Punarnawaa (Boerhaavia diffusa)

Punarnawaa (Boerhaavia diffusa)
Introduction
Punarnawaa (Boerhaavia diffusa) is a perennial, spreading weed found growing wildly in poor soil and is native to both India and Brazil. From Vedic period up to modern era Punarnawaa (Boerhaavia diffusa) is lauded for its medicinal values. 
Punarnawaa (Boerhaavia diffusa) is a folk medicine and super- food as well. In West Bengal and Assam Punarnawaa (Boerhaavia diffusa) leaves are eaten as a pot-herb (as a vegetable or as a flavoring agent) and are understood to prevent renal calculi. In other areas, the entire plant, including the root, is eaten in curries and soups, while the seeds and roots are used in cereals and pancakes. Country folks plant Punarnawaa (Boerhaavia diffusa) in their gardens to repel poisonous snakes and scorpions. 
Traditional herbal healers apply Punarnawaa (Boerhaavia diffusa) to the vagina and tie roots wrapped in red cord, around the woman’s waist to hasten delivery. They also apply Punarnawaa (Boerhaavia diffusa) to the breast to treat breast abscess. They use Punarnawaa (Boerhaavia diffusa) mixed in honey to treat conjunctivitis. [1]

Literally, Punarnawaa (Boerhaavia diffusa) means the ‘Renewer’. (Punarnawaa= Punar+Nawaa; Punar means once again and nawaa means becoming new). Quite a name to live up to for folk observed that the dead, dry plant would spring again to new green life. On the philosophy of the “Doctrine of Signatures” or on the “Theory of Signatures”, the herbalists and Ayurvedic physicians took this to mean that the plant was rejuvenative, a fact now supported by a rigorous scientific research. They also believe that by daily or routine use of Punarnawaa (Boerhaavia diffusa) body rejuvenates and a fellow becomes ‘young’ again. 
[Note: The philosophy of the “Doctrine of Signatures”, dating from the time of Dioscurides and Galen, state that, herbs that resemble various parts of the body can be used to treat ailments of that part of the body. A theological justification offered by botanists like William Coles for this philosophy, was that God would have wanted to show men what plants would be useful for treating ailments of various parts of the body. “It was reasoned that the Almighty must have set his sign or signature upon the various means of curing disease which he provided.”] [2], [3], [4]

As this plant grows low and its numerous, long, slender, interlocking stems of the inflorescence resemble an immature spider it is known as spiderling.  
  
            [5]
    

In 18th century a famous Dutch physician, Hermann Boerhaave described its medicinal uses. The genus of this plant, Boerhaavia is named after Hermann Boerhaave. [6], [7], [8], [9]

Other Names
Taxonomic: Boerhaavia diffusa
Sanskrit : Kahtilla, Shophaghnee, Shothaghnee, Varshabhu
English: Horse Purslene, Hog Weed  
Assamese : Ranga Punarnabha
Bengali : Rakta punarnava
Gujrati : Dholisaturdi, Motosatodo
Hindi : Gadapurna, Lalpunarnava
Kannada : Sanadika, Kommeberu, Komma
Kashmiri : Vanjula Punarnava
Malayalam : Chuvanna Tazhutawa
Marathi : Ghetuli, Vasuchimuli, Satodimula, Punarnava, Khaparkhuti
Oriya: Lalapuiruni, Nalipuruni
Punjabi : ltcit (Ial), Khattan
Tamil : Mukurattai (Shihappu)
Telugu : Atikamamidi, Erra galijeru [10], [11], [12], [13]

Taxonomic classification
Kingdom:  Plantae
(unranked):  Angiosperms
(unranked):  Eudicots
(unranked):  Asterids, Core eudicots                                
Order: Caryophyllales 
Division:     Magnoliophyta
Class:         Magnoliopsida
Family: Nyctaginaceae  [14], [15], [16]
Boerhaavia (Punarnawaa), is a genus of about 40 species of annual herbaceous plants in the four o’clock flower family, Nyctaginaceae.

Geographical Distribution

Punarnawaa (Boerhaavia diffusa) is a trailing herb found from the warmer parts of India up to a height of 2000 meters in the Himalayan area. It is also found grown in the wastelands, ditches, marshy places and fields during and after the rainy season. It is found in many warm, tropical and subtropical countries such as Sri Lanka, Sudan, Africa, China and Australia. Punarnawaa (Boerhaavia diffusa) is cultivated for medicinal purpose in West Bengal. [17], [18]

Plant Morphology


    

                             Punarnawaa (Boerhaavia diffusa) plant, root  


 
                                                 

                            Punarnawaa (Boerhaavia diffusa) stem, leaves

                                            
        


                                 

Punarnawaa (Boerhaavia diffusa) purple, blue and white flowers


     


                                                                                      
                                         Punarnawaa (Boerhaavia diffusa) fruits


Images of Punarnawaa (Boerhaavia diffusa) [19]


Macroscopic

Punarnawaa (Boerhaavia diffusa) is a perennial trailing herb (creeping weed), found throughout India. For medicinal purpose it is collected after rainy season. It is diffusedly branched with stout root stock and many long slender, prostrate or ascending branches.

Root- The root is well developed, thick, stout, woody, fusiform, deep penetrating, long, tortuous, cylindrical, tap root, 0.2 to 1.5 cm in diameter; yellowish brown to brown in color; surface mostly soft but rough due to minute, longitudinal striations; root scars, fracture, short; no distinct odor; taste slightly bitter. The plant has a large root system bearing rootlets.

Stem- The stem is prostrate, woody, succulent, greenish purple, stiff, slender, cylindrical, swollen or thickened at nodes, minutely pubescent, glabrous, prostrate or ascending, 4-10 cm long, divaricately branched; branches from common stalk.  

Leaves- The leaves are simple, thick, fleshy, and hairy; opposite, in unequal pairs, larger ones 2.5-3.7 cm long and smaller ones1.2-1.8 cm long; oblong; apex slightly pointed or rounded; base rounded; upper surface green , lower surface white; margin undulate, dorsal side pinkish; thick in texture; petioles nearly as long as the blade, slender. (The shape of the leaves varies considerably: ovate, oblong, round or subcordate)


Flowers- The flowers are  hermaphrodite, very small, pink, sessile or having a small stalk; 10-25 cm, in small umbels, arranged on slender, long stalks, 4-10 corymb, axillary, in terminal panicles; bracteoles, small, acute, perianth is present in place of calyx and corolla which is tubular in shape, constricted above the ovary, lower part greenish, ovoid, ribbed, upper part pink, funnel shaped, 3mm long, tube 5 lobed; stamen 2-3; the stigma is peltate


Fruit- The fruit is achene, one seeded nut, 6 mm long, rounded, broadly and bluntly 5 ribbed, viscidly glandular

Seed- The seed isone, a nut

Some workers reported induction of adventitious shoots using stem explants. (Explant is a technique of isolation of cells from from a piece of tissue. Tissue harvested in this manner is called explant) Roots were also regenerated from the leaf segments of Punarnawaa (Boerhaavia diffusa) when cultured in vitro. [20], [21]

