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Traditional Indications

Andrographis is alterative, anthelmintic, bitter, febrifuge, stomachic and tonic. Andrographis is also known as Green chireta. Green chireta has a long history of traditional medicinal use in India, various parts of South-East Asia, Central America and the Caribbean. (1)

In Traditional Chinese Medicine Andrographis paniculata is known as 穿心蓮 Chuān Xīn Lián. Chuān Xīn Lián is said to be bitter & cold and enters the Lung, Stomach, Large Intestine, Liver & Bladder meridians and to clear heat & dry damp, purges fire & remove toxicity. (2)

Pharmacognocy

The major constituents of Andrographis are diterpenoids, flavonoids and polyphenols. Single compounds include the major one in terms of bioactive properties and abundance andrographolide. Andrographolide analogues is immunostimulatory, anti-infective and anti-atherosclerotic, neoandrographolide is anti-inflammatory, anti-infective and anti-hepatotoxic. 14-deoxyandrographolide is immunomodulatory and anti-atherosclerotic. Andrograpanin is anti-inflammatory and anti-infective, 14-deoxy-14,15-dehydroandrographolide is anti-inflammatory; isoandrographolide, 3,19-isopropylideneandrographolide and 14-acetylandrographolide are tumour suppressive; arabinogalactan proteins are anti-hepatotoxic. The four flavonoids from A. paniculata, namely 7-O-methylwogonin, apigenin, onysilin and 3,4-dicaffeoylquinic acid are anti-atherosclerotic. (3)

Andrographis contains diterpenolactones which inhibits liver Phase I cytochrome P450 desired in cases of excess Persistent Organic Pollutants, in particular plastic bioaccumulation. (56)

Andrographis paniculata showed potent anti-inflammatory effect on pathogen-induced pelvic inflammatory disease (PID) in rats, with a potential mechanism of inhibiting the NF-κB signal pathway. (4) NF-κB has long been considered a prototypical proinflammatory signaling pathway, largely based on the activation of NF-κB by proinflammatory cytokines such as interleukin 1 (IL-1) and tumor necrosis factor α (TNFα), and the role of NF-κB in the expression of other proinflammatory genes including cytokines, chemokines, and adhesion molecules. (5)

Other studies suggest Andrographolide exerts an anti-inflammatory effect by inhibiting the activation of NF-κB/MAPK signaling pathway and the induction of proinflammatory cytokines. (6)

Andrographis paniculata constituent Andrographolide derivatives display analgesic, antipyretic and anti-inflammatory effects of in experimental animals. (7)

Andrographis paniculata downregulates proinflammatory cytokine production and augments cell mediated immune response in metastatic tumor-bearing mice. (8)

A study investigating the immunomodulatory effects of andrographolide on both innate and adaptive immune responses. Andrographolide can modulate the innate and adaptive immune responses by regulating macrophage phenotypic polarization and Ag-specific antibody production. MAPK and PI3K signaling pathways may participate in the mechanisms of andrographolide regulating macrophage activation and polarization.
Andrographis paniculata extract was found to be effective in preventing liver damage which was evident by morphological, biochemical and functional parameters. (9)

A 12-month double-blind placebo-controlled pilot study concluded that Andrographis paniculata decreases fatigue in patients with relapsing-remitting multiple sclerosis. (10)

A systematic review and meta-analysis analysing the use of Andrographis paniculata for symptomatic relief of acute respiratory tract infections (ARTI) in adults and children concluded that Andrographis paniculata appears beneficial and safe for relieving ARTI symptoms and shortening time to symptom resolution and that in light of antimicrobial resistance (AMR) being a substantial threat to public health well-designed trials evaluating the effectiveness and potential to reduce antibiotic using Andrographis are warranted. (11)

The active constituent Andrographolide inhibits influenza A virus & reduces inflammatory cytokines expression induced by infection. (12)

1. PFAF. Andrographis paniculata 2018
2. Lotus S. Chuan Xin Lian (Green Chiretta or Kariyat or Andrographis) 2018
3. Chao W-W, Lin B-F. Isolation and identification of bioactive compounds in Andrographis paniculata (Chuanxinlian). Chinese medicine. 2010;5:17-.
4. Zou W, Xiao Z, Wen X, Luo J, Chen S, Cheng Z, et al. The anti-inflammatory effect of Andrographis paniculata (Burm. f.) Nees on pelvic inflammatory disease in rats through down-regulation of the NF-κB pathway. BMC complementary and alternative medicine. 2016;16(1):483-.
5. Lawrence T. The nuclear factor NF-kappaB pathway in inflammation. Cold Spring Harbor perspectives in biology. 2009;1(6):a001651-a.
6. Li Y, He S, Tang J, Ding N, Chu X, Cheng L, et al. Andrographolide Inhibits Inflammatory Cytokines Secretion in LPS-Stimulated RAW264.7 Cells through Suppression of NF-κB/MAPK Signaling Pathway. Evidence-based complementary and alternative medicine : eCAM. 2017;2017:8248142-.
7. Suebsasana S, Pongnaratorn P, Sattayasai J, Arkaravichien T, Tiamkao S, Aromdee C. Analgesic, antipyretic, anti-inflammatory and toxic effects of andrographolide derivatives in experimental animals. Arch Pharm Res. 2009;32(9):1191-200.
8. Sheeja K, Kuttan G. Andrographis paniculata downregulates proinflammatory cytokine production and augments cell mediated immune response in metastatic tumor-bearing mice. Asian Pac J Cancer Prev. 2010;11(3):723-9.
9. Rana AC, Avadhoot Y. Hepatoprotective effects of Andrographis paniculata against carbon tetrachloride-induced liver damage. Arch Pharm Res. 1991;14(1):93-5.
10. Bertoglio JC, Baumgartner M, Palma R, Ciampi E, Carcamo C, Cáceres DD, et al. Andrographis paniculata decreases fatigue in patients with relapsing-remitting multiple sclerosis: a 12-month double-blind placebo-controlled pilot study. BMC neurology. 2016;16:77-.
11. Hu XY, Wu RH, Logue M, Blondel C, Lai LYW, Stuart B, et al. Andrographis paniculata (Chuan Xin Lian) for symptomatic relief of acute respiratory tract infections in adults and children: A systematic review and meta-analysis. PLoS One. 2017;12(8):e0181780.
12. Ding Y, Chen L, Wu W, Yang J, Yang Z, Liu S. Andrographolide inhibits influenza A virus-induced inflammation in a murine model through NF-kappaB and JAK-STAT signaling pathway. Microbes and infection. 2017;19(12):605-15.