title: Curative effect of Amorphophallus paeoniifolius tuber on experimental hemorrhoids in rats.
abstract: BACKGROUND
  Amorphophallus paeoniifolius (Dennst.) Nicolson (Family- Araceae) is a crop of south East Asian origin. In India, its tuber is widely used in ethnomedicinal practices by different tribes for the treatment of piles (hemorrhoids).
  
  
  OBJECTIVE
  The present study evaluated the effect of methanolic and aqueous extract of Amorphophallus paeoniifolius tuber on croton oil induced hemorrhoids in rats.
  
  
  METHODS
  The methanolic extract was standardized with the major phenolic compound, betulinic acid, by HPLC. The hemorrhoids were induced by applying 6% croton oil preparation in the ano-rectal region. Rats were orally administered methanolic and aqueous extract at doses of 250 and 500mg/kg, each for 7 days. Pilex (200mg/kg) was used as reference anti-hemorrhoidal drug. Hemorrhoids were assessed on eighth day by measuring hemorrhoidal and biochemical parameters along with histology of ano-rectal tissue.
  
  
  RESULTS
  Croton oil application caused induction of hemorrhoids as indicated by significant (p<0.001) increase in plasma exudation of Evans blue in ano-rectal tissue, macroscopic severity score and ano-rectal coefficient as compared to normal rats. It significantly (p<0.001) elevated lactate dehydrogenase and cytokines (TNF-α and IL-6) levels in serum and increased myeloperoxidase activity and lipid peroxidation in ano-rectal tissue along with marked histological damage as compared to normal rats. Treatment with tuber extracts and pilex significantly (p<0.05-p<0.001) ameliorated Evans blue exudation, hemorrhoidal parameters and other biochemical parameters with attenuation of tissue damage compared to hemorrhoid control rats. The results indicate that tuber extracts exhibited curative action on hemorrhoids. The aqueous extract showed more pronounced effect than methanolic extract. The effects may be attributed to anti-inflammatory and antioxidant properties.
  
  
  CONCLUSIONS
  Results indicate that tuber of Amorphophallus paeoniifolius exhibited curative action on hemorrhoids through anti-inflammatory and antioxidant properties. The study validates the ethnomedicinal use of tuber in hemorrhoids and implicates its therapeutic potential as an anti-hemorrhoidal agent.
authors.affiliation: National Research Institute for Ayurveda-Siddha Human Resource Development, Gwalior, Madhya Pradesh, India; Centre for Advanced Research in Pharmaceutical Sciences, Shobhit University, Meerut, Uttar Pradesh, India.
authors.forename: Yadu Nandan
authors.initials: YN
authors.lastname: Dey
authors.affiliation: National Research Institute for Ayurveda-Siddha Human Resource Development, Gwalior, Madhya Pradesh, India. Electronic address: manish.nriashrd@gmail.com.
authors.forename: Manish M
authors.initials: MM
authors.lastname: Wanjari
authors.affiliation: Centre for Advanced Research in Pharmaceutical Sciences, Shobhit University, Meerut, Uttar Pradesh, India; Faculty of Pharmaceutical Sciences, UCSI University, Kuala Lumpur, Malaysia.
authors.forename: Dharmendra
authors.initials: D
authors.lastname: Kumar
authors.affiliation: Shriram Institute of Industrial Research, New Delhi, India.
authors.forename: Vinay
authors.initials: V
authors.lastname: Lomash
authors.affiliation: National Research Institute for Ayurveda-Siddha Human Resource Development, Gwalior, Madhya Pradesh, India.
authors.forename: Ankush D
authors.initials: AD
authors.lastname: Jadhav
mesh_terms: D031056:Amorphophallus / Q000737:chemistry*; D001003:Anal Canal / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000302:isolation & purification / Q000494:pharmacology*; D000975:Antioxidants / Q000302:isolation & purification / Q000494:pharmacology; D015415:Biomarkers / Q000097:blood; D002851:Chromatography, High Pressure Liquid; D003436:Croton Oil; D004195:Disease Models, Animal; D006484:Hemorrhoids / Q000097:blood / Q000139:chemically induced / Q000188:drug therapy* / Q000473:pathology; D018836:Inflammation Mediators / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D007770:L-Lactate Dehydrogenase / Q000097:blood; D015227:Lipid Peroxidation / Q000187:drug effects; D008297:Male; D000432:Methanol / Q000737:chemistry; D053978:Pentacyclic Triterpenes; D009195:Peroxidase / Q000378:metabolism; D010936:Plant Extracts / Q000302:isolation & purification / Q000494:pharmacology*; D035281:Plant Tubers / Q000737:chemistry*; D017208:Rats, Wistar; D012007:Rectum / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D012074:Remission Induction; D012720:Severity of Illness Index; D012997:Solvents / Q000737:chemistry; D014315:Triterpenes / Q000302:isolation & purification / Q000494:pharmacology; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014867:Water / Q000737:chemistry; D000094062:Betulinic Acid
chemical_list: D000893:Anti-Inflammatory Agents; D000975:Antioxidants; D015415:Biomarkers; D018836:Inflammation Mediators; D015850:Interleukin-6; D053978:Pentacyclic Triterpenes; D010936:Plant Extracts; D012997:Solvents; D014315:Triterpenes; D014409:Tumor Necrosis Factor-alpha; D014867:Water; D003436:Croton Oil; D007770:L-Lactate Dehydrogenase; D009195:Peroxidase; D000432:Methanol; D000094062:Betulinic Acid
keywords: Betulinic acid; Cytokines; Glucomannan; Jimmikand; Piles; Pilex