Immunity is our body’s defence against infection and disease. In Ayurveda, immune health, or vyadhikshamatva, can be preserved and replenished by herbs and practices.
Understanding immune health
The immune system protects the body from illnesses. It defends the body against the pathogens, harmful substances and the cellular changes that can lead to damage and disease. The immune system has two lines of defence, along with chemical and structural barriers. They are innate immunity, which is a rapid response against the pathogen, and adaptive immunity, which is antigen dependent, specific and relies upon previous exposure. Adaptive immunity offers more efficient and rapid immune response. The immune system also has the capability to differentiate between the self and non-self (foreign body) cells (1,2).
If there is a defect in the mechanism of these two systems, then it may lead to diseases and conditions like inflammation, immunodeficiency disorder, autoimmune diseases and hypersensitivity (3).
The immune disorders can present itself in four forms:
- Primary immune deficiency: Being born with a weak immunity or immune system.
- Acquired immune deficiency: The immune system weakens due to a disease or medication.
- Allergic reaction: When the immune system becomes hyperresponsive.
- Autoimmune condition: When the immune system targets the host cells (4).
More than six million people are under the influence of primary immune deficiency all over the world and around 70 to 90% are undiagnosed (5). The example of acquired immune deficiency is human immunodeficiency virus (HIV), and by the end of 2022, it was estimated that 39.0 million people were living with HIV globally (6). One in four people in the UK are believed to be affected by allergies (7). One in 10 individuals in the UK suffer with an autoimmune disorder. (8)
How does immune health work?
The pathophysiology of the immune disorders are as follows:
Hypersensitivity reaction
Hypersensitivity reactions occur when the normal immune system produces undesirable responses. These are of three types. Type 1 is the most common hypersensitivity reaction. Allergens are the specific type of antigen. When there is a re-exposure of these allergens, then it induces type 1 hypersensitivity. The plasma cell secretes IgE which is different from normal immune response. Later, when there is an exposure of allergens, the active mediators like prostaglandins, histamines and leukotrienes are secreted. These cause contraction of smooth vessels and vaso-modulatory changes. Food allergies are the common example. Type 2 reaction takes two to 24 hours and is a rare condition. Here, the IgM and IgG antibodies attach to the cell-surface molecule of the host. This, leading to the clumping of the red blood cells, is anexample of autoimmune anaemia. In type 3 reaction, IgM and IgG form a complex by binding with soluble protein. This leads to inflammation, degranulation of mast cels, and neutrophil influx. Type 4 are antibody-independent, and cell mediated and these are the second most common. It takes 2 or more days to develop. There is an overstimulation of macrophages and T cells (types of white blood cell), which releases cytokines (chemical messengers) causing tissue damage, inflammation and cell death (9,10).
Autoimmunity
When the normal immune homeostasis is lost, an abnormal response is produced by the host’s body towards its own tissues. In case of autoimmunity, auto-antibodies, self-reactive T cells, and inflammation is observed. Some examples include type 1 diabetes, celiac disease, Addison’s disease (11).
Inflammation
In an immunopathological event, tissue damage and improper inflammatory response due inflammation is often noticed. Inflammation can be a part of normal immune response against infection or foreign bodies, but it can convert into chronic inflammatory disease if it is uncontrolled. In this condition, there is overproduction of cytokines and inflammatory cells recruitment.
Immunodeficiency
In this state, there is a compromised capability of the body’s immune system to fight any disease. It can either be primary in which there is any pathway or selected immune cells inhibition or it can be secondary where the immune system is impaired due to a disease or treatment (12,13).
Understanding the root
In Ayurveda, immunity is referred to as vyadhikshamatva. The power or capacity of the body to resist against disease production or to fight against a disease is called vyadhishamatva. Its role can be understood in two forms: 1) to fight against the disease which has already occurred within the body, 2) to prevent the manifestation of any disease within the body (14).
The human body is composed of the doshas, dhatus and mala. Along with these there is another element which is responsible for the integral structure, function and vitality of the body — ojas. The ojas provide strength to the body to develop vyadhishamatva. Some functions of ojas are, destroying the vitiated dosha, development of muscles, normal sensory and motor functioning, unobstructed movements, homeostasis, and clarity of complexion and voice. (15).
When there are abnormalities in the state of ojas, then immunity-related health conditions develop. These abnormalities are known as ojovikriti. There are certain factors, which reduce the ojas: (16)
- Long fasting period
- Excessive physical activity
- Less moisture/ excessive dryness
- Constant worry, anger, grief or sorrow
- Eating less food
- Excessive sun exposure or wind
- Old age
- Excessive alcohol consumption
- Mental or physical trauma
The above factors lead to abnormalities in ojas, which happens in two stages (discussed in signs and symptoms).