Microscopic

Root- TS of mature root shows cork composed of thin-walled tangentially elongated cells with brown walls in outer few layers, cork cambium of 1-2 layers of thin walled cells; secondary cortex consists of consists of 2-3 layers of parenchymatous cells followed by cortex composed of 5-12 layers of thin-walled, oval to polygonal cells; several concentric bands of xylem tissue alternating with wide zone of parenchymatous tissue present below cortical regions; number of bands vary according to thickness of root and composed of vessels, tracheids and fibers; vessels mostly found in groups of 2-8 in radial rows, having simple pits and reticulate thickening; tracheids small, thick-walled with simple pits, fibers separate, elongated, thick-walled, spindle-shaped with pointed ends; phloem occurs as hemispherical or crescentic patches outside each group of xylem vessels and composed of sieve elements and parenchyma, broad zone of parenchymatous tissue, in between two successive rings of xylem elements composed of thin-walled more or less rectangular cells arranged in radial rows; central region of root occupied by primary vascular bundles, numerous raphides, of calcium oxalate, in single or in group present in cortical region and parenchymatous tissue in between xylem tissue; starch grains simple and compound having 2-4 components found in abundance in most of cells of cortex, xylem elements in parenchymatous tissue between xylem elements,  simple starch grains mostly rounded in shape, measuring 2.75-11 microns in diameter.   

Stem- TS of stem shows a single layer of epidermis consisting of cuboidal cells; uniseriate glandular trichome consisting of 9-12 stalked cells and ellipsoidal head, 150-220 micron long; cortex consists of 1-2 layers of parenchyma; endodermis indistinct; pericycle 1-2 layered, thick-walled, often containing scattered, isolated fibers; stele consisting of many small vascular bundles often joined together in a ring and many big vascular bundles scattered in ground tissue; intra fascicular cambium present.

Leaf- TS of leaf shows anomocytic stomata on both sides; a few short hairs on the surface, the epidermis and the hairs of the leaf are covered with a continuous layer of cuticle. The epidermis at the upper side generally consists of cuboidal and lower side of the tubular cells. The lamina is traversed by several veins, each surrounded by permanent bundle sheath. The palisade one layered; spongy parenchyma 2-4 layered with small air spaces; idioblasts containing raphides; occasionally clustered crystals of calcium oxalate and orange-red resinous matter present in mesophyll. [22], [23], [24], [25]

Parts Used

Whole herb, roots and seeds

Phytochemistry

There seems to be a geographical variation in the composition of pharmacological compounds found in Punarnawaa (Boerhaavia diffusa), however the following composition is well accepted world wide…...

Punarnawaa (Boerhaavia diffusa) contains Punarnavine (Alkaloids), Beta-sitosterol (Phytosterol), Liriodendrin (Lignans), Punarnavoside (Rotenoids), Boerhavin (Xanthones), Flavones, Steroids, Triterpenoids, Hypoxanthine, L-arabinofuranoside, Ursolic acid, Punarnavoside (Glycoside) an antifibrinolytic agent, Arachidic acid, Palmitic acid, Tetracosanoic acid, Hexacosonoic acid, Stearic acid, Ursolic acid, Hentriacontane, Beta-Ecdysone, Fifteen aminoacids including six essential amino acids, glycoproteins and large quantities of potassium nitrate. Vitamins: C, B2 and B3 and a good quantity of Calcium
The roots are rich in proteins and fats. They contain 14 amino acids including 7 essential ones. They are rich in alkaloids, rotenoids boeravinones A to F, dihydroisofurenoxanthin, punarnavoside an antifibrinolytic agent, lignans, liriodendrin and syringareseniol. The roots are rich in isopalmitate acetate, behenic acid, arachidic acid and saturated fatty acids
The seeds contain fatty acids and allantoin.
Phytochemical screening of the roots of Boerhaavia diffusa of different ages revealed that the maximum alkaloid count (2%) accumulated in the roots of 3 year old mature plant. [26], [27], [28]

Identity, Purity and Strength
Foreign matter Not more than 2 percent
Total ash Not more than 15 percent
Acid-insoluble ash Not more than 6 percent
Alcohol-soluble extractive Not less than 1 percent
Water-soluble extractive Not less than 4 percent [29]

Standardization values accepted by other researchers
Foreign matter Not more than 2 percent
Total ash Not more than 10 percent
Acid-insoluble ash Not more than 3 percent
Heavy metals 1.0 g complies with the limit test for heavy metals
Loss on drying Not more than 10.0 percent
Microbial contamination should comply with microbial contamination tests. [30]

Chromosome Number

The description of number of chromosomes in Punarnawaa (Boerhaavia diffusa) varies depending on the research wrok of various research workers. As I am not an expert to express my opinion here I mention all figures….

Chromosome number:  2n= 26, 52, 54, 116 [31]

Chromosome number accepted by a large number of scientists: 
n=26 and 2n= 52 (Virendra Kumar and Subramaniam. 1986) [32]

Genetic Identification

By using a DNA barcoding technique a group of researchers have established accurate “genetic identity” of Punarnawaa (Boerhaavia diffusa). This will help distingwish Punarnawaa (Boerhaavia diffusa) from its closely related species which are at times used as adultarants.  [33] 

Properties and Pharmacology
Ayurvedic properties
Ganas (Classical Catagories)

Charaka Ganas- Warga: Swedopaga (Adjunct to sweating)
SushrutaGanas- Warga: Vidhaarigandhaadi gana and Shaaka warga
Ashtaanga Sangraha Ganas-Warga: Shaaka warga

Energetics

 

Rasa (Taste): Madhura (sweet), Tikta (bitter), Kashaaya (astringent), Katu (Acrid, piquant)    

Weerya/Virya (Energy State): Ushna (hot)
Wipaaka/ Vipak (End result, Post digestive effect): Madhura (sweet)
Prabhaawa/ Prabhav (Special Effect, Prominent Effect):
Note: Here I wish to clarify the meaning of these technical words:
Virya (Weerya): Potency, power, vigor
Vipak (Wipaak): After digestion change of taste. The food we take is acted upon by jatharagni (digestive activity) and the taste of the food changes. The original rasa (taste) changes to vipak (new or same taste.)
Prabhav (Prabhaawa): Effect, prominent, peculiar or special action of an herb. Innate and specific property
Gunas  (Qualities): Rooksha (dry)

Effects on Doshas: Waata, Pitta, Kapha

Actions on Dhaatus (Tissues): Rasa (Lymph), Rakta (blood), Maansa (Muscles), Meda (Adipose System), Majja (Bone marrow and nerves), Shukra (Semen or reproductive fluids)

Actions on Srotas (Systems): Rasawaha (Lymphatic system), Raktawaha (Hemopoetic system), Maansa (Muscles)

Ayurvedic Actions (Karma):

 

Anulomana: Prokinetic, Carminative
Shothahara: Anti-inflammatory, Relieves edema
Mootrala: Diuretic
Waatahara: Carminative, causes expulsion of gas
Shlemahara: Expectorant, causes expulsion of phlegm
Kaasaghna: Antitussive
Jwarahara: Antipyretic
Rasaayana: Rejuvenator, Adaptogen [34], [35]

