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Journal of Complementary and Integrative Medicine

Editor-in-Chief: Lui, Edmund

Ed. by Ko, Robert / Leung, Kelvin Sze-Yin / Saunders, Paul / Suntres, PH. D., Zacharias

CiteScore 2017: 1.41

SCImago Journal Rank (SJR) 2017: 0.472
Source Normalized Impact per Paper (SNIP) 2017: 0.564

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Anti-inflammatory and antioxidant effect of ginger in tuberculosis

Rashmi Anant Kulkarni
  • Corresponding author
  • Department of Biochemistry, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
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/ Ajit Ramesh Deshpande
  • Department of Community Medicine, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
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Published Online: 2016-04-16 | DOI: https://doi.org/10.1515/jcim-2015-0032


Background: Tuberculosis (TB) has reemerged to become the world’s leading cause of death from a single infectious agent. Inflammatory cytokines play an important role during the course of the disease and may be responsible for tissue damage by lipid peroxidation. The study was aimed to explore the anti-inflammatory and antioxidant effect of ginger in pulmonary TB patients.

Methods: A total of 69 pulmonary TB patients participated in a randomized and placebo-controlled study. The intervention group received 3 g of ginger extract daily for 1 month and placebo group was supplemented with starch capsule. Participants of both groups were taking standard antitubercular treatment during the study. The concentrations of tumor necrosis factor (TNF) alpha, ferritin and malondialdehyde (MDA) in blood samples were analyzed before and after the intervention by using enzyme-linked immunosorbent assay for TNF alpha and ferritin and spectrophotometry for MDA.

Results: Ginger supplementation significantly reduced the levels of TNF alpha, ferritin and MDA in ginger supplemented group in comparison to baseline. Ginger supplementation with antitubercular treatment significantly lowered TNF alpha, ferritin and MDA concentrations in comparison to control group.

Conclusions: Ginger was found to be effective as an anti-inflammatory and antioxidant supplement along with anti-TB therapy as it possesses strong free radical scavenging property.

Keywords: ferritin; ginger; malondialdehyde; tumor necrosis factor alpha


  • 1. World Health Organization (WHO). Global tuberculosis control: epidemiology, strategy, finances. Geneva: World Health Organization, 2009.

  • 2. Kwiatkowska S, Piasecka G, Zieba M, Piotrowski W, Nowak D. Increased serum concentrations of conjugated dienes and malondialdehyde in patients with pulmonary tuberculosis. Respir Med 1999;93:272–6.Google Scholar

  • 3. Reddy YN, Murthy SV, Krishna DR, Prabhakar MC. Role of free radicals and antioxidants in tuberculosis patients. Indian J Tuberc 2004;51:213–18.Google Scholar

  • 4. Raja A. Immunology of tuberculosis. Indian J Med Res 2004;120:213–32.Google Scholar

  • 5. Baynes RD, Flax H, Bothwell TH, Bezwoda WR, MacPhail AP, Atkinson P, et al. Hematological and iron-related measurements in active pulmonary tuberculosis. Scand J Haematol 1986;36:280–7.Google Scholar

  • 6. Choeduhyeok, Honggiseok, Songgyeyong, Choetaeyeol. Clinical Study of Serum Iron and Ferritin levels in Tuberculosis. The Korea Science and Engineering 1981;13:51–5.

  • 7. Cem Evereklioglu HE, Yusuf T, Mustafa C. Serum levels of TNF-a, sIL-2R, IL-6 and IL-8 are increased and associated with elevated lipid peroxidation in patients with Behçet’s disease. Mediators Inflamm 2002;11:87–93.Google Scholar

  • 8. Madebo T, Lindtjorn B, Aukrust P, Berge RK. Circulating antioxidants and lipid peroxidation products in untreated tuberculosis patients in Ethiopia. Am J Clin Nutr 2003;78:117–22.Google Scholar

  • 9. Ravindran PN, Babu KN. Ginger: the genus Zingiber, medicinal and aromatic plants – industrial profiles. Boca Raton, FL: CRC Press, 2003:41.Google Scholar

  • 10. Baliga MS, Haniadka R, Pereira MM, D’Souza JJ, Pallaty PL. Update on the chemopreventive effects of ginger and its phytochemicals. Crit Rev Food Sci Nutr 2011;51:499–523.Google Scholar

  • 11. Ali BH, Blunden G, Tanira MO, Nemmar A. Some phytochemical, pharmacological and toxicological properties of ginger (Zingiber officinale Roscoe): a review of recent research. Food Chem Toxicol 2008;46:409–20.Web of ScienceGoogle Scholar

