B), Group C showed percentage wise better results in most of the symptoms.
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Pharmacognostical and preliminary phytochemical studies of Triphala churnam were carried out. The churnam of triphala consists of equal quantities of deseeded fruits of Terminalia chebula, Terminalia bellerica and Emblica officinalis. Triphala is exclusively used in more than 200 drug formulations in Indian system of Medicine. The present study involved the pharmacognostical evaluation of Triphala, in which morphological and powder microscopical characters were established. In addition, physico-chemical parameters such as ash values viz, total ash (10.21± 0.42), acid insoluble ash (2.54 ± 0.06), water-soluble ash (5.46±0.24) and sulphated ash (13.12 ± 0.63), extractive values viz, alcohol soluble extractive (11.20±0.18)) and water-soluble extractive (52.56±2.04), fluorescent analysis and microchmical tests were determined. The preliminary phytochemical study revealed the presence of carbohydrates, reducing sugar and tannins in aqueous extract and carbohydrates, flavonoids and tannins in alcoholic extract. This standardization would be very much helpful for the identification of Triphala churnam to differentiate from other powdered sources.
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Stress is one of the basic factors in the etiology of number of diseases. The present study was aimed to investigate the effect of Triphala (Terminalia chebula, Terminalia belerica and Emblica officinalis) on noise-stress induced alterations in the antioxidant status and on the cell-mediated immune response in Wistar strain male albino rats. Noise-stress employed in this study was 100 dB for 4 h/d/15 days and Triphala was used at a dose of 1 g/kg/b.w/48 days. Eight different groups of rats namely, non-immunized: control, Triphala, noise-stress, Triphala with noise-stress, and corresponding immunized groups were used. Sheep red blood cells (5 x 10(9) cells/ml) were used to immunize the animals. Biochemical indicators of oxidative stress namely lipid peroxidation, antioxidants superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), ascorbic acid in plasma and tissues (thymus and spleen) and SOD, GPx and corticosterone level in plasma were estimated. Cell-mediated immune response namely foot pad thickness (FPT) and leukocyte migration inhibition (LMI) test were performed only in immunized groups. Results showed that noise-stress significantly increased the lipid peroxidation and corticosterone level with concomitant depletion of antioxidants in plasma and tissues of both non-immunized and immunized rats. Noise-stress significantly suppressed the cell-mediated immune response by decreased FPT with an enhanced LMI test. The supplementation with Triphala prevents the noise-stress induced changes in the antioxidant as well as cell-mediated immune response in rats. This study concludes that Triphala restores the noise-stress induced changes may be due to its antioxidant properties.
Triphala is a traditional herbal formulation consisting of dried fruits originating from three medicinal plants, namely Terminalia chebula, Terminalia bellerica and Phyllanthus emblica. It is used in folk medicine for the treatment of headaches, dyspepsia and leucorrhoea. There are some reports regarding Triphala's pharmacological effects including its anti-cancer, radioprotective, hypocholesterolaemic, hepatoprotective and anti-oxidant activities. The most important components of these plants are the tannins and gallic acid which they contain. Gallic acid being a compound with tannin structure existing in the Triphala fruit. In this research, the gallic acid content contained in the three plants constituting Triphala was determined. Plant fruits were purchased from available Iranian markets. Milled and powdered fruits from each plant were extracted with 70% acetone and subjected to a reaction with rhodanine reagent in the process forming a colored complex. The complex's absorbance was measured at 520 nm and the amount of gallic acid was determined using its calibration curve. According to the results, the highest amount of gallic acid was observed in Phyllanthus embelica (1.79-2.18%) and the lowest amount was found in Terminalia chebula (0.28-0.80%). Moreover, differences between plant samples from different markets places were found to be statistically significant (p < 0.05). These differences can possibly be due to the source of plant preparation, storage condition and period of Triphala storage. In general, the rhodanine assay is a simple, rapid and reproducible method for the standardization of Triphala as gallic acid.
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Triphala (Sanskrit tri = three and phala = fruits), composed of the three medicinal fruits Phyllanthus emblica L. or Emblica officinalis Gaertn., Terminalia chebula Retz., and Terminalia belerica Retz. is an important herbal preparation in the traditional Indian system of medicine, Ayurveda. Triphala is an antioxidant-rich herbal formulation and possesses diverse beneficial properties. It is a widely prescribed Ayurvedic drug and is used as a colon cleanser, digestive, diuretic, and laxative. Cancer is a major cause of death, and globally studies are being conducted to prevent cancer or to develop effective nontoxic therapeutic agents. Experimental studies in the past decade have shown that Triphala is useful in the prevention of cancer and that it also possesses antineoplastic, radioprotective and chemoprotective effects.