ROLE OF HERBAL NUTRACEUTICALS IN PREVENTION AND TREATMENT OF ATHEROSCLEROSIS

Atherosclerosis falls under non communicable chronic diseases (NCDs), which is of great concern as identified by WHO, as one of the major causes of pre-mature mortality. Early studies have identified several molecular targets related to epigenetic factors and changed life style, psychosomatic issues and food habits as the cause of its pathogenesis. Since it is a progressive inflammatory disorder so its early detection and proper intervention could prove to be an effective tool in preventivecardiology. Only management of diabetes, obesity, dyslipidaemia and hypertension may not be enough. Rather targeting factors responsible for induction of low-grade inflammation would be better option. Immune checkpoint proteins play a pivotal role in atherosclerosis by regulating the activation and proliferation of various immune and non-immune cells, such as T-cells, macrophages and platelets. The immune checkpoint stimulators specifically promote cell survival of T-cells, macrophages and platelets in atherosclerotic lesions and in secondary lymphoid organs, resulting secretion of more proatherogenic cytokines and chemokines. The role of platelets in activation of undesired innate immunity has also been extensively studied. Its main interaction with endothelial cells and immune cells is under focus of studies. The normalization of innate immunity and Toll-like receiptors (TLR) signalling by using nutraceuticals could be a promising approach in this field. These include medicinal plants, fruits, vegetables, legumes etc. Presence of several secondary metabolites as natural cocktail have synergistic response in these regulatory pathways, with lesser adverse effects. However, their safety margins, drug-drug interaction with allopathic medicines etc. must be ascertained. The role of some medicinal plants of Indian medicine (Ayurveda), which have experimental evidences for their therapeutic claims as anti-inflammatory and antioxidants are discussed here.