Important References from Ayurvedic Texts
Charak Samhitaa:
Swedopaga: Adjunct to sweat therapy (diaphoresis) 
Kaasaghna: Antitussive
Wayasthaapaak: Age-stabilizer, Anti-aging
Kushthaghna: Anti-leprotic   [36]

Sushruta Samhitaa:
Shothaghna: Anti-inflammatory, Relieves edema
Jwaraghna: Anti-pyretic

Ashtaanga Sangraha
Kaasaghna: Antitussive
Rasaayana: Adaptogen, Rejuvenator
Wayahsthaapak: Antiaging

Bhaawaprakaasha Nighantu
Kaphaghna: Allays expectoration
Shothaghna: Anti-inflammatory, Relieves edema

Shaarngadhara Samhita
Mootrala: Diuretic     [37]

AYURVEDIC ACTIONS
Deepana: Enkindling appetite, Appetizer               
Shothaghna: Anti-inflammatory, Relieves edema         
Kasahara: Antitussive       
Wayasthaapana: Age-stabilize, Promoter of youth and longevity
Rasayana: Rejuvenative, Adaptogen                     
Hridaya: Beneficial to the heart
Stambhana: Constipating, Styptic                 
Chakshushya: Beneficial to eyes                             
Arshaghna: Anti-hemorrhoidal            
Shoola- prashamana: Anti-colic
Mootrala: Diuretic                     
Ashmarighna: Anti-uro-lithiasis, stone breaker              
Mootrakricchaghna:  Relieves or alleviates dysuria [38]

Modern View
In Ayurveda Punarnawaa (Boerhaavia diffusa) is commonly used for jaundice, liver diseases, diabetes, edema, oliguria, anemia, inflammatory edema, diseases of the eye. Enthralled by its medicinal uses described in Ayurveda, recently pharmacologists and clinicians investigated Punarnawaa (Boerhaavia diffusa) for all these activities. Their studies validated the claims mentioned in Ayurvedic scriptures. They concluded that Punarnawaa (Boerhaavia diffusa) does possess anti-inflammatory, immunomodulatory, anti-microbial, anti-viral, insecticidal, anti-stress, hepatoprotective, diuretic and anti-fertility activities. [39]

Recent pharmacological studies have demonstrated that Punarnawaa (Boerhaavia diffusa) possesses anticonvulsant, anti-nociceptive, anti-inflammatory, antibacterial, anti-oxidant, immunomodulatory, anti-allergic, anthelmintic, febrifuge, hepatoprotective, anti-diabetic, diuretic, anti-urolithiatic, nephroprotective, anti-tumor and anti-metastatic activities. These activities are attributed to the chemical ingredients alkaloids (punarnavine), rotenoids (boeravinones A to J) and flavones. [40]

Punarnawaa (Boerhaavia diffusa)is now officially included as diuretic in IP. Its diuretic action is attributed to the presence of xanthone, beta-ecdysone and flavonoid. Arabinofuranoside present in the herb was found to lower serum uric acid in experimental animals and also in humans.  

Clinical trials on patients suffering from nephritic syndrome revealed that Punarnawaa (Boerhaavia diffusa) reduces urinary protein excretion and increases serum protein levels. This activity is attributed to the presence of rotenoids in the plant.  [41]

Punarnavine / Lunamarine (Alkaloids)

Molecular formula: Punarnavine: C17H22N2O/ Lunamarine: C18H15O14  [42] 

Structural formula: (Lunamarine)


[43]

Punarnavine is a quinolone alkaloid found in Boerhaavia diffusa. It exhibits anti-inflammatory, anti-oxidant, immunomodulatory, anti-angiogenic, (via down regulation of VEGF), anti-metastatic activities. It induces apoptosis in B16F-10 melanoma cells by inhibiting NF-kB signaling.

In experiments on cats, intravenous injection of punarnavine produced persistent rise of blood pressure and marked diuresis. In a clinical trial for treatment of nephrotic syndrome, the aqueous extract induced profuse diuresis, relieved edema, decreased albuminuria, raised serum protein level, normalized serum cholesterol level and caused an overall improvement in health.

 According to some researchers the diuretic action of punarnavine/punarnavoside or entire plant of Punarnawaa (Boerhaavia diffusa) is due to inhibition of kidney succinic dehydrogenase system. [44], [45]   

Beta-sitosterol (Phytosterol)
Sitosterol
Molecular formula: C29H50O
Structural formula:



Beta-Sitosterol
Beta-Sitosterol is one of several phytosterols (plant-sterols) with chemical structural similar to that of cholesterol. Beta-Sitosterol is a white, waxy powder with a characteristic odor. It is hydrophobic and soluble in alcohols.  

Beta-Sitosterol is found in fruits, vegetables, nuts, and seeds. It is found in pumpkin seeds, cashew, rice bran, wheat germ, corn oil, soybeans and dandelion coffee.
It inhibits absorption of cholesterol from the intestine and reduces total cholesterol and LDL cholesterol. After absorption from the intestine it is incorporated in the cellular membrane.

One small study shows a positive effect on male hair loss in combination with Saw palmetto. In Europe Beta-Sitasterol is used in herbal therapy for benign prostatic hyperplasia (BPH). It is also used for boosting the immunity; prevent colonic cancer, gallstones, rheumatoid arthritis, tuberculosis, psoriasis, allergies, bronchial asthma, bronchitis, chronic fatigue syndrome and erectile dysfunction.

Beta-Sitosterol should be avoided during pregnancy and breast-feeding.

Beta-Sitosterol should be avoided by individuals with sitosterolemia, a rare inherited fat-storage disorder. This condition is correlated with increased risk of heart disease (even heart attacks) and worsening existing heart disease. 

Beta-Sitosterol is a precursor of anabolic steroid boldenone undecyclate that is used in veterinary medicine to induce growth in cattle but commonly abused anabolic steroid in sports. [46], [47]

A study conducted in the Department of Urology, Ruhr-University, Bochum, Germany showed significant improvement in symptoms of the patients of benign prostatic hyperplasia treated with Beta-Sitosterol [48]

Liriodendrin (Lignans)

Molecular formula: C34H45O18
Structural formula:
                           
 

Liriodendrin is an antiarrhythmic lignin.  [49]

Liriodendrin is anti-inflammatory and anti-nociceptive. In an experimental study liriodendrin caused a reduction in acute paw edema induced by carrageenan in rats. [50]

Liriodendrin may be a potent suppressor of Calcium chloride-induced arrhythmias. The anti-arrhythmic effect of 5mg/kg of liriodendrin was found to be similar to that of 1.05mg/kg of verapamil [51]

Liriodendrin is calcium channel blocker anti-hypertensive agent. [52]

Punarnavoside (Rotenoids)

Molecular formula: C28H30O10
Structural formula:



Punarnavoside is a phenolic glycoside. [53]

Rotenoids are anti-inflammatory agents. They have anti-oxidant and genoprotective and anti-cancer activity. It is an anti-fibrinolytic agent [54], [55]

Boeravinone (Xanthones)

Molecular formula: C17H12O6
Structural formula:








[56]



Till date A, B. C and O Boeravinones are identified in Punarnawaa (Boerhaavia diffusa)
Boeravinone shows anti-inflammatory, anti-oxidant, genoprotective and anti-cancer activity. [57]

Hypoxanthine

Molecular formula: C5H4N4O
Structural formula:













Hypoxanthine is a naturally occurring purine derivative. It is occasionally found as a constituent of nucleic acids. [58]

Hypoxanthine is calcium channel blocker anti-hypertensive agent. [59]


L-arabinofuranoside
Molecular formula: C11H13NO7
Structural formula:







It has weak anti-malarial activity [60], [61]

Ursolic acid
Molecular formula: C30H48O3
Structural formula:









Ursolic acid is a pentacyclic triterpene acid. It occurs in apples, basil, thyme, peppermint and cranberries. Apple peels contain large quantities of ursolic acid. 

