E-ISSN:2456-3110

Review Article

Aama and Dysbiosis

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 10 OCTOBER
Publisherwww.maharshicharaka.in

Study of Aama and Dysbiosis for Future Microbiological and Biotechnological Advancement in Ayurveda - Case Controlled Literary Study

Gaurav K1*, Goyal P2, Moger AN3
DOI:10.21760/jaims.9.10.35

1* Kumar Gaurav, Assistant Professor, Dept of Kayachikitsa, Dhanvantari Ayurvedic Medical College and Hospital, Bareilly, Uttar Pradesh, India.

2 Prakhar Goyal, Intern, Dhanvantari Ayurvedic Medical College and Hospital, Bareilly, Uttar Pradesh, India.

3 Akshata N Moger, Assistant Professor, Dept of Shalakya Tantra, Dhanvantari Ayurvedic Medical College and Hospital, Bareilly, Uttar Pradesh, India.

Introduction: In Ayurveda there are various concepts that require special attention due to their complex nature and lack of understanding of human mind. One such concept is Aama that is so far considered as toxins or free radicles in body. Our limited understanding in advance sciences like biotechnology has limited us to understand these complex yet highly valuable concepts. Through this study we will try to understand Aama in the reference of gut biota dysbiosis and disease progression.

Aim: To understand Aama in perspective of dysbiosis and establishing its direct relation with advance microbiological and biotechnological researches.

Methodology: Study of major pathological conditions where Aama is involved, Study of affected biota and toxins (if involved/studied) in those conditions. And further evaluation using statistical test.

Discussion: Such studies in the segment of Ayurveda can lead to understand the mechanism of various functional dynamics of body as described in Ayurveda. This can be helpful in developing the concepts further and enhance our understanding toward complexity of human body. Future of this study can be seen as complete understanding of this concept of Aama. Further using biotechnological tools we can develop investigations module for confirming presence or amount of Aama present in cell or body. Further studies in medicine can help us rule out the most appropriate medicines for various pathological groups of organisms.

Keywords: Aama, dysbiosis, biotechnology, microbiology

Corresponding Author How to Cite this Article To Browse
Kumar Gaurav, Assistant Professor, Dept of Kayachikitsa, Dhanvantari Ayurvedic Medical College and Hospital, Bareilly, Uttar Pradesh, India.
Email: 		Gaurav K, Goyal P, Moger AN, Study of Aama and Dysbiosis for Future Microbiological and Biotechnological Advancement in Ayurveda - Case Controlled Literary Study. J Ayu Int Med Sci. 2024;9(10):211-217.
Available From
https://jaims.in/jaims/article/view/3655

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-09-14 2024-09-25 2024-10-05 2024-10-15 2024-10-25
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Yes 11.17

© 2024by Gaurav K, Goyal P, Moger ANand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Introduction

In Ayurveda pathology usually begin with dysfunction of Agni and formation of Aama. From a long time these terminologies were just guessed as break in digestive pathways. Their correct assessment is an important step to provide explanations of treatments that are only possible with Ayurveda approach so far. Dysbiosis is one such concept that seems to be related with the various pathologies explained in Ayurveda.

Dysbiosis is defined as loss of gut microbiota. Compared to number of cell in body there are 100 times more bacteria present in human gut. These bacteria along with viruses and fungi form gut microbiota. This gut microbiota is very essential for proper functioning of various organs. Due to this gut micro biota various metabolic processes occur properly and chances of diseases are less.

Imbalance in gut biota leads to blocked metabolic pathways, this brings chaotic inflammatory responses. All pathologies in Ayurveda are linked with break in digestive or metabolic pathways that is Aama formation. A similar approach is sensed in modern sciences under the lights of dysbiosis.

Most of the diseases studied for the purpose so far are found to give a positive result for this. This break in metabolic and digestive pathways gives a clue where Ayurveda and modern sciences stands on shoulder to shoulder without disapproving the eternal concepts of Ayurveda and newly developed concepts of modern medicine.

Methodology

Selection of cases

Since it is a case controlled literary study, therefore various diseases are taken as sample. Selection of diseases is done on the basis of Charaka Samhita and Sushruta Samhita, considering them as highest reference in Ayurveda.

