- The various matters that need to be
considered whilst affecting drug discovery from plant sources.
Abstract
New drug discovery is facing serious
challenges due to reduction in number of new drug approvals coupled with
exorbitant rising cost. Advent of combinatorial chemistry provided new hope of
higher success rates of new chemical entities (NCEs); however, even this
scientific development has failed to improve the success rate in new drug
discovery.
This scenario has prompted us to come
out with a novel approach of integrated drug discovery, where Ayurvedic wisdom
can synergize with drug discovery from plant sources.
Initial steps in new drug discovery
involve identification of NCEs, which can be either sourced through chemical
synthesis or can be isolated from natural products through biological activity
guided fractionation. The sources of many of the new drugs and active
ingredients of medicines are derived from natural products.
The starting point for plant-based new
drug discovery should be identification of the right candidate plants by
applying Ayurvedic wisdom, traditional documented use, tribal non-documented
use, and exhaustive literature search. Frequency analysis of the ingredients of
the ancient documented formulations and analysis of their Ayurvedic attributes
may provide an in-depth idea of the predominance of particular Ayurvedic
characteristics based on which appropriate candidate plants may be selected for
bioactivity-based fractionation.
The integration of Ayurvedic wisdom with
drug discovery also brings the need for a paradigm shift in the extraction
process from sequential to parallel extraction. Bioassay-guided fractionation
of the identified plant may lead to standardized extract or isolated bioactive
druggable compound as the new drug. This integrated approach would lead to
saving of cost and time, coupled with enhanced success rate in drug discovery.
Introduction
Development of new drug is a complex, time-consuming, and expensive process. The time taken from discovery of a new drug to its reaching the clinic is approximately 12 years, involving more than 1 billion US$ of investments in today's context. Essentially, the new drug discovery involves the identification of new chemical entities (NCEs), having the required characteristic of druggability and medicinal chemistry. These NCEs can be sourced either through chemical synthesis or through isolation from natural products. Initial success stories in new drug discovery came from medicinal chemistry inventions, which led to the need of development of higher number of chemical libraries through combinatorial chemistry. This approach, however, was proven to be less effective in terms of overall success rate.
The second
source of NCEs for potential use as drug molecules has been the natural
products. Before the advent of high throughput screening and the post genomic
era, more than 80% of drug substances were purely natural products or were
inspired by the molecules derived from natural sources (including
semi-synthetic analogs).
An analysis
into the sources of new drugs from 1981 to 2007 reveals that almost half of the
drugs approved since 1994 were based on natural products. During the years
2005-2007, 13 natural product related drugs were approved. 1
There are various examples of development of new drugs from
the plant sources. Morphine was isolated from opium produced from cut seed pods
of the poppy plant (Papaver somniferum) approximately 200 years ago.
Pharmaceutical research expanded after the second world war to include massive
screening of microorganisms for new antibiotics, inspired by the discovery of
penicillin. Few drugs developed from natural sources have undoubtedly
revolutionized medicine, like antibiotics (e.g. penicillin, tetracycline,
erythromycin), antiparasitics (e.g. avermectin), antimalarials (e.g. quinine,
artemisinin), lipid control agents (e.g. lovastatin and analogs),
immunosuppressants for organ transplants (e.g. cyclosporine, rapamycins), and
anticancer drugs (e.g. paclitaxel, irinotecan). 1
Clinical trials are ongoing on more than 100
natural product derived drugs and at least 100 molecules/compounds are in
preclinical development stage.1 Most
of these molecules in the developmental pipeline are derived from leads from
plants and microbial sources. Cancer and infections are the two predominant
therapeutic areas for which the drug discovery program is based on natural
products, but many other therapeutic areas also get covered, such as
neuro-pharmacological, cardiovascular, gastrointestinal, inflammation,
metabolic, etc. 1 Among the
different projects in various therapeutic areas, around 108 projects are based
on plants. A further division of these projects indicates that 46 of them are
in preclinical stage, 14 in phase I, 41 in phase II, 5 in phase III, and 2 are
in pre-registration phase.1
In general, there are six classes of sources for
NCEs. The four classes are botanical sources, fungi, bacteria, and marine
sources. In addition to these four classes, modern pharmaceutical chemistry
added two categories of man-made substances, i.e. synthetic chemistry and
combinatorial chemistry. Of these natural sources, botanical sources are of
specific importance in the context of this review. The botanical sources are
known to provide the following classes of NCEs for drug discovery processes.
