Effect on liver function of an ayurvedic medicine Punarnavasava after 28 days chronic toxicity studies on male Sprague Dawley rats
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20252562Keywords:
Ayurvedic Sandhan formulation, Punarnavasava, Asava, Liver function, Liver enzymesAbstract
Background: Punarnavasava (PVR) is an ayurvedic formulation predominantly used as a traditional medicine in the rural population to get relief from edemic conditions. Though this medication is recognized as generally safe, clinical research on this formulation is scarce. Therefore, contributing to determining the safety of this drug may help ensure safer treatment for thousands of patients.
Methods: The effect of chronic administration of PVR on liver function was determined by administrating chronically to the male Sprague-Dawley rats at a dose of 40 ml per kg body weight for 28 days. In this experiment plasma protein, albumin, serum bilirubin and various serum enzymatic parameters were determined.
Results: In the study, the total protein content in the plasma was increased (11.05%) in the PVR treated male rats. The increase in total protein was not statistically significant but was noticeable (p=0.104). On contrary, the albumin content was decreased (7.92 %) in PVR treated male rats and it was not statistically significant, yet it was noticeable (p=0.076). No difference on the bilirubin level between the control and the experimental group was noted. In the PVR administered male rats, activities of alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and alkaline phosphatase (ALK-P) was decreased by 31.90%, 45.44%, 82.82% and 32.53% respectively and all these changes were statistically very highly significant (p=0.0001) for all these enzymes. In contrast, a not significant negligible increment was observed in the GGT activity.
Conclusions: From this study, it is evident that there was no adverse increase in the liver function parameters in the male rats after chronic administration of PVR, on the contrary significant decrease in the serum liver function enzymes were noted, therefore, it can be concluded that this Asava preparation (PVR) can be administered chronically. With the slight increase in GGT though negligible suggests caution for use in pregnancy related edemic conditions which may deteriorate liver cholestasis related to later stage of pregnancy. Further research should be done to reconfirm the safety of this ayurvedic medicine in pregnancy.
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References
National Center for Complementary and Integrative Health. Ayurvedic Medicine: In Depth. Available at: https://www.nccih.nih.gov/health/ayurvedic-medicine-in-depth. Accessed on 25 May 2025.
Sunitha W. A Study on Users Perception Towards Ayurvedic Medicine with Special Reference to Kanniyakumari District. Shanlax Int J Eco. 2020;8(2):59-64.
Azad MA, Ohidullah M, Nuruzzaman Neon M, Sikder MM, Choudhuri MSK. Preclinical hematological profile studies of an ayurvedic medicine Krishna Chaturmukha after chronic administration to male Sprague-Dawley rats. Int J Basic Clin Pharmacol. 2025;14(2):154-9.
World Health Organization; WHO establishes the Global Centre for Traditional Medicine in India. Available at: https://www.who.int/news/item/25-03-2022-who-establishes-the-global-centre-for-traditional-medicine-in-india. Accessed on 25 May 2025.
Planet Ayurvedha. Punarnavasava (Punarnavasavam)-Benefits, Usage, Indications and Dosage. Available at: https://www.planetayurveda. com/library/punarnavasavapunarnavasavam/?srsltid=AfmBOoosnu7uISlc8lwvuzReg5TPUlT8FeAL_BzAYCJ-9bO. Accessed on 26 May 2025.
Pandit A, Sachdeva T, Bafna P. Drug-Induced Hepatotoxicity: A Review. J Applied Pharmaceut Sci. 2012;2(5):233-43.
Philips CA, Theruvath AH. A comprehensive review on the hepatotoxicity of herbs used in the Indian (Ayush) systems of alternative medicine. Medicine. 2024;103(16):e37903.
Plummer DT. An Introduction to Practical Biochemistry. McGraw-Hill Book Company; 1978.
Doumas BT, Watson WA, Biggs HG. Bromocresol green method for quantitative determination of albumin in serum. Clin Chim Acta. 1971;31:87-96.
Malloy HT, Evelyn KA. The determination of bilirubin with the photoelectric colorimeter. J Biol Chem. 1937.
Schumann G, Bonora R, Ceriotti F, Clerc-Renaud P, Ferrero CA, Férard G, Franck PF, et al. IFCC Primary Reference Procedures for the Measurement of Catalytic Activity Concentrations of Enzymes at 37◦C. Part 3. Reference Procedure for the Measurement of Catalytic Concentration of Lactate Dehydrogenase. International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Scientific Division, Committee on Reference Systems of Enzymes (C-RSE). Clin Chem Lab Med. 2002;40:643-8.
Kaplan MM. Laboratory Tests. In: Schiff L, Schiff ER, eds. Diseases of liver, 7th ed, Philadelphia, JB Lippincott. 1983.
Abraham N, Carty R, DuFour D, Pincus M. Clinical enzymology. Henry’s Clinical Diagnosis and Management by Laboratory Methods. Philadelphia, Pa: Saunders Elsevier; 2006.
Glasnapp, Doulas R. Essentials of Statistical Analysis for the Behavioral Sciences. Merrill Publishing International. 1985.
Chowdhury IH, Sony TA, Basak M, Neon NM, Saha N, Akter K, et al. Hepatotoxicological Studies of an Ayurvedic Medicine “BrihatKhadir Batika” on Biological System of Male Sprague-Dawley Rats. Biol Med (Aligarh). 2020;12:463.
David S, Hamilton JP. Drug-induced Liver Injury. US Gastroenterol Hepatol Rev. 2010;6:73-80.
Gupta RC. Third Edition. Veterinary Toxicology. Academic Press. 2018.
Wisdom Library. Significance of Serum Protein. Available at: https://www.wisdomlib.org/concept/ serum-protein. Accessed on 28 May 2025.
Levy G, Hill MJ, Plowden TC, Catherino WH, Armstrong AY. Biomarkers in uterine leiomyoma. Fertil Steril. 2013;99(4):1146-52.
Gremese E, Bruno D, Varriano V, Perniola S, Petricca L, Ferraccioli G. Serum Albumin Levels: A Biomarker to Be Repurposed in Different Disease Settings in Clinical Practice. J Clin Med. 2023;12:6017.
Ruiz ARG, Crespo J, Martínez RAM, Iruzubieta P, Mercadal GC, Garcés ML, et al. Measurement and clinical usefulness of bilirubin in liver disease. Adv Lab Med. 2021;2(3):352-61.
Kalakonda A, Jenkins BA, John S. Physiology. Bilirubin. StatPearls Publishing. 2025.
Moriles KE, Zubair M, AzerSa. Alanine Aminotransferase (ALT) Test. StatPearls Publishing. 2025.
Vasimahmed Lala; Muhammad Zubair; David A. Minter. Liver Function Test. StatPearls Publishing. 2025.
Williams AL, Hoofnagle JH. Ratio of serum aspartate to alanine aminotransferase in chronic hepatitis. Relationship to cirrhosis. Gastroenterology. 1988;95(3):734-9.
Farhana A, Lappin SL. Biochemistry, Lactate Dehydrogenase. StatPearls Publishing. 2025.
Lowe D, Sanvictores T, Zubair M, John S. Alkaline Phosphatase. StatPearls Publishing. 2025.
Whitfield JB. Gamma glutamyl transferase. Crit Rev Clin Lab Sci. 2001;38(4):263-355.