By inhibiting the STAT3 activation pathway ursolic acid inhibits various cancer cell types one of which includes human fibrosarcoma. It may also induce apoptosis in certain cancer cells. It is used in cosmetics. It has potential use as cardioprotective compound. [62]

Ursolic acid stimulates muscle growth and increases skeletal muscle mass. It increases brown fat, increases energy expenditure leading to reduce obesity. It is improve glucose tolerance and decreases hepatic steatosis. Ursolic acid is therefore used to treat obesity, glucose intolerance and fatty liver disease. [63]

Beta-Ecdysone
Molecular formula:  C27H44O6                       
Structural formula:













Beta-ecdysones are steroidal prohormones. Ecdysteroids appear in many plants. They offer protection to plants against herbivorous insects. They have been reputed to have medicinal value and are part of herbal adaptogenic remedies, yet an ecdysteroid precursor in plants has been shown to have cytotoxic properties. [64]

In animals ecdysones control molting (moulting aka sloughing = shedding feathers, hair, skin, exoskeleton). In higher animals they are known as inducers for gene-switch systems. In mammals and humans they have actions like estrogens without untoward effects of estrogens. [65]

Some testimonials from modern research:

Anti-Inflammatory Activity

In Ayurveda, Punarnawaasawa (Boerhaavia diffusa) is described as “Shothghna” (anti-inflammatory, relieving edema). Traditionally, Punarnawaasawa (Boerhaavia diffusa) leaves have been used either as local application or orally as monotherapy or in polyherbal formulations for the treatment of snake bite/scorpion bite. Leaves were also used for the treatment of wound healing and burns. Recently eleutheroside E, syringaresinol diglucoside, quercetin and kaempferol have been identified as anti-inflammatory phytochemicals found in Punarnawaasawa (Boerhaavia diffusa). [66]

In one study Punarnawaasawa (Boerhaavia diffusa) significantly inhibited carrageenan-induced rat paw edema, cotton pellet-induced granuloma, formalin-induced paw licking and yeast-induced hyperpyrexia. Punarnawaasawaa also healed pyloric ulcers in rats. [67]

The alcoholic extract of leaves and flowers have shown anti-inflammatory activity by decreasing rat paw edema. [68]

Hiruma-Lima and co-workers studied toxicity, anti-inflammatory and analgesic activity of juice and lyophilized decoction of leaves of Punarnawaa (Boerhaavia diffusa). Both juice and decoction (1000mg/kg) produced inhibition of abdominal writhing in mice in comparison to 200mg/kg of dipyrone sodium an antispasmodic, analgesic. The analgesic activity of juice was also comparable to morphine. The analgesic activity of the juice was reversed by pretreatment with 5mg/kg of naloxone. This suggested that the mechanism of analgesic/antinociceptive activity of leaves of Punarnawaa (Boerhaavia diffusa) was similar to that of opioids. [69], [70]

Anti-oxidant activity

Chloroform, ethanol and water extracts of dried roots of Punarnawaa (Boerhaavia diffusa) were screened to evaluate the anti-oxidant activity of the herb. Among these three extracts, ethanol extract showed the best anti-oxidant activity than the other two.
This study validates that Punarnawaasawa containing self- generated alcohol is the best preparation for medicinal use. [71], [72]

Diphenylpicrylhydrazyl (DPPH), formerly known as 2, 2-diphenyl-1-picrylhydrazyl is a cell-permeable, stable free radical. It is used to evaluate the ability of compounds to act as free radical scavengers or hydrogen donors and measure their antioxidant activity.  

By evaluating DPPH radical scavenging activity, OH radical scavenging activity and vitamin C content researchers showed that 50% ethanolic extract of whole plant of Punarnawaa (Boerhaavia diffusa) has a very potent antioxidant activity. [73]

To demonstrated the antioxidant potential of leaf extract of Punarnawaa (Boerhaavia diffusa), Sathesh and coworker induced diabetes in rats by using alloxan. They reported that the leaf extract of Punarnawaa (Boerhaavia diffusa) exhibited considerable antioxidant activity and reduction in various oxidative stress markers. [74]

In experimental studies, H9C2-rat cardiomyoblasts are used to evaluate actions of various drugs on cardiac tissue. Vineetha et al reported cardioprotective activity of ethanolic extract of Punarnawaa (Boerhaavia diffusa) against arsenic trioxide-induced cardiotoxicity. The animals treated with ethanolic extract of Punarnawaa (Boerhaavia diffusa) demonstrated decreased levels of lactate dehydrogenase, oxidative stress and calcium influx. [75]

Immunomodulatory activity

Punarnavine is an alkaloid present in Punarnawaa (Boerhaavia diffusa). The effect of Punarnavine on the immune system was studied by some researchers using Balb/c mice. Intraperitoneal administration of Punarnavine (40 mg/kg body weight) increased WBC count, bone marrow cellularity number of alpha-esterase positive cells. Administration of Punarnavine along with sheep RBCs produced an enhancement in circulating antibody titer and the number of plaque forming cells in the spleen. Punarnavine also showed enhanced proliferation of spleenocytes, thymocytes and bone marrow cells both in the presence and absence of specific mitogens in vitro and in vivo. Administration of Punarnavine significantly reduced the LPS (Lipopolysaccharide) induced elevated levels of proinflammatory cytokines such as TNF-alpha, IL-1beta and IL-6 in mice. These results indicate the immunomodulatory activity of Punarnavine. [76] 

Punarnavine was studied for its effect on cellular and humoral functions in mice. Oral administration of the alkaloid (25-100 mg/kg body weight) significantly inhibited sheep RBC-induced delayed hypersensitive reactions in mice. The inhibition was observed only during post-immunization drug treatment, while no effect during pre-immunization drug treatment was observed. A significant dose-related increase in antibody titer was observed during pre- and post-immunization treatment. Punarnavine failed to show any blastogenic responsiveness of murine splenocytes to Concanvalin A (Con A) and Lipopolysachharide (LPS). Similarly, Punarnavine did not display any mitogenic activity. [77]