- Bioactive compounds for direct use
as drug, e.g. digoxin.
- Bioactive compounds with structures
which themselves may act as lead compounds for more potent compounds, e.g.
paclitaxel from Taxus species.
- The novel chemophore which may be
converted into druggable compounds with/without chemical analoging.
- Pure phytochemicals for use as
marker compounds for standardization of crude plant material or extract.
- Herbal extracts as botanical drugs, e.g. green tea extract.
- Pure phytochemicals which can be
used as pharmacological tools.
Drug Discovery from Natural Resources: Advantages
and Disadvantages
Usage of
botanical sources as starting point in the drug development program is
associated with few specific advantages:
- Mostly, the selection of a candidate species for investigations can be done on the basis of long-term use by humans (ethnomedicine). This approach is based on an assumption that the active compounds isolated from such plants are likely to be safer than those derived from plant species with no history of human use. At certain time point afterward, one may attempt upon synthesis of active molecule and reduce pressure on the resource. Drug development from Rauwolfia
serpentina, Digitalis purpurea, etc. in the past fall
under this category of approach.
- Sometimes, such approaches lead to
development of novel molecules derived from the source due to inherent
limitations of the original molecule. For instance, podophyllin derived
from Podophyllum hexandrum was faced with dose-limiting
toxicities. Such limitations could be overcome to a great extent by semi-synthesis
of etoposide, which continues to be used in cancer therapy today. Similar
was the case with camptothecin (originally isolated from Camptotheca sp.
and subsequently from Mappia sp.), which led to
development of novel anticancer molecules like topotecan and irinotecan.
- Natural resources as starting point
has a bilateral promise of delivering the original isolate as a candidate
or a semi-synthetic molecule development to overcome any inherent
limitations of original molecule.
On the
other hand, drug development from natural resources is also associated with
certain disadvantages:
- More often than not, drug discovery
and eventual commercialization would pressurize the resource substantially
and might lead to undesirable environmental concerns. While synthesis of
active molecule could be an option, not every molecule is amenable for
complete synthesis. Hence, certain degree of dependence on the lead
resource would continue. For instance, anticancer molecules like
etoposide, paclitaxel, docetaxel, topotecan, and irinotecan continue to
depend upon highly vulnerable plant resources for obtaining the starting
material since a complete synthesis is not possible. On the other hand, it
is expected that some 25,000 plant species would cease to exist by the end
of this century.2
- Over a period of time, the
intellectual property rights protection related to the natural products is
going haywire. By and large, the leads are based upon some linkage to
traditional usage. With larger number of countries becoming the parties to
the Convention on Biological Diversity (CBD), the process of accessing the
basic lead resource, benefit sharing during the commercial phase, etc.
became highly complex in many countries. These processes tend to impede
the pace of discovery process at various phases irrespective of the
concerns leading to such processes.
Druggability of Isolated Phytochemical Compounds
- Greater number of chiral centers
- Increased steric complexity
- Higher number of oxygen atoms
- Lower ratio of aromatic ring atoms
to total heavy atoms
- Higher number of solvated hydrogen
bond donors and acceptors
- Grater molecular rigidity
- Broader distribution of molecular
properties such as molecular mass, octanol water partition coefficient,
and diversity of ring systems.
These
unique features of chemical entities of natural origin pose a string of
challenges for medicinal chemists as they start working upon development of
analogs, either to improve the absorption or to reduce the toxicity and improve
upon efficacy which is often achieved by addition or deletion of selected
functional groups. As per a review by Ehrman et al., 4 different
bioactive plant compounds were isolated in China from 1911 to 2000 like
alkaloid, steroid, triterpene, limonoid, diterpene, sesquiterpene, monoterpene,
tanin, isoflavonoid, flavonoid, polycyclic aromatic, lignan, coumarin, simple
phenoloic, aliphatic, etc. Alkaloid may be distributed as 20%, flavonoids as
15%, triterpenes and simple phenolics around 10%, and remaining others below
that, with limonoid being the least.
