Medicinal use of the unique plant Tinospora Cordifolia : evidence from the traditional medicine and recent research

Tinospora cordifolia is commonly known as Gulancha in Bangladesh is belongs to Menispermaceae family and it is also available all over the world. It is widely used as a unique ingredient of various natural medicine and traditionally use for numerous aliment like fever, vomiting, diabetes, jaundice, anaemia, polyuria and skin diseases etc. It has hypoglycemic, antipyretic, anti-allergic, Antineoplastic, anti inflammatory, antioxidant, and immuno modulatory properties. A variety of constituents have been isolated from different parts of Tinospora cordifolia, mainly contains alkaloids like Aporphine alkaloids, clerodane diterpenes, berberine, palmatine, tembertarine, tinosporin, magniflorine, choline, Berberine, Palmatine, Tembetarine, Magnoflorine Choline, Tinosporin etc. and Glycoside like Tinocordiside, Tinocordifolioside, steroids, essential oils, mixture of fatty acids and polysaccharides are found in Gulancha plant. This review presents a detailed survey of the literature on traditional and modern knowledge of Tinospora cordifolia for health benefit.


Introduction
Medicinal plants have played an important role of healthcare for much people based on a combination of time tested traditional usage and ongoing scientific research.Tinospora Cordifolia is a large, glabrous, deciduous, climbing shrub.The stem structure is fibrous and the transverse section exhibits a yellowish wood with radially arranged wedge shaped wood bundles, containing large vessels, separated by narrow medullary rays.The bark is creamy white to grey, deeply left spirally and stem contains rosette like lenticels.The leaves are membranous and cordate in shape.Flowers are in axillary position, 2-9 cm long raceme on leaflet branches, unisexual, small and yellow in color.Male flowers are clustered and female are usually solitary.The seeds are curved.Fruits are fleshy and single seeded.Flowers grow during the summer and fruits during the winter (Sharma et al., 2010).It is found throughout India and also in Srilanka, Bangladesh and China (Meshram et al., 2013).

Parts used
Stems -The stem is bitter, stomachic, diuretic stimulates bile secretion, causes constipation, allays thirst, burning sensation, vomiting, enriches the blood and cures jaundice (Meshram et al., 2013).Roots -The root and stem of T. cordifolia are prescribed in combination with other drugs as an anti-dote to snake bite and scorpion sting (Meshram et al., 2013).Leaves -Juice or decoction of leaves is administered orally with honey in fever (Shah, 1984).

Toxicology
Very less is known about the toxicology of Tinospora cordifolia in humans.No adverse effect was observed when the extract of Tinospora cordifolia stem was administered to rabbits up to the highest oral doses of 1.6 g/kg, and in rats at doses of 1,000 mg/kg of the whole plant extract.But when 500mg/kg body weight of Tinospora stem extract were given to mice, 40% mortality occurred (Neeraja and Margaret, 2013).

Dose
In powder form 3-6 g of the drug In decoction form 20-30 g of the drug (Sharma, 1999).

Pharmacological activity
In the history of traditional medicine using Tinospora cordifolia has revealed it to have pharmacological value as Hypoglycemic, anti-inflammatory, hepatoprotective, immune-modulator activity, anti-oxidant, antitumour activity, Antineoplastic and has antifertility activity.

Hypoglycemic activity
Oral administration of the water extract of Tinospora cordifolia root caused a significant reduction in blood glucose, brain lipid level, hepatic glucose-6-phosphatase, serum acid phosphatase, alkaline and lactate dehydrogenase and increase in body weight, total haemoglobin and hepatic hexokinase in alloxanized diabetic rats (Stanely et al., 2000).

Anti allergic activity
In a clinical study, 100% relief was reported from sneezing in 83% of the patients on treatment with T. cordifolia.Thus Tinospora cordifolia significantly decreased all symptoms of allergic rhinitis and was well tolerated (Badar et al., 2005).

Cardioprotective activity
A dose-dependent reduction in infarct size and in serum and heart lipid peroxide levels was observed with prior treatment with Tinospora cordifolia in ischemia-reperfusion-induced myocardial infarction in rats (Rao et al., 2005).

Hepatoprotective
The hepatoprotective action of T. cordifolia was reported in one of the experiment in which goats treated with Tinospora cordifolia have shown significant clinical and hemato-biochemical improvement in CCl4 induced hepatopathy.Extract of T. cordifolia has also exhibited in vitro inactivating property against Hepatitis B and E surface antigen in 48-72 Hours (Mehrotra et al., 2000).

Anti-stress and tonic property
The anti-stress and tonic property of the plant was clinically tested and it was found that it brought about good response in children with moderate degree of behavior disorders and mental deficit.It has also significantly improved the I.Q.levels (Singh et al.2003).

Anti-inflammatory
The alcoholic extract of Tinospora cordifolia has been found to exert anti-inflammatory actions in models of acute and subacute inflammation (Wesley et al., 2008).

Antineoplastic activity
Intraperitoneal injection of the alcoholic extract of Tinospora cordifolia has been shown to Dalton's lymphoma (DL) bearing mice stimulated macrophage functions like phagocytosis, antigen-presenting ability and secretion of Interleukin-1 (IL-1), tumour necrosis factor (TNF) and Reference Nutrient Intake (RNI) as well as slowed tumor growth and increased lifespan of the tumor-bearing host (Singh et al., 2005).

Osteoprotective activity
Rats treated with Tinospora cordifolia showed an osteoprotective effect, as the bone loss in tibiae was slower than that in controls.Serum osteocalcin and cross-laps levels were significantly reduced.This study demonstrates that extract of Tinospora cordifolia has the potential for being used as anti osteoporotic agent (Kapur et al., 2008).

Antifertility activity
Oral administration of 70% methanolic extract of Tinospora cordifolia stem to male rats at a dose level of 100 mg/d for 60 days did not cause body weight loss but decreased the weight of testes, epididymis, seminal vesicle and ventral prostate in a significant manner (Gupta and Sharma, 2003).

Anti ulcer activity
Treatment with a formulation containing Tinospora cordifolia has been shown to reduce ulcer index total acidity, with an increase in the pH of gastric fluid in pylorus-ligated rats and in the ethanol-induced gastric mucosal injury in rats (Bafna and Balaraman, 2005).

Anti leprotic activity
Tinospora cordifolia is used for its kushtahara (anti-leprotic) properties, along with wide use in Kandu and visarpa (types of skin disorders) and has been shown to exert anti -leprotic activity in a combination formulation (Asthana et al., 2001).

Diuretic
Activity In a scientific study on rats and human volunteers, Tinospora cordifolia was found to have diuretic effects.It was also found effective in modulation of morphology and some gluconeogenic enzymes activity in diabetic rat kidney (Nagaraja et al., 2007).

Safety aspect
Tinospora cordifolia is traditionally considered to be safe in the dose mentioned (Anonymous, 2003).

Conclusions
It is evident from the above review that the Tinospora cordifolia hold unique place in the traditional herbs based remedies.Although the results from this review are quite promising for the use of Tinospora cordifolia as a multi-purpose medicinal agent, several limitations currently exist in the current literature.More clinical trials on the basis of modern knowledge should be conducted to support its therapeutic use and acceptability.It is also noted that Tinospora cordifolia may be effective not only in isolation, but may actually have a potentiating effect when given in combination with other herbs or drugs in the interest of human health.