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Table 3.1 (Continued)
Formulation Plants used Uses
Rumalaya gel Boswellia serrata, Cedrus deodara, Cinnamomum zeylanicum, Gaultheria
fragrantissima, Mentha arvensis, Pinus roxburghii, Vitex negundo and
Zingiber officinale
Pain and joint mobility
Aswagandharishtam Withania somnifera, Chlorophytum tuberosum, Rubia cordifolia, Terminalia
chebula, Curcuma longa, Berberis aristata, Glycyrrhiza glabra, Pluchea
lanceolate, Pueraria tuberosa, Terminalia arjuna, Cyperus rotundus, Ipomoea
turpethum, Hemidesmus indicus, Cryptolepis buchanani, Santalum album,
Pterocarpus santalinus, Acorus calamus, Plumbago zeylanica, Woodfordia
fruticose, Zingiber officinale, Piper nigrum, Piper longum, Cinnamomum
zeylanicum, Elettaria cardamomum, Cinnamomum tamala, Callicarpa
macrophylla and Mesua ferrea
Nervous system and digestive
system
Sarasvata ghrita Terminalia chebula, Zingiber officinale, Piper nigrum, Cissampelos pareira,
Acorus calamus, Piper longum and Moringa pterygosperma
Memory booster
52 Chapter 3
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verticillatum, Pseudarthria viscida, Ricinus communis, Roscoea alpina, Rubia
cordifolia, Sesamum indicum, Sesamum indicum, Stereospermum suaveolen,
Strychnos nuxvomica, Trachyspermum ammi, Tribulus terrestris, Uraria lago-
poides, Valeriana wallichii, Vitex negundo and Zingiber officinale. It relieves pain
in the lumbar region, knee joints, cervical spondylitis, edema and
inflammation.
Divya Svasari Rasa contains Anacyclus pyrethrum, Capparis moonii, Cinna-
momum zeylanicum, Glycyrrhiza glabra, Piper longum, Piper nigrum, Pistacia
integerrima, Syzygium aromaticum and Zingiber officinale. It is used in the
management of bronchitis, cough, coryza, cold, asthm a and sinusitis. Divya
Vatari Churna includes Moringa oleifera, Picrorhiza kurroa, Trigonella foenum-
graecum, Withania somnifera and Zingiber officinale. It remedies rheumatoid
arthritis, sciatica, and pain in the back and lumbar region.
Himalaya Abana contains Acorus calamus, Asparagus racemosus, Boerhaavia
diffusa, Carum copticum, Celastrus paniculatus, Centella asiatica, Cinnamo-
mum cassia, Commiphora wightii, Convolvulus pluricaulis, Crocus sativus, Cy-
perus rotundus, Eclipta alba, Elettaria cardamomum, Embelia ribes, Emblica
officinalis, Foeniculum vulgare, Glycyrrhiza glabra, Nardostachys jatamansi,
Nepeta hindostana, Ocimum sanctum, Piper longum, Rosa damascena, Rosa
centifolia, Santalum album, Syzygium aromaticum, Terminalia arjuna, Termi-
nalia chebula, Tinospora cordifolia, Withania somnifera and Zingiber officinale.
It is used to manage hyperlipidemia and hypertension, as it is an adjuvant in
angina therapy. Himalaya Mentat includes Acorus calamus, Bacopa monnieri,
Celastrus paniculatus, Centella asiatica, Embelia ribes, Elettaria cardamomum,
Emblica officinalis, Evolvulus alsinoides, Foeniculum vulgare, Ipomoea digitata,
Mucuna prurie ns, Myristica fragrans, Nardostachys jatamansi, Orchis mascula,
Oroxylum indicum, Prunus amygdalus, Syzygium aromaticum, Terminalia ar-
juna, Terminalia bellirica, Terminalia chebula, Tinospora cordifolia, Valeriana
officinalis, Withania somnifera and Zingiber officinale. Its adjuvants are used
in Parkinson’s and Alzheimer’s diseases. Rumalaya gel contains Boswellia
serrata, Cedrus deodara, Cinnamomum zeylanicum, Gaultheria fragrantissima,
Mentha arvensis, Pinus roxburghii, Vitex negundo
and Zingiber officinale.It
relieves pain and enhances joint mobility.