It can be safely presumed that large number of natural products, despite being biologically active and having favorable ADMET profile (absorption, distribution, metabolism, excretion, and toxicity), do not satisfy the criteria "drug likeness." The challenge is of building a physio-chemical tuned natural products library in line with the lead generation to promote natural products to their full potential. Lipinski 5 propagated simple set of calculated property called "rule of five" basis the drug candidates reaching Phase II clinical trials. This rule is an algorithm consisting of four rules in which many of the cutoff numbers are five or multiples of five, thus originating the rule's name. To be drug-like, a candidate should have:
- less than five hydrogen bond
donors;
- less than 10 hydrogen bond acceptors;
- molecular weight of less than 500
Da; and
- partition coefficient log P of
less than 5.
The aim of the "rule of five" is to highlight possible bioavailability problems if two or more properties are violated. Had Lipinski's rule been applied, paclitaxel would never have become a drug. Since it does not comply with "rule of five," a biggest challenge is to find alternative druggability criteria for the compounds of natural origin.
Therefore, the
biggest challenge is to find alternative druggability criteria for the
compounds of natural origin.
Selection of Candidate
Plant Species for Screening
To
available estimates, the total number of higher plants species (comprising
angiosperms and gymnosperms) is approximately 250,000 species. Of them, only 6%
have been reportedly screened for biological activity and about 15% have been
screened for phytochemical activity. 6 Initial listing of the candidate species for screening of
biological activity is a major task of specific importance in itself. Fabricant
and Farnsworth 6 have
enumerated the following approaches being used so far by researchers for this
purpose.
Random approach
Two approaches
have been followed for screening of the plants selected randomly for the
purpose of new drug discovery.
a. Screening for selected class
of compounds like alkaloids, flavonoids, etc.:
While this route is simple to perform, however, it is flawed in the sense that
it provides no idea of the biological efficacy. However, chances of getting
novel structures cannot be denied following this approach.
b. Screening of randomly
selected plants for selected bioassays: Central
Drug Research Institute, a premier R and D organization of Council of
Scientific and Industrial Research of India, followed this approach about three
decades ago. They screened almost 2000 plants for biological efficacy. However,
the screening did not yield any new drug. National Cancer Institute (NCI) of
National Institute of Health, USA, studied about 35,000 plant species for
anticancer activity, spending over two decades from 1960 to 1980. It resulted
in proving two success stories, which were those of paclitaxel and
camptothecin. This route, therefore, has been applied for both focused
screening as well as general screening, showing some success in focused
screening. If target-based bioassays are used, e.g. screening against PTP1B,
chances of success would probably be more. This approach, however, needs a huge
library of extracts, which very few organizations in the world are having.
Ethnopharmacology
approach
The approach of ethnopharmacology essentially depends on empirical experiences related to the use of botanical drugs for the discovery of biologically active NCEs. This process involves the observation, description, and experimental investigation of indigenous drugs, and is based on botany, chemistry, biochemistry, pharmacology, and many other disciplines like anthropology, archaeology, history, and linguistics. 7
This
approach based on ethnomedicinal usage history has seen some success,
e.g. Andrographis paniculata was used for dysentery in
ethnomedicine and the compounds responsible for the activity were isolated as
andrographolide. Morphine from Papaver somniferum, Berberine
from Berberis aristata, and Picroside from Picrorrhiza
kurroa are some examples of this approach. Some of the plants which
are not selected on the basis of ethnomedical use also had some success
stories, like L-Dopa from Mucuna prurita and paclitaxel
from Taxus brevifolia.
Traditional system of medicine approach
Countries
like India and China have a rich heritage of well-documented traditional system
of medicine in vogue. Though these codified systems of medicine use largely
botanical sources as medicines, however, these stand apart from ethnomedicine
specifically on three accounts:
- The ethnomedicinal practice is
based on empirical experiences. On the other hand, these codified systems
built up the empirical practices on strong conceptual foundations of human
physiology as well as of pharmacology (though the tools of their
investigations in those times were far different from the existing ones).
- The pharmaceutical processes have
been more advanced as against the use of crudely extracted juices and
decoctions in ethnomedicinal practices. Due to this phenomenon, the concept
of standardization was known to the system.
- They are well documented and widely
institutionalized. On the other hand, the ethnomedicinal practices are
localized and may be largely controlled by few families in each of the
community.
However, in
terms of historicity, ethnomedicinal practices might be older than codified
systems of medicine.
