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Rasayana Drugs From the Ayurvedic System of Medicine as Possible Radioprotective Agents in Cancer
Treatment
Manjeshwar Shrinath Baliga, Sharake Meera, Lalit Kumar Vaishnav, Suresh Rao and Princy Louis Palatty
Integr Cancer Ther 2013 12: 455 originally published online 4 June 2013
DOI: 10.1177/1534735413490233
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research-article2013

ICTXXX10.1177/1534735413490233Integrative Cancer TherapiesBaliga et al

Article

Rasayana Drugs From the Ayurvedic

System of Medicine as Possible
Radioprotective Agents in Cancer
Treatment

Integrative Cancer Therapies

12(6) 455463
The Author(s) 2013
Reprints and permissions:
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DOI: 10.1177/1534735413490233
ict.sagepub.com

Manjeshwar Shrinath Baliga, PhD, MBA1, Sharake Meera, BAMS2,

Lalit Kumar Vaishnav, BAMS3, Suresh Rao, MD3 and Princy Louis Palatty, MD1

Abstract
The use of ionizing radiation, which is the cornerstone of cancer treatment, is compromised by the radiosensitivity of
normal tissues. A chemical that can give selective benefit to the normal cells against the deleterious effects of ionizing
radiation has been a long-sought goal. However, most of the compounds studied have shown inadequate clinical application
owing to their inherent toxicity, undesirable side effects, and high cost. Studies carried out in the past 2 decades have
shown that some of the classical Indian Ayurvedic drugs (Amritaprasham, Ashwagandha Rasayana, Brahma Rasayana,
Chyavanprasha, Narasimha Rasayana, and Triphala Churna) possess radioprotective effects. In the current review, an
attempt is made to summarize the radioprotective observations of these Ayurvedic drugs and the mechanisms responsible
for the radioprotective effects.
Keywords
radiation protection, cancer, Ayurveda, Rasayana drugs, polyherbal preparations

Introduction
The effective use of ionizing radiation is compromised by
the side effects resulting from the sensitivity of the bordering normal tissues. Accordingly, the use of compounds that
can protect normal tissues against radiation injury has been
a long-sought goal as in addition to protecting the normal
tissue it will also permit use of higher doses of radiation to
obtain better cancer control and possible cure.1 Since the
discovery by Patt et al2 that pretreatment with cysteine protected rats against X-ray-induced mortality, several compounds have been synthesized and tested for their
radioprotective properties. The sulfydryl compounds were
found to be good radioprotectors but unfortunately their
inherent toxic effects at their optimal protective doses were
a major deterrent to their clinical use.3,4
Herbal drugs offer an alternative to synthetic compounds
and are considered either nontoxic or less toxic3 and experimental studies have shown that the Ayurvedic drugs
Amritaprasham,5-7 Ashwaganda Rasayana,5-7 Brahma
Rasayana,6-14 Chyavanaprasha,14 Narasimha Rasayana,5-7
and Triphala15-18 possess radioprotective effects. In the current review, for the first time an attempt is made to summarize these observations with emphasis on the plausible
reasons responsible for the radioprotective effects.

Traditional Ayurvedic Drugs With

Radioprotective Effects
Ayurveda (in Sanskrit Ayur means life, and Veda means
knowledge) the traditional Indian system of medicine, is
one of the worlds oldest medical systems.3 The concept
and treatment principles of Ayurveda are different from
that of the modern medicine. Whereas modern medicine is
evidence based and makes use of a distinct well-defined
chemical entity for treatment, emphasis in Ayurveda is
mainly on disease prevention and promotion of good health
by following proper lifestyle and by adopting measures of
rejuvenation.19,20
According to the Ayurvedic system of medicine, the
body is composed of tridosha, known as Vata, Pitta, and
Kapha, the psychophysiological principles that regulate
various functions in the body. Vata governs functions
1

Father Muller Medical College, Mangalore, Karnataka, India

Sanjeevini Ayurveda, Mangalore, Karnataka, India
3
Mangalore Institute of Oncology, Mangalore, Karnataka, India
2

Corresponding Author:
Manjeshwar Shrinath Baliga, Research and Development, Father Muller
Medical College, Kankanady, Mangalore 575002, Karnataka, India.
Email: shrinath.research@gmail.com

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Integrative Cancer Therapies 12(6)

associated with the movement and communication. Pitta

governs functions associated with metabolism, digestion,
and transformation. Kapha governs the structure and cohesion of the body. For optimal functioning of the body, the
3 doshas need to be in a state of equilibrium with each
other and its alterations affect the normal functions and
health of the individual. The balance in tridosha is highly
sensitive and is susceptible to variation because of age,
environmental changes (diurnal, nocturnal, and seasonal
modifications) and altered lifestyle (changes in food habits, physical activity).19-21
Exposure to ionizing radiation alters the balance and leads
to the irreversible changes in the tridoshas that are visible as
radiation sickness and when severe causes mortality.15 The
classical Ayurvedic drugs Amritaprasham,5-7 Ashwaganda
rasayana,5-7 Brahma Rasayana,6-14 Chyavanaprasha,14
Narasimha Rasayana,5-7 and Triphala,15-18 which belong to
Rasayana group of drugs in Ayurveda (drug that imparts rejuvenating effects to the cell and tissues) are reported to possess
radioprotective effects and are addressed in this review.

