Review Articles

2021  |  Vol: 7(3)  |  Issue: 3 (May- June)  |  https://doi.org/10.31024/ajpp.2021.7.3.1
Medicinal importance of Ephedra gerardiana in ayurveda and modern sciences: A review

Shailja Choudhary, Gitika Chaudhary, Hemlata Kaurav*

Research and Development Department, Shuddhi Ayurveda, Jeena Sikho Lifecare Pvt. Ltd. Zirakpur 140603, Punjab, India

*Corresponding Author 

Hemlata Kaurav

Shuddhi Ayurveda, Jeena Sikho Lifecare Pvt. Ltd. Zirakpur 140603, Punjab, India

Abstract

Ephedra gerardiana (Ma-Huang) is a significant medicinal herb that belongs to the family Ephedraceae. There are about 73 species of Ephedra genus that are accepted as of June 2021. This plant is mostly found in dry rocks and sandy soil as its growth requires high and dry mountain deserts. The different parts of the plant such as branches, root, stem are used medicinally in various formulations practices. For example, the dried parts of the plant are used in various medicinal systems such as ayurvedic, Unani, Siddha and Chinese to cure variety of diseases such as asthma, nasal congestion, hay fever, inflammation or swelling, urinary disorders, cardiac disorders, cough, chills and cold. In Chinese medicinal system, the E. gerardiana plant is used for 5000 years to cure fever, asthma and nasal congestion. The active constituents of the plant i.e. ephedrine, nor-ephedrine and pseudoephedrine possess various therapeutic and pharmacological properties. These properties include anti-inflammatory, anti-arthritic, anti-asthmatic, antimicrobial, antidiabetic, cardiovascular, diuretic and CNS stimulant activities. Ephedrine and nor-ephedrine alkaloid constituents of the E. gerardiana plant are used to completely eradicate the symptoms of hay fever and allergy. Also, the catechin and epicatechin constituents of the plant are used in various formulations of weight loss drinks and pills. Besides this, the pulp part of the plant is used as a source of food for birds and rodents and is also used in jam preparation. In this review article, attempts have been made to briefly describe the ayurvedic and folklore uses of the plant along with the general description of the plant.

Keywords: Somlata, Pharmacological properties, Ayurveda, Rasapanchak, Anti-inflammatory


Introduction

Medicinal plants contain numerous phytochemical constituents that are associated with different therapeutic properties (Nair et al., 2005; Ghorbani, 2005). Due to this, these medicinal plants are used in various herbal drug formulations (Chukwuma et al, 2015; Lifongo et al., 2014). These drugs possess various advantages when compared to allopathic drugs such as easy availability, fewer side effects and low cost (Yadav and Aggarwal, 2011; Simmler et al., 2018; Ichim, 2010). In India, medicinal plants are used since ancient times to cure various ailments and disorders (Thakur et al., 2021). More than 45000 species of plants are found in India, thus called as Botanical Garden of the World (Sukumaran and Raj, 2010; Abd EI-Ghani, 2016). The medicinal systems such as folk, ayurvedic, Siddha, Unani and Chinese medicinal systems use these herbal plants to treat various diseases and ailments (Verma and Singh, 2008). Besides this, most of the allopathic or modern drugs are prepared from these herbal plants (Yorek et al., 2008). Nearly, half of the modern drugs out of 104 global drugs have their origin from these herbal plants from the last 37 years (Gen, 1986). These medicinal plants are a rich source of bioactive components and secondary metabolites such as alkaloids, flavonoids, triterpenes, saponins, phenolics and others (Kumari et al., 2021). These compounds have particular suitable physiological action in the human body as a result of which the herbal products derived from medicinal plants carry fewer side effects (Kumari et al., 2021). One such medicinal plant is Ephedra gerardiana (figure 1) which is of great medicinal importance. The plant is commonly called somlata (Ma-huang) and belongs to the Ephedraceae family. It is considered the oldest herb to mankind that is used for 1000 years and originally belongs to the traditional Chinese medicine system. The plant is mainly grown in drylands and sandy deserts. It can survive in drought conditions as well. This plant is used in the Indian medicinal system since ancient times. Also, Ephedra was well known during the time of the Roman Empire. Traditionally, the plant is used in the various medicinal system to treat ailments such as cough, cold, chronic fevers, respiratory disorders, urinary problems, nasal congestion and others (Zhu, 1998). In Ayurvedic medicinal system, the plant is used to treat anti-inflammatory diseases like edema or swelling, cough, fever, asthma, heart diseases, urinary disorders and many more. Also, the plant is associated with anti-arthritic and anti-inflammatory properties. Some ayurvedic formulations containing soma as a main ingredient include Bronkasava liquid (helps in curing respiratory diosrders), Asthmin capsule (asthma, bronchitis, cough) and Branchozen syrup (cure dry and productive cough). The phytochemical constituents of the plant are associated with various therapeutic and pharmacological properties such as antimicrobial, antidiabetic, anti-asthmatic, weight loss effects, CNS stimulant, cardiovascular and diuretic (Gaur and Sharma , 2011). The salts of ephedra are used in the form of nasal sprays to cure swelling and congestion. Also, ephedrine is used in the form of a subcutaneous injection to prevent hypotension. Besides this, due to the overexploitation of E. gerardiana plant for medicinal purposes, overgrazing, export and over-harvesting, it comes under the endangered species (Akbar et al., 2011). The vernacular names and taxonomical classification of the plant are shown in table 1 and 2 respectively.