A group of researchers studied immunomodulatory activity of aqueous extract of Punarnawaa (Boerhaavia diffusa) in E. coli-induced abodominal sepsis in mice. They pretreated the animals by oral administration of aqueous extract of Punarnawaa (Boerhaavia diffusa) at doses of 50-200 mg/kg/day. The animals showed significant leucocytosis and 50% reduction in mortality. The extract also reversed the stress-induced elevation in the levels of glucose, cholesterol, SGPT and BUN. [78]

Munguntiwar et al, also found that oral administration of the alkaloid fraction of Punarnawaa (Boerhaavia diffusa) at doses of 25-100mg/kg decreased and delayed hypersensitivity reactions in animals. They suggest that this immunostimulation is due to metabolic alteration of the alkaloid to its active form. [79]
Sumanth et al reported antistress, adaptogenic and immunostimulating activity of alcoholic extract of roots of Punarnawaa (Boerhaavia diffusa). The extract produced macrophage phagocytic activity comparable to the drug levamizole. [80]

Mehrotra et al found that in vitro the ehtanolic extract of roots of Punarnawaa (Boerhaavia diffusa) at doses of 100 and 500µg/kg prevented cytotoxicity in human NK cells and inhibited generation of NO in mouse macrophage cells. They attributed this immunosuppressive activity to alkaloid and lignin found in the plant. [81]

Punarnavine enhances the adaptive immunity and activity of Natural Killas Cells (NK Cells), but its practical significance is unknown as Punarnawaa (Boerhaavia diffusa) can also show immunosuppressive activity. [82] 

Hexane, chloroform and ethanol extracts of Punarnawaa (Boerhaavia diffusa) were evaluated in vitro for immunomodulatory activity of the plant. The chloroform and ethanolic extracts inhibited phytohemagglutinin (PHA) stimulated proliferation of peripheral blood mononuclear cells, two-way mixed lymphocyte reaction (MLR), Natural Killar (NK) cell tyxicity as well as Lipopolysachharide (LPS)-induced, Nitric Oxide (NO) production by RAW 264.7; but hexane extract did not show any activity. This suggests that Punarnawaa (Boerhaavia diffusa) exerts immunosuppressive action. [83]

Adaptogenic Activity

Parkinson’s disease, degenerative heart disease, myocardial infarction, Alzheimer’s disease and age related symptoms are said to be expressions of oxidative stress. They are effects of free radical-induced tissue injury. Injury to arterial wall and diet derived lipids causing endothelial cell injury are also examples of free radical injuries.[84]

Punarnawaa (Boerhaavia diffusa) exerts antioxidant activity which is instrumental in immunosuppressive, hepatoprotective, antidiabetic and anticancer activities of the plant. All these facts substantiate the use of Punarnawaa (Boerhaavia diffusa) as “Rasaayana” (Rejuvenator/Adaptogen) in Ayurveda.[85]

Researchers attribute “Rjuvenating/Adaptogenic” activities to phytochemicals syringaresinol mono-β-D-glucoside (eleutheroside E1; acanthoside B), punarnavine and quercetin isolated from the plant. [86] 



Antibacterial Activity

The ethanolic extract of the whole plant of Punarnawaa (Boerhaavia diffusa) shows significant antimicrobial activity against Staphylococcus aureus strains, Bacillus subtilis UC564, Salmonella typhi DI and Escherichia coli. Needless to say, that the activity was dose dependant.  [87]

The aqueous and ethanolic extracts of Punarnawaa (Boerhaavia diffusa) were found to possess antibacterial activity against Streptococci, Neisseria gonorrhoeae, Salmonella typhimurium, Shigella dysenteriae, Corynbacterium diphtheria andClostridium tetani [88]

Other researchers found antibacterial activity of various extracts of leaves and roots of Punarnawaa (Boerhaavia diffusa) against Bacillus subtilis and Escherichia coli, Staphylococci, Streptococci, Micrococci, E. coli, Pseudomonas, Salmonella, proteus, Serratia, Shigella and Klebsiella. [89], [90]

Antiviral Activity

Recently Punarnawaa (Boerhaavia diffusa) was found to be a potent antiviral agent. It showed antiviral activity against many viruses. The antiviral agent isolated was a glycoprotein with molecular weight of 16-20 kDa. (Awasthi and Verma, 2006) [91]

The antiviral action glycoprotein is said to be mediated via RNA of viruses. We did not find any reference or research paper stating clearly that Punarnawaa (Boerhaavia diffusa) has anti-hepatitis virus (virus A to E) activity. Punarnawaa (Boerhaavia diffusa) is used in polyherbal Ayurvedic formulations for the treatment of jaundice (viral hepatitis) because of its hepatoprotective activity and the synergism with other herbs having antiviral activity. (For details read below: Hepatoprotective Acivity)   

Antifungal Activity

At a dose of 1mg/mL ethyl acetate extract of Punarnawaa (Boerhaavia diffusa) was found to exert antifungal activity against Microsporum gupseum Microsporum fulvum and Microsporum canis. On increasing the concentration the extract also inhibited sporulation. [92]

Microsporum gypsum has been documented to cause dermatophytosis which is characterized by redness, papulo-vesicular eruption, fissuring and scaling of the skin. Formulations containing Punarnawaa (Boerhaavia diffusa) are useful for the treatment of this dermatophytosis. [93]

Antileishmanial Activity

Punarnawaa (Boerhaavia diffusa) administered orally at 100 mg/kg for 5 days was useful for clearance of Leishmania donovani parasites from infected animals. Punarnawaa (Boerhaavia diffusa) also normalized the elevated levels of SGOT, SGPT, blood urea nitrogen, blood urea, serum creatinine. The treatment did not show any adverse effect. [94]

Actions on the Skin

The root extract of Punarnawaa (Boerhaavia diffusa) is effective remedy for several skin diseases. Paste of root is applied for edematous swellings. Hot poultice of the root is applied on ulcers and abscesses and similar skin disorders.[95]  

In experimental studies DMBA [7, 12-dimethyl benz(a)nthracene) is used to induce cutaneous papilloma. To evaluate cancer chemopreventive property of Punarnawaa (Boerhaavia diffusa), cutaneous papilloma was induced in male Swiss albino mice by a single application of DMBA (50 µg/µL of acetone) followed two weeks later by repeated application of 1% croton oil in acetone. By topical application of Punarnawaa (Boerhaavia diffusa) extract the papilloma regressed significantly. [96]

In a study, Punarnavine at doses of 25-500µg/mL of concentrations ranging from 7-19% showed cytotoxicity on melanoma cells. DNA fragmentation increased with incrasing concentration of Punarnavine.

According to some researchers, Punarnavine is more anti-proliferative than cytotoxic.

