Ayurveda: Bridging innovation for human and animal health

Ayurveda is a phenomenal science. With a deep understanding of the human body and a wealth of knowledge concerning formulations derived from plant, animal and mineral origin, it has offered therapeutic solutions to diseases, and preventive care over the course of thousands of years. It originated in India and has contributed to other traditional systems of medicine, some of which have subsequently outpaced our science in achieving global acceptance and commercial success. The disparity may stem from the inadequate scientific validation of our technologies and products and the mindset of individuals who may hold a skeptical attitude toward traditional systems of medicine while heavily reliant on contemporary system of medicine. When faced with life-threatening or end-stage disease, we run to Ayurveda, but till that happens, there is a firm belief in synthetic pharmaceutical drugs, regardless of their limited efficacy or safety concerns. Why? And what is going to change that? Western civilization is more open to natural products than we are… What is holding us back? The global nutraceutical market was more than $493 Billion in 2022 and is growing at a Compound Annual Growth Rate of 9.0% from 2021 to 2030.[1] Increasing age expectancy with long-term health issues, rising healthcare costs, and changing lifestyle and food preferences, especially for prevention, drive this growth. According to research conducted by the International Trade Administration, it is estimated that the nutraceutical industry in India will reach $18 billion by 2025, with dietary supplements accounting for 65% of the market share. However, in the 2020–2021 fiscal year, the reported exports of herbal products from India totaled $539.57 million, or less than 1% of the global market.[2] We are deeply rooted in our ways and means and have applied that same myopic vision to product development from our traditional science. These create uncertainty and a lack of confidence in the modern medical practitioner or researcher who is used to reading scientific articles published in top peer-reviewed journals. The Ayurvedic community must come together to meet and exceed the standards of modern medicine. That is the juncture at which we can anticipate widespread acceptance, positioning ourselves as a top choice for global health. An attempt has been made in the present article to express the notion of the wider scope of pharmaceutical innovation in Ayurveda from the perspective of modern physicians and scientists. Today, the pharmaceutical industry uses innovative and cutting-edge technology, applying genomics and artificial intelligence for new drug discovery. The same principles can be applied to Ayurvedic plants and their combinations to develop customized yet standardized products.[3] Designer drugs are a fashionable word in modern medicine, but therapies based on “Prakriti” (somatic constitution) are a few 1000-year-old reality in Ayurveda.[4] Whole plants and parts of plants have been used in different parts of the world for similar treatments—from shamans in the Amazon rain forests to Campo medicine in Japan, to Hanbang, the traditional Korean medicine, to traditional Chinese medicine, to Moroccan herbs, and so on—the plants and their uses are very similar. Unless there is something novel and unique, intellectual property protection is either limited or nonexistent. That is, where the first step to validation comes about. In the future, a full Ayurvedic product development ideally must document efficacy and safety by applying the following standards: Utilizing innovative extraction methods to generate unique bioactive fractions, which can be characterized for each constituent molecule within the fraction. Complete chemical analysis and standardization employing multiple techniques, such as high-performance liquid chromatography, high-performance thin layer chromatography, spectrophotometry, potentiometry, and magnetic resonance, ensure the exact content of all active constituents and their marker compounds. Genetic and environmental factors can affect the biochemical components of the plant extracts; hence, the same plant from different parts and soils can yield different active compounds. The results must be accurately reproducible to appeal to the physician and the educated consumer. Bioavailability and pharmacokinetics to document that the active components of the plants are absorbed and transported to the target organs and tissues. In vitro and in vivo Biological studies for efficacy and safety. Genotoxicity to evaluate the potential of damage to deoxyribonucleic acid structures or chromosomes. Cytochrome P450 enzyme studies to demonstrate that there is no drug–plant or plant–plant interactions. human ether-a-go-go-related gene (hERG) assay to evaluate the potential for life-threatening arrhythmias and cardiotoxicity Mechanism of action studies. Analytical method validation. Development of optimal dosage forms. Solubility and stability studies. Phase I, II, and III randomized clinical trials. The above-mentioned standards must be adhered to, in accordance with Good Manufacturing Practices (GMP), as set by the Ministry of Ayush, the World Health Organization (WHO), and the United States Food and Drug Administration (US FDA) for the final product manufacture. Each final product batch must document the exact amount of active marker compound(s) of each plant in the formulation, absence of residual solvents, microbial contamination, pesticide residues, and heavy metals. Evidence-based medicine is also a buzzword that is, popular with Ayurvedic products.