Is biomedicine on its way to becoming Ayurveda?

Ancient Ayurveda theories are receiving a phenomenal reinforcement in the recent years like never before in the form of advances in science. For instance, the emerging trends in personalised medicine, newer insights in neuro-endocrine-immune interactions, advances in chronobiology, role of gut microbiota in health and disease, and, the current stem-cell related research findings are a few areas that show a perfect congruence with Ayurveda principles.

Over the last few years, the studies related to genomes and their derivatives have so advanced that genomic research can now serve as the basis for many medical decisions in the form of ‘individualised medicine’. Precise prediction and treatment of certain diseases has now become possible because of the various genomic tools ^[1]. Though the concept of individualization of medicine is a recent trend in biomedicine, this has received enormous emphasis in the form of Prakriti (constitution) of an individual in Ayurveda ^[2]. Ayurveda proposes that ‘Prakriti’ of an individual is one of the important factors to be considered while planning the treatment in any clinical condition. Furthermore, there have been a few studies suggesting that pharmacogenomics may be a useful tool in verifying this ancient Ayurveda concept ^[2,3,4,5]. It has been also suggested that the theory of Prakriti can guide some serious research into genetic susceptibility of an individual to certain clinical conditions ^[6]. 

The recent trend of recognising the interactions between neuro-endocrine and immune mechanisms to be vital in the regulation of homeostasis is another important understanding that supports the basic theory of Ayurveda, known as Tridosha. In fact, the theory of Tridosha represents the basic ‘homeostatic mechanisms’ as perceived in biomedicine. At a gross level, the three Doshas —Vata, Pitta and Kapha—can be paralleled with the nervous, endocrine, and immune mechanisms respectively as Vata governs all the sensory and motor functions, Pitta controls metabolism, and Kappha confers immunity ^[7,8]. Biomedicine has in recent years started taking note of some of the important interactions that take place between these neuro-endocrine-immune mechanisms and has proposed the role of some potential regulatory feedback loops between these three major integrative bodily systems in maintaining homeostasis. For example, it is now known that the nervous system influences the immune system through hypothalamo-pituitary-adrenal axis; immune cells produce several endocrine hormones, neurotransmitters, and neuropeptides; and, the endocrine and nervous systems express receptors for a variety of immunologically derived substances ^[9,10,11].

Another area that is currently attracting the scientists is chronobiology, where circadian and other biorhythms are being assigned an important role in determining certain physiological responses and also in determining specific outcomes of pharmacological interventions ^[12]. It has been proposed that this approach is likely to be highly beneficial in the management of major chronotherapeutic conditions such as asthma, allergic rhinitis, cardiovascular disorders, rheumatoid arthritis and cancer ^[13]. This kind of an understanding merely re-affirms the Dosha biorhythms explained in Ayurveda. Ayurveda recognises that Doshas show rhythmic variations in relation to day-night cycle, seasonal cycle, stages of digestion, and stages of aging ^[7] and further recommends that medicines be prescribed only after considering these Dosha biorhythms.

The role of gut microbiota in health and disease has been another neglected area that is receiving attention in recent times. It is now known that the microbiota in the gut, apart from contributing to digestion, also play important roles in various mechanisms including the development of human immune system. A healthy human state is now recognized as a homeostasis between the microbiota and the host. Diet, anti-biotics and several other factors can have enormous effects on the composition of microbiota.^[14] In this context, it is interesting to note that most of the important therapeutic procedures (such as Vamana, Virechana and Basti) in Ayurveda are administered through gut and at least one possible mode of action of these therapies could be an intentional manipulation in the composition of gut microbiota.

The very idea that cells from one tissue can be transformed into the cells of a different kind was unconceivable till the stem cell research proved this possibility in the recent past. This understanding has resulted into most important therapeutic applications like regenerative medicine and tissue engineering. Tissue-engineered skin replacement grafts, chondrocyte repair of joint cartilage, and bone regeneration with skeletal stem cell implantation have been already proven to be clinically useful ^[15]. These developments are quite supportive of the theory of ‘Tissue transformation’, also known as ‘Dhatu Parinama’ explained in Ayurveda. Ayurveda proposes that one tissue is converted into another during the developmental phase of an individual, and, also that one can regenerate a lost tissue by replacing it with a similar tissue.

On the basis of these observations, it is logical to presume that Ayurveda can provide many more leads to the development of science. These may include certain unique areas such as Dhatu-Upadhatu-Dhatumala, Ojas, Agni and certain therapeutic procedures like Panchakarma.

References:
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