33
Aswagandharishtam is another traditional medicine for illnesses affecting
the nervous and digestive systems that is organized around a number of
plants and plant parts, and it also contains Zingiber officinale as one of the
main ingredients. The Ayurvedic preparation contains Withania somnifera,
Chlorophytum tuberosum, Rubia cordifolia, Terminalia chebula, Curcuma
longa, Berberis aristata, Glycyrrhiza glabra, Pluchea lanceolate, Pueraria tu-
berosa, Terminalia arjuna, Cyperus rotundus, Ipomoea turpethum, Hemidesmus
indicus, Cryptolepis buchanani, Santalum album, Pterocarpus santalinus,
Acorus calamus, Plumbago zeylanica, Woodfordia fruticose, Zingiber officinale,
Piper nigrum, Piper longum, Cinnamomum zeylanicum, Elettaria cardamomum,
Cinnamomum tamala, Callicarpa macrophylla and Mesua ferrea.
34
Sarasvata
ghrita is a polyherbal preparation described in Ayurveda and utilized as a
memory booster.
35
The preparation includes Terminalia chebula, Zingiber
Ginger in Ayurvedic Preparations and Its Applications 53
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officinale, Piper nigrum, Cissampelos pareira, Acorus calamus, Piper longum and
Moringa pterygosperma, which all have a memory-boosting activity,
36–41
and
the main ingredients of which are chebulinic acid,
42
6-shogaol,
43
piperine,
44
bebeerine,
45
b-asarone,
46
piperine
47
and carotene.
48
An Ayurvedic decoction comprising a combination of 26 bioactive com-
ponents from four selected plants, viz. Zingiber officinale, Glycyrrhiza glabra,
Piper nigrum and Ocimum basilicum, has been shown to be effective in the
management of respiratory ailments.
49
Recently, AYUSH has recommended
utilizing Kadha (herbal tea/decoction) constituting Ocimum basilicum,
Cinnamomum zeylanicum, Pipernigrum, Zingiberofficinale andVitis viniferaand
golden milk to enhance immunity as a prophylactic measure against
COVID-19. Because of the multipart configuration of several phytocon-
stituents from these medicinal plants, the blend of this mixture could modify
numerous proteins andenhance immunity, which can bedescribed through a
network pharmacology andgene-set enhancementinvestigation. The network
pharmacology and geneset enrichmentinvestigation are well-acceptedtactics
to recognize a disease target, leading to successive molecules and modulated
pathways via ‘‘multiple component–protein interactions’’.
50–52
Based on the
Ayurvedic and scientific literature, the Ministry of AYUSH, India, delivered an
advisory where it recommended the utilization of Kadha for self-care, to im-
prove immunity against severe infection caused by COVID-19. Further, it also
suggested the consumption of golden milk, with a half teaspoon of Curcuma
longa powder in 150 mL hot milk to be taken once or twice a day.
53,54
3.6 Ayurvedic Herbal Formulations with Ginger for
Different Health Issues
Ginger is recommended in traditional medicine for high blood pressure,
cardiopathy, palpitations and as a vasodilator to improve the circulation.
The decoction of ginger rhizome is extensively utilized in Ayurvedic medi-
cine. As per the explanation of the Ayurvedic Pharmacopoeia of India,
55
the
ginger decoction was prepared using 30 g of powdered rhizomes mixed with
1000 mL of boiling water, permitting the volume of water to reach 200 mL.
The decoction was cooled at room temperature, then filtered and lyophil-
ized. The effects of the decoction of ginger rhizome were considered on
cardiovascular parameters and vascular and intestinal smooth muscle. The
ginger decoction displayed weak negative inotropic and chronotropic in-
trinsic activities with a substantial intrin sic action on smooth muscle with
the effectiveness on the ileum greater than that on the aorta.
56
Ginger is a
wonderful common spice utilized in Ayurvedic medicine to improve diges-
tion and inhibit nausea. These properties for assisting bowel movements and
relaxing the muscles regulate the digestive system. Ginger is considered
an adjuvant in various Ayurvedic formulations in which it boosts absorption
and inhibits gastrointestinal side effects.
57,58
Some significant Ayurvedic
herbal formulations include ginger as one of the essential components and
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are developed by the percentage dry weight of the various plants for several
health problems.