Discovery of artemisinin from Artemesia
alba for malaria, guggulsterones from Commiphora mukul (for
hyperlipidemia), boswellic acids from Boswellia serrata (anti-inflammatory),
and bacosides from Bacopa monnieri (nootropic and memory
enhancement) was based on the leads from these codified systems of medicine
prevailing in China and India. However, it can be stated that such approach for
selecting candidates in drug discovery programs has not been adopted much so
far. Nonetheless, the approach has a distinct promise in terms of hit rates.
But the distinct example for this approach has been the discovery of reserpine
from Rauwolfia serpentine, which was based on the practices of
Unani medicine.
Zoo-pharmacognosy approach
Observation
of the behavior of the animals with a view to identify the candidate plants for
new drug discovery is not a distant phenomenon. Observation of straight tails
linked to cattle grazing habits in certain regions of South America led to
identification of a plant Cestrum diurnum and three other
plant members of family Solanaceae, which probably are the only known plant
sources of the derivatives of Vitamin D 3 . This approach,
however, needs close observation and monitoring of the behavior of animals.
Application of Ayurvedic
Wisdom in Selection of Plant for its Therapeutic (e.g. Anticancer)
Activity
The key
objective of this review is to emphasize on the usage of traditional wisdom in
selection of candidate species as against random screening or on the basis of
ethnomedicinal records. The author has reviewed few published studies and
classical Ayurvedic literature for anticancer drug plants as the major source
for drug discovery. Basis Ayurvedic wisdom, it is possible to apply the
traditional knowledge on various herbs to identify the better leads for
research and development to find out good anticancer drugs. Three disease
conditions described in classical Ayurvedic texts have possible correlations to
the description of cancer in modern medicine, viz. Arbuda, Granthi,
and Gulma. These classical descriptions in terms of
etiopathogenesis, symptoms, and prognosis related to these conditions go close
to the cancerous conditions in modern context. Hence, it would be logical to
assume that the botanical medicines recommended for use in these three
conditions would have greater potential of hit rates in drug discovery program.
The author tried to identify the herbs from the
authentic classical text, Bhavprakash,8 traditionally employed in the treatment of cancer, and to
analyze the same in terms of Rasa (taste), Guna (physico-chemical
and pharmacodynamic properties), Veerya (potency), Vipaka (action
after digestion and assimilative transformation), and Dosha Karma (actions
of Doshas/humors). Based on this review, it has been possible to enumerate 53
herbs having acclaimed effects on Arbuda, Granthi, and Gulma.
The botanical identity for three of these 53 candidates could not be
established. Therefore, the rest of 50 herbs are enumerated in [Table
1].
Further,
these selected herbs were studied for their Ayurvedic pharmacological
attributes, e.g. Rasa, Guna, Veerya, Vipaka,
and Dosha Karma, as per the descriptions in Ayurvedic texts. The
frequency analysis of the pharmacological attributes among these 50 herbs is
provided in [Table
2], [Table
3], [Table
4], [Table
5], [Table
6].
On the
basis of the classical attributes for the herbs having Arbudahara/Gulmaghna/Granthihara effects,
it can be safely assumed that these herbs share some specific pharmacological
traits in common. Going by the dominance analysis of these attributes and
mapping of their percentage distribution, the following scenario emerges.
Predominant Rasa: Tikta and Katu
Predominant Guna: Laghu, Ruksha,and Tikshna
Predominant Vipaka: Katu
Predominant Veerya: Ushna
Predominant DoshaKarma: Kapha-Vata
Shamana.
Going by Ayurvedic pharmacological concepts, an
anticancer drug tends to exhibit Tikta-Katu Rasa, Laghu-Ruksha-Teekshna
Gunas, Katu Vipaka, and Ushna Veerya. They are
generally Kapha-Vatashamak in terms of their Dosha
Karma. With a view to enhance the scope of potential anticancer species,
further screening of Bhavaprakasha Nighantu was carried out.
The scope of this review was to enumerate other drugs having these specific
pharmacological attributes but not listed under the Gulmahara/Granthihara/Arbudhnashak
Karma properties.
This round
of review led to enumeration of 13 more botanical species which possibly have a
potential for anticancer activity. These species are: Trachyspermum
ammi, Nigella sativa, Juniperus communis, Mallotus philippinensis, Commiphora
wightii, Calotropis procera, Calotropis gigantea, Moringa oleifera, Citrullus
colocynthis, Cassia angustifolia, Luffa echinata, Amorphophallus campanulatus,
and Tephrosia purpurea.