Amritaprasham
According to Ayurveda, regular intake of Amritaprasham
early morning is supposed to improve strength, stamina,
and to retard aging.20,21 It is also advocated for the treatment
of fever, cough, bronchial asthma, burning sensation, and
seminal abnormalities such as azoospermia, oligospermia,
erectly dysfunction, and menstrual disorder. It is indicated
in urinary disorders, hemorrhoids, gastrointestinal disorders, epistaxis, anorexia, thirst, vomiting, and loss of consciousness. It is supposed to improve strength and provide
hemopoetic stimulatory action.20,21
Preclinical studies have shown that the administration of
Amritaprasham reduced the radiation-induced loss of body
weight and arrested the decrease in the weight of liver, kidney, and spleen of mice. Treatment with Amritaprasham
caused a 35.5%, 56.73%, and 40% decrease in serum glutamate pyruvate transaminase (GPT), serum lipid peroxide,
and hepatic lipid peroxide levels, respectively, on day 2 and
54.67%, 40%, and 60% decrease in serum GPT, serum lipid
peroxide, and hepatic lipid peroxide levels, respectively, on
day 7 postirradiation.6

Ashwagandha Rasayana
Ashwagandha Rasayana is accredited to be a bhalya
(drug that improves strength) and vajikara (aphrodisiac).21 Regular consumption is believed to retard senescence, rejuvenate the reproductive organs, and increase
fertility in both men and women.20-23 With respect to
radiation protection, Vayalil et al6 have shown that the
oral feeding of Ashwagandha Rasayana to mice at 50 mg/
kg body weight for 28 consecutive days prevented the

radiation-induced emaciation and decrease in the organ

weight when compared with the irradiated controls. It
also inhibited radiation-induced increase in serum GPT
levels and lipid peroxidation levels.6

Brahma Rasayana
Brahma Rasayana is a brain-specific geriatric drug and its
regular consumption is supposed to promote mental clarity,
improve resilience to mentally demanding chores, and
improve memory and cognition. It is also supposed to
reduce the symptoms of ageing such as wrinkling and graying of hair.13 Animal studies have shown that feeding
Brahma Rasayana protected mice from radiotoxic effects,
reduced the loss of organ (spleen liver and kidney) and body
weight, decreased the levels of serum and liver lipid peroxides, alkaline phosphatase, and GPT.6 Clinical studies have
also shown that oral administration of Brahma Rasayana
increased the levels of lymphocytes and neutrophils in cancer patients undergoing radiotherapy.13 Leukopenia, neutropenia, lymphopenia, and the level of serum lipid peroxidation
were decreased, suggesting its benefit.13

Chyavanaprasha
Chyavanaprasha is a polyherbal preparation made of more
than 65 plants is one of the oldest and most popular
Ayurvedic preparations. It is named after its inventor sage
Chyavana and the first documented evidence of this formulation is observed in the principal Ayurvedic text Charak
Samhita where it is advocated to treat kasa (cough), svasa
(dyspnea), kshaya (consumption), svarabheda (voice problems), and hrdroga (cardiac problems).20 Because of this it
is also termed as the elixir of life. Chyavanaprasha is supposed to be an anabolic agent and its regular consumption
is believed to give health benefit to people of all ages and
health.20,24
Chyavanaprasha also possess radioprotective effects and
administering graded doses of hydroalcoholic extract (5-80
mg/kg body weight) for 5 consecutive days by intraperitoneal route before exposure to supralethal dose of -radiation
(10 Gy) protected animals against the radiation-induced
sickness and mortality.14 The best effect was observed at 15
mg/kg, where the highest survival of 58.33% was observed
on day 30 postirradiation. The chyavanaprasha extract was
nontoxic up to a dose of 6 g/kg body weight suggesting it to
be safe and devoid of systemic toxicity.14 Studies have shown
that Chyavanaprasha decreases the carbon tetrachloride
induced liver damage in rats25 and that it reduces the ascites
and solid tumor volume of tumor-bearing animals, which
then concomitantly increases their life span.26 Intake of
Chyavanaprasha (20 grams) twice a day for 2 months by
bidi smokers, decreased their coughing, increased their
appetite, and helped them gain body weight.27

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Narasimha Rasayana
Ashtangahridayam, one among the major ancient Ayurvedic
treatise by Acharya Vagbhata describes the Narasimha
Rasayana in detail and it is said to be of use in reversing
aging, improving immune function, and increasing sexual
vigor and potency.20,21 Feeding mice with 50 mg/kg body
weight of Narasimha Rasayana consecutively for 5 days
prior to, and for a month after, radiation arrested the radiationinduced deleterious effects. Treatment with Narasimha
Rasayana increased the body weight and the organ weights
of the recipient mice.6 It also decreased the levels of radiotoxic biochemical endpoints and the levels of serum and tissue lipid peroxides, serum alkaline phosphatase, and GPT.6

