Andrographis Paniculata (Burm. F.) Nees Induces Clinical and Sputum Conversion in Pulmonary Tuberculosis Patients

The aim of this study was to determine whether Andrographus paniculata capsule induces clinical and sputum conversion in pulmonary tuberculosis (TB) patients. Randomized, placebo-controlled, double-blind pilot study was conducted to pulmonary tuberculosis patient who admitted to Pulmonology Polyclinic of Persahabatan Central General Hospital, Jakarta. A total of 44 pulmonary TB patients were randomly divided into two groups including one group received standard antituberculosis drugs + Andrographis paniculata (n=21) (AP) and one group received standard antituberculosis drugs + placebo (n=23). APC was given 500 milligram per day for eight weeks. The distribution of sex, body weight and body mass index (BMI) as well as the frequency of cough and feature of chest radiography were not significantly different between groups (P >0.05). The proportion of posiıtive smears in both groups decreased over time until by the twelve weeks, none remained positive. The rate of decline was more pronounced in the AP group reach statistically at weeks 4 and 6 compared to placebo group (P<0.05). Adjunctive supplementation of Andrographis paniculata (Burm. F.) Nees was to accelerate the beneficial therapeutic effect of TB chemotherapy by improving clinical and sputum response.

___

1. Palma C, Vendetti S, Cassone A. Role of 4-1BB Receptor in the control played by CD8+ T cells on IFN-c production by Mycobacterium tuberculosis antigen-specific CD4+ T cells. PLoS ONE. 2010;5(6): e11019.

2. Zuniga J, Torres-Garcia D, Santos-Mendoza T, Rodriquez-Reyna TS, Granados J, Yunis EJ. Cellular and humoral mechanisms invoved in the control of tuberculosis. Clin Dev Immunol. 2012;2012:193923.

3. Wade MM, Zhang Y. Mechanisms of drug resistance in Mycobacterium tuberculosis. Frontiers in Biosci. 2004;9:975-94.

4. Blumberg HM, Burman WJ, Chaisson RE, Daley CL, Etkind SC, Friedman LN, Fujiwara P, Grzemska M, Hopewell PC, Iseman MD, Jasmer RM, Koppaka V, Menzies RI, O'Brien RJ, Reves RR, Reichman LB, Simone PM, Starke JR, Vernon AA. American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America: treatment of tuberculosis. Am J Respir Crit Care Med. 2003;167(4):603-62.

5. Karyadi E, West CE, Schultink W, Nelwan WH, Gross R, Amin Z, Dolmans WMV, Schlebush H, van der Meer JWM. A double-blind, placebo-controlled study of vitamin A and zinc supplementation in persons with tuberculosis in Indonesia: effects on clinical response and nutritional status. Am J Clin Nutr. 2002;75(4):720-7.

6. Flynn J, Chan J. Immunology of tuberculosis. Ann Rev Immunol. 2001;19:93-129. 7. Boussiotis VA, Tsai EY, Yumis EJ, Thim S, Delgado JC, Dascher CC, Berezovskaya A. Rousset D, Reynes JM, Goldfeld AE. IL-10 producing T cells suppress immune response in anergic tuberculosis patients. J Clin Invest. 2000;105(9):1317-25.

8. Geffner L, Yokobori N, Basile J, Schierloh P, Balboa L, Romero MM, Ritacco V. Vescovo M, Montaner PG, Lopez B, Barrera L, Aleman M, Abatte E, Sasiain MC, de la Barrera S. Patients with multidrug tuberculosis display impaired Th1 responses and enhanced regulatory T-cell levels in response to an outbreak of multidrug-resistant Mycobacterium tuberculosis M and Ra strains. Infect Immun. 2009;77:5025-34.

9. Karyadi E, Dolmans WM, West CE, Van Crevel R, Nelwan RH, Amin Z, Gross R, van der ven Jongekrijg, van der Meer JWM. Cytokines related to nutritional status in patients with untreated pulmonary tuberculosis in Indonesia. Asia Pac J Clin Nutr. 2007;16(2):218-26.

