Ameliorating Effect of Stellaria Media, A Common Homoeopathic Medicine on Polyarticular Inflammatory Arthritis: Possible Role in Anti-Inflammatory Action

Abstract

Background: Polyarticular inflammatory arthritis (PIA), characterized by inflammation involving more than four joints, presents a significant clinical challenge due to pain, swelling, and progressive joint destruction. While conventional treatments offer symptomatic relief, the search for safer, cost-effective alternatives continues. Stellaria media, a plant-based Homoeopathic medicine, is traditionally known for its anti-inflammatory properties.

Objectives: This study aimed to evaluate the anti-inflammatory efficacy of hydro-ethanolic extract of Stellaria media through in-vitro assays and a clinical trial in patients with PIA.

Methods: The in-vitro component employed human peripheral blood mononuclear cells (hPBMCs) treated with lipopolysaccharide (LPS) to induce inflammation. These cells were exposed to varying concentrations of Stellaria media extract, and anti-inflammatory effects were assessed through MTT assay for cytotoxicity, ROS generation using H2DCFDA probe, and ELISA-based estimation of IL-6 and COX-2 levels. A one-month open-label, pre-test/post-test clinical study was concurrently conducted with 30 patients diagnosed with PIA. Participants received 0.5 ml of Stellaria media extract diluted in 15 ml distilled water, administered orally twice daily. Outcomes were evaluated using the Numerical Pain Rating Scale (NPRS), Erythrocyte Sedimentation Rate (ESR), and C-Reactive Protein (CRP).

Results: In-vitro analysis demonstrated that Stellaria media extract was non-cytotoxic and significantly reduced ROS levels, IL-6, and COX-2 expression in LPS-induced hPBMCs. Morphological preservation of cells was also noted in treated groups. Clinically, significant reductions were observed in mean ESR (22.8 to 16.5 mm/hr, p < 0.05), CRP (3.2 to 2.1 mg/dL, p < 0.05), and NPRS scores (7.13 to 3.27, p < 0.0001) after treatment.

Conclusion: The results from both in-vitro and clinical arms strongly suggest that Stellaria media possesses anti-inflammatory activity, possibly mediated through reduction of oxidative stress and downregulation of inflammatory mediators like IL-6 and COX-2. These findings support its potential as a cost-effective therapeutic option for managing polyarticular inflammatory arthritis. Further controlled trials with larger sample sizes and longer follow-up are warranted.