In another study aqueous: methanol (3:7) extract of Punarnawaa (Boerhaavia diffusa) was found to be effective in metastasis formation by B16F10 melanoma cells. Further more prophylactic administration of the extract at the dose of 0.5mg/kg inhibited the metastasis formation by about 95 percent. [97]

Actions on the Breast

In a test on oestrogen-responsive breast cancer cells (MCF-7) at doses of 20-320mcg/mL, methanolic extract of Punarnawaa (Boerhaavia diffusa) reduced viability of cancer cells by 46.8. [98]
Punarnawaa (Boerhaavia diffusa) possesses antiproliferative and anti-estrogenic properties. These findings may suggest that the herb may have a potential in the treatment of estrogen dependent breast cancers. [99]

Two rotenoids, boeravinones G and H isolated from Punarnawaa (Boerhaavia diffusa) roots were found to inhibit breast cancer resistance protein ABCG2. The researchers proposed a correlation between structure and activity of compounds having BCRP (Breast Cancer Resistance Protein) inhibitory activity. [100]

Actions on Endocrine System

Punarnawaa (Boerhaavia diffusa) appears to have anti-oestrogenic effect. Methanolic extract of Punarnawaa (Boerhaavia diffusa) was as effective as the the standard ICI 182-780 (potent antiestrogen) for down regulating estrogen-dependent signaling. [101]

One study showed that Punarnawaa (Boerhaavia diffusa) decreased serum cortisol in mice. [102]

Actions on RES/ Hematopoetic System

Ethanolic extract of Punarnawaa (Boerhaavia diffusa) has been found to inhibit T cell mitogen phytohemagglutinin and concanavalin A-stimulated proliferation of human peripheral blood mononuclear cells (PBMC). The extract also inhibited proliferation of mixed lymphocyte culture. The extract also inhibited several cell lines of mouse and human origin such as mouse macrophage cells (RAW 264.7), human macrophage cells (U937), human monocytic cells (THP-1), mouse fibroblast cells (L929), human embryonic kidney cells (HEK293), mouse liver cells (BNLCL.2), African green monkey kidney cells (COS-1), mouse lymphoma cells (EL-4), human erythroleukemic cells (K562) and human T cells (Jukart). Thus the study demonstrated the antiproliferative potential of ethanolic extract of Punarnawaa (Boerhaavia diffusa) [103]
Actions on Musculoskeletal System
Osteoporosis is a part of aging process. In addition it is associated with (non specific) inflammation of the bones. Recently it has emerged that the process has an immune component also. Cytokines secreted for immune response are also important for development and activation of osteoclasts besides being critical for immunity. [104]
Recently Pandey et al, isolated eupalitin-3-O-β-D-galactopyranoside from Punarnawaa (Boerhaavia diffusa). The compound is said to have immunosuppressive activity. Punarnawaa (Boerhaavia diffusa) is therefore used to treat osteoporosis. [105], [106]
Actions on the Eye
Recently Punarnawaa (Boerhaavia diffusa) has been employed as a standard natural drug for ophthalmic disorders. [107]
Actions on Nervous system
Punarnawaa (Boerhaavia diffusa) showed antipyretic and analgesic activity. (See above)
In Caribian medicine, Punarnawaa (Boerhaavia diffusa) is used as analgesic. The plant extract at the dose of 1gm/kg body weight reduces pain in mice. But it is less potent than morphine. The plant extract is more potent than the dry powder. The analgesic effect is inhibited by naloxone suggesting that the effect is similar to opiods. [108] 
Anticonvulsant
In Nigerian folk medicine, Punarnawaa (Boerhaavia diffusa) is used for the treatment of epilepsy. In experimental studies injections of methanolic extract of Punarnawaa (Boerhaavia diffusa) at doses of 500-2000mg/kg could control Pentylenetetrazole (PTZ)-induced seizures. Borrelli et al believe that the extract is calcium channel blocker. Kaur-Gulati and R. K. Goel et al found that the potency of methanolic extract at the dose of 500mg/kg is similar to 1mg/kg of Diazepam. [109], [110], [111]
Analgesic
In Martinican folk Medicine Punarnawaa (Boerhaavia diffusa) has neen in vogue as a pain reducing agent. In experimental study, at the dose of 1g/kg bodyweight the plant extract reduced pain in mice. Its analgesic activity is inhibited by naloxone suggesting that the action is similar to that of opioids. The powder of the plant is less effective than the extract. The potency of both is less than that of morphine. The herb does not possess any sedatory action [112], [113]  
Anti-stress Activity

The ethanolic extract of root of Punarnawaa (Boerhaavia diffusa) shows antistress and adaptogenic activity in albino mice.This is attributed to anti-oxidant activity of flavonoids, alkaloids, glycosides and sterols found in the extract. [114], [115], [116]

Actions on RS

In the Ivory Coase leaves of Punarnawaa (Boerhaavia diffusa) are used for treatment of bronchial asthma cough and symptomatic treatment of any dyspnoea. When tested in precontracted tracheal rings of mouse at the dose of 30mcg/mL Punarnawaa (Boerhaavia diffusa) was able to relax the trachea. Irie-N Guessan et al documented tracheal relaxation in carbachol-induced contration of trachea. The exact mechanism of action is not known.  [117], [118]

Actions on CVS

Mitochondrial dysfunction plays a key role in the development of cardiac hypertrophy and cardiac failure. So newer drug therapy is aimed at correcting the mitochondrial dysfunction. Recently ethanolic extract of Punarnawaa (Boerhaavia diffusa) has been used to treat Angiotensin II induced cardiac hypertrophy and mitochondrial dysfunction with good results. The beneficial effects were attributed to antioxidant and calcium homoeostasis exerted by the phytochemicals found in the plant.  [119]

Actions on GI syatem

To evaluate anti-ulcer activity of Punarnawaa (Boerhaavia diffusa) gastric ulcers were induced by 25mg/kg Indomethacin and Pylorus ligation in Sprague Dawley rats. The animals were divided in two groups. To one group Punarnawaa (Boerhaavia diffusa) was administered in two doses 200 and 400mg/kg body weight and to other group a combination of Punarnawaa (Boerhaavia diffusa) and Omeprazole 2mg/kg bodyweight. In both the groups gastric ulcers healed but the combination therapy was superior to mono therapy with Punarnawaa (Boerhaavia diffusa). [120]   

Electrical stimulation, acetyl choline, histamine and barium chloride induce intestinal contraction in isolated ileum. In experimental studies on isolated ileum Borrelli et al demonstrated spasmolytic action of methanolic extract of Punarnawaa (Boerhaavia diffusa). The researchers established that boeravinone E is the most potent spasmolytic agent in the root extract of the plant. [121]

Punarnawaa (Boerhaavia diffusa) is useful in strengthening the stomach and strengthening its action. It is useful in the treatment of intestinal colic. Root powder of Punarnawaa (Boerhaavia diffusa) in doses of 5gms thrice a day is useful in expelling and expelling intestinal worms.  [122] 

Hepatoprotective Activity

Punarnawaa (Boerhaavia diffusa) roots normalize the elevated levels of SGOT, SGPT, serum acid phosphatase and serum alphafetoprotein. The experimental work done by researchers validates the use of Punarnawaa (Boerhaavia diffusa) roots in hepatic ailments by several tribes in India. The alcoholic extract of whole plant produced increase in bile flow in rats. This shows Punarnawaa (Boerhaavia diffusa) has choleretic activity.

