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:
1. Hong KW, Oh B. Overview of personalized medicine in the disease genomic era. BMB Rep. 2010 Oct;43(10):643-8.
2. Prasher B, Negi S, Aggarwal S, Mandal AK, Sethi TP, Deshmukh SR, Purohit SG, Sengupta S, Khanna S, Mohammad F, Garg G, Brahmachari SK; Indian Genome Variation Consortium, Mukerji M. Whole genome expression and biochemical correlates of extreme constitutional types defined in Ayurveda. J Transl Med. 2008 Sep 9;6:48.
3. Patwardhan B, Bodeker G. Ayurvedic genomics: establishing a genetic basis for mind-body typologies. J Altern Complement Med. 2008 Jun;14(5):571-6. Review. PubMed PMID: 18564959.
4. Bhushan P, Kalpana J, Arvind C. Classification of human population based on HLA gene polymorphism and the concept of Prakriti in Ayurveda. J Altern Complement Med. 2005 Apr;11(2):349-53.
5. Ghodke Y, Joshi K, Patwardhan B. Traditional Medicine to Modern Pharmacogenomics: Ayurveda Prakriti Type and CYP2C19 Gene Polymorphism Associated with the Metabolic Variability. Evid Based Complement Alternat Med. 2009 Dec 16. [Epub ahead of print]
6. Aggarwal S, Negi S, Jha P, Singh PK, Stobdan T, Pasha MA, Ghosh S, Agrawal A; Indian Genome Variation Consortium, Prasher B, Mukerji M. EGLN1 involvement in high-altitude adaptation revealed through genetic analysis of extreme constitution types defined in Ayurveda. Proc Natl Acad Sci U S A. 2010 Nov 2;107(44):18961-6. Epub 2010 Oct 18.
7. K. Patwardhan, Human Physiology in Ayurveda, Jiakrishnadas Series No.134, Chaukhambha Orientalia, Varanasi, India, 2008.
8. Tripathi PK, Patwardhan K, Singh G. The basic cardiovascular responses to postural changes, exercise, and cold pressor test: do they vary in accordance with the dual constitutional types of ayurveda? Evid Based Complement Alternat Med. 2011;2011. pii: 251850.
9. Marchetti B, Morale MC, Gallo F, Batticane N, Farinella Z, Cioni M. Neuroendocrineimmunology (NEI) at the turn of the century: towards a molecular understanding of basic mechanisms and implications for reproductive physiopathology. Endocrine. 1995 Dec;3(12):845-61.
10. Licinio J, Frost P. The neuroimmune-endocrine axis: pathophysiological implications for the central nervous system cytokines and hypothalamus-pituitary-adrenal hormone dynamics. Braz J Med Biol Res. 2000 Oct;33(10):1141-8.
11. Turrin NP, Rivest S. Unraveling the molecular details involved in the intimate link between the immune and neuroendocrine systems. Exp Biol Med (Maywood). 2004 Nov;229(10):996-1006
12. Sewlall S, Pillay V, Danckwerts MP, Choonara YE, Ndesendo VM, du Toit LC. A timely review of state-of-the-art chronopharmaceuticals synchronized with biological rhythms. Curr Drug Deliv. 2010 Dec;7(5):370-88.
13. Ohdo S. Chronopharmaceutics: pharmaceutics focused on biological rhythm. Biol Pharm Bull. 2010 Feb;33(2):159-67
14. Shen D, Liu C, Xu R, Zhang F. Human gut microbiota: dysbiosis and manipulation. Frontiers in Cellular and Infection Microbiology. 2012 September; Vol 2, Article 123. doi: 10.3389/fcimb.2012.00123.
15. Humes HD. Stem cells: the next therapeutic frontier. Trans Am Clin Climatol Assoc. 2005;116:167-83; discussion 183-4.
16. Bianco P, Robey PG. Stem cells in tissue engineering. Nature. 2001 Nov 1;414(6859):118-21
1. Hong KW, Oh B. Overview of personalized medicine in the disease genomic era. BMB Rep. 2010 Oct;43(10):643-8.
2. Prasher B, Negi S, Aggarwal S, Mandal AK, Sethi TP, Deshmukh SR, Purohit SG, Sengupta S, Khanna S, Mohammad F, Garg G, Brahmachari SK; Indian Genome Variation Consortium, Mukerji M. Whole genome expression and biochemical correlates of extreme constitutional types defined in Ayurveda. J Transl Med. 2008 Sep 9;6:48.
3. Patwardhan B, Bodeker G. Ayurvedic genomics: establishing a genetic basis for mind-body typologies. J Altern Complement Med. 2008 Jun;14(5):571-6. Review. PubMed PMID: 18564959.
4. Bhushan P, Kalpana J, Arvind C. Classification of human population based on HLA gene polymorphism and the concept of Prakriti in Ayurveda. J Altern Complement Med. 2005 Apr;11(2):349-53.
