Gotu kola

Gotu Kola (Centella asiatica)

1. Identity and Botanical Classification

Accepted Names and Synonyms

Centella asiatica (L.) Urban — the accepted botanical name — carries several synonyms including Centella coriacea Nannfd., Hydrocotyle asiatica L., Hydrocotyle lunata Lam., and Trisanthus cochinchinensis Lour. It is a tropical medicinal plant from the family Apiaceae, native to Southeast Asian countries such as India, Sri Lanka, China, Indonesia, and Malaysia, as well as South Africa and Madagascar. C. asiatica was initially described and published under the name Hydrocotyle asiatica by Carl Linnaeus until it was reclassified in the valid botanical systematics as C. asiatica (Linn.) Urban.

In herbal medicine systems, it is known as Brahmi in traditional medicine, Gotu kola in Europe and the Americas, Mandookaparni in Ayurveda, and Brahmi in Unani medicine. It was confused with another plant known as Bacopa monnieri Wettst. in India because both herbs were sold under the name "Brahmi." This was resolved by designating Brahmi to B. monnieri and Mandookaparni to C. asiatica. Other vernacular names include Asiatic pennywort, Indian pennywort, Indian water navelwort, wild violet, and tiger herb.

Plant Description and Habitat

Centella asiatica is a creeping, herbaceous, flowering plant native to tropical swampy areas of Southeast Asia and Australia, but now found in many tropical and subtropical areas of the world. It is a small, creeping herb with slender stolons that root at each node. Leaves are peltate, 1–5 cm in diameter, with 3–7 lobes radiating from the petiole point, resembling tiny umbrellas. The plant thrives in swampy areas across tropical Asia, especially India, Sri Lanka, and parts of Southeast Asia. The leaves, which are edible, are yellowish-green in color, thin, alternate with long petioles, and quite characteristic reniform, orbicular, or oblong-elliptic shapes with seven veins.

Wild populations of C. asiatica have undergone severe decline due to unchecked and unregulated exploitation of the herb, particularly for medicinal purposes. Due to gradual decline in its numbers, limited cultivation, poor seed viability, and insignificant restoration efforts, the herb has been included in the threatened category by the International Union for Conservation of Nature and Natural Resources (IUCN) and has been categorized as an endemic species to the Western Ghats of Southern India.

Plant Parts Used

The leaves, roots, and stems of the C. asiatica plant are utilized for medicinal purposes. The whole plant, including the root, can be dried and powdered and taken orally or used as a topical ointment. Juice can also be extracted from the aerial parts of the plant and the leaves can be eaten whole.

2. Traditional and Historical Use

Ayurvedic and Indian Traditions

For hundreds of years, before recorded modern use, C. asiatica was used in the Ayurvedic system of medicine, with records appearing in the Sushruta Samhita, an ancient Ayurvedic medical manuscript. References to Mandookaparni appear in the Charaka Samhita (circa 2nd century CE) as a "rasayana" herb promoting mental clarity and longevity. Early Ayurvedic physicians like Vagbhata extolled its ability to pacify Kapha and stimulate tissue regeneration. Throughout history, Gotu Kola has been referred to as a rasayana — rejuvenative measures that impart biological sustenance to bodily tissues — used to revitalize brain and nervous system function and combat the effects of aging.

It has been used in India since ancient times, particularly as an adaptogen to enhance cognitive function, where it is known as Brahmi, or "brain food." In Ayurveda, it is described as Mandookaparni. Indian systems of medicine employ Centella asiatica for memory improvement, the treatment of skin conditions, and the management of nervous system illnesses.

Chinese Traditional Medicine

C. asiatica was referred to in the ancient Chinese Shennong Herbal and in Indian Ayurvedic medicine about 2,000 to 3,000 years ago, respectively. It has been listed in the Susruta Samhita, an ancient Indian medicinal text. Over time, its reputation spread to Chinese traditional medicine, where it is known as "ji xue cao," and was used to support circulation and treat varicose veins. For hundreds of years, this well-known folk remedy has been used in Chinese and Indian traditional medicine to promote brain function, prevent cognitive impairments, and enhance memory.

