Hypouricemic Significance of Ledum Palustre (Marsh Tea): A Review

 

Bhuwanendra Singh¹*, Jitendra Gupta², Rohit Mohan³, Reena Gupta², Kanchan Pal⁴

¹Department of Pharmacognosy, NKBR College of Pharmacy and Research Centre,

Meerut, Uttar Pradesh, India- 245206.

²Institute of Pharmaceutical Research, GLA University, Mathura-281406, Uttar Pradesh, India-281406.

³Department of Pharmacology, Goel Institute of Pharmacy and Sciences, Lucknow, U.P, India-226028.

⁴Department of Biochemistry, Jhunjhun Wala, P.C College, Ayodhya, Faizabad- India-224001.

 

ABSTRACT:

The current review article is based on the facts to reveal the biological potentials of the genus ledum, and specie palustre. Although in the article all the species are well described with their distribution in all over the world and their pharmacological activities are also discussed. Rhododendron tomantosum is also known as Marsh Tea or northern Labrador tea, which is an evergreen shrub having the height of about 40 cm and the plant has about ten species in all over the world. Article has very informative aspect regarding Hypouricemic Significance of Ledum palustre (L. palustre), its chemical compounds extracted and analyzed by different spectroscopic and chromatographic techniques to report the active principles from the oil of the Rhododendron tomantosum fresh leaves. The main active compounds were found are given as (41.0–43.4%) ledol (23.3–26.7%) and ascaridole (15.1–4.5%). L. palustre has a very significant role in the gout and arthritis occurs due the presence of high amount of uric acid in the blood plasma. Various dosage forms are mentioned in the review article to explore the potentials of the drug. Hence according to literature if L. palustre is significantly capable to reduce the high level of the uric acid if give in the potency if 30 c (diluted 30 times)) and 1 M ((1000 dilutions) to the patients, and may be a good alternative to the allopurinol. So, this drug is frequently used in the homeopathic system of medicine to get the hypouricemic significance in the human beings.

 

 

 

INTRODUCTION:

As all we know that Uric acid is one of the waste by-product in our body. Formation of uric acid takes place when the body breaks down purines which present in some foods or in the sea foods. When the cells die and get taken apart then this leads to the purines. While Most of the uric acid pass out from the body with urination. If the person shows high levels of uric acid, then further it can be a sign of certain disease such as gout. Thus, the condition of Hyperuricemia may be explained such as, when the amount of uric acid is found very high means beyond the prescribed limits in the blood of the patients.

 

If we noted in the terms of pH of the fluid present in the body, then the uric acid found in the form of salts, that is urates, so it is clear that uric acid is present in the forms of ions. Hyperuricemia condition can be described as a condition in which the concentration of serum level and or plasma urate amount found more than the limits i.e. 7.0 mg/dl for males and for females is 6.0mg/dl¹.

 

Hyperuricemia is common disorder of metabolism in the humans so the condition of hyperuricemia may indicate an increased risk of gout and other joint diseases. But still there is no actual evidence that show gout is the result of hyperuricemia. While if we talk about Arthritis then this a condition in which the uric acid deposits in the small joints of the body such as fingers, toe, and causes the swelling with pain and redness in the joints. the consequences of the disease associated with a single joint or numerous joint. Arthritis has been classified more than hundred types, with dissimilar genesis and methods of treatment. So more over Arthritis here classified in the two classes first one is degenerative joint disease i.e. osteoarthritis and second one is joint inflammatory disease which is called as rheumatoid arthritis. Thus, up to some extent increased level of uric acid is also responsible for the Arthritis. The commonly administered drug to treat the Hyperuricemia is allopurinol but this drug has many adverse drug reactions on various parts of the body viz allergic reaction, gestrohepatic problems, renal impairment etc².

 

Plant Profile:

L. palustre is known from various other names also such as Rhododendron tomantosum (northern Labrador tea, previously L. palustre) or marsh tea or northern labradore tea, and other species are named as Rhododendron groenlandicum, (bog Labrador tea, previously Ledum Greenlandic or L. latifolium) and Rhododendron neoglandulosum, (western Labrador tea, or trapper's tea,)³.