  • 12. Lyudmila GN, Tatiana VM, Volodymyr SP, Yuri LV, Valery MF, Galyna AK. Cytokine profiles of HIV patients with pulmonary tuberculosis resulting from adjunct immunotherapy with herbal phytoconcentrates Dzherelo and Anemin. Cytokine 2008;44:392–6.Google Scholar

  • 13. Hiserodt RD, Franzblau SG, Rosen RT. Isolation of 6-, 8-, and 10-gingerol from ginger rhizome by HPLC and preliminary evaluation of inhibition of mycobacterium avium and mycobacterium tuberculosis. J Agric Food Chem 1998;46:2504–8.Google Scholar

  • 14. Grzanna R, Lindmark L, Frondoza CG. Ginger – an herbal medicinal product with broad anti-inflammatory actions. J Med Food 2005;8:125–32.Google Scholar

  • 15. Chrubasik S, Pittler MH, Roufogalis BD. Zingiberis rhizoma: a comprehensive review on the ginger effect and efficacy profiles. Phytomedicine 2005;12:684–701.Google Scholar

  • 16. Wilbur KM, Bernheim F, Shapiro OW. The thiobarbituric acid reagent as a test for the oxidation of unsaturated fatty acid by various agents. Arch Biochem Biophys 1949;24:305–13.Google Scholar

  • 17. Kart L, Buyukoglan H, Tekin IOAltin R, Senturk Z, Gulmez I, et al. Correlation of serum tumor necrosis factor-alpha, interleukin-4 and soluble interleukin-2 receptor levels with radiologic and clinical manifestations in active pulmonary tuberculosis. Mediators Inflamm 2003;:9–14.Google Scholar

  • 18. Jack CI, Jackson MJ, Hind CR. Circulating markers of free radical activity in patients with pulmonary tuberculosis. Tuberc Lung Dis 1994;75:132–7.Google Scholar

  • 19. Haniadka R, Saldanha E, Sunita V, Palatty PL, Fayad R. A review of the gastroprotective effects of ginger (Zingiber officinale Roscoe). Food Funct 2013;4:845–55.Web of ScienceGoogle Scholar

  • 20. Baliga MS, Jagetia GC, Rao SK, Babu K. Evaluation of nitric oxide scavenging activity of certain spices in vitro: a preliminary study. Nahrung 2003;47:261–4.Google Scholar

  • 21. Al-Tahtawy RH, El-Bastawesy AM, Monem MG, Zekry ZK, Al-Mehdar HA. Antioxidant activity of the volatile oils of Zingiber officinale (ginger). Spatula 2011;1:1–8.Google Scholar

  • 22. Cancer BJ, Natural Medicine A. Textbook of basic science and clinical research. Princeton, MN: Oregon Medical Press, 1995.Google Scholar

  • 23. Mallikarjuna K, Sahitya CP, Reddy SK, Rajendra W. Ethanol toxicity: rehabilitation of hepatic antioxidant defense system with dietary ginger. Fitoterapia 2008;79:174–8.Web of ScienceGoogle Scholar

  • 24. Afshari AT, Shirpoor A, Farshid A, Saadatian R, Rasmi Y. The effect of ginger on diabetic nephropathy, plasma antioxidant capacity and lipid peroxidation in rats. Food Chem 2007;101:148–53.Web of ScienceGoogle Scholar

  • 25. Shanmugam KR, Mallikarjuna K, Nishanth K, Kuo CH, Reddy KS. Protective effect of dietary ginger on antioxidant enzymes and oxidative damage in experimental diabetic rat tissues. Food Chem 2011;124:1436–42.Web of ScienceGoogle Scholar

  • 26. Masuda Y, Kikuzaki H, Hisamoto M, Nakatani N. Antioxidant properties of gingerol related compounds from ginger. Biofactors 2004;21:293–6.Google Scholar

  • 27. Kota N, Prasanna K, Kalpagam P. Alterations in antioxidant status of rats following intake of ginger through diet. Food Chem 2008;106:991–6.Web of ScienceGoogle Scholar

  • 28. Verma SK, Bordia A, Jain P, Srivastava KC. Antioxidant property of ginger in patients with coronary artery disease. South Asian J Prev Cardiol 1999;3:95–102.Google Scholar

  • 29. Kiuchi F, Iwakami S, Shibuya M, Hanaoka F, Sankawa U. Inhibition of prostaglandin and leukotriene biosynthesis by gingerol and diarylheptanoids. Chem Pharm Bull 1992;40:387–91.Google Scholar