[5] A quick review of recommended journals to publish Ayurvedic research shows journals on Scopus, Web of Science, and university grants commission-consortium for academic and research ethics.[6] Publishing in journals with indexing on PubMed and good impact factor can enhance the credibility of Ayurveda. Continuing education and proactive awareness campaigns led by governmental bodies, academic institutions, and industry stakeholders will bolster confidence, increase recognition, and drive global sales. The economic opportunities are endless. Today, global coffee and beverage chains proudly serve turmeric-based drinks to boost immunity. Some companies add small amounts of Ayurvedic extracts to skin care products; others use common herbs as food additives. The potential is huge and can easily be expanded to medicinal beverages, including water, teas, and other drinks; beauty from within products; and therapeutic functional foods. We must adapt to a changing world by utilizing the best digital and biotechnical tools. Artificial intelligence offers an opportunity to validate our ancient herbal therapies in a more systematic and focused manner. Furthermore, Ayurveda can also be used effectively as an adjunct to modern medical drugs and vaccines for synergistic efficacy and/or to prevent toxicity. The control and prevention of exploitation must be managed by setting the highest standards and meeting regulatory requirements of sophisticated bodies such as the US FDA, European Medicines Agency, Health Canada, Medicines and Healthcare products Regulatory Authority, Pharmaceuticals and Medical Devices Agency, and others. The pandemic saw an unprecedented adoption of companion animals across the world. One in every three households globally now owns a pet. The same concern of safety is predominant in every pet owner’s mind. Ayurveda offers an outstanding opportunity to make safe and effective products for the use of companion animals such as dogs and cats and commercial animals such as horses and cattle. These be made available in diverse dosage forms, such as animal feed, chews, pellets, or simple tablets/capsules. Palatability, taste, bioavailability, and toxicity are paramount in developing animal health products. Four widely used Ayurvedic plants, with the precise bio-actives in an optimal ratio, were found to be extremely important for general inflammation, osteoarthritis and rheumatoid arthritis; without any toxicity effects, even after long term treatment. The combination was one of the first US patents awarded in Ayurveda.[7] It showed statistically significant efficacy in these conditions in multiple double-blind placebo-controlled trials. Mechanism of action studies showed potent Tumor Necrosis Factor (TNF) and other cytokine inhibition. It was further validated in extensive toxicology including genotoxicity and plant/drug interaction studies. With Cytokine storm as the main cause of death in Covid-19, a very stringent randomized clinical trial was conducted on the same proprietary combination, extracted by a US patented method,[8] at higher doses. It showed statistical significance in Moderate COVID-19, including a reduction in duration of illness, severity scores of majority symptoms, and improvement in taste and smell starting from day 5. Most importantly, there was an improvement in the key biomarker Interleukin-6, responsible for the severity of the illness and Long-Covid.[9] This higher dose combination, called Artovid-20® is a potent broad-spectrum pan-viral immunity booster. It has been recently awarded a US Patent for “Methods and Compounds for Treating Effects of Covid-19 Disease.”[10] Such significant science or hypothesis based processes can bring Ayurvedic plants to their real targeted mechanism based use. The same success can be repeated with many other plants and their combinations for various difficult-to-treat conditions and wellness. Diseases that have challenges in modern medicine, such as cancers, heart and liver conditions, and mental health, can be managed very well by scientifically validated, evidence-based wisdom of Ayurvedic medicine. Innovations do not come about in a day. They are developed in a very focused and dedicated way to impact worldwide health and markets. Ayurveda has the tremendous potential to meet the needs of humans and animals. In this regard, the efforts of our Honorable Prime Minister, the Ministry of Ayush, and the Central Council for Research in Ayurvedic Sciences are highly appreciated in positioning Ayurveda not as an alternative or complementary medicine but on the forefront as “Core Medicine” for global health and wellness. Financial support and sponsorship Nil. Conflicts of interest Dr. Chitre is CEO and holds shares of Bioved Pharmaceuticals.

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