To rectify asthma bronchitis: mixed powder (4 g) of Solanum xanthocarpum
(whole plant) 25%, Piper longum (fruits) 10%, Adhatoda vasica (leaves) 25%,
Zingiber officinale (roots) 10%, Curcuma zedoaria (roots) 10%, Ocimum sanc-
tum (leaves) 10% and Phyllanthus emblica (fruits) should be given to the
patient, twice a day (morning and night before sleep) with water.
58,59
To
manage blood circulation: powdered mixer (4 g) of Zingiber officinale (roots)
20%, Piper longum (roots) 10%, Withania somnifera (roots) 10%, Phyllanthu s
emblica (fruits) 10%, Curcuma longa (roots) 10%, Terminalia bellirica (fruits)
10%, Terminalia chebula (fruits) 10%, Ocimum sanctum (leaves) 10% and
Tephrosia purpurea (leaves) 10% should be given to the patient, twice daily
with water.
58,59
To cure chronic fever: mixed powder (4 g) of Tinospora cordifolia (stems)
15%, Ocimum sanctum (leaves) 15%, Adhatoda vasica (leaves) 15%, Azadir-
achta indica (leaves) 15%, Holarrhena antidysenterica (bark) 10%, Piper
longum (fruits) 10%, Zingiber officinale (roots) 10% and Terminalia bellirica
(fruits) 10% is given to the patient, twice daily before meals with water.
58,59
To cure cough: mixed powder (3 g) of Phyllanthus emblica (fruits) 25%, Ad-
hatoda vasica (leaves) 20%, Ocimum sanctum (leaves) 10%, Piper longum
(fruits) 10%, Zingiber officinale (roots) 10%, Glycyrrhiza glabra (roots) 15%
and Solanum xanthocarpum (whole plant) 10% should be given to the patient
twice daily (morning and at night before going to bed) mixed with lukewarm
honey.
58,59
To manage dysentery and diarrhea: mixed powder (3 g) of Holarrhena
antidysenterica (bark) 25%, Aegle marmelos (fruits) 25%, Zingiber officinale
(roots) 10%, Terminalia chebula (fruits) 10%, Cyperus rotundus (roots) 10%,
Syzygium cumini (seeds) 10% and Phyllanthus emblica (fruits) 10% should be
given to the patient, three times a day, with curd.
58,59
To cure gastritis: mixed
powder (4 g) of Zingiber officinale (roots) 10%, Piper longum (fruits) 10%,
Mentha piperita (leaves) 10%, Terminalia chebula (fruits) 15%, Terminalia
bellirica (fruits) 15%, Phyllanthus emblica (fruits) 15%, Plumbago zeylanica
(roots) 10% and Tinospora cordifolia (stems) 15% should be given to the
patient twice daily, half an hour before meals with water.
58,59
To rectify high blood pressure: mixed powder (4 g) of Terminalia arjuna
(bark) 35%, Terminalia chebula (fruits) 15%, Asparagus racemosus (roots)
15%, Zingiber officinale (roots) 10% and Withania somnifera (roots) 25%
should be given to the patient, twice a day (morning and night) with
honey.
58,59
To manage indigestion (lack of appetite): mixed powder (4 g) of
Zingiber officinale (roots) 10%, Piper longum (fruits) 10%, Phyllanthus emblica
(fruits) 30%, Terminalia chebula (fruits) 15%, Tinospora cordifolia (stems)
15%, Cassia angustifolia (leaves) 10% and Mentha piperita (leaves) 10%
should be given to the patient, twice a day after meals with water.
58,59
To rectify male sterility: mixed powder (3 g) of Withania somnifera (roots)
15%, Mucuna pruriens (seeds) 25%, Tribulus terrestris (fruits) 20%, Glycyr-
rhiza glabra (roots) 10%, Terminalia arjuna (bark) 10%, Phyllanthus emblica
Ginger in Ayurvedic Preparations and Its Applications 55
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(fruits) 10%, Zingiber officinale (roots) 5% and Piper longum (fruits) 5%
should be given to the patient, twice a day with honey.
58,59
To manage
obesity: mixed powder (4 g) of Terminalia chebula (fruits) 15%, Terminalia
bellirica (fruits) 15%, Phyllanthus emblica (fruits) 10%, Crateva nurvala (bark)
25%, Tribulus terrestris (fruits) 25% and Zingiber officinale (roots) 10% should
be given to the patient, twice a day with warm water.