A schematic representation of this entire review
process is shown in [Figure
1].
The above
scheme of review of classical Ayurvedic Nighantus was taken up
to identify and shortlist potential anticancer candidates with a presumption
that such methodology would enhance overall hit rate during the screening
phase.
The above-mentioned approach of the author is
substantiated by a similar type of study conducted earlier by Smit et
al., 9 who
tried to identify the potential plant candidates for their cytostatic activity.
The investigators worked to identify the candidate species on the basis
of Samprapti (pathogenesis) of the disease. In this process,
they zeroed down to the herbs having Pitta Vardhak, Kapha Shamak effects
and Laghu, Ruksha, and Tikshna Gunas as their
Ayurvedic attributes.
In all, the
investigators enlisted 44 species of which 14 candidates (Acorus calamus,
Calotropis procera, Curcuma zedoaria, Datura metel, Mallotus philippinensis,
Melia azedarach, Moringa oleifera, Plumbago zeylanica, Scindapsus officinalis,
Semecarpus anacardium, Solanum indicum, Solanum xanthocarpum, Sphaeranthus
indicus, and Vitex negundo) were screened against
COLO 320 tumor cells, using cisplatin as control. It was observed in the study
that seven species exhibited growth inhibition ranging between 83 and 100%.
Interestingly, three species, viz. Calotropis
procera, Mallotus philippinensis, and Moringa oleifera find
place in both the lists of anticancer herbs enumerated by Smit et al. and
by the author. Two of these three common candidates (Calotropis procera and Mallotus
philippinensis) exhibited cytostatic activity as reported by Smit et
al. Such commonality of species indicates that it is possible to identify
and shortlist the potential candidates for research purposes using the
approaches having either a disease orientation (pathophysiological foundations)
or drug orientation (pharmacological foundations). The concept can be relied
upon from both these perspectives of Ayurveda.
This approach gets further validated by few
published reports on anticancer activity of the botanical species shortlisted
through the review mechanism being suggested by the author.
As seen from the study by Smit et al.
and the reports enlisted in [Table
7], the hit rates in biological screening tend to
improve with selection of candidates on the basis of Ayurvedic tenets of
pharmacology. If this approach is widely accepted and practiced, newer horizons
would open for the development of potent Ayurvedic formulations in addition to
the improved success rate in development of new drugs.
Biological Activity Guided Fractionation for
Compound Isolation
Biological
activity guided fractionation has been the process deployed to identify the
lead druggable candidate from any given phytochemical matrix. However, there is
no uniformity in its methodology. Two approaches might be followed as the
design of extraction for bioactive guided fractionation leading to compound
isolation to act as a lead compound:
i. Parallel approach
This
approach may be applied when the biological activity of the plant is known by
its traditional use. The objective of this approach is to isolate compounds
responsible for the activity based on their biologic activity. As explained
in [Figure
2], in parallel extraction approach, three types of
extracts are obtained, viz. 100% methanolic extract, 50% methanolic extract,
and 100% aqueous extract from a crude plant. The most active fraction based on
the primary screening for bioactivity is chosen for further extraction and
evaluation.
ii.
Sequential approach
This
approach may be useful when the biological activity of the subject plant is not
known and random selection strategy is adopted for plants. As explained
in [Figure
3], extraction is done based on the polarity of the
solvents and fractions are obtained in a sequential process using hexane,
chloroform, ethyl acetate, and butanol as solvents.
Further
extraction involves purification stage where structural elucidation is done for
different compounds.
Since the
bioactivity is assessed at two stages, two distinct models should be chosen
keeping in view the end points. The screening model for stage I should be
designed to elicit the efficacy. On the other hand, the screening model for
secondary screening should be designed with an orientation toward mechanism of
action. For example, for discovering potential anti-diabetic molecules from a
natural source, glucose uptake assay can be employed as the primary screening
model. At stage II, it would be desirable to choose a secondary assay model
like Glut 4, PI3 K, and IRTK, which may provide some clue for the mechanism of
action. It is also desirable to include an assay for cytotoxicity so as to
elicit the safety profile during secondary screening level.
Bioactivity guided fractionation of any crude
extract from natural source in any case would lead to a wide array of possible
outcomes at different stages. Also, these outcomes might provide unforeseen
opportunities for modulating the discovery design during subsequent
stages. [Figure
4] depicts the possible outcomes of a typical
bioactivity guided fractionation.