Punarnawaa (Boerhaavia diffusa) reduces elevated levels of cholesterol and triglycerides and reduces or prevents the accumulation of fat in the liver. [123]

R. Gulati et al demonstrated that 50% aqueous-ethanolic extract of roors of Punarnawaa (Boerhaavia diffusa) at a dose of 100mg/100g showed hepatoprotective activity in hepatotoxicity induced by country liquor in albino rats. The conclusions were supported by biochemical and histolological studies.  [124]

Chandan et al demonstrated hepatoprotective activity of 50% aqueous-ethanolic extract of whole plant of Punarnawaa (Boerhaavia diffusa) in carbon tetrachloride induced hepatotoxicity in rats. The extract also doubled the flow of bile. [125]
Rawat et al studied the effect of various factors responsible for hepatoprotection by Punarnawaa (Boerhaavia diffusa). They found that aqueous extract (2mL/kg) of roots having 1-3 cm diameter acquired in the month of May showed a significant hepatoprotection. They also pointed out that thin roots were more effective in hepatoprotection than the thick roots. [126]
The aqueous-ethanolic extract of fresh leaves of Punarnawaa (Boerhaavia diffusa) shows a very potent hepatoprotective activity in acetaminophen-induced hepatotoxicity in rats. The extract contains appreciable quantities of phenolics and flavonoids along with vitamins C and E, selenium and zinc. According to Olaleye et al these chemicals are responsible for hepatoprotective activity of the plant. [127]
Cirrhosis of the liver is the major casue of ascites which is followed by congestive cardiac failure (CCF). Use of diuretics is the first line of therapy. Newer diuretics such as frusemide (furosemide) produce profuse dieresis, abnormalities in fluid dynamics in the body and sodium-potassium imbalance. Punarnawaa (Boerhaavia diffusa) is hepatoprotective, nephroprotective, a mild diuretic. By ACE inhibitor activity Punarnawaa (Boerhaavia diffusa) decreases cardiac load. Its nephroprotective and renal Na+ K+ -ATPase activity and antioxidant status prevent the electrolyte and bodyfluid imbalance.  [128]


Mechanism of Hepatoprotection
Does Punarnawaa (Boerhaavia diffusa) regenerate hepatocytes? May be may be not! If administered internally as medicine, does it repair hepatocyte damage? It certainly does! If administered internally as adaptogen (Known as Rasaayana in Ayurveda); does it arrest further liver damage? It certainly does!!  
By virtue of its anti-inflammatory, anti-oxidative, anti-microbial, anti-viral, immunomodulatory, laxative, choleretic, detoxificating and diuretic activities Punarnawaa (Boerhaavia diffusa) acts as a hepatoprotective agent. I would say Punarnawaa (Boerhaavia diffusa) is a hepatoprotective agent par excellence! [129]

Actions on metabolism

Thiobarbituric acid reactive substances (TBARS) are formed as byproduct of lipid peroxidation (i.e. degeneration products of fats). TBARS are used to determine the damage produced by oxidative stress. Antioxidant property of the leaf extract of Punarnawaa (Boerhaavia diffusa) reduced the elevated TBARS in alloxan induced diabetic rats. [130]

The root extract of Punarnawaa (Boerhaavia diffusa) at doses of 100 1nd 200mg/kg bodyweight normalized elevated levels of lipids, AST, ALT, urea, creatinine in female Sprague-Dawley rats. The extract also normalized the bodyweight in obese animals. This suggests that Punarnawaa (Boerhaavia diffusa) can be useful for the treatment of obesity. [131]

Antidiabetic Activity
Punarnawaa (Boerhaavia diffusa) has inhibitory potential against α-glucosidase enzyme with no effect on α-amylase, an enzyme mediating starch digestion. The plant shows some inhibitory effects on carbohydrate absorption but there is no enough evidence to suggest it is potent to be used on regular basis to treat diabetes. [132], [133]

Oral administration of 500mg/kg of Punarnawaa (Boerhaavia diffusa) over 30 days in diabetic rats normalizes elevated blood sugar in alloxan-induced diabetic rats. This was comparable to 500mcg/kg Metformin. There was no significant effect of Punarnawaa (Boerhaavia diffusa) on non-diabetic rats. [134]

Administration orally of Punarnawaa (Boerhaavia diffusa) tea (200mg/kg bodyweighi in hot water) to alloxan-induced rats lowered elevated blood sugar by 50% and insulin by 52%. These results were comparable to 600mcg/kg of Glibenclamide. [135], [136]
In another study Punarnawaa (Boerhaavia diffusa) outperformed Glibenclamide. [137]
These studies suggest that β-cell renewal or some extrapancreatic action of Punarnawaa (Boerhaavia diffusa) is responsible for such effects.  [138] 

Actions on Urinary System

At concentration of 1-100 mg/mL Punarnawaa (Boerhaavia diffusa) has anti-urolithiasis actions. The concentrations above 32mg/mL reduced both the size of Calcium Oxalate Monohydrate stones and increased elimination of these from urine. [139], [140]

Aqueous extract of Punarnawaa (Boerhaavia diffusa) administered to rats at 100 and 200mg/kg was able to reduce the size of kidney stones, normalized blood urea and creatinine as was proved by biochemical studies and normalized the damaged kidney as was proved by histology. This shows that Punarnawaa (Boerhaavia diffusa) has a good nephro protective activity. The dose of 100mg/kg of Punarnawaa (Boerhaavia diffusa) used in rats should be 16mg/kg for human beings. [141]      

Punarnawaa (Boerhaavia diffusa) is well known for its diuretic activity. The diuretic activity is due to the phytochemicals present in both the leaves and roots but the diuretic activity of stem has lesser efficacy than that of leaves and the roots. [142]

Wahi et al isolated alkaloid punarnavine and water soluble base choline from Punarnawaa (Boerhaavia diffusa). Administered at 5mg/100g in rats the alkaloid produced significant diuresis. [143]

Aqueous extract of the whole plant of Punarnawaa (Boerhaavia diffusa) significantly decreased the osmotic fragility of erythrocytes from end stage renal renal disease patients. Sathyapriya et al suggested that this to be due to alteration in the composition of the erythrocyte-cell membrane or due to a direct or indirect effect of the extract on intracellular sodium and alleviation of oxidative stress. [144]

Actions on Male Reproductive System

To evaluate the efficacy of Punarnawaa (Boerhaavia diffusa) on benign prostatic hyperplasia (BPH); BPH was induced in one group of rats by subcutaneous injection of 5mg/kg bodyweight daily of testosterone for 28 days. The other group of animals received simultaneously 100 mg/kg bodyweight of Punarnawaa (Boerhaavia diffusa) for 28 days. The results showed that Punarnawaa (Boerhaavia diffusa) significannly inhibited the prostatic hyperplasia. The extract did not have significant change on serum testosterone level. Histopathological analysis of the prostate gland supported above results.  [145]
On investigation of the effect of 2.4 % aqueous extract of leaf of Punarnawaa (Boerhaavia diffusa) at doses of 100 and 150mg/kg for 60 days on Wister rats researchers found that there was no significant change in testosterone level, the weight of testes, epididymis and seminal vesicles significantly decreased, sperm count and sperm motility significantly decreased and live/dead sperm ratio decreased significantly. Histopathology of the testes revealed marked degeneration of germinal epithelia with sperminostasis. The results suggest that the extract of Punarnawaa (Boerhaavia diffusa) has adverse effect on male reproductive system i.e. semen and morphology of testes of the rats. [146]