Triphala
Triphala churna, which in Sanskrit means 3 fruits, is made
of Terminalia chebula Retz, Terminalia bellerica Roxb, and
Phyllanthus emblica Linn or Emblica officinalis gaertn and
is an important Ayurvedic formulation. The ancient Indian
physicians used Triphala for many ailments but most importantly for gastrointestinal disorders such as dyspepsia, poor
food assimilation, cleansing of colon, constipation, gastrointestinal tract, and colon tonifier.20 Triphala has been
reported to cause weight loss and to be useful in anemia,
jaundice, constipation, cough, asthma, fever, chronic ulcers,
leucorrhea, and pyorrhea.20,28 Preclinical studies have
shown that Triphala is a potent free radical scavenger and
possesses antioxidant, anti-inflammatory, antipyretic, analgesic, antibacterial, antimutagenic, adaptogenic, anticancer,
and hypoglycemic effects.15
Triphala is observed to exert radioprotective effects
when administered through both intraperitoneal15,16 and
oral routes.17 Jagetia et al15 have observed that administration of aqueous extract of Triphala (5-20 mg/kg) by the
intraperitoneal route for 5 consecutive days prior to supralethal dose of 10 Gy -radiation protected mice against radiation sickness and mortality.15 The best protection was
observed for 10 mg/kg Triphala as nearly 60% survival was
observed at the end of the study period of 30 days postirradiation.15 The optimum radioprotective dose of 10 mg/kg
Triphala was found to be 1/28 of the LD50 dose 280 mg/kg
body weight and caused a dose reduction factor of 1.15.16
Animal studies have also shown that oral feeding of Triphala
powder for 14 consecutive days, 7 days prior to and 7 days
after exposure to lethal dose of 7.5 Gy of whole-body
-radiation. Triphala was ineffective when administered
only after irradiation thereby indicating its benefit to be
only when exposure to radiation is planned.17 Recently,
Yoon et al18 also observed that administering Triphala (1
and 1.5 g/kg/d orally for 10 consecutive days) protected rats
against the single fraction of 12.5Gy -irradiation-induced
acute intestinal mucosal damage.

Mechanisms Responsible for the

Radioprotective Effects
The exact mechanism of action responsible for the radioprotective effects of these Rasayana drugs is unknown. As
these formulations contain many plants with diverse pharmacological properties with some of them possessing radioprotective effects (Table 1), it is logical to expect that
myriad protective mechanisms are concomitantly operating
(Figure 1). Some of the studied and reported mechanisms
are explained in the following sections.

Free Radical Scavenging

Agents that can scavenge free radicals or reactive metabolites without affecting the outcome of the treatment
would be beneficial to the host and can enhance the efficiency of the treatment. Studies have shown that the
Triphala, Chyavanaprasha, and Brahma Rasayana possess
free radical scavenging and antioxidant effects. In vitro
studies suggest that Brahma Rasayana scavenged Fe2+ascorbate and Fe3+-ADP-ascorbateinduced lipid peroxidation and scavenged the hydroxyl, superoxide, and nitric
oxide generated in vitro. It also inhibited the phorbol
myristate acetateinduced superoxide generation in mice
peritoneal macrophages and nitrite production in peritoneal macrophages.16 Triphala and Chyavanaprash have
also been observed to scavenge nitric oxide in vitro.29
Rasayana drugs are composite herbal formulations and
many plants that are an integral part of Rasayana preparations possess free radical scavenging and antioxidant prpperties (Table 2).3,6,7,30-32

Increase in Antioxidant Enzymes

Studies have shown that Triphala and Brahma Rasayana
increase the levels of glutathione and antioxidant enzymes
and protect against the oxidative stress.11,17,35 The administration of aqueous extract of the medicinal plants such
as Aegle marmelos, Terminalia chebula, Emblica officinalis, which are an integral part of many Rasayana formulations, have been reported to effectively modulate the
oxidative stress and enhance the antioxidant status in
rodents.36-39

Antimutagenic Activities
There is increasing evidence that many phytochemicals,
plants, and their compound formulations present in rasayana can act as inhibitors of mutagenesis and carcinogenesis.3,40,41 Studies by Yadav et al27 have shown that
consumption of Chyavanaprasha by bidi smokers decreased
the genotoxic risk caused by mutagenic agents present in
tobacco smoke. When compared with bidi smokers alone,

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Integrative Cancer Therapies 12(6)

Table 1. Composition of Various Traditional and Proprietary Herbal Drugs Reported to Possess Radioprotective Effects.
Name
Classical Ayurvedic formulations
Amritaprasham