58,59
To manage paralysis: mixed powder (3 g) of Curcuma zedoaria (roots) 20%,
Withania somnifera (roots) 20%, Tribulus terrestris (fruits) 20%, Zingiber
officinale (roots) 20%, Piper longum (fruits) 5%, Crataeva nurvala (leaves)
10% and Plumbago zeylanica (roots) 5% should be given to the patient, three
times a day with honey.
58,59
To rectify prostate enlargement: mixed powder
(4 g) of Tinospora cordifolia (stems) 15%, Tribulus terrestris (fruits) 15%,
Phyllanthus emblica (fruits) 15%, Zingiber officinale (roots) 10%, Butea
monosperma (seeds) 10%, Adhatoda vasica (leaves) 5%, Terminalia chebula
(fruits) 10%, Terminalia bellirica (fruits) 10% and Glycyrrhiza glabra (roots)
10% should be given to the patient twice a day, morning and evening, before
meals with water.
58,59
To cure thyroid problems: mixed powder (3 g) of Crataeva nurvala (bark)
20%, Bauhinia variegata (bark) 20%, Sida cordifolia (leaves) 15%, Terminalia
chebula (fruits) 10%, Terminalia bellirica (fruits) 10%, Glycyrrhiza glabra
(roots) 15% and Zingiber officinale (roots) 10% should be given to the patient,
twice daily with lukewarm water.
58,59
To manage urinary tract-related issues:
mixed powder (4 g) of Tribulus terrestris (fruits) 25%, Zingiber officinale
(roots) 10%, Solanum xanthocarpum (whole plant) 10%, Crataeva nurvala
(bark) 25%, Tinospo ra cordifolia (stems) 10%, Asparagus racemosus (roots)
10% and Tephrosia purpurea (leaves) 10% should be given to the patient,
twice a day with water.
58,59
Remarkably, various Ayurvedic ginger-based formulations have the ability
to treat many chronic diseases such as chronic fever, cough, gastritis, in-
digestion, dysentery and diarrhea, blood circulation, blood pressure, male
sterility, obesity, asthma bronchitis, thyroid problems, paralysis, urinary
tract-related issues, etc. Unfortunately, owing to the absence of scientific
authentication in several conceptions, this treasurable gift from our ances-
tors is underused. Moreover, the WHO records that ‘‘inappropriate utiliza-
tion of traditional medicines or practices can have negative or dangerous
effects’’ and that additional investigations are required to determine their
efficacy and safety. Indeed, there are multidimensional problems associated
with the prevalence of traditional medicine, a field contaminated by
fraudulent practitioners, adulterated medications, pseudoscience, unsafe
supply chains, toxic components and alternative medical approaches
vaguely and improperly abstracted from their original use and formu-
lations.
5
Hence, evidence-based research is urgently required for worldwide
appreciation and acceptance of Ayurvedic-based formulations, which re-
quires additional improvements in the investigative methods. Therefore,
Ayurvedic scientists make should efforts to improve the fundamental cap-
ability of Ayurveda without compromising its fundamental principles.
60
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3.7 Evidence-based Formulations in Various
Nutraceuticals and Functional Foods
Recently, various studies have reported evidence-based research in different
ginger formulations with Ayurvedic applications (Figure 3.2). A polyherbal
mixture for prediabetes comprised aqueous extracts of stem of Tinospora
cordifolia, bark of Pterocarpus marsupium, leaves of Gymnema sylvestre,rhi-
zome of Zingiber officinale and fruit of Momordica charantia in equal
amounts. The polyherbal formulation was realized to be an effective and safe
method for the management of prediabetes and decreased progress to type 2
diabetes mellitus by altering bl ood glucose levels, serum insulin and lipid
profiles without any adverse effects. Ayurveda parameters like Agni, Aahar
and Nidra, in short Dincharya, also play a very significant role in the
progress from prediabetes to diabetes.
61
The utilization of an ancient, time-
tested design for nasal cleansing coul d perform an essential role in miti-
gating the contagiousness of SARS-CoV-2 by preventing the multiplication
and shedding of the virus in the nasal epithelium. An in silico study rec-
ommended that the phytochemical components in Citrus medica and Zin-
giber officinale may have real potential in decreasing the load of virus and
shedding of SARS-CoV-2 in the nasal routes.