Southeast Asian, Indonesian, and Pacific Traditions

Indonesian and Javanese peoples have used the plant for over 2,000 years. In Indonesian Jamu traditions, it is mixed with ginger and lemongrass for detox teas. C. asiatica has been used as a vegetable for a very long time in China, Southeast Asia, India, Sri Lanka, Oceania, and Africa. It has a long history of use in Southeast Asia for a number of ailments, including skin conditions, rheumatism, inflammation, syphilis, mental illness, epilepsy, hysteria, dehydration, and diarrhoea.

Madagascan and African Use

Centella asiatica has been known and used in Madagascan, Indian, Chinese, American Indian, and Indonesian medicine for more than 3,000 years. It has been used extensively, particularly in Madagascar, in the fight against the consequences of leprosy. In 1942, its healing properties led to the development by physicians Ch. Grimes and P. Boiteau of a medicine known as Madécassol.

Traditional Preparations

Traditionally, leaves and stems are used fresh or dried, packed into teas, poultices, and medicated oils. It is eaten as a vegetable and in salads and has been used for centuries in traditional Ayurvedic and Chinese medicine for a large variety of conditions. This perennial creeper has been traditionally used for rheumatism, indigestion, diabetes, dysentery, fever, fractures, hepatitis, jaundice, constipation, wounds, and eye problems.

3. Phytochemistry: Key Constituents and Active Compounds

Triterpene Saponins (Primary Bioactives)

The active ingredients are thought to be the pentacyclic triterpenoid glycosides — asiaticoside, centelloside, and madecassoside — and their aglycones, asiatic acid and madecassic acid. Major constituents with a range of pharmacological properties — including antioxidant, anti-inflammatory, antibacterial, anticancer, hepatoprotective, immunomodulatory, neuroprotective, cardioprotective, and wound healing properties — have been identified as pentacyclic triterpenoids, including asiaticoside, madecassoside, asiatic acid, and madecassic acid.

The plant is known to produce a wide range of active metabolites such as triterpenoids including asiatic acid, asiaticoside, brahmoside, and madecassic acid, along with other constituents including centellose, centelloside, and madecassoside. In order to investigate the potential health benefits of C. asiatica, various bioactive compounds have been isolated, identified, and purified in recent decades. The majority of the compounds in this plant are triterpene saponins (glycosides).

Additional Constituents

Centella extracts contain more than 100 constituents including polyacetylenes, flavonoids, flavones, sterols, and lipids. Its medicinal values are attributed to the presence of tri-terpenes, carotenoids, glycosides, flavonoids, alkaloids, volatile and fatty oils. In addition to triterpenes, caffeoylquinic acids (CQAs) are known to contribute to C. asiatica's neurological activity.

Standardized Extract Compositions (TECA / TTFCA)

Clinical research has largely employed standardized extracts. Literature reports studies on the following extracts: TECA (titrated extract of Centella asiatica), TTFCA (total triterpenoid fraction of Centella asiatica), and TTF — all containing 40% of asiaticoside and 60% of the aglycones (asiatic acid and madecassic acid). The extracts TECA and TTFCA are reported to contain 30% of asiatic acid and 30% of madecassic acid, while the remaining 40% is purified asiaticoside. TECA refers to a titrated extract standardized to 40% asiaticoside, 30% madecassoside, 30% asiatic and madecassic acids.

The European Medicines Agency reports that, for cutaneous use in the treatment of leg ulcers, wounds, and burns, ointments contain 1% TECA. A cutaneous powder containing 2% TECA is used for the treatment of scars, keloid scars, and burns.

4. Mechanisms of Action

Collagen Synthesis and Wound Repair

At the molecular signaling level, asiaticoside and madecassoside activate the TGF-β/Smad pathway to drive extracellular matrix synthesis, thereby enhancing collagen deposition and improving skin elasticity and hydration. Oral administration of both asiaticoside and madecassoside has been shown to enhance collagen type III synthesis by activating skin fibroblasts via the TGF-β/Smad pathway, facilitating burn wound healing in animal models. Asiaticoside, a key compound, stimulates the synthesis of type 1 collagen inhibitors in human fibroblast cells. It also enhances skin cell behavior during the wound healing process by increasing the migration rate of skin cells, promoting cellular proliferation, improving initial skin cell adhesion, and increasing the number of normal human dermal fibroblasts.