  • 30. Tjendraputra E, Tran VH, Liu-Brennan D, Roufogalis BD, Duke CC. Effect of ginger constituents and synthetic analogues on cyclooxygenase-2 enzyme in intact cells. Bioorg Chem 2001;29:156–63.Google Scholar

  • 31. Mustafa T, Srivastava KC, Jeusen KB. Drug development reports. Pharmacology of ginger (Zingiber officinale). J Drug Dev 1993;6: 25– 39.Google Scholar

  • 32. Al-Omar IA, Oluboyede OA. Serum ferritin and other iron parameters in patients with pulmonary tuberculosis. Saudi Med J 2002;23:244–6.Google Scholar

  • 33. Torti SV, Kwak EL, Miller SC, Miller LL, Ringold GM, Myambo KB, et al. The molecular cloning and characterization of murine ferritin heavy chain, a tumor necrosis factor-inducible gene. J Biol Chem 1988;263:12638–44.Google Scholar

  • 34. Thomson M, Al-Qattan KK, Al-Sawan SM, Alnaqeeb MA, Khan I, Ali M. The use of ginger (Zingiber officinale Rosc.) as a potential anti-inflammatory and antithrombotic agent. Prostaglandins Leukot Essent Fatty Acids 2002;67:475–8.Google Scholar

  • 35. Habib SH, Makpol S, Hamid NA, Das S, Ngah WZ, Yusof YA. Ginger extract (Zingiber officinale) has anti-cancer and anti-inflammatory effects on ethionine-induced hepatoma rats. Clinics 2008;63:807–13.Google Scholar

  • 36. World Health Organization (WHO). Monograph on selected medicinal plants, vol. 1. Geneva: WHO, 2000.

  • 37. Bliddal H, Rosetzsky A, Schlchting P, Weidner MS, Anderson LA, Ibfelt HH. A randomized, placebo-controlled, cross-over study of ginger extracts and ibuprofen in osteoarthritis. Osteoarthr Cartil 2000;8:9–12.Google Scholar

  • 38. Alireza O, Sepide M, Majid M, Ebrahimzade VA, Laleh P. Anti-inflammatory effects of Zingiber officinale in type 2 diabetic patients. Adv Pharmaceut Bull 2013;3:273–6.Google Scholar

  • 39. Kim SO, Chun KS, Kundu J, Surh YJ. Inhibitory effects pg 6-gingerol on PMA-induced COX-2 expression and activation of NFκB and p38 MAPK in skin mouse. Biofactors 2004;21:27–31.Google Scholar

  • 40. Jung HW, Yoon CH, Park KM, Han HS, Park YK. Hexane fraction of Zingiberis rhizoma Crudus extract inhibits the production of nitric oxide and proinflammatory cytokines in LPS stimulated BV2 microglial cells via the NF-kappaB pathway. Food Chem Toxicol 2009;47:1190–7.Google Scholar

  • 41. Chowdhary A, Santra A, Kundu S, Mukherjee A, Pandit A, Chaudhuri S, et al. Induction of oxidative stress in antitubercular drug induced hepatotoxicity. Indian J Gastroenterol 2001;20:97–100.Google Scholar

  • 42. Walubo A, Smith PJ, Folb PI. Oxidative stress during antituberculosis therapy in young and elderly patients. Biomed Environ Sci 1995;8:106–13.Google Scholar

  • 43. Lamsal M, Gautam N, Bhatta N, Toora BD, Bhattacharya SK, Baral N. Evaluation of lipid peroxidation product, nitrite and antioxidant levels in newly diagnosed and two months follow-up patients with pulmonary tuberculosis. Southeast Asian J Trop Med Public Health 2007;38:695–703.Google Scholar

  • 44. Patrick-Iwuanyanwu KC, Wegwu MO, Ayalogu EO. The protective effect of garlic, ginger and vitamin E on CCl4-induced hepatotoxicity in rats. Asian J Biochem 2007;2:409–14.Google Scholar

  • 45. Haniadka R, Saxena A, Shivashankara AR, Fayad R, Palatty PL. Ginger protects the liver against the toxic effects of xenobiotic compounds: preclinical observations. J Nutr Food Sci 2013;3:226.Google Scholar

About the article

Received: 2015-05-15

Accepted: 2016-03-16

Published Online: 2016-04-16

Published in Print: 2016-06-01

Citation Information: Journal of Complementary and Integrative Medicine, Volume 13, Issue 2, Pages 201–206, ISSN (Online) 1553-3840, ISSN (Print) 2194-6329, DOI: https://doi.org/10.1515/jcim-2015-0032.

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