SWARNA BHASMA AS AN AYURVEDIC NANOMEDICINE: A SYSTEMATIC REVIEW OF IMMUNOMODULATORY, ANTI INFLAMMATORY, AND ANTI CANCER SIGNALLING PATHWAYS

Abstract

Background: Swarna Bhasma (SB), incinerated gold nanoparticles used in Ayurveda, is traditionally indicated for immunomodulation and treatment of inflammation. However, its molecular signalling pathways have not been systematically elucidated. Objective: To identify, appraise, and synthesize evidence on the molecular pathways underlying SB’s immunomodulatory, anti-inflammatory‑, and anti‑cancer effects of SB. Methods: The methods employed were search of PubMed, Scopus, Web of Science, Embase, Google Scholar, DHARA and AYUSH Research Portal from inception till 8th April 2026. This review included in vitro, in vivo and human studies reporting molecular endpoints following SB intervention. The risk of bias was evaluated which included the SYRCLE RoB tool and the Cochrane RoB 2. A narrative synthesis using a pathway mapping approach was performed. No meta-analysis was performed as there was some heterogeneity. Results: 19 studies were included. Phagocytes take up SB nanoparticles (7–60 nm). SB decreases pro inflammatory cytokines (TNF α and IL 6) in cancer models. Direct measurement of the translocation of p65 into the nucleus or the phosphorylation of IκBα has not yet been done. SB promotes the antigen presentation capacity of macrophages and polarization of CD4+ T cells to Th1 by decreasing the levels of IL 10 and increasing the levels of IFN γ and TNF α. But there is no study directly examining the MAPK, PI3K/Akt, JAK/STAT, Nrf2 or apoptotic pathways. Immunomodulatory effects have been reported in children and with low clinical toxicity during clinical trials. Conclusion: SB exhibits immunomodulatory and anti‑cancer activities; however, direct molecular evidence is limited to cytokine profiling and cellular phenotypes. Major gaps exist in all the key signalling pathways. Future research should use pathway-specific‑ assays to validate these mechanistic claims.