Anti-inflammatory Pathways

Madecassoside and asiatic acid suppress NF-κB signaling, thereby attenuating the production of pro-inflammatory cytokines and enzymes such as TNF-α, IL-6, COX-2, and iNOS. Asiaticoside acts during the inflammatory phase by reducing the synthesis of pro-inflammatory cytokines (TNF-α, IL-6) and growth factors (TGF-β, PDGF, VEGF).

Neuroprotective and Cognitive Mechanisms

The capability of C. asiatica to increase memory function has been reported to be mediated by its active compounds, especially asiatic acid, crossing the blood-brain barrier. Asiaticoside prevents cell death and apoptosis on NMDA-induced excitotoxicity in cultured cortical neurons, and asiatic acid is known to accelerate the repair of damaged neurons through axon regeneration and neurite growth. Outcomes are thought to arise from the plant's ability to enhance neuroplasticity and upregulate BDNF (brain-derived neurotrophic factor), particularly in models of neurodegeneration and age-associated cognitive decline.

Preclinical studies have demonstrated that aqueous extracts of C. asiatica improve cognition in mouse models of aging and Alzheimer's disease through the modulation of mitochondrial biogenesis and NRF2-dependent antioxidant response genes. According to the literature survey, C. asiatica has been reported to have comprehensive neuroprotection by different modes of action such as enzyme inhibition, prevention of amyloid plaque formation in Alzheimer's disease, dopamine neurotoxicity in Parkinson's disease, and decreasing oxidative stress.

Vascular and Microcirculatory Mechanisms

With regard to the total triterpenic fraction of Centella asiatica (TTFCA), its effects on metabolism in the connective tissue of the vascular wall and on the microcirculation have been demonstrated. This compound is effective in venous insufficiency, reducing ankle edema, foot swelling, capillary filtration rate, and improving microcirculatory parameters. C. asiatica may enhance wound healing resulting from improved angiogenesis, occurring due to its stimulating effect on collagen I, Fibroblast Growth Factor (FGF), and Vascular Endothelial Growth Factor (VEGF) production.

5. Scientific Evidence by Area of Use

5.1 Wound Healing and Dermatology

Preclinical evidence (strong): Studies have shown that Centella asiatica extracts (CAE) display activity in tissue regeneration, cell migration, and wound repair processes by promoting fibroblast proliferation and collagen synthesis. Preliminary findings have shown that asiatic acid is one of the main active constituents of C. asiatica directly associated with its healing activity. Preclinical studies consistently demonstrate that C. asiatica accelerates wound healing through stimulation of fibroblast activity, collagen synthesis, and angiogenesis. In rodent models of excision and ulcerative wounds, both topical and oral applications significantly enhance healing through fibroblast activation, collagen biosynthesis, and angiogenesis. These beneficial effects manifest as accelerated wound contraction, increased hydroxyproline content — an indicator of collagen production — and improved tensile strength of newly formed tissue.

Clinical evidence (moderate, limited sample sizes): A systematic review of C. asiatica on wound healing identified four clinical trials meeting inclusion criteria, covering wound contraction and granulation, healing/bleeding time and re-epithelialization, VAS (visual analogue scale) scores, and skin erythema and wound appearance. Topical application of Centiderm ointment made from C. asiatica ethanol extract significantly improved the objective and subjective signs in patients with second-degree burn wounds on their limbs. The means of re-epithelialization and complete healing were significantly better in the Centiderm group than in the control group. A randomized clinical trial revealed that a polymeric spray film solution containing Centella asiatica extract was advantageous for acute wound treatment, accelerating healing time without adverse effects. Available data from clinical and experimental studies provide strong evidence of wound healing activity of Centella asiatica and its bioactive constituent, asiatic acid. CAE and asiatic acid act in one or more phases of the cutaneous repair process, displaying activity in tissue regeneration, cell migration, and wound repair process by promoting inhibition of pro-inflammatory mediators, fibroblast proliferation, and extracellular matrix and collagen synthesis.