 

 

 

 

 

 

Figure 1. Ephedra gerardiana

Table 1. Vernacular names of E. gerardiana

Sanskrit

Somlata

English

Ephedra, jointfir

Hindi

Tootagantha

Tamang

Tseh

Pashto

Uman

Tibetan

 Amsania, Budagur, Chefrat, Khanda Ma Houng

Chinese

Ma-huang

Ladakh

Somlata plant, thayon

Table 2. Taxonomical Classification

Taxonomical Rank

Taxon

Kingdom

Plantae

Clade

Tracheophytes

Division

Gnetophyta

Class

Gnetopsida

Order

Ephedrales

Family

Ephedraceae

Genus

Ephedra

Species

E. gerardiana

Common name

Somlata

Botanical description

The genus Ephedra consists of 42 species. One of the species of the Ephedra genus is Ephedra gerardiana which is an erect, perennial shrub, dioecious, evergreen, profusely branched, xerophytic plant with densely clustered slender erect joined branches arise from the woody base. These branches are curved, dark green, arising in whorls and can grow up to 3700-5600m above sea level (Akbar et al., 2011). It is mainly found on dry rocks and sandy deserts (Friedman, 1996). The plant can survive in parched conditions and can also grow in soil containing high salt content (Rungsung et al., 1997). The height of the plant reaches up to one-half to 6 feet tall. The width of the basal stem ranges from 3 to 5 inches with thick bark. Nodes and internodes are present in the ascending branched stem which constitutes the drug. The plant contains very few stipulate leaves consists of teeth-like projections called stalks that form a sheath around the nodes. The flowers directly germinate from terminal axillary stalks. The fruits of the plant are sweet, edible, red, round, single-seeded, 1-3 mm in width which matures in autumn (Morton, 1997). The stem of the plant is cylindrical, greenish-yellow astringent, slightly aromatic and bitter (Rinchen et al., 2021).

