Ayurgenomics – a new player in biomedical sciences.

Contemporary medical science has, until recent times, remained in perennial search of a single cause of a disease, be it physiological or molecular. Looking at the human body through a systems perspective is a relatively new approach in the field of biomedicine. Ayurveda, the Indian traditional medical system, on the other hand, has always looked at diseases as a holistic response of an individual to the environmental challenge.

The bane of Ayurveda, however, is that unlike the present day allopathic system it lacks documented records of experiments, research methodology, peer-reviewed studies, and population-based investigations, in the manner as seen today. There are only a few molecular correlates to back up this ancient system of healing – to connect it to our present understanding of human health. Well, that was so, at least until recently.

The situation now seems to be changing rather positively. In an article, recently published in the Journal of Genetics (Prasher et al., “Genomic insights into ayurvedic and western approaches to personalised medicine), Dr Mitali Mukerji and Dr. Bhavana Prasher, from CSIR-Institute of Genomics and Integrative Biology have described Ayurgenomics – an emerging field that integrates the science of genomics to investigate Ayurvedic concepts, drawing parallels between ‘Prakriti’ and ‘gene expression patterns’ in people. The paper argues that “recognition of the underlying systems biology has been effective in the translation of network medicine into clinical practice of Ayurveda for thousands of years”.

In the Ayurvedic system, people are classified on the basis of Prakriti, which basically characterises a person’s constitution, defined by the relative proportions of three basic elements, a.k.a. ‘three doshas’ or ‘Tridosha’. The three doshasVata (kinetic), Pitta (metabolic) and Kapha (potential) and their combinations Vata-Pitta, Pitta-Kapha, Vata-Kapha and Vata-Pitta-Kapha are the 7 classes of healthy physiological constitutions that, according to Ayurveda, any person can be categorised into. A person’s Prakriti, based on his inherent dosha, is responsible for the way he looks, his skin, hair, body type, physical-, mental-, metabolic- abilities, health, etc. Any disruption, in any of these basal states of Vata, Pitta and Kapha, leads to disease. Ayurvedic therapy, therefore, is directed towards the restitution of a balanced state of doshas, based on a person’s Prakriti.

While Ayurvedic concepts may sound abstract and unrealistic, the Ayurgenomics team at CSIR-IGIB, through their studies, has been able to identify unique molecular signatures for each individual. In an earlier study, the first of its kind, the authors sampled 96 healthy unrelated individuals – belonging to any of the three basic Prakriti types (Vata, Pitta or Kapha), in order to determine whether each class could be mapped to a unique molecular signature. The answer, following Genome-Wide Association Studies and various biochemical profiling analyses, was in the affirmative.

The study, reported in the Journal of Translational Medicine in 2008, revealed a number of genes that were differently expressed between the three Prakriti classes. More authentically, the list of genes included were those involved in core regulatory functions – ones known to impact multiple phenotypes and physiological processes. “Since the method of Prakriti phenotyping captures multiple seemingly unconnected systems, genetic variation underlying Prakriti could enable identification of hub genes that would have system-wide effects”, say the researchers in their article. Their studies provide proof of concept for the Ayurvedic principle of Tridoshas.

One of the genes identified in the study was ELGN1, whose product regulates the activity of a transcription factor, HIF1a, that is involved in allowing cells adapt to hypoxia. The EGLN1 product has multiple roles in the body, and dysregulation of this gene has been linked to diseases affecting various body systems. Genotypic variations responsible for variable expression of this gene can either assist recovery, like in the case of ischemia, or exacerbate the disease as observed in cancer. Based on their findings, the authors propose that this molecule could be a ‘molecular contributor to Tridosha’. Of course, this is only the beginning. Multiple studies are now being carried out whose results can be applied to the Ayurvedic concept of Trisutra (meaning: causes, symptoms and treatment of a disease), warranting further investigations along the same line.

The review article, co-authored by Dr Bhavana Prasher and Prof. Mitali Mukerji from CSIR-Institute of Genomics and Integrative Biology, New Delhi, and Prof. Greg Gibson from the Georgia Institute of Technology, Atlanta, can be freely accessed using the link provided here.

Ayurveda meets Allopathy


For many Indians, Ayurveda represents a traditional system of holistic approaches to good health, practiced since generations. With the advent of the more conventional ‘scientific medicine’ or ‘Biomedicine’ or ‘Allopathy’, Ayurveda has retreated into what is now popularly known as ‘alternative medicine’.
The 25 July 2016 issue of Current Science includes a compilation of nine articles under a SPECIAL SECTION on INTEGRATIVE MEDICINE (IM) that focuses on the integration of the methods of Ayurveda with classical biomedicine. These articles, authored by various medical experts, both from India and outside, discuss the benefits of such an integrative approach, the current healthcare scenario in India– emphasising the role of government policies, and the challenges that exist in implementing strategies that can combine the best of both worlds.
Dr S R Narahari and Dr M Guruprasad Aggithaya, from the Institute of Applied Dermatology, Kerala, and Dr. Terence J Ryan, from the Dept. of Dermatology, University of Oxford, UK, state the importance of collaborations between practitioners of Ayurveda and Allopathy in developing protocols for managing diseases using Integrative Medicine, in the preface to this special section. Ms Sanju Arianayagam from the Dept. of Dermatology, University of Oxford, UK, in her article ‘Disorders of pigmentation of the skin–hypotheses underlying interventions by multiple systems of medicine: is there a role for integrated medicine?’ explains, using the skin as an illustration, how various factors play a part in physiological processes and diseases and how “Biomedicine that seeks single causes is reductionist in its approach to therapy and often ignores the synergism that characterises cellular biochemistry.”
Touching upon topics such as Ayurvedic intervention in the eradication of leprosy, treating of skin diseases, promoting sleep quality in patients with generalized anxiety disorder and co-morbid generalized social phobia and the reverse pharmacology approach for drug discovery employing insights from Ayurveda, particularly in the context of the treatment of arthritis, the authors agree that an integrative approach involving Ayurveda is no doubt beneficial, especially when combined with biomedical therapy. A successfully developed IM protocol by a ‘Multi System Medical Team’ at the Institute of Applied Dermatology (IAD), for managing lower-limb lymphoedema, with proven clinical results, sets the standards for developing protocols for conducting evidence-based clinical studies to develop new IM therapies for chronic skin diseases.
India’s current position on the regulation of Ayurvedic practice, research and education, however, requires an extensive revaluation and amendments, so as to fit into the current standards of health administration and patient care. With dedicated collaborative efforts from researchers, doctors, educators and policy makers in the field of Ayurveda one can envision a future where integrative medicine, incorporating Ayurvedic methods, plays important roles in the restitution of health in the cases of many, suffering from various chronic ailments.
The special section on integrative medicine published in Vol. 111(2) on 25 July 2016 can be freely accessed via the link provided here. The section has received a mention in Deccan Herald and The Wire and these articles are available via the following links:
Deccan Herald
The Wire