Keloid and hypertrophic scarring: The inhibition of both TGF-β1 and PAI-1 by C. asiatica, mainly by one of its constituents, asiatic acid, makes it a promising compound for the management of keloids, though evidence in this specific area remains largely preclinical.

5.2 Chronic Venous Insufficiency and Microangiopathy

Clinical evidence (moderate): A systematic review aimed to assess the efficacy of Centella asiatica for improvement of the signs and symptoms of chronic venous insufficiency (CVI), searching 13 electronic databases including the Cochrane Central Register of Controlled Trials. Eight studies met the inclusion criteria. Three of these eight studies recruited patients with venous insufficiency of the lower limbs and five involved patients with venous hypertension. Sample sizes ranged from 17 to 99, with a mean sample size of 65 and a median of 71, and the duration of trials ranged from 28 to 60 days.

A single-blind, placebo-controlled, randomized study was performed on the effects of different doses of TTFCA in patients with venous hypertensive microangiopathy, using a combined microcirculatory model that considered laser Doppler flowmetry and transcutaneous oxygen and carbon dioxide tension measurements. All tests provided a significant difference between drug-treated groups and the placebo group, allowing a distinction to be made between the higher dose (120 mg daily) and the lower dose (60 mg daily) of TTFCA. Important symptomatological effects followed TTFCA administration, especially at the higher dose level, while no effect was obtained with placebo.

Several randomized double-blind studies show improvements in circulation measures, such as resting peri-malleolar skin blood flow and symptoms such as edema and heaviness of the lower limbs, in patients with lower-limb venous insufficiency or hypertensive venous microangiopathy. In one study, oral administration of 90 mg of a triterpenic fraction of Centella per day for 3 weeks in 15 patients with chronic venous insufficiency resulted in a significant reduction in the number of circulating endothelial cells to levels found in normal subjects.

Cochrane context: In a 2016 Cochrane systematic review of 53 randomized controlled trials testing various treatments for venous insufficiency, 2 trials tested Centella asiatica. In one study, two 10 mg tablets of Centella asiatica were taken 3 times per day (60 mg/day) for 30 days; the other study used two 30 mg tablets twice daily (120 mg/day) for 56 days. One study showed non-significant effects compared to placebo, while the other study showed favorable results for Centella asiatica in the dichotomous variable of global assessment by the subject. Both studies are from the 1980s. This indicates that while the results are generally positive, the body of evidence remains limited by age, small sample sizes, and methodological constraints of earlier trials.

5.3 Cognitive Function and Memory

Clinical evidence (mixed/weak-to-moderate): A systematic review and meta-analysis aimed to determine the effects of C. asiatica on cognitive function and related properties, including five RCTs conducted with C. asiatica alone and six RCTs with C. asiatica-containing products. Meta-analysis indicated that there are no significant differences in all cognitive function domains of C. asiatica when compared to placebo. However, it could improve mood by increasing alert scores (SMD: 0.71; 95% CI: 0.01 to 1.41; I² = 30.5%) and decreasing anger scores at 1 hour after treatment (SMD: −0.81; 95% CI: −1.51 to −0.09; I² = 36.6%).

The authors concluded that there is not strong evidence to support the use of C. asiatica for cognitive function improvement in each cognitive domain. C. asiatica could improve alertness and relieve anger. Limitations include variability in dose regimen, plant preparation, standardization, and product variation. Future well-designed clinical trials using suitable doses of standardized C. asiatica are still needed.

A more recent systematic review and meta-analysis reported that supplementation with C. asiatica extracts may lead to modest but statistically significant improvements in cognitive performance and anxiety-related symptoms in human subjects. However, considerable heterogeneity across clinical trials — including differences in extract formulations, dosages (ranging from 300 to 750 mg/day), and cognitive endpoints — poses challenges in drawing definitive conclusions and highlights the urgent need for standardized, high-quality randomized controlled trials.