Geographical distribution

E. gerardiana is mainly found in the dry alpine and temperate Himalayan regions at an altitude of 3900 m above sea level. The plant is grown world-widely in countries like China, Baluchistan, Pakistan, Europe, South America, Temperate Asia, Afghanistan and Bhutan. In India, the plant is distributed from Kashmir to Sikkim (altitude range 2100-4800 m above sea level), Lahaul-Spiti, Chamba, Kinnaur, Uttarakhand, Himachal Pradesh, Jammu and Ladakh (Abourashed et al., 2003). China was the main producer of E. gerardiana but now India and Pakistan have also become the main producer of E. gerardiana plant (Chaudhari, 1957) Phytochemical constituents of e. Gerardiana

The chemical constituents present in the aerial parts of Ephedra species are alkaloids. The alkaloids are present in 0.5% to 2.5% while it is present in 0.02-3.4% in aerial parts containing six other alkaloids which are mostly present in the internodes (Soni et al., 2004). The main active constituent present is (-)-Ephedrine (EPH) which constitutes 30-90% of the total alkaloids. It was the first alkaloid extracted from the plant in 1887 by the Japanese pharmacist Nagai. The other alkaloids present are (+)-pseudoephedrine (PSE) which is a diastereomer of (-)-EPH (extracted in 1889 by Ladenburg and Oelschlagel), ephedroxane, oxazolidone derivative of (-)-EPH, l- (-) ephedrine, methylephedrine (Konno et al., 1979). Ephedroxane alkaloid was found to be associated with anti-inflammatory activity (Manandhar, 1980). Also, the plant is a good source of catechins and (-) epicatechin that helps in weight loss. The other components present are polyphenols, quercetin, gallic acid, macrocyclic spermine alkaloids, kynurenic acid derivative, flavones, tannins, anoproline amino acid, flavonols, methanoproline amino acid, ephedradinnes A-D, carboxylic acid, volatile terpenes and herbacetin. Gallic acid is known for anti-cancer and anti-inflammatory activity, ephedrannine A is known for hypotensive activity while quercetin is known for antioxidant activity (Tai, 2003). The other active isomers extracted from the plant include (-) N-methylephedrine, (-) norephedrine, (+) N-methylpseudoephedrine and (_) nor pseudoephedrine that were found in the 1920s. Pseudoephedrine is reported as the second major isomer while the other alkaloids are found in very few amounts (Konno et al., 1979). The structures of some major phytochemicals are shown in figure no. 2.

 

 

 

Figure 2. Structures of some major phytochemicals present in Ephedra geradiana

Traditional and modern view

a) Ayurvedic View: E. gerardiana plant is used in Ayurveda and other medicinal systems such as Unani, Siddha and Chinese medicinal systems since ancient times to treat various ailments. In Ayurveda, the plant is used to treat cough, headache, edema, headaches, allergies, chills, flu and nasal congestions. The plant alleviates the Kapha (Earth and Water component) and Vata (Air) component. The dried parts of the plant are used in tea which helps in elevating blood pressure, for diuretic and also helpful in the constriction of blood vessels of blood. It is also used to treat hay fevers asthma and other respiratory disorders by the people of Nepal (Baker, 2010). The plant extracts of the plant are also used in the formulation of psychotic medicines with other plants such as mushrooms (Morton, 1977). Also, the oral intake of the plant extract helps in treating angioneurotic edema, nocturnal enuresis, urticarial, epilepsy, nasal congestion and myasthenia gravis. The oral intake of the pseudoephedrine constituent showed a positive effect as a nasal decongestant (Chaturvedi and Dass, 2011). The rasapanchak (properties) of the plant is shown in table 3.

Table 3. Rasapanchak (properties) of E. gerardiana

Sanskrit / English

Sanskrit / English

Veerya / Potency

Ushna / Hot

Vipak / Metabolic property

Katu / Bitter

Guna / Physical property

Laghu / Light, Ruksha / Dry

Rasa / Taste

Kshaya / astringent

Actions and Properties (Sharma, 1956) Kaphavatashamak: It alleviates the Kapha and Vata components.

Shothahara: It is used as an anti-inflammatory agent which helps in reducing swelling or inflammation.

Vedanasthapan: It is used as an analgesic agent.

Naadimandal: It stimulates the pulse chamber.