 

Rhododendron tomantosum or marsh tea is an evergreen shrub having the height of about 40 cm and the plant has about ten species in all over the world⁴. Thus, plant is also known as rosemary in the northern chin and America here this is found as wildly growing low shrub and needed marsh type soil for the better growth. The leaves and flowers possess a strong odour which induce headache in some of the human beings. If we talk chemical compounds of the drug then All aerial fragments of L. palustre contain toxic terpenes which have an effect on CNS, which result in hostile action⁵. Moreover, Rhododendron tomantosum is frequently used as ethnomedicine to treat the insect bites⁶, mosquito bites and join inflammations in the homeopathic system of medicines. The plant of marsh tea has spitter and discursive properties for these effects a poisonous sesquiterpene compound is responsible, which is present in the oil of the L. palustre, named as ledol⁶. (there are so many active principles are characterized from the oil of Ledum palustre such as ledol, and palustrol⁷.

 

Taxonomy and morphology of ledum palustre:

Since 1990 on the basis of morphological evaluation it was revealed that species was put down in the Ledum genus and this ledum is subsection of genus Rhododendron, which is placed in the Ericaceae family, with respect to the order, Ericales^{8, 9}.

 

L. palustre is enduring resin rich evergreen shrub which grow well up to 50- 150 cm long. This is a perennial in nature with erect young branches with thick and strong spindle shaped roots Leaves are small oblong to linear in shaped with green in color. Flowers are five petaled, bisexual and they burgeon in the month of May to June. Fruits are ovoid capsule with the measurement of 4.5-5.5 mm long¹⁰.

 

 

Figure 1 Pics of two different species of Marsh Tea

 

Phytochemical potentials of ledum palustre based on previous and current Research:

Ethnomedicines are always a subject to attract the scientific researchers, thus it seems same in the case of L. palustre, with respect to its phytochemistry several research papers has been published to report the active chemical compounds, mainly concerned with the oil of the herb, which is isolated mainly form the aerial parts of the plant. The yield of oil with the sufficient presence of chemical compounds is depends on the various factors such as type of species, age of plant, geographical distribution as well as time and season of collection¹⁰, with the consideration of part of the shrub (Table 1). Recent researchers have been reported about 90 chemical compounds from the essential oil of the shrub.

Table 1: Collective Information Regarding Various Factors Which Are Related to The Chemical Constituents of The Oil Isolated from The Plant.

Plant Species	Part of shrub and its condition	Geography and month of collection	Extraction and isolation methods	Characterization methods	% age of active principles	Reported Pharmacological activity of the species	References
Rhododendron tomentosum	Young Shoots	Distributed near the Pudisoo River. In the month of September	Simultaneous distillation	GC/MS	γ-terpineol (31.2%), and ledol (11.8%),	Arthrosis, rheumatism, cold, fever, throat, infections, Eye problems, Women’s disease, Dental infections.	11and12
Rhododendron tomentosum	Fresh leaves	Distributed near the Pudisoo River. In the month of September	Simultaneous distillation	GC/MS	(+)-ledol (10.3%), p-cymene (10.0%),	Arthrosis, rheumatism, cold, hangovers, throat infections, Eye problems, Dental infections.	11and12
Rhododendron tomentosum	Juvenile shoots	Located at village named as Juodupė, Lithuania, in the month of June	Hydrodistillation	GC, GC-MS	(-)-Palustrol (35.2%), ledol (30.8%), cyclocolorenones (9.3%),	Arthrosis, rheumatism cold, fever, fever, throat infections, Eye problems, Women’s disease, Dental infections.	11and12
Rhododendron groenlandicum,	aerial parts, (Dry leaves)	northern part of the North American, Canada	Hydrodiffusion	GC-FID and GC-MS	Limomene (0.3 – 65%) β-selinene (2.3-35.5%) β -pinene (0.05-8.4%), p-cymene (0.2-3.4%), ( palustrol and ledol< 1%).	treatment of respiratory diseases, antidiabetic	13and14
Rhododendron groenlandicum,	Dried leaves	western part of North America (California)	Hydrodistillation	GC/MS	p-cymene, 𝛼- and 𝛽-pinene, 𝛾-terpineol	Constipation, stomach disease	12
Rhododendron neoglandulosum	aerial parts,	California, western part of north Ameria	Hydrodistillation	GC/MS	cyclocolorenones	Constipation, stomach disease	10

