Diabetes Does Damage The Liver Protect It With Phytomedicines

Adults with newly diagnosed diabetes are at increased risk for advanced liver disease, known as diabetic hepatopathy, according to the results of a population-based, matched, retrospective cohort study reported online June 21, 2010 in the Canadian Medical Association Journal.

"The negative impact of diabetes mellitus is well recognized, yet little is known about the effect of this disease on the liver, an organ susceptible to nonalcoholic fatty liver disease related to insulin resistance," write Liane Porepa, MD, from the University of Toronto in Ontario, Canada, and colleagues.

The investigators used administrative health databases for the province of Ontario from 1994 to 2006 to identify 438,069 adults with newly diagnosed diabetes. A comparison group of 2,059,708 individuals without known diabetes were matched 5:1 to exposed persons by birth year, sex, and local health region. Persons with preexisting liver or alcohol-related disease were excluded. The main study endpoint was incident serious liver disease, defined as Cirrhosis, liver failure and its complications, or receipt of a liver transplant.

Among persons with newly diagnosed Diabetes, the incidence rate of serious liver disease was 8.19 per 10,000 person-years vs 4.17 per 10,000 person-years among those without diabetes, yielding an unadjusted hazard ratio (HR) of 1.92. After adjustment for age, income, urban residence, healthcare utilization, and preexisting comorbid conditions (hypertension, dyslipidemia, obesity, and cardiovascular disease), the HR was 1.77 (95% CI, 1.68 - 1.86). The authors write, "Whether the increased risk of liver damage reflects nonalcoholic fatty liver disease or direct glycemic injury of the liver remains to be determined."

Whatever may be the underlying mechanism of the diabetic hepatopathy, the most natural way to protect the liver from most damaging influences would call for the use of herbs like Picrorrhiza kurroa, Andrographis paniculata, Phyllanthus niruri and Tephrosia purpurea, which offer the best documented hepato-protective effects.

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Man to Mouse, not Mouse to Man Experts Laud Reverse Pharmacology of Ayurveda

It may sound like asking Shakespeare to appear for BA examination in English, but such are the ways of the world. Ayurveda is well known to work. And it works very well too, especially in chronic disorders where many modern systems of medicine bite the dust. But for reasons of regulatory compliance, the powers that be often ask for data in black and white. Not just in animals but in patients as well. And such demands come from practicing doctors too, who are not exactly Doubting Thomases but need reassurance on herbal medicines from time to time. So it is time for time-tested Ayurveda to subject itself to an examination that it had already passed with flying color millennia ago. That is the time for reverse pharmacology (RP).

While drug discovery around the world is focused on moving drugs from test tubes to mice to men, the process of reverse pharmacology, as the name suggests, takes the reverse route. "The drugs are studied in this technology through a total shift in paradigm where the effects of drugs or natural products in humans are considered supremely important," says Dr Ashok D B Vaidya, well known expert in Ayurveda as well as allopathy.

While the conventional path of Ayurvedic Medicines starts with a hypothesis, there is no idea about how the humans will react or respond to a particular drug. That is one reason why it starts from molecules to mice and finally goes on to men. But in contrast to that, RP starts with the known clinical drug effect and safety. "RP is beneficial because you already have a starting point through which you know that the molecule is non-toxic and has some effect on humans," says Dr Rama Mukherjee, a leading figure in drug research in India.

The RP avenue offers the benefit of conducting limited trials and simultaneously demonstrating safety and efficacy in clinical and pre-clinical studies. Besides, efficacy criteria can be modulated as per clinical needs. The RP route is thus faster and more cost-effective. In contrast, the conventional drug discovery approach of screening tens of thousands of molecules and their biological targets is time-consuming, and expensive. According to Vaidya, the success rate through RP is one in ten, whereas the current success rate through conventional method of R&D is one in 50,000.

Some hot pursuit trails in reverse pharmacology are given below:
•    Tinospora cordifolia for cancer
•    Curcuma longa for precancerous mouth lesions
•    Commiphora wightii and Withania somnifera for arthritis
•    Terminalia arjuna for coronary heart disease
•    Picrorrhiza kurroa as hepatoprotective
•    Saraca asoca for menorrhagia

A blue-blooded pharmacology baptized in allopathic faith may frown on reverse pharmacology. Our medical colleges too may turn a blind eye and not bother to include it in their syllabus. But reverse pharmacology has arrived in style. And it is here to stay. Much to the relief of millions of practitioners of traditional Ayurvedic Products and the delight of the faithful.

(Source: Express Pharma 16th - 31st Jan 2007, Pharmacology on a reverse trail by Sushmi Dey)

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