Andrographis is one of the most used herbs in Ayurvedic medicine. Ayurveda traditionally used this bitter herb, also called the “King of bitters” as digestive remedy. Its use is widespread throughout India and Asia, and it is used in the treatment of diarrhea, diabetes, fevers, and even snake bites. Chinese medicine categorizes Andrographis as a cold herb used in the treatment of acute (hot) conditions and infections. Additionally, it is used as a laxative, and it has immune enhancing and hepatoprotective properties.

Clinical trials have shown that it has effects upon the common cold, sinusitis, and pharyngotonsillitis infections. In a study done by Hu et al (2017), thirty-three trials were conducted involving over 7000 patients with respiratory tract infections. The findings suggested that Andrographis improved symptoms of cough and sore throat, and overall symptoms of respiratory tract infections. The length of symptoms was also decreased with the use of Andrographis. The use of Andrographis was associated with fewer adverse effects; the majority of reported adverse effects were gastrointestinal symptoms.

Of all the clinical uses, the most compelling to me is it potential anticancer effect. In vitro and in vivo studies have shown that Andrographolide, a diterpenoid found in Andrographis, has the ability to act on several kinds cancer cell by inhibiting replication. Andrographis also enhances the individual’s immune system causing apoptosis and necrosis of cancer cells (Rajagopal, Kumar, Deevi, Satyanarayana, & Rajagopalan, 2003). Animal studies show potential anti-cancer effect on melanoma, as well as on pancreatic cancer cells. Andrographolide has high solubility that allows it to cross the blood-brain barriers. This property is showing promising anti-cancer activity against glioblastomas (Li et al., 2012). In vitro studies also demonstrated that Andrographolide shows remarkable anti-tumor properties in pancreatic cancer cells by inhibiting STAT3 and activating Akt, which caused cell cycle arrest and tumor cell apoptosis. It did so without any of the side effects and toxicity caused by Gemcitabine, the medication of choice for patients with pancreatic cancer (Bao et al., 2013). A review of the literature demonstrates that Andrographis anti-cancer properties are executed by several mechanisms of actions (Soo et al., 2019): cell cycle arrest, angiogenesis, apoptosis, cytokine inhibition, to name a few (Malik et al., 2021). This is fascinating. The main hindrance is the poor oral bioavailability and low aqueous solubility of the compound. For this reason, scientists are hard at work trying to find ways to increase Andrographolide’s bioavailability. 

References

Bao, G. Q., Shen, B. Y., Pan, C. P., Zhang, Y. J., Shi, M. M., & Peng, C. H. (2013). Andrographolide causes apoptosis via inactivation of STAT3 and Akt and potentiates antitumor activity of gemcitabine in pancreatic cancer. Toxicology letters, 222(1), 23–35. https://doi.org/10.1016/j.toxlet.2013.06.241

Hu, X. Y., Wu, R. H., Logue, M., Blondel, C., Lai, L. Y. W., Stuart, B., Flower, A., Fei, Y. T., Moore, M., Shepherd, J., Liu, J. P., & Lewith, G. (2017). Andrographis paniculata (Chuān Xīn Lián) for symptomatic relief of acute respiratory tract infections in adults and children: A systematic review and meta-analysis. PLoS ONE, 12(8). https://doi.org/10.1371/journal.pone.0181780

Li, Y., Zhang, P., Qiu, F., Chen, L., Miao, C., Li, J., Xiao, W., & Ma, E. (2012). Inactivation of PI3K/Akt signaling mediates proliferation inhibition and G2/M phase arrest induced by andrographolide in human glioblastoma cells. Life sciences, 90(25-26), 962–967. https://doi.org/10.1016/j.lfs.2012.04.044

Malik, Z., Parveen, R., Parveen, B., Zahiruddin, S., Aasif Khan, M., Khan, A., Massey, S., Ahmad, S., & Husain, S. A. (2021). Anticancer potential of andrographolide from Andrographis paniculata (Burm.f.) Nees and its mechanisms of action. Journal of ethnopharmacology, 272, 113936. https://doi.org/10.1016/j.jep.2021.113936

Soo, H. L., Quah, S. Y., Sulaiman, I., Sagineedu, S. R., Lim, J., & Stanslas, J. (2019). Advances and challenges in developing andrographolide and its analogues as cancer therapeutic agents. Drug discovery today, 24(9), 1890–1898. https://doi.org/10.1016/j.drudis.2019.05.017