All the endogenous diseases studied in these Samhita are considered to contain Aama mechanism within them. Their corresponding modern parts are studied for dysbiosis mechanism. Modern parts are not the direct correlations of diseases mentioned in Ayurveda, but they are just one small part of their corresponding Ayurveda diseases.

Case Size

Total 30 chapters are described in Charaka Samhita, Chikitsa Sthanam and 40 chapters in Sushruta Samhita. Out of 30 chapters in Charaka Samhita, 28 diseases are taken and out of 40 chapters in Sushruta Samhita 9 diseases are taken in consideration. Considering Aama in endogenous route and absence of Aama in exogenous route in pathology of diseases, total 37 diseases are considered as case size. Their counterpart modern diseases are also taken 37 in number.

Categorization of diseases

Diseases are categorized in two folds, first is Ayurveda parameter and other is modern. In Ayurveda further 2 classifications are made, as endogenous and exogenous. Term endogenous refers to the diseases that begin within body and consist Aama as an essential and unavoidable mechanism. Exogenous diseases are one that begin outside the body, and may contain Aama in later stages of diseases. Aama formation has no role in beginning these diseases. In modern section, 2 categorizations are made as diseases with dysbiosis and diseases without dysbiosis.

Conduction of study

This study is conducted in multiple steps, consisting of literary studies, evaluation of cases and statistical analysis. Diseases are studied for Aama section in Ayurveda and dysbiosis in modern. Mechanism of action of gut biota is studied and various microorganisms as well as involved metabolic pathways are noted. These parameters are tested for mutual relationship with Aama in body. Total 4 categories are made for our studies; these categories define the mutual relationship of both Aama and dysbiosis together. First category consists of both Aama and dysbiosis and number of diseases found under this section are 27. Second category mention Aama but no dysbiosis, number of diseases in this category are 6. Third category is no Aama but dysbiosis is present, total number of diseases in this category is 1. Last category is no Aama and no dysbiosis and no of diseases here are 3.

Statistical tool

Study of Aama along with dysbiosis is majorly a qualitative study, so non-parametric tests are taken into consideration.


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Specifically Fisher’s test is used for fair calculation and analysis of research data. For the purpose of clean calculation site QUICKCALCS is used.

Exclusion criteria

Diseases affecting single part (e.g. - Mukh Roga) or minor diseases (e.g. - Kshudra Roga) are excluded.

Diseases from Sushruta Samhita that are already mentioned in Charaka Samhita are excluded.

Inclusion criteria

Diseases of both medicinal and surgical importance are considered. Only diseases from Chikitsa Sthanam from both Samhita are considered. Both endogenous and exogenous routes of diseases are kept in mind during the study.

Result

Agni Mandhya and Aama are the working dynamics of the body.

Studies on Agni Mandhya and Aama suggested different opinions on each level of study. On gross level they are pathological agents, on Dhatu level they are vitiated Dhatu, on Mahabhoot level they are Jala and Prathivi dominant compositions. But at all the levels they are referred as pathological agencies and supposed to perform severe mischiefs within the body. Studies on dysbiosis strongly suggested the presence of some pathologies that are hidden deep within.

On further examination it was found that gut biota through various pathological route affect various organs and become a crucial part of every pathology within the body. In modern medical sciences, various pathways related with organ and gut are referred in axis. Various axis has been defined since the discovery of gut’s involvement in pathology of various organs. Most common channels found are - gut-lung axis, gut-joint axis, gut-brain axis etc. various papers related with each pathology are described below.