Phase I pharmacokinetic trial: A randomized, double-blind, crossover Phase I trial explored the oral bioavailability and pharmacokinetics of key compounds from two doses (2 g and 4 g) of a standardized C. asiatica aqueous extract product (CAP) over 10 hours in four mildly demented older adults on cholinesterase inhibitor therapy. The analysis focused on triterpenes and caffeoylquinic acids, which are known to contribute to C. asiatica's neurological activity. The acute safety of CAP and the effects on NRF2 gene expression in peripheral blood mononuclear cells were also evaluated.

5.4 Anxiety and Mood

Clinical evidence (preliminary): A double-blind, placebo-controlled study was undertaken to evaluate the anxiolytic activity of Gotu Kola (Centella asiatica) in healthy subjects. Investigations revealed that a number of plants with purported anxiolytic activity bind to cholecystokinin (CCK) receptors, a finding considered intriguing in view of the proposed involvement of CCK in the pathophysiology of fear and anxiety. Preliminary findings from this study suggest that Gotu Kola has anxiolytic activity in humans as revealed by the acoustic startle response (ASR). This 2000 trial by Bradwejn et al. remains one of the few placebo-controlled human studies of Gotu Kola's anxiolytic properties and is of modest size.

5.5 Neuroprotection and Neurodegenerative Disease

Preclinical evidence (moderate-to-strong in animal models); clinical evidence (very limited): C. asiatica has been reported to have comprehensive neuroprotection by different modes of action such as enzyme inhibition, prevention of amyloid plaque formation in Alzheimer's disease, dopamine neurotoxicity in Parkinson's disease, and decreasing oxidative stress. Preclinical data indicate that Centella asiatica accelerates nerve regeneration upon oral administration and contains multiple active fractions increasing neurite elongation in vitro. These findings remain at the preclinical stage, and well-powered human trials specifically targeting Alzheimer's disease or Parkinson's disease prevention or treatment are lacking.

5.6 Skin and Cosmetic Applications

Active compounds such as asiaticoside, madecassoside, asiatic acid, and madecassic acid enhance collagen synthesis, modulate inflammation, and offer antioxidant protection in dermatological applications. Clinical trials have summarized that innovative delivery systems, such as hydrogels, nanostructures, or microneedles, can accelerate wound healing, reduce wound size, and improve recovery times in various wound types, including diabetic ulcers and burns. Centella asiatica is increasingly used in dermatology and cosmeceuticals for wound repair, barrier support, scar modulation, and photoaging.

6. Body Systems and Health Areas

• Integumentary system (skin): Used to treat a variety of skin diseases, such as leprosy, lupus, varicose ulcers, eczema, and psoriasis, in Asiatic traditional medicine for thousands of years. Collagen-stimulating and anti-inflammatory mechanisms underpin modern dermatological and cosmeceutical use.
• Vascular/circulatory system: TTFCA is effective in venous insufficiency, reducing ankle edema, foot swelling, capillary filtration rate, and improving microcirculatory parameters.
• Central nervous system: Gotu Kola is known to improve memory, intelligence, and neural protection, although the precise mechanism is not fully understood.
• Mood and anxiety: Gotu Kola has been used for centuries in Ayurvedic and traditional Chinese medicine to alleviate symptoms of depression and anxiety.
• Digestive system: Traditional use includes management of indigestion, dysentery, and constipation.
• Musculoskeletal system: Traditional use in the management of rheumatism and fractures is recorded.

7. Dosage Forms and Doses Reported in Studies

Oral Forms

Centella is widely available as capsules, tablets, powders, solutions, and skin creams in over-the-counter herbal products. The typical oral dose is 60 to 120 mg daily of purified extracts, but may be 600 to 1800 mg daily of capsules or powders of dried leaves.

