T h e r a p e u t i c I n d e x 163 Special Precautions To be prescribed as per the physician’s discretion in children, as the product’s safety is not established in this group. Presentation Pilfer-proof bottle of 100 mL. Pharmacological Actions of Principal Ingredients 1. Anti-inflammatory and antioxidant actions: Curcumin, a natural yellow pigment present in Curcuma longa, suppresses acute and chronic inflammation. It has been reported that curcumin has the potential to inhibit nuclear factor (NF)-κB. The expression of several genes that are regulated by NF-κB has also shown to be suppressed by curcumin. These include cell surface adhesion molecules, chemokines, tumor necrosis factor, matrix metalloproteinase 9 (MMP-9), cyclooxygenase 2 (COX-2), and nitric oxide synthase (NOS). As these genes are critical regulators of inflammation, the suppression of expression of these genes explains the anti-inflammatory effect of curcumin. The anti-inflammatory and antioxidant properties of curcumin are responsible for its chemopreventive action. In vitro studies have shown that curcumin inhibits the activities of lipoxygenase and COX that induce inflammation. Curcumin lowers the activity of smokeless tobacco extract (STE) or nicotine-derived nitrosamine ketone (NNK)–induced NF-κB and COX-2 in oral premalignant and cancer cells. Curcuma longa acts by increasing the number of micronuclei in the circulating lymphocytes and by functioning as an excellent scavenger of free radicals. Curcumin exerts anti-inflammatory activity by inhibiting several different molecules that participate in the process of inflammation. The anti-inflammatory effect of Triphala has been shown to significantly inhibit the levels of lysosomal enzymes, lipopolysaccharides, and the inflammatory mediator TNF-α. 2. Antibacterial and wound-healing actions: Triphala is reported to exert broad-spectrum antibacterial activity against human pathogenic bacteria. The antibacterial activity of honey can be attributed to its high osmotic pressure, acidic nature (pH ranging from 3.2 to 4.5), its constituents such as glucose oxidase, and its effect on the proliferation of B and T lymphocytes. Honey reduces the inflammation and edema surrounding wounds. It prevents infection by forming a physical protective barrier. This barrier prevents tissue oxygenation, provides a moist healing environment, and promotes the formation of new cells. Through its antibacterial property, honey destroys the odor-causing bacteria, and thus, prevents odor. 3. Radioprotective action: Triphala is rich in antioxidants and is effective in inhibiting γ radiation–induced damage in microsomal lipids and plasmid pBR 322 DNA. The polyphenolic contents of Triphala convert reactive oxygen free radicals to nonreactive products and provide radioprotection. 4. Chemopreventive action: A study shows the chemopreventive action of curcumin in tumors of the colon, stomach, and skin through the inhibition of COX, phospholipase A2, and phospholipase CR1. Oro-TTMOral Rinse (liquid)
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