62
A study was conducted to
improve the nutraceutical properties of ginger extract by using super-
saturable self-emulsifying drug-delivery systems. After oral administration of
ginger extract in rats, the relative bioavailability of bioactive components
such as 6-gingerol and 8-gingerol in the supersaturable self-emulsifying
drug-delivery system treated group was threefold higher than the group
treated with ginger extract alone. Therefore, the utilization of a super-
saturable self-emulsifying drug-delivery system could boost the dissolution
and pharmacokinetic properties of active components in gin ger extract,
Figure 3.2 Various biological activities of Ayurvedic-based ginger formulations.
Ginger in Ayurvedic Preparations and Its Applications 57
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contributing to effective hepatoprotective function and other nutraceutical
effects.
63
A superfine ginger food powder was developed using high-energy ball
milling utensils, which modifies the internal cohesion, crystal structure and
interplane distance of the nanocrystalline food powder. This superfine gin-
ger powder may be appropriate in the pharmaceutical, health and medicine
sectors for research and development of innovative composites, or func-
tional materials by reason of its physical behavior and effective antioxidant
property.
64
A healthy fruit drink was formulated from a combination of
ginger, lemon, orange and honey that was found to be highly nutritive and
rich in carbohydrates.
65
Ginger essential oil encapsulated onto polyvinyl
alcohol/gum arabic/chitosan composite film and chitosan/gum arabic/
polyethylene glycol composite films were developed by the solvent casting
method as promising wound-healing and food-packaging materials .
66,67
A powder form of microencapsulated ginger extract was prepared using
maltodextrin and/or gum arabic, which could be readily encapsulated into
food products, particularly tea and bread.
68
Dietary supplementation with turmeric and ginger restricted cholinergic
and purinergic neurotransmission in the cerebral cortex of hypertensive rats
by adaptation of reducing adenosine triphosphate and adenosine mono-
phosphate hydrolysis, and adenosine deaminase and acetylcholinesterase
activities in the synaptic cleft of the cerebral cortex. These outcomes recom-
mended that both rhizomes apply a neuroprotective effect under a hyper-
tensive state.
69
Likewise, dietary supplementation with turmeric and ginger
rhizome was also related to the renovation of sperm mobility, testosterone
level, systolic blood pressure and enhancement of antioxidant status in the
epididymides and testes of
L-nitro-arginine methyl ester (L-NAME)-induced
hypertensive rats. This study recommended that both rhizomes could be
connected as functional foods to inhibit hypertension-mediated male re-
productive dysfunction.
70
Turmeric and ginger rhizomes modify platelet ec-
tonucleotidase activities in
L-NAME hypertensive rats by effecting a rise in
adenosine diphosphate and adenosine monophosphate hydrolysi s and in-
hibiting adenosine deaminase activity, thus leadingto an enhancementin the
level of adenosine, an effective vasodilator and inhibitor of platelet accumu-
lation, which could be utilized as nutraceuticals or functional foods for
managing or preventing hypertension related to platelet hyperactivity.
71
A ginger extract-loaded solid dispersion system was prepared by a freeze-
drying method with improved oral absorption of 6-gingerol and 8-gingerol
resulting in an improved antihypothermic action in a rat model of hypo-
thermia induced by ethanol treatment.
72
Ginger extracts containing
6-paradol and 6-shogaol suppressed human telomerase reverse transcriptase
(hTERT) expression in addition to telomerase activity in A549 cells without
any adverse effects. The ginger extract has an anticlastogenic effect against
diethylnitrosamine-induced liver micronucleus development in rats, which
proposed that the ginger extract could potentially be beneficial in dietary
cancer prevention.
73
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Lei et al.
74
investigated the effect of dietary gingerol and shogaol-improved
ginger extract on plasma total cholesterol and gene expression of intestinal
Niemann–Pick C1-like protein 1 (NPC1L1), acyl CoA:chole sterol acyl-
transferase 1 (ACAT2), microsomal triacylglycerol transport protein (MTP)
and ATP-binding cassette transporters 5 and 8 (ABCG5/8) along with hepatic
sterol regulatory element-binding protein 2 (SREBP2), liver X receptor
(LXRa), 3-hydroxy-3-methylglutaryl-CoA reductase (HMG-CoA-R), low-density
lipoprotein receptor and cholesterol-7a-hydroxylase (CYP7A1) in hamsters
fed a high-cholesterol diet. The gingerol and shogaol-enriched ginger extract
reduced the plasma total cholesterol concentration through a combination
of two mechanisms, prevention of cholesterol absorption and improvement
of bile acid excretion, leading to considerable decreases in the apparent
cholesterol absorption, which was complemented by upregulation of hepatic
CYP7A1 and downregulation of the genes of intestinal NPC1L1, ACAT2 and
MTP.