 

Table 2: Phytochemicals Reported from Different Species of Rhododendron (Ledum palustre)

Plant Species	Part of shrub	Reported chemical compounds	Chemical Structures	References
Rhododendron tomentosum	Young Shoots, fresh leaves	(+)-ledol		11 and12
Rhododendron tomentosum	Young Shoots	γ-terpineol		11 and 12
Rhododendron tomentosum	Fresh leaves	p-cymene		11 and12
Rhododendron tomentosum	Young shoots	(-)-Palustrol		11and 12
Rhododendron tomentosum	Young shoots	cyclocolorenones		11 and 12
Rhododendron tomentosum	leaves	lepalol		11 and 12
Rhododendron groenlandicum,	aerial parts,	Limomene		13
Rhododendron groenlandicum,	aerial parts,	β-selinene		13
Rhododendron groenlandicum,	aerial parts,	β -pinene		14
Rhododendron groenlandicum	aerial parts,	Germacrone		13
Rhododendron groenlandicum	aerial parts,	α-Pinene		13
Rhododendron groenlandicum	aerial parts,	β -Bisabolene		13
Rhododendron groenlandicum	aerial parts,	germacrene B		13
Rhododendron neoglandulosum	aerial parts,	cyclocolorenones		12

 

Phytochemistry of Ledum palustre:

On the account of oil different methods are available for the extraction, isolation and analysis of essential oil and volatile oil of the drug. Such as the supercritical fluid extraction (SFE), method was used for the volatile oil extraction and hydro-distillation was applied for the extraction of essential oil. Gas chromatography–mass spectrometry is generally used to monitor the composition of oil obtained from aerial parts of the L. palustre. The main active compound is as (41.0–43.4%) ledol (23.3–26.7%) and ascaridole (15.1–4.5%)¹⁵. Some research has been reported that essential oil contain about 90 chemical compounds and few others are reported about 160 chemical compounds are present in this drug. In the year of 1948 a sesquiterpene compound names as ledol was reported first time from the marsh tea, while after thirty years later the essential oil of the shrub contains cyclocolorenone¹⁰. Which is an oxygenated sesquiterpenoids, with the aromadendrin carbon skeleton, oxygenated monoterpenes, monoterpenoids with a menthane skeleton and aliphatic monoterpenoids^{11, 16 and 17}. It was reported that R. tomentosum’s essential oil contain the oxygenated monoterpenes of furyl structure, like lepalon, lepalol or lepalin (4.6–7.6%). Some more compounds are given in the table 2. with their chemical class, species, and biological activities and chemical structures. Such the essential oil contains Polyphenols (Flavonoids), Hydroxycinnamic acids, Coumarins.

 

Hypouricemic potential of ledum palustre:

As we know some of the diseases are found in rich society, same is related among all the disorders occurs due to elevated uric acid and this is a very common metabolic disorder in almost all over the world. The range of uric acid or urate is accounted high if denoted as 6.8 mg/dL². Causes of the high level of urate/uric acid is listed as it may be obesity, kidney diseases, hepatic complications. When uric acid is deposited in the form of monosodium urate crystals in the joints then it leads to arthritis, gout, inflammation in the joints.

 

Thus, to avoid the side effect of allopathic medicines mainly allopurinol, some medicinal Practioners rely on the alternative system of medicine i.e. homeopathy and in this system of medicine, L. palustre is the drug which shows hypouricemic effect². Hence ledum is frequently used for the treatment of sore throat, inflammation and acute rheumatism in the homeopathic system of medicine.

