Role of Rasayana Chikitsa in Auto-Immune Disease With Special Reference to Amavata PDF

INTERNATIONAL AYURVEDIC MEDICAL JOURNAL International Ayurvedic Medical Journal, (ISSN:2320 5091) (February, 2107) 5 (2) ROLE OF RASAYANA CHIKITSA IN AUTO-IMMUNE DISEASE WITH SPECIAL REFERENCE TO AMAVATA Wnkhede Arun U1, Khirodkar Sushma R2, Zombade Dinesh N3 1 Associate Professor, 3PG Sch...

INTERNATIONAL AYURVEDIC MEDICAL JOURNAL International Ayurvedic Medical Journal, (ISSN:2320 5091) (February, 2107) 5 (2) ROLE OF RASAYANA CHIKITSA IN AUTO-IMMUNE DISEASE WITH SPECIAL REFERENCE TO AMAVATA Wnkhede Arun U1, Khirodkar Sushma R2, Zombade Dinesh N3 1 Associate Professor, 3PG Scholar, Dep of Rognidan Avum Vikruti Vigyan 2 Assistant Professor, Dep of Swasthavritta; Yashwant Ayurved College Kodoli, Maharashtra, India Email: [email protected] ABSTRACT In an autoimmune disease, there is a wrong reaction of our defense mechanism against the body's own tissue. Our immune system has a very sophisticated system to keep us disease free. Auto- immune diseases occur when the body is working hard to defend against potentially hazardous sub- stances our bodies, such as allergens, toxins, infections or food, but does not see the difference be- tween the invaders and our own body cells. Ayurveda describes this in a slightly different way. Ayur- veda suggests that the immune system attacks the body's own cells do not accidentally, but it does to defend against a form of harmful metabolites body, ama’. Amavata is a chronic, progressive auto- immune disease. Amavata is a special disease entity in Ayurveda and were Ama as well as vata play a predominant role in samprapti of the disease Amavata. So many Ayurvedic management had been described in different Ayurvedic classical books for the treatment of Amavata such Ayurvedic man- agement i.e Rasayanchikitsasevan. Keywords: Auto-immune disease, Ama, Free radical theory, Amavata, Rasayanachikitsa INTRODUCTION Autoimmune diseases occur when immune system attacks the body's own cells the body is working hard to defend against do not accidentally, but it does to defend potentially hazardous substances our bodies, against a form of harmful metabolites body, such as allergens, toxins, infections or food, genaamd ‘Ama’. Ama is produced in the tis- but does not see the difference between the sues that are attacked. There are several rea- invaders and our own body cells. Because cer- sons for the emergence of Ama Likewise, tain body cells for harmful antibodies are sent there are several reasons for the different ways on off. This leads to considerable physical in which Ama out. Actually, Ama also respon- properties Ayurveda describes this in a slight- sible for a number of other conditions, ranging ly different way. Ayurveda suggests that the from occasional diarrhea to chronic diseases,  Zombade Dinesh N Et Al: Role Of Rasayana Chikitsa In Auto-Immune Disease With Special Reference To Amavata such as diabetes, and an everyday until incur-  To study the concept Amavata able indigestion SLE (systemic lupus erythe-  To evaluate the concept of Amaas per matosus). The reason behind such a wide Ayurveda. range of disorders caused by Ama lies in the  To evaluate the correlation of concept Ama property of the Ama that it takes out on vari- and free radical theory. ous cells of the body, and deep within the bio-  To understand the role of Amain pathology logical systems calls. Autoimmune diseases of disease in Ayurveda as well as contem- are usually caused by large amounts of Ama porary science. penetrate certain body tissues or physiological MATERIALS AND METHODS- systems. In addition, prolonged exposure to Ayurvedic textual materials were re- poorly digestible food, pollutants, allergenic, ferred, mainly Charakasamhita, Sushruta toxic synthetic chemicals and drugs is another samhita, Astangahridaya and available com- cause of autoimmune diseases. Poor treatment mentaries of these samhitas, for the study. of the disease and repeated suppression of Some modern books of biochemistry, journals symptoms without addressing the cause, also etc. accelerates disease progression. Rheumatoid Autoimmune disease arthritis is a common autoimmune systemic Autoimmune diseases a case of mis- inflammatory disease affecting worldwide taken identity; it is an abnormal condition in population. A similar