5. Ghodke Y, Joshi K, Patwardhan B. Traditional Medicine to Modern Pharmacogenomics: Ayurveda Prakriti Type and CYP2C19 Gene Polymorphism Associated with the Metabolic Variability. Evid Based Complement Alternat Med. 2009 Dec 16. [Epub ahead of print]
6. Aggarwal S, Negi S, Jha P, Singh PK, Stobdan T, Pasha MA, Ghosh S, Agrawal A; Indian Genome Variation Consortium, Prasher B, Mukerji M. EGLN1 involvement in high-altitude adaptation revealed through genetic analysis of extreme constitution types defined in Ayurveda. Proc Natl Acad Sci U S A. 2010 Nov 2;107(44):18961-6. Epub 2010 Oct 18.
7. K. Patwardhan, Human Physiology in Ayurveda, Jiakrishnadas Series No.134, Chaukhambha Orientalia, Varanasi, India, 2008.
8. Tripathi PK, Patwardhan K, Singh G. The basic cardiovascular responses to postural changes, exercise, and cold pressor test: do they vary in accordance with the dual constitutional types of ayurveda? Evid Based Complement Alternat Med. 2011;2011. pii: 251850.
9. Marchetti B, Morale MC, Gallo F, Batticane N, Farinella Z, Cioni M. Neuroendocrineimmunology (NEI) at the turn of the century: towards a molecular understanding of basic mechanisms and implications for reproductive physiopathology. Endocrine. 1995 Dec;3(12):845-61.
10. Licinio J, Frost P. The neuroimmune-endocrine axis: pathophysiological implications for the central nervous system cytokines and hypothalamus-pituitary-adrenal hormone dynamics. Braz J Med Biol Res. 2000 Oct;33(10):1141-8.
11. Turrin NP, Rivest S. Unraveling the molecular details involved in the intimate link between the immune and neuroendocrine systems. Exp Biol Med (Maywood). 2004 Nov;229(10):996-1006
12. Sewlall S, Pillay V, Danckwerts MP, Choonara YE, Ndesendo VM, du Toit LC. A timely review of state-of-the-art chronopharmaceuticals synchronized with biological rhythms. Curr Drug Deliv. 2010 Dec;7(5):370-88.
13. Ohdo S. Chronopharmaceutics: pharmaceutics focused on biological rhythm. Biol Pharm Bull. 2010 Feb;33(2):159-67
14. Shen D, Liu C, Xu R, Zhang F. Human gut microbiota: dysbiosis and manipulation. Frontiers in Cellular and Infection Microbiology. 2012 September; Vol 2, Article 123. doi: 10.3389/fcimb.2012.00123.
15. Humes HD. Stem cells: the next therapeutic frontier. Trans Am Clin Climatol Assoc. 2005;116:167-83; discussion 183-4.
16. Bianco P, Robey PG. Stem cells in tissue engineering. Nature. 2001 Nov 1;414(6859):118-21
4 comments:
Dear Kishore,
It is very glad to see such a transformation taking place in the modern science in the form of Bio medicine, where in the concepts of Doshas, the tridosa's equilibrium,The dhatu transformation and Prakruthi have been knowingly or unknowingly in resemblance to our science of Life.
Please enlighten with more facts, as and when you come across about this field of Bio medicine.
This blog is really kindling the interest regarding the same.
Keep up the good work.
Hi,
Nice thoughts. Currently, there is a basic difference in approach towards attaining knowledge and treating patients. Modern medicine follows a reductionist approach and Ayurveda follows a holistic approach. This gap may slowly reduce in future.
Another striking difference is that all the approaches in modern medicine are quite expensive and they depend on laboratory evaluation techniques. For example, pharmacogenomics is a field where the treatment is dependent on genetics. However, the diagnosis of the genetic abnormality and genetic nature of the person before deciding the treatment would be expensive. Ayurvedic approach may reduce the expenses through simplified approach.
Ultimately, all the medicinal fields need to be combined and there should be integrated medicine. Integrated medicine is the one which can offer best benefits to the patient. May be this transition will help in formation of integrated medicine owing to the understanding of the similarity between the currently different looking medical disciplines. In the world of medicine superiority, inferiority and equality should not exist. The word of achievement is "complementary". If all medical disciplines play complementary to each other patients would be benefited.
Dear Ranga and Sandeep,
Thanks for appreciating my views. Well, I think instead of using the term 'integrated', which is indicative of a 'closed' or 'completed' process, the term 'integrative' is more appropriate , which hints at an open-ended and ever continuous process.
In fact, my intention of writing down these thoughts was a little different. I think this process of understanding Ayurveda first and then advancing science is not possible with the existing system of Ayurveda education. This is because Ayurveda students don't know these recent advances in science and Science students don't know what is Ayurveda. To enable an integration at this level, I propose some program like BSc in Ayurveda to be introduced. This should include basic sciences along with Basic Ayurveda.
Dear Kishore,
Yes your idea of B.Sc (Ayurveda) is good & applaud-able.
I think you had also done a work on census regarding the above topic and sent the inputs to CCIM, for their perusal?
But, careful approach towards Syllabus contents should be taken, for there are very chances of people,to misuse it and it may increase the number of the quack physicians,who had already done a lot of their contribution to the Ayurveda community in spoiling it's reputation.
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