Female Reproductive System

Srivastava et al studied the effect of 50mg/kg of root extract of Punarnawaa (Boerhaavia diffusa) extract on Intra Uterine Device (IUD)-induced bleeding in rhesus monkeys. They attributed this activity of the herb to antifibrinolytic activity of Punarnawaa (Boerhaavia diffusa). This activity was comparable to aminocproic acid 100mg/kg/day administered orally and tranexamic acid 5.5mg/kg/day administered by intravenous injection. [147]

Some researchers isolated a phenolytic glycoside punarvoside having antifibrinolytic activity. Punarnavoside has been used to treat irregularities of menstruation, dysmenorrhea and diverse gynaecological disorders.  [148]

Administered orally to pregnant albino female rats in a dose of 250mg/kg during entire period of gestation did not induce abortion and did not show fetal abnormalities and teratogenic effects [149]

Cervical Cancer

Hela cell (HeLa cell) is an immortal cell line derived from cervical cancer cells used in cancer research. Punarnawaa (Boerhaavia diffusa) fraction 5 (BDF 5) could inhibit HeLa cancer cells. Bio-assays of ethanolic extracts and chloroform fraction (BDF) of root of Punarnawaa (Boerhaavia diffusa) showed antiproliferative effect on HeLa cells. After exposure for 48 hours, at a concentration of 200µg/mL, the fraction significantly reduced cell proliferation and brought about changes in the morphology of HeLa cell. [150]

Anticancer Activity

Punarnawaa (Boerhaavia diffusa) inhibits T cell mitogen phytohemagglutinin and concavalin A-stimulated proliferation of human mononuclear cells (PBMC). It also inhibited purified protein derivative antigen-stimulated PBMC proliferation and human mixed lymphocyte culture. In addition, various extracts of Punarnawaa (Boerhaavia diffusa) inhibited the growth of several ciee lines of human and mouse origin such as human macrophage cells (U937), human monocytic cells (THP-1), human embryonic kidney cells (HEK 293), human erythroleukemic cells (K562), human T cells (Jurkat), mouse macrophage cells (RAW 264.7), mouse fibroblast cells (L929), mouse liver cells (BNLCL.2), mouse lymphoma cells (EL-4) etc. various extracts of Punarnawaa (Boerhaavia diffusa) also inhibited African green monkey kidney cells (COS-1) [151]

In a study Punarnawaa (Boerhaavia diffusa) exhibited cancer chemopreventive property. The study led to the hypothesis that the inhibition of tumorogenesis by the plant extract might have been executed either by preventing the formation of active carcinogens from their precursors or by augmenting detoxification process. [152]

Ethanolic extract of Punarnawaa (Boerhaavia diffusa) at the dose of 50µg/mL showed cytotoxic activity against Vero cell lines (i.e. cells from kidney of African green monkey, a fibroblast-like kidney cell)  [153]

In vitro studies by Srivastava and coworkers showed cytotoxic effect of extracts of root and leaves of Punarnawaa (Boerhaavia diffusa) in HeLa and U-87 cell lines. At a concentration of 200 µg/mL crude ethanolic extract of root showed 30%, the leaf extract at 300 µg/mL showed 40% and the alkaloid fraction at 300 µg/mL showed 40% cell death. [154]
Punarnawaa (Boerhaavia diffusa) shows the protective effect against gamma radiation-induced damage in mice. [155], [156]
The alkaloid Punarnavine showed inhibitory activity against cancer metastasis. [157]

Culinary uses
Used as vegetable in some states in India. Tribals in Purulia (West Bengal) eat this plant as vegetable. The leaves of the plant are cooked in Assam. [158]

Medicinal Actions and Uses
Traditional Uses
In India, Nepal, Sri Lanka and Tibet Punarnawaa (Boerhaavia diffusa) is used for gastritis, amlapitta (hyperacidity), intestinal colic, diarrhea, jaundice, liver-gallbladder disorders, fatigue, anemia, muscular pain, urinary disorders, ophthalmic problems, blindness, menstrual disorders, increasing virility and treatment of edema. People in tribal area use it to hasten child birth. [159]

Usages in Ayurveda

In Ayurveda it is used as stomachic in dyspepsia, to treat intestinal colic, jaundice and anemia. As diuretic it is used to treat ascites, dropsy (CCF); to treat enlargement of the spleen. It is used for obesity and alopecia [160]

Usages in Modern Medicine
It should be considered for the treatment of viral hepatitis, non alcoholic fatty liver disease, in precirrhotic stage of liver disease and as diuretic in portal hypertension to treat ascites.     

Drug-interactions

As Punarnawaa (Boerhaavia diffusa) exhibits a wide range of pharmacological actions researchers think, that the herb might interact with anticonvulsants, anxiolytics, immunomodulators, hormones, diuretics, ACE inhibitors etc.
Studies show that Punarnawaa (Boerhaavia diffusa) potentiates the actions of anticonvulsants and anxiolytics especially benzodiazepines and barbiturates.
Another study shows that quercetin found in Punarnawaa (Boerhaavia diffusa) increases the bioavailability of tamoxifen by about 20% upon coadministration. Quercetin at a dose of 10mg/kg bodyweight also increased the bioavailability of simvastatin. [161], [162]

Toxicity, Contraindications

Punarnawaa (Boerhaavia diffusa) in moderate doses is laxative but in large doses can be a drastic purgative; hence should be used with caution in children and must not be used during pregnancy and lactation.  [163]

Preparations and dosages

The standard dose of Punarnawaa (Boerhaavia diffusa) used in studies on rats ranges from 200-400 mg/kg with maximally effective dose is 1000mg/kg. For humans the dose is 32-64mg/kg bodywetght [164]

Punarnawaadi Kwaath: (Punarnawaashtak)

A dose of 30ml of decoction is prepared from 1.56 gm each of Punarnawaa (Boerhaavia diffusa)(Boerhaavia diffusa), Bakan ninb (Melia azadirachta), Kutakee (Picrorrhiza kurroa), Guduchee (Tinospora cordifolia), Hareetakee (Terminalia chebula), Daaru haridraa (Berberis aristata), Patola (Trichosanthes dioica), Aardraka or Shunthee (Zingiber officinalis/ Zingiber officinale). 
Dose: 20 to 30 ml

Punarnawaasawa:
Dose: 20 t0 30 ml

Punarnawaadi Choorna:
Root powder

Punarnawaadi Mandoor:
For anemia

Punarnawaa (Boerhaavia diffusa)Guggula:

Punarnawaambu:

Sukumaara ghrita:

Shothaghna Lepa: Antiphlogistic Paste:     [165], [166]


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