74
A novel bioavailable gingerol formulation (Ginactiv) was developed
by polar–nonpolar sandwich (PNS) technology with the full spectrum of the
ginger matrix, with an improved and sustained release profile of bioactive
components and high antioxidant potential. The presence of the synergistic
effects of the full spectrum of ginger matrix in Ginactiv specifies its usage as
a natural nutritional supplement to maintain gastrointestinal, digestive and
gut health and to aid the gut–brain axis.
75
3.8 Biological Activities of Ginger in Different Uses
3.8.1 Anti-inflammatory Effect
Dysfunction of endothelial cells (ECs) is essential for atherosclerosis pro-
gression. The potential of ginger extract containing 6-gingerol and 6-shogaol
has been assessed to reverse EC dysfunction and its mechanism of action
was examined utilizing cultured human ECs incubated with tumor necrosis
factor alpha (TNF-a). Ginger extract reduced monocyte chemoattractant
protein-1, vascular cell adhesion molecule-1 and monocyte adhesion, which
was connected with the reduction of ninjurin-1 expression; a decrease of
TNF-a receptor 1 and the receptor for advanced glycation end-products ex-
pression (RAGE), in common with the enhancement of soluble RAGE, re-
duction of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase
subunits expression, stimulation of antioxidant nuclear factor erythroid
2-related factor 2 (Nrf2) and heme oxygenase-1, and inhibition of nuclear
factor kappa-light-chain-enhancer of activated B cells (NF-kB). Ginger extract
might be a successful substitute to ameliorate sicknesses in which oxidative
stress and inflammation are essential.
76
Ho et al.
77
demonstrated that ginger
and gingerol-associated components, particularly shogaols, are extremely
positive nutritional adjuvants for neurodegenerative diseases, because of
their effective antineuroinflammatory capability by preventing the creation
of nitric oxide, interleukin 1 beta (IL-1b), interleukin 6 (IL-6) and TNF-a
in addition to their messenger ribonucleic acid (mRNA) levels in
Ginger in Ayurvedic Preparations and Its Applications 59
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lipopolysaccharide-activated BV2 microglia and blocking NF-kB act ivation,
which was the essential mechanism for preventing proinflammatory gene
expression.
77
The anti-inflammatory activity of ginger is mediated by preventing neu-
trophil and macrophage activation in addition to reducing leukocyte and
monocyte migration. This was demonstrated through the dose-dependent
reduction in pro-inflammatory cytokines and chemokines and replacement
of the total antioxidant capacity.
78
The 6-gingerol-rich portion of ginger
presented a chemo-protective role on chlorpyrifos-in duced toxicity,
chlorpyrifos-induced oxidative damage, inflammation and apoptosis in the
brain, ovary and uterus of rat tissues owing to its antioxidative, anti-
inflammatory and antiapoptotic properties.
79
Another bioactive compound
of ginger, 6-shogaol, reduced clinical skin severity scores, transepidermal
water loss, and epidermal thickness induced by 2,4-dinitrochlorobenzene in
mice, and inhibited TNF-a þ interferon gamma (IFN-g)-induced inflamma-
tory mediators in human keratinocytes. Therefore, 6-shogaol could be a
suitable candidate for improving skin inflammation associated with allergic
dermatitis.
80
The anti-inflammatory effects of ginger and its bioactive
compound, zingerone, were evaluated on lipopolysaccharide-induced sys-
temic inflammation through NF-kB bioluminescent imaging. The ginger
and zingerone suppressed NF-kB drive luminescence in a number of organs
owing to their wide range of anti-inflammatory actions in most organs that
reduced the activation of NF-kB, the production of IL-1b and the infiltration
of inflammatory cells.