Hridorabalya: It stimulates heart functions and strengthens the heart muscle.

Shwasana: It stimulates the respiratory system.

Mutrala: It acts as a diuretic agent.

Garbhashayesankochak: It helps in uterine contraction.

Jwarghna: It acts as an antipyretic agent.

Vatikmanovikar: It helps in treating psychosomatic disorders.

b) Folk Uses: E. gerardiana plant is used in folklore to treat several diseases. It is the oldest medicinal plant known in the Chinese medicinal system. In China, the plant is used traditionally to treat coughs, colds, allergies, influenza, bronchial asthma, chills, headaches, fever, flu, edema, nasal congestion and arthralgia (Musselman, 1996). The plant is also used to cure fever, low BP, headache, hives and lack of perspiration (Gonzalez-Juarez et al., 2020). The stem part of E. gerardiana is used to treat diaphoretic indications while the root or rhizome part of the plant is associated with antiperspirant property (Leung, 1990). In India, somlata plant is known from the Vedic eras where it was used as a substitute for the psychoactive plant with a lost identity. The formulations of E. gerardiana are used as a mood enhancer and CNS stimulant in the West (Hussain et al., 2006). The fruit pulp of the plant is found to be the richest source of amino acids and is used in the preparation of jams (Calzada et al., 2020). In Mexico, Ephedra species are used to cure infectious and chronic – degenerative diseases (Salazar JR et al., 2020) Gurmeet and Stobgais, 2016). In the US, E. gerardiana is a famous herb and is used for weight loss and performance enhancement. The local practitioners or ethnic people of Ladakh use E. gerardiana plant to treat cough, sweating, chronic fever, tumor, breathing disorders and urinary disorders (Bhattacharyya, 1991). The twigs of the plant are used as a toothbrush in Ladakh (Navchoo and Buth, 1992). In cold deserts, the whole plant is used for fuel, fruits are used for eating and aerial parts of the plants are used for religious purposes and washing utensils. The decoction of the aerial parts is used to cure liver disorders, respiratory problems and menstrual problems (Choudhary et al., 2021). In the Kumaon Himalayan region, tribal people use E. gerardianaplant to cure asthma disease (Kumar, 2006).

c) Modern View: In the modern world, people are taking more interest in herbal medicines because of their lesser side effects, easy availability and cheaper prices. The consumption of herbal medicines has increased world widely. With the increasing demand of the people, adulteration and substitution also rise in the herbal drug industry which is considered as a major threat to the quality and in the research areas on commercial natural products. The main reason for the adulteration is the non-availability of the original plant product, deforestation, extinction of many herbal plant species, confusion in the species identification, etc. Also, many herbal dealers have developed new methods of high-quality adulteration that can only be identified by using chemical analysis and microscopic examination (Choudhary et al., 2021). The poor quality of the drug and lack of standardization are the two weaknesses that lie behind the acceptance of herbal products which results in the decreased market value of the product. So, there is a need to develop an Herbal Authentication System (HAS) which can serve as a regulator and helps in improving the quality of herbal trade (Uttra, 2017).

Reported pharmacological and therapeutic properties

Anti-arthritic: The in vivo and in vitro on the aqueous-ethanolic, n-butanol and ethyl acetate extract of the plant showed anti-arthritic activity. The in vitro study include thermally induced bovine serum albumin denaturation and egg albumin denaturationb and membrane stabilizing assay at a dosage of 50-6400 mg/ml.assayThe in vivo study include formaldehyde-induced arthritis at a dosage of 50,100 and 200 mg/kg. The crude extract and fractions was found to stabilize the red blood cells and inhibited the protein denaturation in a dose dependent manner. The maximum effect was shown at a dosage of 6,400 mg/ml. Diclofenac sodium was used as a standard drug that showed less inhibition of the protein denaturation in a dose dependent manner as compared to the crude extract and fractions of E. gerardiana (Younis et al., 2018).