SNDisease in AyurvedaDisease in modernReference for dysbiosis
1.JwaraCovid caseGut Microbiota Dysbiosis in COVID-19: Modulation and Approaches for Prevention and Therapy[1]
2.Rakta-pittaEpistaxis-
3.GulmaAbdominal tumourIntestinal dysbiosis promotes epithelial-mesenchymal transition by activating tumor-associated macrophages in ovarian cancer[2]
4.PramehaT2DMGut Microbiota: An Important Player in Type 2 Diabetes Mellitus[3]
5.KushthaPsoriasisGut Microbiota in Psoriasis [4]
6.RajyakshamaT.B.The gut microbiome in tuberculosis susceptibility and treatment response: guilty or not guilty?[5]
7.UnmaadASDAutism Spectrum Disorders and the Gut Microbiota[6]
8.ApasmaarEpilepsyThe gut microbiome in drug-resistant epilepsy[7]
9.Kshata-KsheenLung tissue tearDysbiosis, malnutrition and enhanced gut-lung axis contribute to age-related respiratory diseases[8]
10.SwauthuInflammationThe interplay between microbiota and inflammation: lessons from peritonitis and sepsis[9]
11.UdararogaPeritonitisThe interplay between microbiota and inflammation: lessons from peritonitis and sepsis[10]
12.ArshaHaemorrhoidsAltered Gut Microbic Flora and Haemorrhoids: Could They Have a Possible Relationship? [11]
13GrahaniFGIDGut microbiota dysbiosis in functional gastrointestinal disorders[12]
14.PanduAnaemia-
15.Hikka-shwasaCOPDAssociation of Intestinal Microbial Dysbiosis With Chronic Obstructive Pulmonary Disease[13]
16.KasaAge related respiratory diseasesDysbiosis, malnutrition and enhanced gut-lung axis contribute to age-related respiratory diseases [14]
17.AtisaaraFGIDGut microbiota dysbiosis in functional gastrointestinal disorders[15]
18.ChardiFGIDGut microbiota dysbiosis in functional gastrointestinal disorders[16]
19.VisarpaErysipelas-
20.TrishanaWater-electrolyte imbalance-
21.VishaPoisoning-
22.MadatyaAlcoholismGut Microbiome Dysbiosis in Alcoholism: Consequences for Health and Recovery[17]
23.Dwi-braniyaDiabetic Foot UlcerGut Dysbiosis and Diabetic Foot Ulcer: Role of Probiotics[18]
24.Tri-MarmiyaCardiac ProblemsDysbiosis of Gut Microbiota With Reduced Trimethylamine‐N‐Oxide Level in Patients With Large‐Artery Atherosclerotic Stroke or Transient Ischemic Attack[19]
25.UrustambhaNMOSDDysbiosis of gut microbiota in patients with neuromyelitis optica spectrum disorders: A cross sectional study[20]

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26.Vata-vyadhiNeurological disordersDysbiosis of Gut Microbiota from the Perspective of the Gut-Brain Axis: Role in the Provocation of Neurological Disorders[21]
27.Vata-RaktaRheumatoid ArthritisGut-joint axis: Gut dysbiosis can contribute to the onset of rheumatoid arthritis via multiple pathways [22]
28.Yoni Rogareproductive diseasesVaginal Probiotics for Reproductive Health and Related Dysbiosis: Systematic Review and Meta-Analysis[23]
29.BhagandaraFistulaIntestinal Dysbiosis Disguised as a Rectal Fistula Treated With Autologous Fecal Microbiota Transplantation[24]
30.Sadhyo-VranaTraumatic injury-
31.BhaganaFractures-
32.AshmariRenal stonesGut microbiota in patients with kidney stones: a systematic review and meta-analysis[25]
33.Mood GarbhaPregnancy complicationIntestinal dysbiosis: An emerging cause of pregnancy complications?[26]
34.VidradhiAbscess-
35.Stana-RogaBreast cancerBreast and gut microbiome in health and cancer[27]
36.GalagandaThyroid disordersThyroid-Gut-Axis: How Does the Microbiota Influence Thyroid Function [28]
37.BraddhiInguinal hernia-

From above mentioned table diseases are classified in 4 sections of Fisher’ table. There were 27 diseases in which dysbiosis was present and as well as Aama was noticed in them. Similarly in 6 diseases dysbiosis was absent but Aama was present. In 3 diseases both Aama and dysbiosis was absent and in only 1 disease dysbiosis was present but Aama was not. Fisher’s exact test is a non-parametric test that consist a tabulated form of data. Data in table describe the number of observations acquired in experiment or study. On calculation by fisher’s exact test, the two-tailed P value equals 0.0375. This shows that diseases having endogenous route are certainly linked with dysbiosis. In other words Aama is highly associated with dysbiosis.