 

Experimental report on the hypouricemic potential of ledum palustre:

1.       It is reported in the various literature that the use of this drug decreases the inflammation or gout condition arises in the joints of knee, and wrist fingers, or toes along with the significant relief in the pain also^{18, 19}. A experimental result has shown reduction in the amount of uric acid 0.4mMol/L when the drug was given in potency of 30 centesimal more than two weeks to the alcoholic male patients and it leads to the significant reduction in the gout pain².

2.       L. palustre is also most preferred drug in emergency condition of inflammation due to significant effect as an anti-inflammatory property^{20, 21}.

3.       Hence according to literature if L. palustre is significantly reduce the high uric acid if give in the potency if 30 c and 1 M to the patients, and may be a good alternative to the allopurinol².

4.       In a research it was mentioned that application of L. palustre in 30 CH potency when administered three times in a day then symptoms of patients were the same symptoms that are given in different Materia medica as described by the patients²².

5.       In the treatment of acute gout L. palustre is prescribed as a very useful homeopathic medicine when the toe become swollen, sore and painful on the movement. It is prescribed when colchicum has been administered in the allopathic treatment²³.

6.       When joints are swollen, hot to touch and pale in color then pain is worst in the night time. And it is as reported that the warmth of bed induces the pain while improvement has recorded by cold application with rest²⁴.

7.       It joint are very stiff then it can only be moved after bathing in the cold water or by applying ice cold water and L. palustre is also give cooling sensations²⁵.

8.       An experimental study showed that L. palustre has used to treat calcaneal spur (CS), i.e. When L. palustre is given in different power then it showed revealed better results as 30C, 200C, 1M, 10M to the patients suffering from calcaneal spur, then it gives the positive response of 21.5 % ²⁶.

9.       L. palustre prescribed when these indications arises in the patients, Pains of soles of feet and heels, as if bruised, when walking Painful heel with hard nodes < step on them Stiffness with heaviness in feet in morning with burning; wants to uncover Sticking, tearing, throbbing pain with swelling of feet, heels By motion, at night, by warmth of bed and bedcovering > only when holding feet in ice water²⁶.

10.    When L. palustre is given with a combination of Archangelica officinalis in the extracts form before irradiation it rendered 70% survival in the case of radiation both of the drugs act as radioprotectives²⁷.

 

Table 3. Marketed Products Detail of Ledum Palustre

Drug	Dosage form	Potency	Uses	Company
Ledum palustre	Mother tincture	1X(Q)	For small joints pain.	SBL, Pvt Ltd. Karnataka.
Ledum palustre	Mother tincture	30 c	For small joints pain.	Dr. Reckeweg Germany.
Ledum palustre	pellets	30c	For small joints pain.	Boiron -Mumbai, India.
Ledum palustre	Tablet	6X, 30C, 12X, 12C	For small joints pain.	Peace health, Alaska Washington.

 

CONCLUSION:

Thus, this is the true that L. palustre has been used in the kitchen form very ancient times, and nowadays its popularity is even increasing in the field of homeopathic medicines, but there is still no sufficient documentation is available regarding its safe use. Medicinal use of L. palustre is supported by the various researchers in the case of hypouricemic conditions, along with this property L. palustre has various other biological potentials such as it possesses antioxidant properties, also beneficial in the sore throats, cold and cough ailments. Although the drug has hypouricemic potential but still it is preferred to administered after some other homeopathic drugs. Various chemicals are reported from the drug which ae responsible for the pharmacological activities such as sesquiterpenes, flavonoids, polyphenols, so these all have their significant role in the reduction of uric acid from the joints. As the research revealed from all the species mainly Rhododendron tomentosum is widely used for the treatment. So still there is need to explore the shrub and to report its pharmacology for the betterment of human kind.

 

CONFLICT OF INTEREST:

The authors declare no conflict of interest.

 

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Received on 06.05.2020           Modified on 10.07.2020

Accepted on 15.08.2020         © RJPT All right reserved