Ashwaganda Rasayana
Brahma Rasayana

Chyavanaprasha
Chyawanprash
chyavanaprasha
chyavanaprash
chyawanaprash

Narasimha Rasayana
Triphala

Composition
Holstemma annulare, Vigna vexilata, Phaseolus adenanthus, Glycyrrhiza glabra, Zingiber officinale,
Asparagus recemosus, Boerhaavia diffusa, Sida retusa, Clerodendrum serratum, Macuna pruriens,
Hedychium spicatium, Phylanthus niruri, Piper longum, Vitis viniferra, Embelica officinalis, Purerira
tuberose, Saccharum officinalum, Piper nigrum, Cinnamomum zeylanica, Elettaria cardamomum,
Garcinia Morella, and Mesua ferrea5,6
Withania sominifera, Purerira tuberosa, Hemidesmus indicus, Ciminum cuminum, Aloe barbidensis, Vitis
vinifera, Elettaria cardamomum, Zingiber officinale, Piper nigrum, and Piper5,6
Embelica officinalis, Terminalia chebula, Urarira pitca, Desmodium gangeticum, Gmelina arborea,
Solanum nigrum, Tribulus terrestris, Aegle marmelos, Premna tomentosa, Stereospermum suaveolens,
Oroxylon indicum, Sida rhombilfolia, Boerhaavia diffusa, Ricinus communis, Vigna vexilata, Phaseolus
adenanthus, Asparagus recemosus, Holostemma annulare, Leptadenia reticulata, Desmostachya
bipinnata, Saccharum officinalum, Oryza malampuzhensis, Cinnamomum iners, Elettaria
cardamomum, Cyperus rotundus, Curcuma longa, Piper longum, Aquilaria agallocha, Santalum album,
Centella asciatica, Mesua ferrea, Clitoria ternate, Acorus calamus, Scirpus crossus, Glycyrrhiza glabra,
and Embelia ribe5,6
Emblica officinalis, Bambusa arundinacea, Agele marmelos, Clerodendrum phlomidis, Oroxylum indicum,
Gmelina arborea, Stereospermum suaveolens, Sida cordifolia, Desmodium gangeticum, Uraria picta,
Teramnus labialis, Piper longum, Tribulus terrestris, Solanum indicum, Solanum xanthocarpum, Pistacia
integerrima, Phaseolus trilobus, Phyllanthus niruri, Vitis vinifera, Leptadenia reticulata, Inula racemosa,
Aquilaria agallocha, Tinospora cordifolia, Terminalia chebula, Ellettaria cardamomum, Cinnamom
cassia, Cinnamom iners, Habenaria intermedia, Microstylis walichii, Microstylis museifera, Mesua ferra,
Hedychium spicatum, Cyperus rotundus, Boerhaavia diffusa, Polygonatum verticillatum, Nymphaea alba,
Santalum album, Pueraria tuberosa, Adhatoda vasica, Roscoea alpina, Martynia diandra, and Sesamum
indicum14
Acacia catechu, Plumbago xylanica, Xylia dolabriformis, Pterocarpus marsupium, Embelia ribes,
Semicarpus anacardium, Eclipta alba, Terminalia chebula, Embelica officinalis, and Terminalia
belerica5,6
Emblica officinalis, Terminalia chebula, and Terminalia belerica15-17

consumption of Chyavanaprasha decreased the mitotic

index, chromosomal aberrations, sister chromatid exchanges,
and satellite associations.27
Kaur et al40 have reported that aqueous, chloroform, and
acetone extracts of Triphala was observed to possess antimutagenic effects against both direct and indirect mutagens
in the Ames histidine reversion assay. The results demonstrate that the extracts inhibited the mutagenicity induced
by both direct- and indirect-acting mutagens, but the inhibition was greater for S9-dependent mutagens.40 The acetone
and chloroform extracts were observed to be better than the
aqueous extracts in the TA98 and TA100 tester strains of
Salmonella typhimurium. Maximum inhibition was
observed for the acetone extract.40
Triphala and its individual constituents are reported to
prevent -radiation-induced DNA strand break formation in
the plasmid DNA (pBR322) in vitro.42 Feeding of triphala
was also observed to inhibit the radiation-induced DNA
strand breaks in leukocytes and splenocytes of mice exposed
to whole-body irradiation of 7.5 Gy.17 Furthermore, plants
such as Ocimum sanctum, Podophyllum hexandrum,
Phyllanthus amarus, Phyllanthus amarus, Moringa
oliefera, Tinospora cordifoila, Mentha piperita, Syzygium

cumini, Aegle marmelos, and Aphanamixis polystachya

have been reported to inhibit radiation-induced DNA damage as evaluated by chromosomal aberration or micronucleus assay.41

Inhibition of Lipid Peroxidation

In vitro studies have shown that the both alcoholic and aqueous extracts of Rasayana inhibit enzymatic- and
nonenzymatic-induced microsomal lipid peroxidation in a
concentration-dependent manner.33,43 Triphala is also
observed to decrease the radiation-induced lipid peroxidation in vitro.32 Brahma Rasayana treatment decreased the
radiation-induced increase in the serum lipid peroxidation in
cancer treatment13 and serum and liver lipid peroxidation in
the chickens subjected to heat stress.44 Studies also indicate
that several botanicals such as Centella asiatica, Ocimum
sanctum, Podophyllum hexandrum, Amaranthus paniculatus, Emblica officinalis, Phyllanthus amarus, Piper longum,
Tinospora cordifoila, Mentha arvensis, Mentha piperita,
Syzygium cumini, Zingiber officinale, Ageratum conyzoides,
Aegle marmelos, and Aphanamixis polystachya protect
against radiation-induced lipid peroxidation (Table 2).41

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Baliga et al

Figure 1. Biochemical targets responsible for radioprotective effects of the Ayurvedic Rasayana drugs (arrows up = increase; arrows
down = decrease).

Table 2. Plants With Various Pharmacological Properties That Are an Integral Part of the Rasayana Drugs.
Pharmacological Properties

Plants

Radioprotective

Emblica officinalis, Terminalia chebula, Terminalia bellerica, Asparagus racemosus, Tinospora