type of disabilities men- which the body reacts against constituents of tioned in Ayurveda known as Amavata.Ama its own tissues. The result may be simple hy- and Vata Dosha plays important role in this persensitivity reaction and or autoimmune dis- disease. Modern treatment has so many side ease when the body begins attacking its own effects so think an alternative approach that is healthy tissues. We can say it is a case of mis- Rasayanchikitsa, which is very effective in its taken identity resulting in failure of the im- management. Free radical plays an important mune system to differentiate role in pathogenesis of rheumatoid arthritis. between self and non-self This failure to dif- Concept of Ama and free radical Correlated ferentiate between self and non-self may result between, Ama is not a single entity but is a due to some extraneous environmental factors generalized erm which can be applicable for like some viral infections and exposure to many malformed substances in the body and some mutagenic agents; can be due to the responsible for various diseases. In the same breakdown and failure of immune regulation way, free radicles are found to be root cause of and due to some aberration in the genes. many diseases in contemporary science. Whatever the reason the result is autoimmune disease which may involve a particular organ AIMS AND OBJECTIVES – when it is called an organ specific disease. Ox- Aim- To evaluate the role of Rasayanachikitsa idative stress plays a role in autoimmune dis- in Auto-immune disease w.s.r to Amavata.” eases. It can be compared to a piece of metal Objectives- rusting and results from the action of damag-  To study the concept of autoimmune dis- ing molecules (ie, free radicals), which are a ease natural byproduct of the body's metabolism. IAMJ: FEBRUARY, 2017 433  Zombade Dinesh N Et Al: Role Of Rasayana Chikitsa In Auto-Immune Disease With Special Reference To Amavata The electrically charged free radicals attack  Mala sanga (obstruction of stools, urine healthy cells, causing them to lose their struc- etc) ture and function and eventually destroying  Aruchi (anorexia) them. Free radicals are not only produced by  Klama (lethargy). our bodies, but are also ingested from toxins and pollution in the air we breathe. The correct Etiological Factors: use of antioxidants may be useful to prevent Charaka has very elaborated view re- free radical-related disorders. garding etiology and pathogenesis of Ama. He says that not only food taken in excess quanti- Concept of Ama: ty cause production of Amabut heavy, cold, According to Ayurveda “Ama” is re- dry, impure etc. diets may also cause ama. He sponsible for most of the diseases we suffer also indicates mental factors causing Ama like from. The synonym of disease i.e., Amaya is anger, greed, jealousness, grief, fear etc. In- said to be a condition produced by Ama1. Ac- take of wholesome food in proper quantity do cording to Acharya Vagbhatta due to the dim- not get properly digested when individual is inution of agni the first dhatu namely rasa is afflicted with these mental conditions. Again, not formed properly and the anna rasa (food the impairment of agni may be brought about essence) undergoes fermentation and purifying by abstinence from food, indigestion, never- retained in the amashaya (stomach) this state eating, irregular diet habits, indulgence in in- of rasa is Ama. So, the improperly digested compatible food items, the consumption of rasa is Ama. Ama (as per the different classics) cold substances can be understood as- Correlation of concept Ama and free radi-  Undigested food. cal theory-  Unprocessed food. Majority of the endogenous disease  Food which is undergoing the process of begins with the formation of Ama in the body. digestion. It has tremendous capacity to vitiate the  Partially digested. Doshas and disturbing the homeostasis  Matter which requires further parinama2. (Dhatu-samya). Ama is the resultant of im- proper digestion or partially digestion of the Effects of Ama: food particle due to hypofunction of Jatha- According to Acharya VagbhattaAmaproduc- ragni and also due to accumulation of mala in es- the body and also considered as  Srotarodh (obstruction of channels). Prathamdoshadusti. It may be considered as  Balabhramsa (loss of strength) partially or incompletely metabolized Dhatu in  Gaurava (heaviness) case of Dhatvagnimandya.  