Protective and therapeutic role of Itrīfal (Unani dosage form) in neuro behavior, neurodegeneration, and immunomodulation: An appraisal

Background

Itrīfal, an important dosage form of Unani medicine, was introduced some 1000 years ago for the treatment of mainly brain disorders. This semi-solid dosage form is usually prepared by adding the dried fruits of E. officinalis, T. chebula, and T. bellirica, along with other important herbs mainly of plant origin. The present review is aimed at evaluating the potential effects of different formulations of Itrīfal and its important ingredients with respect to traditional uses and scientific studies.

Methods

The present review was carried out after going through Unani classical literature related to the potential therapeutic uses of various formulations of Itrīfal in cerebral diseases. The scientific data related to pharmacological activities and biologically active compounds of various formulations of Itrīfal and their important ingredients were explored through search engines like PubMed, Science Direct, Springer, MEDLINE, Research Gate, and Google Scholar.

Results

The review of Unani classical literature revealed that various formulations of Itrīfal eliminate phlegmatic, bilious, and melancholic morbid humors produced because of ihtirāq at the microcellular level in cases of cerebral diseases. The phytochemical review of different ingredients of Itrīfal revealed that they contain various bioactive secondary metabolites, including flavonoids, polyphenols, monoterpenes, alkaloids, glycosides, amino acids, tannins, etc., which possess several pharmacological activities, such as antioxidant, neuroprotective, anxiolytic, antidepressant, anti-aging, memory enhancer, neuroprotective, immunomodulatory, etc., through different mechanisms of actions like inhibition of acetylcholinesterase and butrylcholinesterase enzymes, modulation of neurotransmitters, interaction with adrenergic, dopaminergic, and serotonergic systems, blockade of dopamine receptors and enhancement of GABAergic neurotransmission, neurogenesis, synaptogenesis, etc.

Conclusion

Itrīfal has been prepared by adding rationale mixtures of herbs, which possess preventive and curative effects in brain diseases. They can provide much-needed protection to the brain and nerves against oxidative stress and other disease-oriented factors. The limitations with this unique dosage form of Unani medicine are that adequate scientific studies have not been carried out on different preparations of Itrīfal for holistic and scientific exploration of such an extraordinary dosage form. Hence, it is suggested that more studies on different aspects, like pharmacological, toxicological, pharmacodynamics, pharmacokinetics, etc., may be carried out in the future.