INTRODUCTION: Osteoarthritis
(OS-tee-oh-are-THRY-tis) (OA), or degenerative
joint disease, is one of the oldest
and most common types of arthritis.
It is characterized by the breakdown
of the joint's cartilage. Cartilage
is the part of the joint that cushions
the ends of bones. Cartilage breakdown
causes bones to rub against each other,
causing pain and loss of movement.
Most commonly affecting middle-aged
and older people, OA can range from
very mild to very severe. It affects
hands and weight-bearing joints such
as knees, hips, feet and the back.
The other common form of arthritis is
Rheumatoid arthritis (RA) involves inflammation
of the lining of many different joints
in your body. In some people, RA can
also affect other parts of the body,
including the blood, the lungs, and
the heart. Inflammation of the joint
lining, called the synovium, can cause
pain, stiffness, swelling, warmth, and
redness. The affected joint may also
lose its shape, resulting in loss of
normal movement. RA can last a long
time, and can be a disease of flares
(active) and remissions (little to no
activity.
Arthritis is caused by an immune system
disorder commonly referred to autoimmune
disorder. It is characterized by chronic
inflammation of joints, immobility of
joints, chronic pain and water retention.
Conventional therapies used in the treatment
of arthritis are only palliative and
offer no cure. Ayurveda recognizes the
root cause of Arthritis and has been
successfully used in the treatment of
various forms of arthritis for centuries.
Causes:
- Abnormal wear and tear of connective
tissues
- Use of steroids and other muscle
building drugs
- Autoimmune disorder
- Allergies
- Lack of exercise
THE PRODUCT:AV
MBJ is a scientifically formulated natural
anti-arthritic product. Combining powerful
anti-oxidants and natural anti-inflammatory
extracts, AV MBJ allows the body to
regulate its immune response whilst
reducing the pain and inflammation caused
by a hyperactive immune system.
COMPOSITION:
Each Capsule of AV MBJ contains extracts
of:
RESEARCH:
Evaluation
of A Polyherbal Formulation AV MBJ
Boswellia
serrata:
Boswellia serrata tree is commonly found
in India. The therapeutic value of its
gum (sallaki) has been known. It posses
good anti-inflammatory, anti-arthritic
and analgesic activity. A randomized
double blind placebo controlled crossover
study was conducted to assess the efficacy,
safety and tolerability of Boswellia
serrata Extract (BSE) in 30 patients
of osteoarthritis of knee, 15 each receiving
active drug or placebo for eight weeks.
After the first intervention, washout
was given and then the groups were crossed
over to receive the opposite intervention
for eight weeks. All patients receiving
drug treatment reported decrease in
knee pain, increased knee flexion and
increased walking distance. The frequency
of swelling in the knee joint was decreased.
Radiologically there was no change.
The observed differences between drug
treated and placebo being statistically
significant, are clinically relevant.
BSE was well tolerated by the subjects
except for minor gastrointestinal ADRs.
BSE is recommended in the patients of
osteoarthritis of the knee with possible
therapeutic use in other arthritis.
In a separate study the researchers
showed that compounds from the gum with
genuine antiinflammatory effects are
pentacyclic triterpenes of the boswellic
acid type. Boswellic acids inhibit the
leukotriene biosynthesis in neutrophilic
granulocytes by a non-redox, noncompetitive
inhibition of 5-lipoxygenase. The effect
is triggered by boswellic acids binding
to the enzyme. Moreover certain boswellic
acids have been described to inhibit
elastase in leukocytes, to inhibit proliferation,
induce apoptosis and to inhibit topoisomerases
of leukoma- and glioma cell lines. A
series of chronic inflammatory diseases
are thought to be perpetuated by leukotrienes.
In clinical trials promising results
were observed in patients with rheumatoid
arthritis, chronic colitis, ulcerative
colitis, Crohn's disease, bronchial
asthma und peritumoral brains edemas.
Commiphora
mukul:
One of the ingredients most commonly
found in Ayurvedic arthritis formulas
is guggul, an oleoresin of the herb
Commiphora mukul (CM). The authors have
conducted both preclinical and clinical
investigations of guggul for reduction
of pain, stiffness, and improved function,
and to determine tolerability in older
patients with a diagnosis of OA of the
knee. METHODS: The study was conducted
using an outcome, quasi-experimental,
model. Thirty male and female participants
meeting the inclusion/exclusion criteria,
with a score of 2 or more on the Kellegran-Lawrence
scale for at least 1 knee, were admitted
in the study. CM was administered in
capsule form (500 mg concentrated exact
delivered TID) along with food. The
WOMAC Total Score was used as a primary
outcome measure. VAS scales, 6-minute
walk-test, and WOMAC subscales were
used as outcome measures. RESULTS: At
the end of treatment, there was a significant
difference in the scores of the primary
and secondary outcome measures. On the
primary measure, WOMAC total score,
participants were significantly improved
(P < 0.0001) after taking the supplement
for 1 month and continued to improve
at the 2-month marker and follow-up.
Secondary measures of pain in the VAS
format demonstrated participant improvement;
however, mood state, and current pain
were not significantly different (P
< 0.05) than baseline until the 2
month assessment (P < 0.001). CONCLUSIONS:
Overall data indicate significant improvement
for participants during the trial in
both scales and objective measures used
for assessment purposes. There were
no side effects reported during the
trial. CM appears to be a relatively
safe and effective supplement to reduce
symptoms of OA.