81
3.8.2 Protective Effect on Liver Health
Piroxicam is a nonsteroidal anti-inflammatory drug extensively utilized in
rheumatic diseases. Piroxicam hepatotoxicity has been described as one of
its main adverse side effects. Administration of ginger reduced and allevi-
ated serum aspartate aminotransferase (AST), alanine aminotransferase
(ALT) and alkaline phosphatase (ALP), and immunoexpression of the proa-
poptotic protein (Bax), induced by piroxicam. It enhanced immunoexpres-
sion of the antiapoptotic protein (Bcl2). It also ameliorated the
morphological alterations induced by piroxicam. Accordingly, ginger has
defensive effects against piroxicam hepatotoxicity by decreasing serum
marker enzymes, liver fibrosis and apoptosis in male mice.
82
The relation-
ship between chronic alcohol consumption and the progress of alcoholic
liver disease is an observed occurrence, however the specific core molecular
mediators involved in ethanol-induced liver sickness remain elusive. In one
study, the rescue effect of ginger extract was measured in improved hepatic
fatty acid translocase/cluster of differentiation 36 (FAT/CD36), protein tyr-
osine phosphatase 1B (PTP1B) and decreased hepatocyte nuclear factor 4
alpha (HNF4A) expression leading to dyslipidemia linked with ethanol-
induced liver dysfunction. Chronic ethanol exposure can improve hepatic
FAT/CD36, and PTP1B expression, whereas it can reduce HNF4A gene
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expressions. The alteration of enzyme expression related to lipid metabolism
resulted in hepatic lipid metabolism disruption as manifested by increased
plasma low-density lipoproteins, cholesterol, triglyceride, as well as AST and
ALT in the ethanol group. Consumption of ginger extract along with etha-
nol, partially ameliorated gene expression modification and h istological
changes, enhan ced the u ndesirable lipid profile and liver enzyme modifi-
cations compared to those in the ethanol group, which revealed that the
ginger extract as an antioxidant and anti-inflammatory agent.
83
Aflatoxin
B1 (AFB1) is one of the main mycotoxin contaminants in feed and food,
causing hepatotoxicity and oxidative stress. Pretreatm ent with ginger ex-
tract protected hepatoma G2 (HepG2 ) c ells from AFB1-induced cytotoxicity
through the inhibition of reactive oxygen species generation, deoxyribo-
nucleic acid (DNA) damage and cell death. Likewise, experiments with a rat
model further revealed th e protective effects of ginger extract against AFB1-
induced hepatotoxicity by improving antioxidant enzyme levels and upre-
gulation of the Nrf2/heme oxygenase-1 (HO-1) pathway, which could be
because of the synergistic effects of various phenolic compounds present in
it. This study suggested that ginger extract might be considered as a po-
tential natural agent for the inhibition of AFB1-induced oxidative stress
and hepatotoxicity.
84
3.8.3 Protective Effect on Kidney Health
Gabr et al.
85
assessed the defensive and antioxidant effects of ginger extract
against cadmium-induced renal toxicity in animal models and the utiliza-
tion of ginger as an anti-renal failure natural remedy. Ginger considerably
protected renal cell dysfunction, reduced the severity of tubular cells and
DNA destruction affected by cadmium intoxication by antioxidant and free
radical scavenging activity. Accordingly, ginger extracts could have an ef-
fective protective effect against nephrotoxicity induced by several toxicants.
85
Cyclosporine, a common immune-suppressant drug that is utilized in organ
transplants, is linked with nephrotoxic effects. Ginger polyphenols de-
creased some indices of experimental cyclosporine-induced kidney damage
in a Wistar rat model by antioxidant and membrane-stabilizing effects in
addition to variation of transport proteins. Components of ginger poly-
phenol extract may have a potential application as future adjuvant usages in
renal and other transplant therapies.
86
3.8.4 Gastrointestinal Health
Necrotizing enterocolitis (NEC) is a most significant gastrointestinal emer-
gency, particularly affecting preterm infants, and causes severe morbidities
and mortality. Oxidative stress, inflammation, apoptosis along with pre-
maturity are included in the pathogenesis of this illness. A study evaluated
the advantageous effects of ginger on the intestinal injury in an investi-
gational rat model of NEC. The levels of TNF-a, IL-1b and IL-6 in the ginger-
Ginger in Ayurvedic Preparations and Its Applications 61
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