Ayurveda / ModernDysbiosis presentDysbiosis absentTotal
Endogenous diseases27633
Exogenous diseases134
Total28937

Through statistical analysis is seen that dysbiosis in modern and Aama in Ayurveda are related somewhere. But so far there are no evidences to prove this analogy. One way to understand this relationship is deep literary studies. Diseases with Aama show various constitutional as well as local symptoms. A similar observation is seen in dysbiosis. This symptom based approach is first clue of association between both of them. Best example for this condition is ASD (autism), here mental condition is detoriated but symptomatically all the features of Aama are present in patient clinically.[29] Similarly in LRT diseases, presence of Aama symptom[30] is another example that shows the presence of interconnection of various organs with gut, defining primary concept of Ayurveda रोगः सर्वेआपि मन्द् अग्नेः. Another clue is domination of auto-immune disorders in present time.

Recent discoveries show that dysbiosis, leads to formation and activation of such compounds, that causes auto-immune diseases. All the immune diseases are directly or indirectly mentioned in Ayurveda. And their primary pathological conditions contain Aama as precursor of that disease.

Discussion

In Ayurveda pathology is defined on certain predefined sets of concepts. One such concept is suppression of Agni and formation of Aama. According to texts no pathology exist without the formation of Aama. Recent scholars of Ayurveda define this concept in terms of ADS (Aama, Dosha, Sthanam) mechanism of diagnosis. According to this concept Dosha vitiates in body and causes suppression of Agni, which further lead to formation of Aama. This Aama and vitiated Dosha settle in various settlements in body causes various pathologies. This concept beautifully depicts the pathology in Ayurveda but unanswerable in modern terms.[31] Their understanding in modern terms is required to process new investigation modules in Ayurveda.

Aama is a broad concept in Ayurveda and represent the working dynamics in body. Its direct correlation with any single mechanism or metabolic pathway is not possible. Still for further advancement in biotechnological aspect of Ayurveda some mechanisms are picked up as a part of Aama to evaluate and developing new technologies. Imbalance in gut biota is primarily associated with break in metabolic pathway. Decrease in quantity of good gut bacteria like provitella, bifidobacteria, fumingatus etc. lead to disruption of various metabolic chains, most importantly cycles of SCFAs, tryptophan, TREG mechanism and bile acids.


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Short chain fatty acids are fatty acids contain 4-6 carbon atoms in them. Some important SCFAs are butyrate, propionate and acetate. Due to imbalance in gut microbiota, SCFAs like butyrate does not form properly and are responsible for formation of improper inflammatory compounds, decrease IgG, IgA and IgE secretions and polarize M2. There are different roles of SCFAs according to different diseases mentioned above. Gut biota is also responsible for conversion of tryptophan into IDA (indole derivatives), it further enhances immune function and decrease inflammatory processes. Gut biota metabolises function of bile acids, this kind of pathology can be seen in IDA (iron efficiency anaemia), jaundice and other diseases.

Conclusion

This study on Aama and dysbiosis is small sized but first of its kind in field of Ayurveda. Various diseases are studied to derive a direct relation between Aama in Ayurveda and dysbiosis in modern science. During study it is seen that all the diseases in modern are linked to a common channel that is break in metabolic pathway. This break in metabolic pathway is due to abolishing gut biota. It leads to various inflammatory, metabolic and immune related reactions. A similar concept is seen in Ayurveda in form of Agni-Mandhya and Aama. Any disease that begins within the body certainly have above mentioned pathological state. Through thorough study and statistical analysis, both of the concepts are found to be similar in nature. That’s why it is concluded that Aama and dysbiosis are related concept. This research doesn’t claim that Aama is same as dysbiosis, but dysbiosis is somewhere related with Aama. Further studies on the topic will enhance our understanding toward biotechnical studies in Ayurveda.

  • Main aim of this study is to set a parameter that can be used to find broken metabolic pathways in terms of Ayurveda. This way can open a passage for biotechnological advancement in Ayurveda. If further studies support the concept, we have a better chance to develop biotech on the grounds of bio dynamics as well as gross microscopic examinations.
  • Future interoception of this study is extremely important as further studies on the topic will reveal the detailed mechanism of every single disease and will help in investigating Ayurveda in more expressible terms.
  • Once the understanding of Aama is clear we can seek for some investigating model from the concept, to strengthen the concept of investigating tools in Ayurveda.
  • Further researches in the area will help in establishing concept of bio-dynamics rather than gross looking under microscopes.
  • Similar studies in future can be useful to minimize the role of antibiotics. As resistance development and damaging gut biota are the two essential problems associated with antibiotics, so minimizing its use and maximising Ayurveda approach for treatment can influence health sector in positive dimension.

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