Anti-asthmatic: The ethanolic extract of the plant was investigated in vivo for anti-asthmatic activity. It was found that the extract significantly decreases the albumin-induced eosinophilic inflammation of rats at a dosage of 100-200 mg/kg (Andraws et al., 2005). Also, the ethanolic extract of the plant showed positive effects against inflammation or swelling and compared with the standard drug dexamethasone. The extract showed inhibitory action against prostaglandins, histamine and serotonin mediators that are released during bronchial asthma and inflammation. Thus it showed an anti-inflammatory effect by inhibiting these mediator receptors.

Weight-loss effects: From the reported studies, it was found that the ephedrine alkaloid obtained from E. gerardiana plant showed positive effects in weight loss in a shorter period in both animal and plant studies, thus found to be effective against obesity. Although, the excessive use was found to be lethal as it alters the heart function that may lead to heart attack. The ephedrine alkaloid showed significant reduction in body weight in obese patients i.e. 0.9 kg weight loss / month when given at a dosage of 60 to 150 mg/day as compared to the standard drug placebo. However, there are certain limitations of its use as it is associated with certain side effects such as attrition, alters central nervous system and cardiovascular system (Pipe, 2004). This mechanism was possible through the release of norepinephrine through the hypothalamus which exerts an anorexic effect (Tutin, et al., 1965). The same activity was also noted for other drugs such as caffeine and aspirin. In another study, it was reported that the ephedra component of the plant alone results in a 14% reduction in body weight along with a decrease in body fat of approximately 42%. Moreover, when taken with caffeine and theophylline resulted in a 25% and 75% reduction in body weight with minimum side effects (Celine et al., 2016).

Antidiabetic: The antidiabetic effect of the plant was tested against alloxan-induced diabetic mice. It was found that the (-) ephedrine and (+) pseudoephedrine alkaloid component of the plant were associated with a hypoglycemic activity that stimulates the release of epinephrine that results in lowering the sugar level (Soltan and Zaki, 2009).

Antimicrobial: From the literature, it was found that the volatile oil of the ephedra exhibits significant inhibitory activity against the influenza virus (Baltch and Smith, 1994). In another study, it was also found that the methanolic extract of Ephedra species showed significant antimicrobial activity against Staphylococcus aureus, Pseudomonas aeruginosa, Bacillus subtilis, Colibacillus spp., Aspergillus spp., Klebsiella spp., and Candida albicans using disc diffusion method (Parsaeimehr, 2010). Also, the plant showed potent antimicrobial effects against Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Bacillus anthracis, Staphylococcus aureus and Pseudomonas aeruginosa (Taylor et al., 2002; Mack, 1997).

Cardiovascular: The ephedrine, norepinephrine and epinephrine alkaloid component of the plant stimulates the cardiac system and causes vasoconstriction via exciting the sympathetic nervous system. Also, the alkaloid component enhances the performance of cardiac indices, stimulates heartbeat and causes systolic as well as diastolic blood pressure elevation. However, from recent studies, it was found that the extracts of Ephedra shrubs contain highly active alpha and beta adrenergic agonists that directly affect the heart and vasculature which may lead to stroke, myocardial infarcation and others. (Maglione et al., 2005; WHO,1999).

Diuretic: The in vivo study was carried out in anesthetized dogs. The intravenously injection of D- pseudoephedrine and ephedrine components of the E. gerardiana plant at a dosage of 0.5-1.0 mg/kg showed diuretic effects by increasing renal blood flow, dilation of renal vessels, or hindering sodium ion reabsorption from renal tubules in anaesthetized dogs (Hong  et al., 2011; Kwon  et al., 2001).

CNS stimulant: The ephedrine constituent of the E. gerardiana plant acts as a strong CNS stimulant. The ephedrine and nor-pseudoephedrine components of the plant can pass through the blood-brain barrier and cause a significant stimulating effect on the hypothalamus and limbic system neurons which results in dopamine release, adrenaline production and which regulates heartbeat and blood pressure (Chen  et al., 2004).