cordifolia, Ocimum sanctum, Curcuma longa, Zingiber officinale, Agele marmelos, Phyllanthus
niruri, Boerhaavia diffusa, Adhatoda vasica, Sesamum indicum, Cinnamomum zeylanica, Centella
asciatica, Acorus calamus, Glycyrrhiza glabra, Embelia ribes, Hemidesmus indicus, Ciminum
cuminum, Aloe barbidensis, Syzygium cumini, Mentha piperita, Mentha arvensis, and Podophyllum
hexandrum4
Emblica officinalis, Withania somnifera, Terminalia chebula, Terminalia bellerica, Asparagus
racemosus, Tinospora cordifolia, Ocimum sanctum, Curcuma longa, Zingiber officinale, Agele
marmelos, Oroxylum indicum, Sida cordifolia, Tribulus terrestris, Phyllanthus niruri, Vitis vinifera,
Ellettaria cardamomum, Cinnamom cassia, Cyperus rotundus, Boerhaavia diffusa, Santalum
album, Adhatoda vasica, Sesamum indicum, Cinnamomum zeylanica, Glycyrrhiza glabra, Centella
asciatica, Acorus calamus, Glycyrrhiza glabra, Embelia ribes, Hemidesmus indicus, Ciminum
cuminum, and Aloe barbidensis3,4,6,7,16,30-32
Asparagus racemosus, Ocimum sanctum, Podophyllum hexandrum, Tinospora cordifolia, Hippophae
rhamnoides, Zingiber officinalis, Centella asiatica, Syzygium cumini, Ligusticum wallichii, Vitis
vinifera3,4,6,7,16,30-32
Glycyrrhiza glabra, Allium sativum, Aloe vera, Tinospora cordifolia, Hippophae rhamnoides, Curcuma
longa, Centella asiatica, Syzygium cumini, Ocimum sanctum, Moringa oleifera, Zingiber officinale,
Eleutherococcus senticosus4
Triphala, Chyavanaprasha, Ocimum sanctum, Curcuma longa, Zingiber officinale, Agele marmelos,
Phyllanthus niruri, Tinospora cordifolia, Emblica officinalis, Terminalia chebula, and Terminalia
belerica4
Emblica officinalis, Withania somnifera, Viscum album, Ocimum sanctum, Tinospora
cordifolia3,4,30,33,34

Free radical scavenging

Antioxidant
Anti-inflammatory
Antimutagenic and
prevention of DNA
damage
Immune modulatory and
adoptogenic activities

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Anti-Inflammatory Effects
Studies have shown that Rasayana drugs and some of their
constituent plants are potent inhibitors of inflammation as
shown by reduction in paw edema induced by carrageenan
and various experimentally induced inflammatory reactions.45,46 They are also shown to alleviate rheumatoid
arthritis.47 Triphala is also reported was effective in preventing the Freunds adjuvantinduced arthritis and inflammation in mice.48 The effect was observed to be better than
that of indomethacin and the levels of lysosomal enzymes,
tissue marker enzymes, glycoproteins, and paw thickness
were significantly altered in the Triphala group to near normal conditions.48

Hemopoietic Stimulation
Studies suggest that the Rasayana drugs possess hemopoietic
stimulatory function against cytotoxic effects of anticancer
agents. Triphala, Brahma Rasayana, Narasimha Rasayana,
Ashwaganda Rasayana, Amritaprasham Chayavanprasha
have been observed to attenuate the radiation-induced damage to the hemopoietic system.6,7,15 The plants Acanthopanax
senticosus, Embelica officinalis, Withania somenifera,
Tinospora cordifolia, and Boerhaavia diffusa provide totalbody radiation protection by stimulating hematopoiesis.3,41

Immune Modulation
Rasayanas are observed to possess immunomodulating
effects and unlike the conventional agents activate
immune system without altering other basic parameters
of the body.6,7,48 Administering Rasayana to animals
improved the total number of leukocytes, absolute number of polymorphonuclear cells and lymphocytes in the
peripheral blood of mice without altering liver or kidney
function.5-7,49 Clinical studies have shown that administration of Brahma Rasayana did not alter the total leukocyte, the white blood cell counts, and the ratios. An
increase in the activity of lymphocytes and increase in
serum granulocyte macrophage colony-stimulating factor
were also observed.13
Triphala has been reported to possess immunomodulatory
activities and to stimulate the neutrophil functions in immunized rats and stress-induced suppression in the neutrophil
functions.50 Additionally, some of the medicinal plants that
are an integral part of the Rasayana, such as Picrorhiza kurroa, Tylophora indica, Aconitum heterophyllum, Holarrhena
antidysenterica, Tinospora cordifolia, and Ocimum gratissimum, are reported to improve the phagocytic function without affecting the humoral or cell-mediated immune system.51
Plants possessing immunomodulating and immunostimulatory activities, for example, Podophyllum hexandrum,
Hippophae rhamnoides, Viscum album, Ocimum sanctum,

and Tinospora cordifolia, have also been reported to provide

protection by increasing spleen colony-forming units.
Several triterpenoids such as glycyrrhizic acids, ursolic
acid, and oleanolic acid possess immunopotentiating activity.3 Studies have also shown that the phytochemicals glycyrrhizin and glycyrrhizic acid, present in Glycyrrhiza
glabra increased cellular immunocompetence.51 Tinospora
cordifolia is suggested to activate macrophages and release
granulocyte macrophage colony-stimulating factor activity,52 whereas its active constituents syringin and cordiol are
reported to enhance the humoral and cell-mediated immunity.53 Reports also indicate that the plants such as Allium
sativum and Ocimum sanctum, which also possess radioprotective effects, augment NK cells, whereas Aloe vera is
shown to stimulate synthesis of interleukin-1 and tumor
necrosis factor-3,54,55 (Table 2).

