An anecdote of CCRAS core research initiatives on “Rasayana”

Background Rasayana is one of the multi-pronged therapeutic approach of Ayurveda, which involve a specialized use of Aushadha (single or multi-ingredient formulations), Ahara (diet and nutrition), and Vihara (lifestyle/ daily and seasonal regimen), along with Achara rasayana (code of conduct/self-discipline with social decorum) to achieve the optimum state of body tissues and systems. Recent studies indicate that Rasayana has an explicit role to play in maintaining and preserving human health, and appropriate use of Rasayana can help in prevention of many diseases, ultimately reducing the healthcare burden. There is an unmet need for research in Ayurveda to focus on identifying key areas of application of Rasayana and to generate sufficient evidence with guidelines so that Rasayana therapy can be included in the country’s national health policy. Central Council for Research in Ayurvedic Sciences (CCRAS), being an apex organization of research in Ayurveda, is playing an incredible role in bringing this fundamental discipline of Ayurveda into the realm of modern scientific evidence in order to meet national and global demand [Figure 1].[1]Figure 1: Central Council for Research in Ayurvedic Sciences core research activities on “Rasayana”Glimpses of CCRAS research initiatives The Council has undertaken R&D initiatives for drug development and also undertaken clinical studies to validate the clinical safety and efficacy of classical Ayurveda medicines indicated for Rasayana. Ayush Rasayan “A” & “B” The council has developed Ayush Rasayana A and Ayush Rasayana B through a systematic process of drug development wherein Ayush Rasayana A is meant for shodhana and Ayush Rasayana B for Rasayana purpose. A multi-centric trial was conducted in AIIMS, New Delhi; IMS, BHU, Varanasi and Central Ayurveda Research Institute (CARI), Kolkata among 256 apparently healthy volunteers of either sex between 60 and 75 years of age to evaluate the efficacy of Rasayana formulation in improving the general body health and quality of life in elderly people. Ayush Rasayan “A” 10 gm powder orally once a day at bedtime was administered with lukewarm water for initially 6 days, followed by Ayush Rasayan “B” containing extract of three herbs [Amalaki- Phyllanthus emblica L.; Ashwagandha- Withania somnifera (L.) Dunal; Guduchi- Tinospora sinensis (Lour.) Merr.] 750 mg (2 capsules 375 mg each) twice a day for 6 months was administered twice daily for the next 6 months. The result suggested a statistically significant improvement in the 6-min walk test and a statistically significant improvement in the quality of life [World Health Organization Quality of Life-Brief Version (WHOQOL-BREF)] physical health domain, social relationship domain and environment domain. Hindi Mental State Examination scale (HMSE) score also showed significant improvement.[2] The study concluded that, this ayurvedic intervention can be safely given to apparently healthy elderly to improve their functionality, quality of life and cognition. Study also institutes that after systemic cleansing with Ayush Rasayana-“A” for an initial 6 days, administration of Ayush Rasayana-“B” twice daily for the next 6 months is significantly effective in improving six-minute walk distance and quality of life for healthy elderly.[3] Brahma Rasayana In another multi-centric study, Brahma Rasayana was administered orally in the dose of 15 g twice a day in an empty stomach with lukewarm milk for a period of 12 weeks (84th day) among 180 apparently healthy individuals of either sex, with age ranging between 50 and 75 years. The study opined that a statistically significant effect (P < 0.0001) was observed at the end of the 84th day on all the four domains of the WHOQOL-BREF score, PGI Memory Scale, Hamilton Depression Rating Scale (HAM-D), and chief complaints at the end of 12 weeks.[4] Chyavanaprasha Lehyam A multi-centric clinical study was conducted among 214 healthy elderly subjects who were administered Chyavanaprasha Lehyam 12 gm twice daily before food with milk for 12 weeks, and the effect of the drug was assessed at intervals of 14 days up to 84 days. The researcher opined that a statistically significant improvement was observed in WHOQOL-BREF score (P-value < 0.001) and functional exercise capacity. Blood sugar, serum cholesterol, kidney function test, and liver function test (LFT) were within normal limits during the entire trial. Further, no adverse drug reaction (ADR)/adverse event (AE) was reported during the trial period.[5] Ayush Peya or Antarctica Tea A clinical trial was conducted on Antarctic Expedition members (n = 20, trial group) for a period of 6 weeks on Ayush Peya or Antarctica Tea. The study revealed the potential adaptogenic properties of the formulation along with immuno-stimulant and anti-oxidant effects besides significant anti-stress effects (P < 0.05) against a series of stress like extreme cold, mental stress (isolation and some psychological factors), and nutritional stress. No clinical toxicity was noticed, and lipid profile, body weight, body mass index, or lean body mass were not affected.[6] Ashwagandhadi Lehya To evaluate the Rasayana effect and clinical safety of Ashwagandhadi lehya on apparently healthy elderly individuals, a multi-centric clinical study was conducted in 3 CCRAS institutes viz., Achanta Lakshmipathy Regional Ayurveda Research Institute (ALRARI), Chennai; CARI, Bangalore; Raja Ramdev Anandilal Podar (RRAP) -CARI, Mumbai. Ashwagandhadi Lehya 10 gm BD after meals with Luke warm milk for 12 weeks (84 days) was administered in 156 healthy elderly volunteers of 50–75 years. The study demonstrated significant improvement in all the domains of the WHOQOL- BREF SCORE, that is, Physical health (Domain 1), Psychological (Domain 2), Social relationship (Domain 3), and Environment (Domain 4) significantly on the 84th day. The results also showed significant improvement in the HAM-D Score and PGI Memory Scale. Further no AE/ADR was reported; the trial intervention was found clinically safe on LFT & kidney function test (KFT) parameters.[7] Kushmandaka Rasayana Another study was conducted in 3 CCRAS institutes among 196 participants to evaluate the efficacy and safety of Kushmandaka Rasayana in managing chronic bronchitis. Kushmandaka Rasayana 10 g twice daily was administered with lukewarm water for 12 weeks. The study reported that a statistically significant improvement was observed in clinical symptoms, forced expiratory volume in the first second (FEV1), and clinical COPD questionnaire (CCQ) without any AE/ADR. Further, all the safety parameters were within normal limits.[8] Conclusion and way forward Immunomodulation is considered as one of the key property of Rasayana, and the CCRAS has also completed the study “Immunomodulatory activity of Ayush-A in rats” at Captain Srinivasa murthy Central Ayurveda Research Institute (CSMCARI), Chennai in 2009. Another study entitled “Pharmacological assessment of AYUSH PJ7 for antipyretic and Immunomodulatory activities” was completed in 2018 at Regional Ayurveda Research Institute (RARI), Gwalior. The findings of all these studies indicate that “Rasayana” has a definite role to play in maintaining and preserving health, and appropriate use of “Rasayana” can help reduce the prevalence of many diseases, ultimately tumbling the healthcare burden. Further, two multi-centric collaborative studies entitled “Understanding mechanistic role of Carctol-S as immunomodulatory and anti-cancer formulation against Ovarian Cancer” and “Understanding mechanistic role of CARAF & CAGHE as immunomodulatory and anti-cancer compounds against pre-clinical models of Leukemia, Lymphoma, Melanoma, Lung and Breast cancer” are ongoing at RRAP-CARI, Mumbai and Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Mumbai. It is well known that quality of life is vital for an individual. Thus, research in Ayurveda shall also focus on identifying key areas of application of Rasayana, and ample data shall be spawned for the betterment of humankind. Financial support and sponsorship Nil. Conflicts of interests There are no conflicts of interest.