T h e r a p e u t i c I n d e x 130 4. Antimicrobial action: The extract derived from the fruits of Terminalia chebula was demonstrated to have broad-spectrum antibacterial activity against some multidrug-resistant human pathogens. Piper nigrum exerts potent antibacterial action by affecting the permeability of the bacterial cell membrane, which can be attributed to the action of the alkaloids piperine, piperidine, and other volatile constituents. Glycyrrhizin and the related compounds from Glycyrrhiza glabra possess antiviral property. They inhibit viral gene expression and replication, reduce adhesion force and stress, and inhibit HMGB1 binding to DNA. In addition, glycyrrhizin also enhances host cell activity (eg, by blocking the degradation of IκB and activating T-lymphocyte proliferation), which may benefit in attenuating the virulence. The essential oil from Syzygium aromaticum demonstrates broad-spectrum antimicrobial activity against human pathogens. Eugenol exerts antimicrobial activity by facilitating the disruption of the bacterial and fungal cell membranes. Eugenol also exhibits potent inhibitory action against several oral pathogenic bacteria, thus helping maintain oral health. Elettaria cardamomum essential oil exhibits potent antimicrobial effect, especially against oral pathogenic bacteria, thereby helping maintain oral health. 5. Anti-allergic action: Piperine suppresses allergy-induced airway inflammation and hyperresponsiveness, pulmonary eosinophilic infiltration, suppression of Th-2 cytokines (interleukin [IL]-4, IL-5), immunoglobulin E, and histamine with a marked reduction of thymus and activation-regulated chemokine (eotaxin) in the lung tissue. Alpinia galanga extract was observed to suppress mucosal mast cell degranulation by both allergic and nonallergic triggers. It suppressed IgE/antigen and ionophore-induced enhanced expression of the inflammatory cytokines (tumor necrosis factor-α and IL-4) in mucosal type mast cells. The phenylpropanoids found in Alpinia galanga are responsible for its anti-allergic property. Galangin, a flavonoid constituent of Alpinia galanga, also helps attenuate allergy-induced airway hyperresponsiveness and inflammation; reduces pulmonary eosinophil infiltration and goblet cell hyperplasia; inhibits IL-4, IL-5, and IL-13 production in the bronchoalveolar lavage fluid; and reduces the expression of inducible nitric oxide synthase and vascular cell adhesion protein-1 (VCAM-1) levels in lung tissue. Glycyrrhizin attenuates allergen-induced airway hyperresponsiveness, airway constriction, and pulmonary inflammation. 6. Immunostimulatory action: The water-soluble active constituents found in Alpinia galanga have an immunoenhancing effect on both phagocytic and lymphocytic systems, thus, helping the patient cope with infective conditions. Koflet-SF® (lozenge)
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