Signs and symptoms
The signs and symptoms of altered immunity present themselves in two stages (17):
First stage of altered immunity
- Loosening of the joints
- Weakness in the body
- Movement of all three doshas from their normal seat
- Inability or difficulty in performing normal function
Second stage of altered immunity
- Heaviness and stiffness in the body
- Swelling due to vata imbalance
- Exhaustion
- Drowsiness or feeling sleepy
- Discolouration or change in complexion
Some symptoms of low immunity
- Death in severe conditions
- Decrease in muscles
- Fainting and unconsciousness
- Brain fog or mental disturbance
- Delirium
Herbal solutions
There are a wide range of herbs that possess immune-modulatory properties. Some are discussed below:
Guduchi (Tinospora cordifolia)
Numerous studies have noted that guduchi enhances the intercellular bactericidal potential, phagocytic capacity, activity of lysozyme, antiprotease activity, level of enhanced nitro-blue tetrazolium (NBT), myelo-peroxide activity, total immunoglobulin level, macrophage activation, prevention of Kupffer cell activity deterioration and lysosome secretion. (18–20) Furthermore, an in vitro study reported that on IL-6 cytokines it showed an upregulating effect in response to inflammation, injuries, B cell diffraction or activation of cytotoxic T cell. (21) Another study suggested that it enhances the phagocytic function without interacting with the humoral and cell-mediated immune system. It also acts like an immunomodulator by inhibiting C3 canvertase. (22)
Turmeric (Curcuma longa)
A total of 117 randomised controlled trials have suggested that the active constituent of turmeric, curcumin, inhibits the activation of NF-kB after inflammatory stimuli. (23) Another study suggests that after the supplementation with curcumin, the levels of IL-6, TNF-a, MCP-1 and TGF-B were significantly reduced. (24) It inhibits NF-kB activation, IL-2 synthesis and lymphocyte proliferation stimulated by mitogen. (25) It was reported in a study that higher and early immune response of humoral and cell mediated system were initiated by curcumin. It also increases the weight of lymphoid organs and the production of white blood cells. (26)
Yashtimadhu (Glycyrrhiza glabra)
Yashtimadhu (liquorice) is known for its anti-inflammatory, antioxidant, antipyretic, immunomodulatory, antiviral and antitussive activities. (27). The main component is glycyrrhizin, which targets the dendritic cells to produce the immune response. It enhance the production of IL-12 and upregulate the presentation of CD86, CD40 and MHC-2 on dendritic cells. It increases the production of IL-10 and IFN-Y and reduces the production of IL-4. (28) In mice with allergic rhinitis, it decreased the lipid peroxidation which was free-radical induced and increased the antioxidant activity. (29) along with zinc, the root of yashtimadhu has reported immunomodulatory activity. (30)
Amalaki (Emblica officinalis)
Amalaki possesses an antioxidant, antimicrobial, anti-inflammatory, immunomodulatory, anticancer, antidiabetic, hepatoprotective, diuretic, nephroprotective, hypolipidemic and antimalarial properties. (31) the fruit restores the gamma-IFN and IL-2 production and decreases reactive oxygen species (ROS) production, lipid peroxidation level, apoptosis and caspase-3 activity. It also increases antioxidant enzyme levels, cell viability, potential of mitochondrial membrane and cytochrome c oxidase levels. (32) Along with macrophage phagocyte, it stimulates the cell-mediated and humoral immunity. (33)
Ashwagandha (Withania somnifera)
It is widely known for its immunomodulatory, adaptogenic, antioxidant, anti-tumorigenic, antidiabetic, antihypertensive, antifungal, antimicrobial, anti-inflammatory anti-stress and organ-protective activities. (34) In BALB/c mice, it was noticed that ashwagandha supported cell-mediated and humoral immunity by upregulating Th-1- dominant polarisation. (35) Another study suggests that the nitric oxide synthase activity of macrophages are enhanced by ashwagandha aqueous extract. It also enhances the phagocytic activity of macrophage and lysosomal enzyme activity. (36) Along with fatty acids, it also inhibits the pro-inflammatory cytokines and NF-kB expression. (37)
There are certain herbs like, tulsi (Ocimum sanctum), ginseng (Panax ginseng), arjuna (Terminalia arjuna) and guduchi (Tinospora cordifolia), which stimulate the immune system and colla (Alternanthera tenella), which suppresses the immunity.
Holistic solutions
Food choices
It is important to eat the right food along with right eating habits. It is best to eat when the previously eaten meal is well digested.
There are certain foods that act like a immunomodulators for example, cow milk, clarified butter (ghee), dark grape raisins, easily digestible meal, meal which contains all six tastes, and meals that includes a variety of ingredients, containing an abundance of nutrients and micronutrients.
However, if the food choice and eating habits are unwholesome, then it can compromise immunity. This may include eating before the previous meal is undigested or eating wrong food combinations like milk and fruit. Excessive use of packaged and refrigerated food items, over or under consumption of food, mixing wholesome and unwholesome food and eating at improper time.
Suitability and habit
Ayurveda suggests eating and following a routine that one has become habitual to. Every region has a specific climate and environment; therefore, it is best to eat the seasonal as well as regional food and follow the routine based on climate and season changes.
Mind acuity
A healthy mind can be achieved by avoiding unwholesome activities and consumption, and following of wholesome activities. One must not be overly indulgence of the sense organs (indriya). Mental stability and management of mental stress enhances the immunity.
Daily routine
Waking up at a regular time, having adequate sleep, daily body massage, exercising within the capacity, nasya with ghee (putting two drops of ghee in each nasal cavity), bathing and not eating before taking bath and a regular spiritual practice enhances the immunity.
References
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