Adoptogenic and Antistress Properties

Oral administration of Triphala is reported to significantly
prevent the noise-induced56 and cold stressinduced57
behavioral and biochemical abnormalities in albino rats.
With regards to radiation-induced stress it is logical to
expect that the adoptogenic properties of triphala may contribute, at least in part, to the observed radiation protection.
Studies have shown that the Rasayana drugs such as
Chyavanaprasha, Triphala, and Brahma Rasayana as well as
the plants used in them such as Withania somnifera, Emblica
officinalis, Asparagus racemosus, and Tinospora cordifolia
also possess these effects (Table 2).3,30,33,34

Conclusions
Scientific studies carried in the recent past have shown that
the Rasayana drugs Chyavanprasha, Triphala, Brahma
Rasayana, Ashwagandha Rasayana, Narasimha Rasayana,
and Amritaprasham are effective in preventing the toxic
effects of ionizing radiation and physiologically attainable
nontoxic doses. A combination of factors such as free radical scavenging, prevention of lipid peroxidation, inhibition
of DNA damage, protection and rapid regeneration of bone
marrow progenitors after cytotoxic therapy, and increase in
or restoration of glutathione and antioxidant status of
enzymes would have contributed to the radioprotective
effects. With regard to radiation protection, all published
studies with these Rasayana drugs have been carried out
with animals and human studies are required.
With regard to the use of these individual rasayans in
clinics as radioprotective agent, it is hypothesized that the
organ-specific Brahma Rasayana and Triphala would be
useful in brain and gastrointestinal cancers, whereas
Amritaprasham, Ashwagandha Rasayana, Chyavanprasha,
and Narasimha Rasayana would be useful in improving the
overall health of the patient. However, for these to be of

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Baliga et al
use in cancer treatment their selective radioprotective
effects needs to be investigated. Suitable studies with
tumor-bearing animals of different histological and metastatic potentiality are warranted as only then it will be of
use in clinics. Studies are also required to understand the
pharmacokinetic, pharmacodynamic, and safety issues of
Rasayana at various doses and also the effects when administered for prolonged periods of time. Additionally, mechanistic studies with cultured mammalian cells (normal and
neoplastic) are also required for understanding the effect of
these drugs, the principal plants, and phytochemicals at
molecular level. Furthermore, Rasayana formulations are
polyherbal and their biological actions depend on the presence of bioactive compounds. It is a well known fact that
the concentration of the bioactive compounds varies from
place to place and the way in which the plants have been
processed postharvesting in the preparation of Rasayana
and that this affects the pharmacological action. In view of
these observations, it is imperative to validate the uniformity of the herbal mixing and also the proportion by using
standards and internationally accepted assays such as
high-performance thin layer chromatography, ultra-highperformance liquid chromatography/ultraviolet spectroscopy/mass spectrometry, and reversed phase high-performance liquid chromatography.58,59
Rasayana drugs have been consumed by the habitants in
the Indian subcontinent since time immemorial and this
gives it an advantage over the synthetic drugs. The nontoxic
nature of Rasayana drugs gives immense advantage as they
can be easily recommended for human trials and at lesser
costs when compared with their synthetic counterparts.
Apart from applications in the clinics as an adjuvant in
radiotherapy, Rasayana drugs can also be used as a radiation countermeasure agent in the management of nuclear
incidents, for example, for the protection of defense personnel from nuclear weapon radiations, for protecting reactor
workers and rescue crew, and protection of astronauts from
cosmic rays against radiation-induced genomic instability
and carcinogenesis. As there are no existing safe and effective synthetic radioprotectors, these studies are useful. Pilot
studies should be initiated with personnel continuously
exposed to low doses of radiation such as flight attendants
and radiotherapy/nuclear medicine staff and technicians.
Such study will give valuable information on the radioprotective effects of Rasayana drugs in humans and on the
maximal permissible dose for optimal radioprotective
effects.
These Rasayana drugs are of use in the treatment, prevention, and improvement of the quality of life of both
healthy and diseased individuals, and their regular consumption may benefit humans against other age-related diseases and ailments. Most of these Rasayanas can be used
regularly as a food for maintaining balanced mental and
physical health. They may be used either alone or along

with other modalities of treatment as an adjuvant. Their free

radical scavenging, antioxidant, anti-inflammatory chemoprotective, chemopreventive, and immunomodulatory
effects will also be of immense use in maintaining a healthy
lifestyle and a disease-free life.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect
to the research, authorship, and/or publication of this article.

Funding
The authors received no financial support for the research, authorship, and/or publication of this article.

