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Majoon Suranjan (MS) is a polyherbal formulation used in Unani system of medicine for the treatment of rheumatoid arthritis (RA). The present study evaluates the antiarthritic efficacy of this formulation in three different experimental models.
The anti-inflammatory activity of MS (in doses of 450, 900 and 1800 mg/kg body wt) was evaluated using the turpentine oil induced paw oedema model and the antiarthritic efficacy was evaluated using the formaldehyde and complete Freund’s adjuvant (CFA) induced arthritis models. Aspirin (100 mg/kg body wt) was used as the standard drug in all the models. In order to assess the safety of the test drug, oral acute and 28 day toxicity studies were also carried out.
MS produced a dose dependent protective effect in all the experimental models. Its antiarthritic efficacy was comparable to aspirin in formaldehyde induced arthritis and was superior to aspirin in turpentine oil induced paw oedema and CFA induced arthritis. MS also inhibited the delayed increase in joint diameter as seen in control and aspirin treated animals in CFA induced arthritis.
Results of the present study suggest that the antiarthritic activity of MS was due to the interplay between its anti-inflammatory and disease modifying activities, thus supporting its use in traditional medicine for the treatment of RA.
Keywords: Adjuvant arthritis, analgesia, formaldehyde, Majoon Suranjan, paw edema, turpentine oil
Rheumatoid arthritis (RA) is a progressive, disabling, chronic multisystem disease of unknown cause characterized by pain, swelling and stiffness of synovial joints. An inflammatory reaction, increased cellularity of synovial tissue and joint damage are the pathological hallmarks of RA1. Though conventional treatment options for this condition have improved in terms of effectiveness, the use of non-steroidal anti-inflammatory drugs (NSAIDs) like etoricoxib, disease modifying anti-rheumatic drugs (DMARDs) like methotrexate, sulphasalazine, leflunomide, hydroxychloroquine, and corticosteroids like prednisolone, methylprednisolone have all been associated with adverse effects. Because of this reason, patients suffering from chronic musculoskeletal disorders are likely to seek alternative methods for symptomatic relief and are amongst the highest users of complementary and alternative medicine2. This revival of herbal and other complementary therapies in the management of chronic diseases (RA and other inflammatory disorders) is well documented3. However, despite an increase in use, evidence for effectiveness and safety of these complementary therapies is limited.
Unani system identifies and attributes diseases like RA to a weak immune and digestive system. It suggests a number of polyherbal formulations as being effective in the treatment of this condition. Majoon Suranjan (MS) is one such polyherbal formulation composed of Lawsonia inermis, Foeniculum vulgare, Capparis spinosa, Terminalia chebula, Ipomoea turpethum, Apium graveolens, Zingiber officinalis, Convulvulus scammony, Colchicum luteum, Cassia angustifolia, Piper nigrum, Coriandrum sativum, Rosa damascus, Origanum vulgare, Pyrethrum indicum, Plumbago zelanicum, Verbascum thapus, Ricinus communis oil4. Even though this formulation has been used in the Unani system of medicine for hundreds of years, its efficacy in rheumatoid arthritis has not been validated using modern scientific parameters. Therefore, the present study was carried out to evaluate the antiarthritic potential of the polyherbal formulation Majoon Suranjan using experimental models of arthritis.