Hemidesmus

In the Ayurvedic tradition hemidesmus is a popular, refreshing, naturally sweet fragrant tea commonly used daily as a healthy drink to promote vitality. Traditionally it is used for cooling (good for menopausal hot flushing), blood cleansing (acne), detoxing (diaphoretic (for fever) and diuretic (for urinary disease) via sweat and urine), diarrhoea (it has been suggested the water (not ethanolic) extract could be used as a supplement for oral rehydration therapy), infections, wounds and rashes, diabetes, gout, bad breath and to promote relaxation before bed. It is said to be rich in antioxidants potentiating immunity. Women in rural Sri Lanka use hemidesmus root (where it is known as iramusu) to reduce the possibility of a miscarriage, to promote a healthy pregnancy and for post-partum recovery, and it is used in arthritis which is very common due to all the hard work in the rice fields. Hemidesmus has a traditional reputation for use in treating snake bites and the plant can neutralise venom in vitro. Constituents isolated from the root have also been shown to neutralise viper and cobra venom in vitro however there are no human trials, and the plant is not recommended as an alternative to antivenom.

In stark contrast, in Western herbal medicine the root of hemidesmus, commonly known as Indian sarsaparilla, is regarded as immunosuppressive and it is advised that this plant be avoided in acute conditions because it could dampen the immune response. It is indicated in instances where the immune system is overactive and thus it is prescribed for autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus and asthma where it is said to work well with low dose echinacea. Perhaps misguided, this Western understanding of hemidesmus appears to be based on preclinical evidence from a 1986 preliminary screening of immunomodulating agents of plant origin, as most modern texts reference this almost 40-year-old study. In the in vivo study the effect of an ethanolic extract of hemidesmus was tested for immune responses after being fed to mice injected with sheep red blood cells (used as an antigen to study immune competence). Hemidesmus was found to suppress cell mediated and humoral components of the immune system in the mice. However, it should be noted that, while promising, animal studies cannot be extrapolated to human use and human clinical trials are needed. Converse to this, in a more recent study (2018), hemidesmus exhibited direct immunostimulatory activity on immune system cells indicating that it could induce immunogenic cell death in human tumour cells, thus suggesting its potential relevance in cancer immunotherapy protocols. No human clinical trials, immune or otherwise, could be located by the author. Perhaps this herb is another case where disregard for the traditional use of a plant has possibly hindered modern scientific attempts to understand it? It is worth noting that the traditional Ayurvedic uses of hemidesmus are reflective of its extraction process and may not directly correspond with ethanol-based extracts used in Western herbal medicine.

In her 2020 book, Advanced Clinical Medicine, experienced naturopathic clinician Leah Hechtman (via naturopathic clinician Angela Hywood who wrote the miscarriage chapter) echoes the rural Sri Lankan women’s traditional use suggesting hemidesmus may be of benefit in autoimmune mediated miscarriage cases. According to the references this is based on the 1986 study above. “In a series of tests, oral administration of ethanol extract of hemidesmus decreased both the cell-mediated and the humoral components of the immune system in mice. In the context of miscarriage cases, this activity would be of benefit in autoimmune-mediated miscarriage cases.” 

References

Compendium of Medicinal Plants A Sri Lankan study. Volume 1. Department of Ayurveda, 2004. p. 104.

Priyantha KM. Know your herbs Iramusu (Hemidesmus Indicus). [Internet]. [Updated 13 Jan 2020]. Available from http://www.dailymirror.lk/medicine/Know-your-herbs-Iramusu-Hemidesmus-Indicus/308-181162

Nandy S, Mukherjee A, Pandey DK, Ray P, Dey A. Indian Sarsaparilla (Hemidesmus indicus): Recent progress in research on ethnobotany, phytochemistry and pharmacology. J Ethnopharmacol. 2020 May 23;254:112609. doi: 10.1016/j.jep.2020.112609. Epub 2020 Jan 30. PMID: 3200763

Das S, Bisht SS. The bioactive and therapeutic potential of Hemidesmus indicus R. Br. (Indian Sarsaparilla) root. Phytother Res. 2013 Jun;27(6):791-801. doi: 10.1002/ptr.4788. Epub 2012 Aug 8. PMID: 22887725.

Turrini E, Catanzaro E, Muraro MG, Governa V, Trella E, Mele V, Calcabrini C, Morroni F, Sita G, Hrelia P, Tacchini M, Fimognari C. Hemidesmus indicus induces immunogenic death in human colorectal cancer cells. Oncotarget. 2018 May 11;9(36):24443-24456. doi: 10.18632/oncotarget.25325. PMID: 29849952; PMCID: PMC5966270.

Sarris J, Wardle J. Clinical Naturopathy. Churchill Livingstone Elsevier:Sydney. 2010. p472.

Hechtman L. Clinical Naturopathic Medicine. Sydney:Churchill Livingstone Elsevier. 2012. p.349,600,610

Atal CK, Sharma ML, Kaul A, Khajuria A. Immunomodulating agents of plant origin. I: Preliminary screening. J Ethnopharmacol. 1986;18(2):133-141. doi:10.1016/0378-8741(86)90025-5

Johnson TL, Fahey JW. Black cohosh: coming full circle?. J Ethnopharmacol. 2012;141(3):775-779. doi:10.1016/j.jep.2012.03.050

Hechtman L. Advanced Clinical Naturopathic Medicine. Elsevier Australia:Chatswood. 2020. p. 375