- Scientific Name: Centella asiatica (L.) Urban, synonym: Hydrocotyle asiatica L.
- Family: Apiaceae (Umbelliferae).
- Other Common Names: Asiatic pennywort, Indian pennywort, hydrocotyle,manduk(a) parni (Hindi), luei gong gen (Chinese).Gotu kola is an aromatic creeping perennial herb that is indigenous to subtropical and tropical climates.
- The medicinal parts are the dried aerial parts, the fresh and dried leaves and stem. The leaves, 1 to 6 cm wide, are kidney-shaped (gotu kola means cup-shaped leaf in Sinhalese, the language of Sri Lanka).
- The active components of gotu kola leaves are the triterpenoids, especially asiatic acid, madecassic acid, asiaticoside and madecassoside. [Gotu kola, unreleated to cola or kola nut (Cola nitida, C. acuminate), contains no caffeinic]. 1, 2
Functions 
 | | - A primary mode of action of gotu kola appears to be on the various phases of connective tissue development.
- The total triterpenic fraction of C. asiatica, has been shown to be active on connective tissue modulation, improve the synthesis of collagen and other tissue proteins by modulating the action of fibroblasts in the vein wall, and stimulate collagen remodeling in and around the venous wall.
- Gotu kola appears to exert its anxiolytic and anti-stress activity bye depressant action on the central nervous system (CNS) involving an increase in the concentration of GABA (gamma-aminobutyric acid) in the brain. 6
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Dosage
| | The usual dose of gotu kola is 20-60 mg 3 times daily of an extract standardized to contain 40% asiaticoside , 29-30% asiatic acid, 29-30% madecassic acid, and 1-2% madecassoside.
Specific Applications:
Leprosy – 0.5 g powdered dried leaf In capsules, 3 times daily
Leg ulcers – 6 x 10 mg tablets daily of standardized extract for 3 to 8 weeks
Ulcerous skin – 20 mg asiaticoside daily, Intramuscularly, – 40 mg extract every 2nd day
Liver disease – 90 to 150 mg extract daily
Venous Insufficiency – 3 to 6 tabs. Madecassol® (10 mg stand. ext. per tab.) for 1-3 months 60 to 120 mg TECA (titrated extract) daily
Special skin Disease – Salve with 0.5% asiaticoside or powder with 2% asiaticoside, once or twice daily
Wounds – Pure asiaticoside in powder form
Eye wash – 1% solution of asiaticoside, 6 times daily2 |  back to top | Toxicity
| | Oral gotu kola appears to be non-toxic with the proper administration of designated therapeutic dosages. Mild allergic contact dermatitis may be produced in sensitive individuals. 1 Safety in young children, pregnant and lactating women and those with severe liver or kidney disease has not been established. | | back to top | Research Summary
| | Kartnig5 has tabulated an exhaustive list, with references, of the clinical applications of C. asiatica extracts and commercial formulations up to 1987. The treatment conditions were classified under three main headings: Diseases and Injuries of the Skin, Diseases of the Veins, and Diseases of the Liver.
Venous Insufficiency: DeSanctis and colleagues evaluated the variation of capillary filtration rate, ankle circumference, and ankle edema in 3 groups with venous hypertension and one group of normal subjects before and after 4 weeks of treatment with total triterpenic fraction of C. asiatica (TTFCA). Twenty patients with venous insufficiency were treated with 180 mg/daily, 20 others with 90 mg/daily, and group 3 with a placebo. After 4 weeks, there was a significant decrease in the evaluated parameters mentioned above as well as symptoms, with greater decreases in the higher dose group. 7 120 mg daily of TTFCA or placebo was prescribed for 6 weeks to 40 patients with venous hypertension. The results showed that TTFCA improves microcirculation and leg volume in venous hypertension. 8 Cesarone and colleagues studied the effects of TTFCA on 30 patients with diabetic microangiography. Patients received 120 mg daily of TTFCA for 6 months while 2 other groups received either placebo or no treatment. After 6 months, no significant changes were seen in either control group. There was, however, a significant improvement of microcirculatory parameters in subjects treated with TTFCA. The authors conclude that TTFCA was useful in diabetic microangiopathy by improving microcirculation and decreasing capillary permeability in this study. 9
Skin Problems: Extracts of C. asiatica, as well as various preparations of its prime constituent, asiaticoside, have been shown in numerous studies to effectively promote the healing of skin wounds, particularly burns. Extracts of C.asiatica have also successfully treated surgical wounds, skin grafts, gangrene, and traumatic injuries, including perineal lesions from childbirth. 5 Lawrence10 concluded that the most successful use of asiaticoside was for treatment of chronic skin lesions such as ulcers and leprosy wounds.