In a separate study, researchers at
the Department of Physiology and Pharmacology,
Royal College, University of Strathclyde,
Glasgow, Scotland demonstrated the anti-inflammatory
activities of extracts from the resins
of four species of the plant family
Burseraceae, Boswellia dalzielli, Boswellia
carteri (gum olibanum), Commiphora mukul,
and Commiphora incisa, were studied.
The aqueous extracts of the resins of
B. dalzielli, C. incisa, and C. mukul
significantly inhibited both the maximal
edema response and the total edema response
during 6 h of carrageenan-induced rat
paw edema. The octanordammarane triterpenes,
mansumbinone and mansumbinoic acid,
isolated from the resin of C. incisa,
were separated and tested. Administered
prophylactically, mansumbinone proved
to be more than 20 times less potent
than indomethacin and prednisolone in
inhibiting carrageenan-induced rat paw
edema. However, the molar potency of
mansumbinoic acid was within one order
of magnitude of those of indomethacin
and prednisolone. The anti-inflammatory
action of the acid on the carrageenan-induced
edema was dose-related between 1.3 x
10(-5) and 2.5 x 10(-4) mol kg-1 when
given before the inflammatory stimulus.
The acid was able to reverse an established
carrageenan-induced inflammatory response
when administered 2 h after induction.
Daily administration of mansumbinoic
acid at a single dose level (1.5 x 10(-4)
mol kg-1) significantly reduced joint
swelling in adjuvant arthritis in rats.
The results indicated that this compound
is worthy of further investigation as
an anti-inflammatory drug.
Cyprus scariosus:
It is a pestiferous perennial weed with
dark green glabrous culms, arising from
a system of underground tubers. The
plant has an elaborate underground system
consisting of tubers, rhizomes and roots.
The tubers are white and succulent when
young, and hard and black when mature.
Cyperine is the major constituent in
the plant. The plant is a reputed hypotensive,
anti-inflammatory & diuretic.
Zingiber officinalis:
Ginger, the rhizome of Zingiber officinale
Roscoe (Zingiberaceae), is a commom
constituent of diet worldwide and it
has been reported that its extracts
present some pharmacological activities.
Here the researchers investigated the
effects of the crude hydro-proprietory
extract of ginger rhizomes on the classical
models of rat paw and skin edema. The
carrageenan-, compound 48/80- or serotonin-induced
rat paw edema were inhibited significantly
by the intraperitoneal administration
of proprietory ginger extract. Ginger
extract was also effective in inhibiting
48/80-induced rat skin edema at doses
of 0.6 and 1.8 mg/site. Rat skin edema
induced by substance P or bradikinin
was not affected by treatment with Z.
officinalis extract. The intraperitoneal
administration of ginger extract (186
mg/kg(-1) body wt.) 1 hr. prior to serotonin
injections, reduced significantly the
serotonin-induced rat skin edema. Our
results demonstrated that crude extract
of Zingiber officinale was able to reduce
rat paw and skin edema induced by carrageenan,
48/80 compound and serotonin. The antiedematogenic
activity seems to be related, at least
partially, to an antagonism of the serotonin
receptor.
In a separate study conducted at the
Miami Veterans Affairs Medical Center
and University of Miami, Florida, USA,
261 patients with OA of the knee and
moderate-to-severe pain were enrolled
in a randomized, double-blind, placebo-controlled,
multicenter, parallel-group, 6-week
study. After washout, patients received
ginger extract or placebo twice daily,
with acetaminophen allowed as rescue
medication. The primary efficacy variable
was the proportion of responders experiencing
a reduction in "knee pain on standing,"
using an intent-to-treat analysis. A
responder was defined by a reduction
in pain of > or = 15 mm on a visual
analog scale. RESULTS: In the 247 evaluable
patients, the percentage of responders
experiencing a reduction in knee pain
on standing was superior in the ginger
extract group compared with the control
group (63% versus 50%; P = 0.048). Analysis
of the secondary efficacy variables
revealed a consistently greater response
in the ginger extract group compared
with the control group, when analyzing
mean values: reduction in knee pain
on standing (24.5 mm versus 16.4 mm;
P = 0.005), reduction in knee pain after
walking 50 feet (15.1 mm versus 8.7
mm; P = 0.016), and reduction in the
Western Ontario and McMaster Universities
osteoarthritis composite index (12.9
mm versus 9.0 mm; P = 0.087). Change
in global status and reduction in intake
of rescue medication were numerically
greater in the ginger extract group.
Change in quality of life was equal
in the 2 groups. Patients receiving
ginger extract experienced more gastrointestinal
(GI) adverse events than did the placebo
group (59 patients versus 21 patients).
GI adverse events were mostly mild.
Ricinus communis:
In a study by S. BANERJEE, S. K. BANDYOPADHYAY,
P. K. MUKHERJEE, *ARATI MUKHERJEE AND
*S. SIKDAR at the Department of Pharmacology,
Calcutta National Medical College and
University College of Medicine, Calcutta
University & Department of Biochemistry,
N.R.S. Medical College Calcutta , the
authors demonstrated that the extract
of the plant displays a significant
anti-inflammatory activity against experimentally
induced acute and subacute inflammation.
INDICATIONS:
AV-MBJ acts by:
- Reducing inflammation
- Correcting the immune system by
a process known as immunomodulation.
- Removing excessive fluids from
joints
- Increasing blood circulation.
- Lubrication of connective tissues
DOSAGE:
1 Capsule two to three times daily.
It is recommended that AV MBJ is taken
along with AV URI K.
CONTRAINDICATIONS
: None reported.
PREGNANCY:
Take under medical supervision.
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