Anilamudhata In modern parameters, Ama is sup-  Alasya posed to be deadly Free radical. Free radical is  Apakti (indigestion) an atom/molecule that contains one or more  Nisthiva (excessive salivation) unpaired electron, which requires neutrali- zation by free radical scavengers. Ama is not IAMJ: FEBRUARY, 2017 434  Zombade Dinesh N Et Al: Role Of Rasayana Chikitsa In Auto-Immune Disease With Special Reference To Amavata a single entity but is a generalized term, which Stabdhata, Sandhisoola, Sandhishotha, can be applied to many malformed substances SparsasahataTrisna, Gaurava, Gatrast- in the body. This Ama is responsible for the abdhata, Agnimandya, Apaka,Angamarda, production of various diseases. In the same Aruchi way, free radicals are also found to be the root and Jwar are found in this disease. Tikata and cause of many diseases. Here we discuss about katu rasa have got the antagonistic properties properties and qualities in both entities, which that of ama and kapha. Because of their Ag- are similar and dissimilar, also whether free niVardhaka property, they increase digestive radicals can be considered under Ama. power which digests amarasa and reduces the Amavata- excessive production of kapha and also re- Acharya Madhavakara was the first moves the obstruction of channels. Deepana scholar to give appropriate definition of rugs act through the same mechanism. These Amavata vitiated Vataand Ama simultaneously all properties also help in transportation of the moves into the trika and other sandh is leading dosha from sakhas to kosta and thus help in to stabdhata of the body. This condition is the sampraptivighatana process in Amavata known as Amavata. The terms Ama and Vata disease. unite to form the word Amavata, which are the two main pathogenic factors in the causation Laboratory Findings of disease Amavata. When Vitiated vata and The laboratory findings in rheumatoid arthritis ama simultaneously move towards the trika are those of a chronic inflammatory disease. and sandh is leading to stabdhata of the body. a. Hematologic Findings: This condition is known as Amavata. Ama and Normochromic or hypochromic, normo- vata get vitiated due to their own respective cytic anemia usually moderate in degree is causes to promote disease. The nidana of common in RA. White cell counts are usually amavata can be Viruddha Ahara, Viruddha in the normal range or only slightly elevated. Chesta, Mandagni Nishchalata, Vyayama Leukocytosis is generally not associated with soon after the Snigdha Ahara. The accumulat- increased activity of the disease. Leukopenia ed ama circulate throughout the body along is rare in RA but may be observed in chronic with vitiated vata, exhibiting an affinity to get stage. The differential white cell count is usu- lodged in Shleshma Sthana i.e. sandhi and ally within normal limits but on increase in immune system. There by due to action of vi- neutrophils may occur in more acute cases. In tiated vata, ama propelled into the whole body active RA, the ESR is usually markedly ele- through the Dhamani. Then by the combined vated and tends to parallel and activity of the action of vata, pitta and kapha, ama becomes disease. more vitiated further with the interaction of b. Biochemical Investigations: tridoshas. So, after the lodging of ama and C-reactive protein is present in almost all vitiated vata dosha-dushya sammurchana the patients and also indicates the disease ac- starts in the sandhisthana. The features of the tivity just as ESR. Measurements of immuno- pain present in the sandhi is typical like Scor- globulins may show increased levels of IgG, pion bite pain and other symptoms like IgM and IgA. These findings however have IAMJ: FEBRUARY, 2017 435  Zombade Dinesh N Et Al: Role Of Rasayana Chikitsa In Auto-Immune Disease With Special Reference To Amavata little diagnostic value. Like other inflammato- Rheumatoid arthritis is a common autoim- ry arthritis the serum cholesterol level is re- mune systemic inflammatory disease affecting duced and is related with severity and activity worldwide population. The interaction of ge- of the disease. netic and environmental factors results in an increase of immune reactions, which ultimate- Rheumatoid factor: ly lead to the development of synovitis, joint In