Dr. Samir Malhotra , MD, DM (PGIMER, Chandigarh )
Dr. Amrit Pal Singh, MD (Alternative Medicine), Medical Executive. Ind ? Swift Ltd Samir Malhotra, Amrit Pal Singh, A.S.Sandhu.
Abstract:
Objective: To study the anti-psoriatic activity ofbenzene extract of Cassia tora - [CT-s125].
Authors
Samir Malhotra, Amrit Pal Singh, A.S.Sandhu.
Abstract
Objective: To study the anti-psoriatic activity ofbenzene extract of Cassia tora - [CT-s125].
Methods
Authentical plant material was purchased from reputed source, the extraction was carried out with soxhlet apparatus using benzene. Infra red (IR) method was used for determination of chrysophanic acid in the extract. The extract of the whole plant was tested positive for chrysophanic acid using confirmatory tests. The study was carried out in 28 patients suffering from psoriasis. The result was evaluated in terms of psoriasis score.
Results
The ointment containing benzene extract of Cassia tora showed activity in 23 psoriatic patients. The significant point was reduction in number of papulo-squamous lesions in majority of the patients.
Conclusions
Chrysophanic acid has significant anti-psoriatic activity.
Introduction
Medicinal plants constitute an effective source of traditional [Ayurvedic, Unani and Homeopathy] and modern medicine. About 80% of rural populations depend on medicinal herbs as their primary health care [1]. In India, various medicinal herbs are used for curing different ailments with remarkable success. Among the enormous number of these medicinal plants are members of the genus Cassia.
The genus is represented by various species in the world. However, only few species, Cassia tora, Cassia occidentalis, Cassia obovata and Cassia fistula have been reported to have medicinal properties [2]. Extracts of seeds of Cassia tora are popular remedy for the treatment of skin diseases characterized by scale formation.
The medicinal herb is used for the relief of constipation and belongs to the family Leguminoseae [3]. The seeds are reported to contain anthracene derivatives like chrysophanic acid, chrysophanol, emodin, aloe-emodin and rhein [4]-.The active constituents have laxative property [5].
Psoriasis is a chronic skin disorder, which is characterized by scaling skin eruptions caused by keratinocyte hyperproliferation. The characteristic lesions are pink-red, silvery and sharply demarcated.Taking into consideration the problem of unavailability of suitable drugs for the treatment of psoriasis and increasing popularity of herbal drugs among patients, activity of benzene seed extract of Cassia tora against psoriasis is reported here.
Materials and Methods:
A. Plant material
1. Sampling: Before evaluation of Cassia tora, a sample was drawn for analysis. Considerable care was exercised to ensure that this sample was truly representative.
The fresh plant seed was purchased from Gopal provisional store, Chandigarh (concerned person specializes raw Ayurvedic drugs) in November 1999.The plant was identified by Dr.A.S.Sandhu in the Department of Natural Products, National Institute of Pharmaceutical Education & Research (NIPER) Mohali.
2. Preliminary examination
Macroscopic and quantitative microscopic examination lycopodium score method) for foreign matter was carried out and it was removed.
3. Extraction
The dried seeds were worked into a fine powder, using a Waring blender. The powdered drug was of pungent taste and brown color. After complete trituration [a process of treating a drug in a pestle and mortar].
The ingredients of the powdered seeds were then extracted with 200-ml of water in a Soxhlet extractor apparatus. The extract was further treated with benzene, as a result of which yellow powder was obtained.
It was referred to as chrysophan, which on treatment with dilute sulfuric acid yielded a brown amorphous mass, termed as Chrysophanic acid [6 $ 7]. The extract was sterilized, using a membrane filtration unit. The resulting sterile extract was aseptically transferred into a labeled sterile bottle.
The chrysophanic acid in the extract was estimated by Infrared (IR) methodology [8]. Normally the process of electrophoresis is used for determination of chrysophanic acid in plant flora [9]. One part of the drug was triturated with four parts of Vaseline to obtain uniform ointment.
B. Patient's study & criteria of evaluationThe incidence of psoriasis was investigated by studying all the patients who were called at Sohana eye hospital near Chandigarh during a specific day.
The patients were examined thoroughly and it took 2 doctors and 5 hours to complete the program. Psoriasis was present in 28 patients and majorities were from rural background. Females in age group of 25 years were predominating. Contact with rubber was reported in 25-year-old female patient.One person gave history of physical injury.2 patients in age group of 19 and 25 years gave family history of psoriasis. The written consent of the patients was taken for trial purpose. Patients diagnosed with psoriasis were asked to apply the ointment of the herbal drug [CT-s 125].
They were directed to look for any local reaction, itching or blister formation. They were directed to undergo treatment for 30 days and asked to report on due date.
They were also advised to consult the same doctors, if some side effect was encountered.The response to therapy was evaluated at time interval of 4 weeks by calculating psoriasis score [PS]. Efficacy was determined by enhancement inpsoriasis score [P.S] at the end of 30 days of treatment and it was graded as shown in following table.
| Score | |||
| 1 | 2 | 3 | 4 |
| No Reduction | 20% | 55-65% | 70% |
[Reduction was observed in terms of psoriasis score[P.S] | |||
1] -------------- Poor response.
2]--------------- Fair response.
3]-------------- Good response.
4]-------------- Excellent response.
Psoriasis score [P.S] is a parameter, which helps in determination of improvement in psoriatic lesions [reduction of papulo-squamous lesions, improvement in texture of nails and yellow discoloration]. Greater the P.S, more favorable is action of the drug.
In case of various drugs used in treatment of psoriasis; it is determined by calculating the time taken by the drug in showing the improvement. Psoriasis score [P.S] of Cassia tora was found greater than Psoralia corlyfolia and Berberis aquifolium [10].
The active principles of the herbs [psoralen and berberine] find application in formulations written in old texts of Ayurveda [11]. Final assessment was carried out after 4 weeks.
Results
23 out of 28 patients attended the 2nd phase of the clinical trial after 1 month. Most of the patients responded to the remedy. After 4 weeks, 8 patients showed 15-33% improvement, 5 patients showed 35-60 % improvement and 10 patients showed less than 25% improvement.
Thus it was concluded that 30% of the patients showed significant improvement in terms of psoriasis score [P.S]. Slight itching and blister formation was reported in couple of cases but they disappeared on discontinuation of the treatment.
Discussion
In case of treatment it was concluded that results shown by the herbal drug were in comparison to Psoralen and Berberine but it often failed to bringback complete remission in the diseased area. The significant point was reduction in number of papulo-squamous lesions in majority of the patients.
Important parameters:
Ash value of the herbal drug was 4.4%
Water solubility was 3.6%
Moisture determination was 11.8%.[13].
Acknowldegements
1.The work was carried out at Ayurvedic wing, Sohana Eye Institution, Sohana (Mohali).
2. We are highly thankful to Dr Rajnish Chabra.Organic chemist, Max India & Dr.Satish Narula, Professor, Punjab Agriculture University, Ludhiana for their expertise in Phytochemistry and Botanical consultation.
References
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13 William Dymock, C.J.H Warden, David Hooper, Pharmacographia indica-A History of the Principal Drugs of Vegetable Origin.LPP82 515-516.