10. Panossian A, Davtyan T, Gukassyan N, Gukasova G, Mamikonyan G, Gabrielian E, Wikman G. Effect of andrographolide and Kan Jang fixed combination of extract SHA-10 and extract SHE-3 on proliferation of human lymphocytes, production of cytokines and immune activation markers in whole blood cell culture. Phytomedicine. 2002;9(7):598-605.

11. Tawde KV, Gacche RN, Pund MM. Evaluation of selected Indian traditional folk medicinal plants against Mycobacterium tuberculosis with antioxidant and cytotoxicity study. Asia Pac J Trop Dis. 2012;2(2):S685-91.

12. Mishra PK, Singh RK, Gupta A, Chaturvedi A, Pandey R, Tiwari SP, Mohapatra TB. Antibacterial activity of Andrographis paniculata (Burm.f) Wall ex Ness leaves against clinical pathogens. J Pharm Res. 2013;7:459-62.

13. Gabrielian ES, Shukarian AK, Goukasova GI, Chandanian GL, Panossian AG, Wikman G, Wangner H. A double blind, placebo-controlled study of Andrographis paniculata fixed combination Kan Jang in the treatment of acute upper respiratory tract infections including sinusitis. Phytomedicine. 2002;9(7):589-97.

14. Hancke JL, Burgos RA, Caceres DD, Wikman GK. A double-blind study with a new monodrug Kan Jang: decrease of symptoms and improvement in the recovery from common colds. Phytother Res. 1995;9(8):559-62.

15. Melchior J, Palm S, Wikman G. Controlled clinical study of standardized Andrographis paniculata extract in common cold pilot trial. Phytomedicine. 1996; 3(4):314-8.

16. Caceres DD, Hancke JL, Burgos RA, Sendberg F, Wikman GK. Use of visual analogue scale measurements (VAS) to assess the effectiveness of standardized Andrographis paniculata extract SHA-10 in reducing the symptoms of common cold. A randomized double blind-placebo study. Phytomedicine. 1999;6(4):217-23.

17. Caceres DD, Hancke JL, Burgos RA, Wilkman GK. Prevention of common colds with Andrographis paniculata dried extract: A pilot double blind trial. Phytomedicine. 1997;4(2):101-4.

18. Thamlikitkul V, Dechatiwongse T, Theerapong S, Chantrakul C, Boonroj P, Punkrut W, Ekpalakorn W, Boontaeng N, Taechaiya S, Petcharoen S. Efficacy of Andrographis paniculata (Nees) for pharyngotonsillitis in adults. J Med Assoc Thai. 1991;74(10):437-42.

19. Xia XF, Ye BQ, Li YD, Wang JG, He XJ, Lin X, Yao X, Ma D, Slungaard A, Hebbel RP, Key NS, Geng JG. Andrographolide attenuates inflammation by inhibition of NFkappaB activation through covalent modification of reduced cysteine 62 of p501. J Immunol. 2004;173(6):4207-17.

20. Hidalgo MA, Romero A, Figueroa J, Cortes P, Concha II, Hancke JL, Burgos RA. Andrographolide interferes with binding of nuclear factor-kappa-B to DNA in HL-60- derived neutrophilic cells. Br J Pharmacol. 2005;144(5):680-6.

21. Jing X, Yu P, Jiang J, Zhang Z, Wang Z, Yang Z, Tian Z, Wright SC, Larrick JW, Wang Y. Synthesis and evaluation of antibacterial of andrographolide analogues. Eur J Med Chem. 2009;44(7):2936-43.

22. Liu J, Wang ZT, Ge BX. Andrograpanin, isolated from Andrographis paniculata, exhibits anti-inflammatory property in lipopolysaccharide-induced macrophage cells through down-regulating the p38 MAPKs signaling pathways. Int Immunopharmacol. 2008;8(7):951-8.

23. O'Garra A, Vieira PL, Vieira P, Goldfeld AE. IL-10 producing and naturally occurring CD4+ Tregs: limiting collateral damage. J Clin Invest. 2004;114(10):1372-8.

24. Chao WW, Kuo YH, Li WC, Lin BF. The production of nitric oxide and prostaglandin E2 in peritoneal macrophages is inhibited by Andrographis paniculata, Angelica sinensis and Morus alba ethyl acetate fractions. J Ethnopharmacol. 2009;122(1):68-75.
Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )