A Review on the Role of “Adhatoda vasica” in COPD Management

Chronic Obstructive Pulmonary Disease (COPD) is a progressive, non-communicable respiratory condition marked by persistent airflow limitation, chronic inflammation, oxidative stress, mucus hypersecretion, and mitochondrial dysfunction induced by hypoxia. Although advancements have been made in conventional pharmacotherapy, current treatments mainly offer symptomatic relief and do not sufficiently alter disease progression. This has led to increasing interest in complementary and plant-based therapies. Adhatoda vasica (Justicia adhatoda), commonly referred to as Vasaka, is a well-regarded medicinal plant in Ayurvedic and Unani medicine, traditionally utilized for treating asthma, bronchitis, cough, and other respiratory issues. This review critically examines the therapeutic potential of A. vasica in managing COPD by synthesizing findings from recent phytochemical, pharmacological, preclinical, and emerging clinical studies. The plant is abundant in bioactive compounds, especially quinazoline alkaloids (such as vasicine and vasicinone), flavonoids, phenolic acids, phytosterols, saponins, and tannins. Collectively, these constituents demonstrate bronchodilatory, mucolytic, anti- inflammatory, antioxidant, antimicrobial, and anti-hypoxic properties. Experimental research indicates that A. vasica modulates essential inflammatory pathways, mitigates oxidative damage, enhances mucus clearance, protects mitochondrial function via Nrf2 and HIF-1α signaling, and reduces airway remodeling—key pathological features of COPD. Recent advancements in formulation strategies, including standardized extracts and innovative pulmonary delivery systems, have further improved its therapeutic potential. Overall, Adhatoda vasica stands out as a promising multi-targeted herbal option for adjunctive COPD therapy. However, comprehensive clinical trials that are large-scale and well-structured, along with standardized phytochemical profiling and thorough safety and pharmacokinetic studies, are crucial to confirm its clinical efficacy and long-term therapeutic role in managing COPD.