By and large, the natural products, if shortlisted on the basis of existing knowledge of usage (be it ethnomedicinal lead or from codified systems of medicine), are likely to lead to three distinct possibilities. A decision on "Go" or "No Go" can be taken based on the strategies suggested in [Table
8].
Way Forward
There is a
pertinent need to renew scientific enthusiasm toward natural products for
inclusion in drug discovery program. One of the important concerns related to
natural products has been the predictability of hit rate during various phases
of drug development. Such predictability is expected to be lower in case of
random selection of candidate species considering the overall complexity of
botanical sources for NCEs. In order to enhance the predictability, strategic
selection and shortlisting of candidate species is necessary. Documented
clinical experience with botanical medicines as codified in traditional systems
of medicine might simplify the issues associated with poor predictability. New
functional leads picked up from the traditional knowledge and experiential
database may help to reduce time, money, and toxicity, which are the three
specific hurdles in the drug development. 15
An integrative approach by combining the various
discovery tools and the new discipline of integrative biology will provide the
key for success in natural product drug discovery and development. Since plant
selection is the major step involved, it needs a well-designed strategy.
The following scheme may be followed for
appropriate plant selection:
- Identification of plants: Through a
tactical application of traditional wisdom, especially in the context of
usage frequency. For this purpose, it is suggested to search classical
treatises of Ayurveda like Bhaishajya Ratnavali and Charak
Samhita, in which the formulations are enumerated for the identified
therapeutic segment.
- Listing of all the formulations and
their herbal ingredients (metallic and herbo-mineral formulations need not
be considered).
- Frequency analysis of the
ingredients.
- Arriving at Ayurvedic hypothesis of
the desired Rasa, Guna, Veerya, Vipaka, etc. to achieve
particular therapeutic area, e.g. in the case of diabetes, the drug should
have dominance of Katu and Tikta Rasa, Laghu
Guna, Ushna Veerya, and Katu Vipaka.
- Mapping of the ingredients
identified above against these Ayurvedic attributes.
- Shortlisting of those plant species
which match both frequency analysis as well as the Ayurvedic attributes.
Once the
task of enumerating potential candidates for screening is over, the extraction
procedure can go by a parallel approach instead of the sequential approach as
followed for randomly selected species. Rest of the investigational course
shall follow the following steps:
- Screening of biological activity on
selective assays.
- Bioassay guided fractionation of
the identified plant.
- Isolation and structure elucidation
of the active compound.
- Evaluation of chemical do-ability,
druggability, and patentability.
- Go or no go decisions based on
safety, biological activity screening.
It is time
for large-scale pharmaceutical organizations to open up the developmental
strategies. In view of the increasing cost of development of new drugs,
alternative approaches like development of herbal extracts hitting multiple
targets as new drugs need serious consideration. Obviously, the cost of
development shall be substantially lower in case of herbal extracts. Such
strategy would not only enhance the chances of success in terms of providing
effective and safe drugs, but also is considered to minimize the risk of post-marketing
withdrawals. Such a complementary scenario shall go a long way in safeguarding
the interests of both pharmaceutical industry and common man.
Acknowledgement
The first
author Dr. Chandrakant Katiyar is thankful to Prof. S. S. Handa, former
Consultant and Dr. Pradip Bhatnagar, Head at New Drug Discovery Research
(NDDR), Ranbaxy Research Lab, Gurgaon for facilitating the new drug discovery
tools exposure to him, during his tenure in 2003 - 2008.
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Source of Support: None. Conflict of
Interest: None.
Authors are Chandrakant Katiyar1, Arun Gupta2, Satyajyoti Kanjilal2 and Shefali Katiyar3. 1.Healthcare Research, Dabur Research and Development Centre, Ghaziabad, Uttar Pradesh, India, 2. Medical Services and Clinical Research, Dabur Research and Development Centre, Ghaziabad, Uttar Pradesh, India. 3 Faculty of Pharmacy, Jamia Hamdard, New Delhi, India.
Article available online/offline on:
AYU, Vol. 33, Issue 1, January-March 2012, Page no 10-19, for more details
please visit: www.ayujournal.org
Address for correspondence: Chandrakant
Katiyar
Healthcare Research, Dabur Research and Development Centre, 22, Site IV,
Sahibabad, Ghaziabad, Uttar Pradesh - 201 010, India.
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