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OBJECTIVE: PADMA 28 is a multicompound preparation of 20 herbs, calcium sulphate, and camphor, derived from Tibetan medicine. It is usually used in the treatment of peripheral circulatory disorders, accompanied by the symptoms tingling, formication, heaviness and tenseness in arms and legs, numbness in hands and feet, and cramps in the calf. Recently, the question of whether appropriate preparations of PADMA 28 also exhibit antibacterial and antimycotic activity has often been raised. As there are as yet no experimental findings that answer this question, an in vitro study was carried out. In a parallel survey we investigated the antimicrobial properties of 5 herbal drugs which are commonly used in the traditional European folk medicine for the topical treatment of mild skin infections, wounds and eczematous skin lesions.METHODS: The minimum inhibitory concentrations (MIC) and the minimum bactericidal concentrations (MBC) of alcohol-based (tinctures) and aqueous (teas) herbal drug preparations were determined in vitro by a broth microdilution method for 5 Gram-positive and 5 Gram-negative bacteria, as well as the yeast Candida albicans.
RESULTS: The aqueous and alcohol-based PADMA 28 preparations as well as the corresponding preparations of the European herbal drugs showed an antibacterial effect against Gram-positive bacteria in vitro. These bacteria revealed a somewhat higher sensitivity to the teas prepared from the European herbal drugs (MIC: 1.3-20.0 mg/ml) than to the aqueous preparations of PADMA 28 (MIC: 5.0-40.0 mg/ml). The better antibacterial activity of the European herbal drugs is probably based on their relatively high amount of tanning agents. On the other hand, all tested plant preparations inhibited not at all or only insufficiently the growth of the Gram-negative bacteria tested and that of Candida albicans. The ethanolic PADMA 28 tinctures showed an improved inhibitory effect on the Gram-positive bacteria (MIC: 0.38-1.51% tincture or 0.38-1.51 mg PADMA 28/ml) compared with the aqueous preparations; this effect is comparable to the ethanolic tinctures of the tested European herbal drugs (MIC: 0.4-1.6/3.2% tincture or 0.4-1.6/3.2 mg herbal drug/ml).
CONCLUSION: All tested tea preparations and alcoholic tinctures of PADMA 28 as well as those of the selected European herbal drugs exhibited evident antibacterial effects against Gram-positive bacteria in vitro. On the other hand, except for Klebsiella pneumoniae, all Gram-negative bacteria tested and the yeast Candida albicans were insensitive against the different aqueous and alcohol-based plant extracts.
BACKGROUND: Previous studies showed an anti-atherosclerotic effect of PADMA 28, an herbal formula based on Tibetan medicine. As the mechanisms of action are not fully understood, we investigated whether PADMA 28 may lower blood lipids and lipid oxidisability, and affect early endothelial dysfunction.PATIENTS AND METHODS: Sixty otherwise healthy subjects with total cholesterol > or = 5.2 mmol/l and < 8.0 mmol/l were randomly assigned to placebo or PADMA 28, 3 x 2 capsules daily, for 4 weeks (double-blind). Blood lipids (total, LDL-, and HDL-cholesterol, triglycerides, Apo-lipoprotein A1 and B) and ex vivo lipid oxidisability were measured before and after treatment. In a subset of 24 subjects, endothelial function was assessed using venous occlusion plethysmography with intraarterial infusion of acetylcholine. Isolated LDL and plasma both untreated and pre-treated with PADMA 28 extract were oxidised by the radical generator AAPH. Conjugated diene formation was measured at 245 nm.
RESULTS: Blood lipids did not change during the study in both groups. In contrast to previous reports in mild hypercholesterolaemia, no endothelial dysfunction was seen and, consequently, was not influenced by therapy. Ex vivo blood lipid oxidisability was significantly reduced with PADMA 28 (area undercurve: 5.29 +/- 1.62 to 4.99 +/- 1.46, p = 0.01), and remained unchanged in the placebo group (5.33 +/- 1.88 to 5.18 +/- 1.78, p > 0. 1). This effect persisted one week after cessation of medication. In vitro experiments confirmed the prevention of lipid peroxidation in the presence of PADMA 28 extracts. Persistent protection was also seen for LDL isolated from PADMA 28-pretreated blood after being subjected to rigorous purification.
CONCLUSIONS: This study suggests that the inhibition of blood lipid oxidisability by PADMA 28 may play a role in its anti-atherosclerotic effect.