References
1. Hall EJ. Radiobiology for the Radiologist. 5th ed. Philadelphia,
PA: Lippincott Williams & Wilkins; 2005.
2. Patt HM, Tyree EB, Straube RL, Smith DE. Cysteine protection against X-irradiation. Science. 1949;110:213-214.
3. Baliga MS. Triphala, Ayurvedic formulation for treating
and preventing cancer: a review. J Altern Complement Med.
2010;16:1301-1308.
4. Arora R, Gupta D, Chawla R, et al. Radioprotection by plant
products: present status and future prospects. Phytother Res.
2005;19:1-22.
5. Kumar VP, Kuttan R, Kuttan G. Effect of rasayanas, a
herbal drug preparation on immune responses and its significance in cancer treatment. Indian J Exp Biol. 199;37:
27-31.
6. Vayalil PK, Kuttan G, Kuttan R. Protective effects of
Rasayanas on cyclophosphamide and radiation-induced damage. J Altern Complement Med. 2002;8:787-796.
7. Vayalil PK, Kuttan G. Kuttan R. Rasayanas: evidence
for the concept of prevention of diseases. Am J Chin Med.
2002;30:155-171.
8. Rekha PS, Kuttan G, Kuttan R. Immunopotentiating activity
of Brahma Rasayana. Amala Res Bull. 1998;18:85-90.
9. Rekha PS, Kuttan G, Kuttan R. Effect of herbal preparation,
Brahma Rasayana, in amelioration of radiation induced damage. Indian J Exp Biol. 2000;38:999-1002.
10. Rekha PS, Kuttan G, Kuttan R. Antioxidant activity of brahma
rasayana. Indian J Exp Biol. 2001;39:447-452.
11. Rekha PS, Kuttan G, Kuttan R. Effect of Brahma Rasayana
on antioxidant system after radiation. Indian J Exp Biol.
2001;39:1173-1175.
12. Rekha PS, Kuttan G, Kuttan R. Effect of Brahma Rasayana
on antioxidant systems and cytokine levels in mice during
cyclophosphamide administration. J Exp Clin Cancer Res.
2001;20:219-223.
13. Joseph CD, Praveenkumar V, Kuttan G, Kuttan R. Myeloprotective
effect of a non-toxic indigenous preparation Rasayana in cancer
patients receiving chemotherapy and radiation therapy. A pilot
study. J Exp Clin Cancer Res. 1999;18:325-329.
14. Jagetia GC, Baliga MS. The evaluation of the radioprotective effect of chyavanaprasha (an ayurvedic rasayana drug)
in mice exposed to lethal dose of -radiation: a preliminary
study. Phytother Res. 2004;18:14-18.

Downloaded from ict.sagepub.com by Gheorghies Alina on October 30, 2014

462

Integrative Cancer Therapies 12(6)

15. Jagetia GC, Baliga MS, Malagi KJ, Sethukumar Kamath M.

The evaluation of the radioprotective effect of Triphala (an
ayurvedic rejuvenating drug) in the mice exposed to gammaradiation. Phytomedicine. 2002;9:99-108.
16. Jagetia GC, Malagi KJ, Baliga MS, Venkatesh P, Veruva RR.
Triphala, an ayurvedic rasayana drug, protects mice against
radiation-induced lethality by free-radical scavenging. J
Altern Complement Med. 2004;10:971-978.
17. Sandhya T, Lathika KM, Pandey BN, et al. Protection against
radiation oxidative damage in mice by Triphala. Mutat Res.
2006;609:17-25.
18. Yoon WS, Kim CY, Yang DS, et al. Protective effect of
triphala on radiation induced acute intestinal mucosal damage
in Sprague Dawley rats. Indian J Exp Biol. 2012;50:195-200.
19. Kulkarni RD. Principles of Pharmacology in Ayurveda.
Mumbai, India: Ram Sangam Graphics; 1997.
20. Nadkarni AK. Indian Materia Medica. 3rd ed. Mumbai,
India: Popular Press; 1976.
21. Kaviratna AC, Sharma P. Caraka Samhita Vols. 1-4. New
Delhi, India: Sri Satguru Publications; 1996.
22. Mahdihassan S. The tradition of alchemy in India. Am J Chin
Med. 1981;9:23-33.
23. Mahdihassan S. Indian Alchemy or Rasayana in the Light
of Ascetism and Geriatrics. New Delhi, India: Motilal
Banarsidass; 1991.
24. Singh K. Concept of Ojas and the effect of Rasayanas in the
management of cancer. In: Proceedings of Ayurveda Seminar
on Cancer, Thrissur, India. 1990:15-18.
25. Jose JK, Kuttan R. Hepatoprotective activity of Emblica officinalis and Chyavanaprash. J Ethnopharmacol. 2000;72:135-140.
26. Jose JK, Kuttan G, Kuttan R. Antitumour activity of Emblica
officinalis. J Ethnopharmacol. 2001;75:65-69.
27. Yadav JS, Thakur S, Chadha P. Chyawanprash Awaleha:
a genoprotective agent for bidi smokers. Int J Hum Genet.
2003;3:33-38.
28. Mukherjee PK, Rai S, Bhattacharya S, et al. Clinical studies
of Triphalaa well known phytomedicine from India. Iran
J Pharmacol Ther. 2006;5:51-54.
29. Jagetia GC, Rao SK, Baliga MS, Babu KS. The evaluation of
nitric oxide scavenging activity of certain herbal formulations
in vitro: a preliminary study. Phytother Res. 2004;18:561565.
30. Rege NN, Thatte UM, Dahanukar SA. Adaptogenic properties
of six rasayana herbs used in Ayurvedic medicine. Phytother
Res. 1999;13:275-291.
31. Scartezzini P, Speroni E. Review on some plants of Indian traditional medicine with antioxidant activity. J Ethnopharmacol.
2000;71:23-43.
32. Naik GH, Priyadarsini KI, Satav JG, et al. Comparative antioxidant activity of individual herbal components used in
Ayurvedic medicine. Phytochemistry. 2003;63:97-104.
33. Hanna AN, Kauffman EM, Newman HA, Sharma HM.

Prevention of oxidant stress by Student Rasayana (SR). Adv
Exp Med Biol. 1994;366:444-445.
34. Suresh K, Vasudevan DM. Augmentation of murine natural killer cell and antibody dependent cellular cytotoxicity
activities by Phyllanthus emblica, a new immunomodulator. J
Ethnopharmacol. 1994;44:55-60.