a majority of rheumatoid arthritis, damage, and structural bone damage. These, in the test for rheumatoid factor is positive as turn, lead to pain, disability, and emotional, indicated by the latex agglutination. The test is social, and economic challenges. Free radical based on the principle that the antigen, human plays an important role in pathogenesis of or rabbit - IgG coated on a carrier particle i.e. rheumatoid arthritis. A similar type of disabili- red blood cell, latex or bentonite is allowed to ties mentioned in Ayurveda known as Amava- react with rheumatoid factor and the aggluti- ta. Ama and Vata Dosha play an important nation is visualized. The rheumatoid factor role in this disease. Modern treatment has so usually can be detected within the first year of many side effects so think an alternative ap- disease. It is observed that the patients with proach that is Rasayan chikitsa, which is very seropositive results are also found to have effective in its management. Rasayana not on- rheumatoid nodules or clinical evidence of ly slowdown the process of destruction in the vasculitis. joint but also helps in rejuvenation. Rasayana Liver function tests: therapy is very effective in reducing symp- All the liver function tests with exception of toms of Amavata due to its Deepana- the tests which reflect the serum protein syn- Paachana, Vata-Kapha Shamaka, antioxidant thesis are reported to be within normal range. properties, it is very suitable for interrupting There may be mild to moderate abnormalities the pathogenesis of the disease, For example – in A: G ratio. Vardhamana Pippali Rasayana. Synovial fluid: DISCUSSION Synovial fluid has a turbid appearance because Amavata (Autoimmune disease) is of increased number of leukocytes. The cells challenging to the physician owing to its ap- are predominantly neutrophils and range from parent chronicity, incurability, complications 10,000 to 50,000 per cubic millimeter. In and morbidity. Despite of the administration rheumatoid synovial fluid, the viscosity is de- of best available modern drugs, the disease has creased and the mucin clot is poor because of a tendency to persisting progress and disables smaller than the patients. Major events that take place in the pathogenesis of Amavata are Ama that is Rasayanachikitsa- produce due to Agnimandya, tridosa especial- Rasayanachikitsa is a boon to mankind. Dif- ly of Kapha and Vata, SrotoVibandha. In ferent rasayan has been explained in the clas- modern point of view free radical also play sics which are helpful not only to preserve the important role in destruction of joint. The in- health but also to get rid of diseases. creased free radical levels and diminished ac- IAMJ: FEBRUARY, 2017 436  Zombade Dinesh N Et Al: Role Of Rasayana Chikitsa In Auto-Immune Disease With Special Reference To Amavata tivity of body antioxidant system are also the ed. 5, Chaukhambha Orientalia, Varanasi major responsible factors for the cartilage (2000) damage and the disease progression. For this 5. Human Physiology: C. C. Chatterjee, J. N. rasayana is better approach because majority Sen, New Central Agency, Calcutta. of these drugs having dipana, pachana, 6. Sharma C. Text Book of Biochemistry and medhya, antioxidant. human biology. pretice hall of India. New Delhi 1980- p 973. CONCLUSION 7. Praveen j. Kumar, Michaell L. Clark, edi- Amavata (Autoimmune disease) severe tor, Clinical Medicine. 2nd ed., London; degree of pain and progressive disability asso- ELBS with Bailliere Tindall: 1990, pp. ciated, so it needs active and urgent care 400. which has no side effect on the health for long 8. S. Ramakrishna, KG prasannam R. Rajana. term use of medicine. For this Rasayana ther- Text book of medical biochemistry- orient apy is very effective in reducing symptoms of Longman Ltd Hyderabad 1986. Amavata due to its Deepana-Paachana, Vata- 9. BhishagacharyaHarishastriParadakar- Kapha Shamaka, antioxidant properties, it is VaidyaAshtanghradayam composed by very suitable for interrupting the pathogenesis Vagbhatasutrasthana chapter 1 verse 5 p.n. of the disease. Anti-oxidants are the key ele- 5 chaukhambhaorientalia Varanasi edition ments in the immune system which the body 2005 uses in order to neutralize the activity of dan- 10. Soni A, Patel K, Gupta SN. 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