Shukla and colleagues studied the activity of asiaticoside from gotu kola in normal and delayed-type wound healing in guinea pigs. Results suggest that both topical (0.2% and 0.4% solution of asiaticoside) and oral (1mg/kg) administration of asiaticoside exhibit significant wound healing activity in normal and delayed healing models. 11 In an open clinical trial involving 20 patients with soiled wounds and chronic or recurrent atony, treatment with a galenical formulation containing 89.5% C. asiatica healed 64% and produced improvement in another 16% of the lesions examined. 12 A tincture of C. asiatica containing asiaticoside as the main ingredient healed 4% of soiled wounds and chronic or recurrent atony that was resistant to standard treatment regimens. 13
Antianxiety/Antistress/Sedative: Extracts of C. asiatica have been shown to possess mild tranquilizing, antistress and antianxiety ability, apparently by enhancing cholinergic mechanism. 14 An evaluation of the influence on the CNS of an aqueous extract of C. asiatica has been conducted in mice. Administered intraperitoneally, the extract decreased spontaneous motor activity and delayed pentylenetetrazole-induced convulsions to a degree comparable with diazepam. It also potentiated pentabarbitone-induced sleep but did not affect immobility time in swimming tests. 15 An ethanolic extract of C. asiatica was found to exhibit significant anti-stress activity in a variety of stress tests on rats, again using diazepam as a control. Antidepressant activity was also indicated, and an analgesic effect demonstrated along with a reduction in the adrenocortical response. 16 Studies with a hydroalcoholic extract of C. asiatica leaves have confirmed the plants anxiolytic/sedative influence, potentiating in rats, the hypnotic effect of phenobarbitone as well as anticonvulstant acitivity against PTZ as previously observed for the aqueous extract in mice. 15 Mental Function: The ancient reputation in India of C. asiatica as a plant whose consumption advances intelligence and improves memory, gains support from some modern investigation. - A significant enhancement of mental abilities was observed in 30 developmentally disabled children treated with a leaf preparation of the plant. After six months the children exhibited better overall adjustment, were more attentive, and better able to concentrate on assigned tasks. 17
- The performance of rats in a passive avoidance test was evaluated after oral treatment with an aqueous extract of fresh leaves for 15 days and compared with a control group administered saline. Levels of norepinephrine, dopamine, serotonin and their metabolites in brain and urine were monitored. Retention of learned behavior in the medicated rats was three to 60 times greater than in the controls, and was associated with a significant lowering of the levels of the three neurotransmitters in the brain and of their metabolites in both brain and urine in the drug-treated group of test animals. The correlation of performance with levels of Biogenic amines supported their role in Learning and memory. 18
- In a double-blin, placebo-controlled, randomized study the effect of gotu kola on acoustic startle response (ASR) was assessed in 40 healthy subjects (21 men, 19 women) ranging in age from 18 to 45 years, were admininstered a one-time dose of either 12g gotu kola dried leaf powder (Nature’s Way Canada, Ltd.) mixed in 300 ml grape juice or 300 ml or plain grape juice (matched for color, taste, and smell). ASR, heart rate, blood pressure and mood data were recorded at baseline, and at 30, 60, 90 and 120 minutes after ingestion. The startle response was statistically significantly lower 30 and 60 minutes after ingestion of gotu kola as compared to placebo, with an affect size of 0.48 and 0.77, respectively, supporting anxiolytic activity. There was no difference between placebo and treatment for later times or at baseline. There was also no differnce in heart rate or blood pressure, and mood response, except for self-rated energy level. 19
Anticancer: A 5:1 methanolic extract of C. asiatica was found effective, at a level of 100 micrograms per ml, in destroying cultured cancer tumor cells. In addition, no appreciable toxic effect were detected in normal human lymphocytes. [~20~] | | back to top | Uses
| | - Traditionally, inhabitants of the Indonesian islands and surrounding territories have used extracts of the plant, both topically and internally, mainly for wound healing and treating leprosy; in India3 and Africa4 also, preparations of the plant have been employed traditionally in the treatment of leprosy. In India, the plant and its extracts have been recommended since the 19th century for skin conditions associated with eczema, lupus and psoriasis, and for varicose ulcers; in addition, C. asiatica was regarded as particularly beneficial in female conditions such as amenorrhea and diseases of the genital and urinary systems. 5, 6 A plethora of other folk uses, not supported by experimental or clinical data, are catalogued in the WHO monograph on Herba Centellae 1
- Gotu kola’s principal modern uses are the promotion of wound healing and for varicose veins and venous insufficiency.
- The other significant areas of application of gotu kola involve the mental functioning of developmentally disabled children and as anti-anxiety and anti-stress treatmens. 2
- Extract of C. asiatica are available worldwide in a vriety of over-the-counter formulations a skin creams and lotions, hair conditioners and shampoos. Usually combined with other materials of natural origin, cosmetic creams have been recommended for regeneration of aged skin, relief of itching and other skin irritations. In Canada, Cothilyne®, a combination product that is 90 per cent C. asiatica tincture is labeled for external use for cicatrisation of wounds. 2
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