35. Deep G, Dhiman M, Rao AR, Kale RK. Chemopreventive

potential of Triphala (a composite Indian drug) on benzo(a)
pyrene induced forestomach tumorigenesis in murine tumor
model system. J Exp Clin Cancer Res. 2005;24:555-563.
36. Singh RP, Banerjee S, Rao AR. Effect of Aegle marmelos
on biotransformation enzyme systems and protection against
free-radical-mediated damage in mice. J Pharm Pharmacol.
2000;8:991-1000.
37. Bhattacharya A, Ghosal S, Bhattacharya SK. Antioxidant

activity of tannoid principles of Emblica officinalis (amla) in
chronic stress induced changes in rat brain. Indian J Exp Biol.
2000;38:877-880.
38. Yokozawa T, Kim HY, Kim HJ, et al. Amla (Emblica officinalis Gaertn.) attenuates age-related renal dysfunction by
oxidative stress. J Agric Food Chem. 2007;55:7744-7752.
39. Mahesh R, Bhuvana S, Begum VM. Effect of Terminalia chebula aqueous extract on oxidative stress and antioxidant status
in the liver and kidney of young and aged rats. Cell Biochem
Funct. 2009;27:358-363.
40. Kaur S, Arora S, Kaur K, Kumar S. The in vitro antimutagenic activity of Triphalaan Indian herbal drug. Food Chem
Toxicol. 2002;40:527-534.
41. Jagetia G. Radioprotective potential of plants and herbs

against the effects of ionizing radiation. J Clin Biochem Nutr.
2007;40:74-81.
42. Naik GH, Priyadarsini KI, Bhagirathi RG, et al. In vitro
antioxidant studies and free radical reactions of triphala, an
ayurvedic formulation and its constituents. Phytother Res.
2005;19:582-586.
43. Sharma HM, Hanna AN, Kauffman EM, Newman HA. Effect
of herbal mixture Student Rasayana on lipoxygenase activity
and lipid peroxidation. Free Radic Biol Med. 1995;18:687697.
44. Ramnath V, Rekha PS, Sujatha KS. Amelioration of heat
stress induced disturbances of antioxidant defense system
in chicken by Brahma Rasayana. Evid Based Complement
Alternat Med. 2008;5:77-84.
45. Rekha PS, Kuttan G, Kuttan R. Antioxidant and anti
inflammatory activity of Brahma Rasayana. Amala Res Bull.
1997;17:68-72.
46. Jain P, Khanna NK, Trehan N, Pendse VK, Godhwani

JL. Anti-inflammatory effects of an Ayurvedic preparation, Brahmi Rasayan, in rodents. Indian J Exp Biol.
1994;32:633-636.
47. Chopra A. Ayurvedic medicine and arthritis. Rheum Dis Clin
North Am. 2000;26:133-144.
48. Rasool M, Sabina EP. Anti-inflammatory effect of the Indian
Ayurvedic herbal formulation Triphala on adjuvant-induced
arthritis in mice. Phytother Res. 2007;21:889-894.
49. Praveen Kumar V, Kuttan R, Kuttan G. Effect of Rasayanas
an herbal drug preparation on immune responses and its
significance in cancer treatment. Indian J Exp Biol. 1999;
37:27-31.
50. Srikumar R, Jeya Parthasarathy N, Sheela Devi R.

Immunomodulatory activity of triphala on neutrophil functions. Biol Pharm Bull. 2005;28:398-403.
51. Lin IH, Hau DM, Chen WC, Chen KT, Lin JG. Effects of
glycyrrhizae and glycyrrhizic acid on cellular immunocompe-

Downloaded from ict.sagepub.com by Gheorghies Alina on October 30, 2014

463

Baliga et al
tence of gamma-ray-irradiated mice. Chin Med J. 1996;109:
138-142.
52. Thatte UM, Chabria S, Karandikar SM, Dhanukar S.

Immunotherapeutic modification by Indian medicinal plants.
Indian Drugs. 1988;25:95-97.
53. Kapil A, Sharma S. Immunopotentiating compounds from
Tinospora cordifolia. J Ethnopharmacol. 1997;58:89-95.
54. Agarwal SS, Singh VK. Immunomodulation: a review of
studies on Indian medicinal plants and synthetic peptides.
Proc Indian Natl Acad Sci. 1999;65:179-204.
55. Atal CK, Sharma ML, Kaul A, Khajuria A. Immunomodulating
agents of plant origin. I: preliminary screening. J
Ethnopharmacol. 1986;18:133-141.
56. Srikumar R, Parthasarathy NJ, Manikandan S, Narayanan GS,
Sheeladevi R. Effect of Triphala on oxidative stress and on

cell-mediated immune response against noise stress in rats.

Mol Cell Biochem. 2006;283:67-74.
57. Dhanalakshmi S, Devi RS, Srikumar R, Manikandan S,

Thangaraj R. Protective effect of Triphala on cold stressinduced behavioral and biochemical abnormalities in rats.
Yakugaku Zasshi. 2007;127:1863-1867.
58. Pawar V, Lahorkar P, Anantha Narayana DB. Development
of a RP-HPLC method for analysis of Triphala Curna and its
applicability to test variations in Triphala Curna preparations.
Indian J Pharm Sci. 2009;71:382-386.
59. Avula B, Wang YH, Wang M, Shen YH, Khan IA. Simultaneous
determination and characterization of tannins and triterpene
saponins from the fruits of various species of Terminalia and
Phyllantus emblica using a UHPLC-UV-MS method: application to Triphala. Planta Med. 2013;79:181-188.

Downloaded from ict.sagepub.com by Gheorghies Alina on October 30, 2014