Nasal Decongestant effect: Pseudoephedrine and ephedrine constituents of the plant are used as nasal contestants to cure allergic rhinitis. The active constituent of the plant i.e. ephedrine is associated with a nasal decongestant activity. This alkaloid constituent acts on the sympathomimetic neurons where it stimulates the alpha-receptor activity hence results in vasoconstriction if applied on the mucosal surface of the nose and pharynx. Moreover, the alkaloid components are not effective for the nasal congestant treatment resulting from colds (Maglione et al., 2005).

Mydriatic effect: The experimental study was conducted on the eyes of 15 individuals using ephedrine hydrochloride in solutions ranging from 1 to 10 percent. Two drops of the solution was inserted 4 times in each eye at intervals of 5 minutes. The alkaloid component ephedrine of E. gerardiana plant cause mydriases effect i.e. dilation of pupils which occurs without pupillary light reflex blocking (Caveney et al., 2001)

Muscle Endurance effect: From the literature, it was found that the ephedrine constituent of E. gerardiana plant alone or with other stimulants enhance anaerobic exercise performance by stimulating the central nervous system and release of catecholamine. It is also used in other manufacturing products used for muscle development. Although, the excessive intake of the plant products can show adverse effects like heart palpitation and increase risk of GIT, autonomic and psychiatric symptoms (Howard  and Lee, 1927).

Toxicity: E. gerardiana plant have certain toxic effects if use in over-dosage. However, it shows no potential toxicity if use in dose control. The therapeutic and pharmacological activities of the plant were found to be toxic that's why people have stopped working on the plant which created a gap of 30 years in the research area. But the reinvestigation was again done on the plant which showed its cardiac stimulant activity, a relaxant of smooth muscles of bronchi, and in elevating blood pressure like adrenaline hormone. The toxicity may cause delusions, psychosis and hallucinations (Reynolds, 1982). The overdose of the plant alkaloids showed fatal results due to heart failure and hypothermia. 1-2g dose of ephedrine alkaloid is considered lethal. Also, the over-dosage of the plant can cause nervousness, headache, dizziness, palpitation, vomiting, insomnia, nervousness, palpitations, anxiety, seizures, nausea, hypertension, strokes, hypothermia and myocardial ischemia. Also, E. gerardiana plants can show hepatic injury and other indications mainly hemorrhage, vascular ischemia and vasculitis (Peters et al., 2005). In 2004, the Food and Drug Administration banned the sale of dietary supplements containing ephedra due to its toxic effects (Limberger et al., 2013). Various scientific and experimental studies revealed that the ephedra containing products depends mainly on the content of ephedrine and the other associated substances. Various clinical studies indicate that the ephedrine and other alkaloids of the plant can be safe if taken according to the recommendations of the official codes. Hence, to prevent accidents, the knowledge of the chemical composition of the species of ephedra species is essential (Soni et al., 2004).

Conclusion: From the literature study, it is quite evident that the E. gerardiana plant is associated with various medicinal properties. The presence of the major phytochemical constituents i.e. (-)-Ephedrine (EPH) is responsible for therapeutic actions and cure a variety of ailments such as cold, cough, chills, fever, asthma and many more. In Ayurveda, the plant acts as an anti-inflammatory, anti-arthritic and diuretic agent and is used to cure asthma, cough, chronic fever, heart diseases, uterine, contraction and others. The pharmacological activity of the plant was also studied by the scientists and researchers using different animal models and the plant was found to be anti-arthritic and anti-inflammatory. Although, the plant needs more experimental studies and clinical research to identify its more pharmacological and therapeutic properties which will be beneficial to humankind.

Acknowledgement: Authors are very thankful to the Department of Research and Development of JeenaSikho Pvt. Ltd. Zirakpur Punjab for giving us opportunity to explore the medicinal importance of this herbal plant.

Conflict of interest: None

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