Doses in Venous Insufficiency Trials

TTFCA (a purified triterpene mixture) was well-tolerated at all of the following doses in microcirculation studies: 30 or 60 mg daily for 7 days; 30 or 60 mg administered twice daily for 6 months; and 60 mg twice daily for 12 months. Two studies on femoral and carotid plaque formation both used TTFCA at 180 mg daily for 12 months. In one placebo-controlled trial, participants in the treatment group received TTFCA tablets, 60 mg, twice daily for 8 weeks. Effective doses appear to be those providing at least 60 mg of total triterpenic fraction of Centella asiatica per day.

Doses in Cognitive/Neurological Trials

A Phase I trial explored doses of 2 g and 4 g of a standardized C. asiatica aqueous extract product (CAP) in older adults. Across cognitive trials reviewed in a meta-analysis, dosages ranged from 300 to 750 mg/day, though considerable heterogeneity in formulations and endpoints was noted.

Topical Forms

For cutaneous use, ointments contain 1% TECA for leg ulcers, wounds, and burns; a cutaneous powder containing 2% TECA is used for treatment of scars, keloid scars, and burns.

Regulatory Status

None of the pharmacological properties reported for Centella have been proven in prospective, controlled trials sufficient for regulatory approval in the United States as therapy for any medical condition. Nevertheless, it is widely available as capsules, tablets, powders, solutions, and skin creams in over-the-counter herbal products. Hard capsules containing 30 mg of asiatic acid are authorised in Portugal since 1989 for prevention and recovery of venous insufficiency: heavy legs, fatigability, oedema, itching, pain, and leg ulcer.

8. Safety Considerations and Drug Interactions

General Tolerability

Centella has few if any adverse events and no known proven severe adverse effects. In small trials, Centella asiatica extracts have appeared to be well tolerated with only mild, transient, and nonspecific adverse effects such as headache, dizziness, bloating, diarrhea, and nausea, which often have been similar in frequency to placebo.

Hepatotoxicity

While generally regarded as safe, Centella has been linked to rare instances of clinically apparent acute liver injury with jaundice. There have been reports of hepatotoxicity associated with prolonged or high-dose ingestion, particularly in susceptible individuals. As a precaution, monitoring of liver function is advisable in patients undergoing extended treatment, especially when oral formulations are used. These rare but significant events appear to be dose-dependent and may be exacerbated by pre-existing hepatic impairment.

A review of hepatotoxicity linked to herbs or dietary supplements lists two reports associated with Centella asiatica. However, the lack of detailed information on the products used in the first report, and the presence of additional ingredients, a low Centella asiatica dose, and concomitant use of lymecycline in the second report, make it unclear what role (if any) Centella asiatica played in the hepatotoxicity seen in these individuals. In one clinical trial, one female participant receiving a triterpene-standardized product (CAST) at 240 mg per day withdrew due to abnormal liver enzyme levels, which returned to normal on stopping CAST. However, CAST was well tolerated by other participants who completed the 52-week study, with dose escalation from 120 mg and 180 mg during weeks 1–8, to 240 mg daily for weeks 9–52.

Adverse Events in Venous Insufficiency Trials

In one relevant trial, 31% of participants in the Centella asiatica group (19/61) experienced adverse events and 27.3% (9/33) in the placebo group. Two participants who took Centella asiatica (120 mg) withdrew — one because of gastric colic and the other because of absence of nerve activity — and it was unknown whether these events were related to Centella asiatica.

Cytochrome P450 Drug Interactions

An aqueous extract of C. asiatica (CAW-R61J) was evaluated for inhibitory effects on CYP1A2, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, and CYP3A4/5 using human liver microsomes. CAW-R61J showed weak reversible inhibition of most P450 forms tested, with the strongest being CYP2C9 (IC50 of 330 µg/ml). CAW-R61J (≤1000 µg/ml) was not a time-dependent inhibitor of any of these P450 enzymes. In summary, CAW-R61J had no, or only a weak impact, on P450 induction and inhibition in vitro. The clinical relevance of these results depends on the in vivo concentration of components achieved in humans. Plasma triterpene concentrations measured in clinical studies suggest minimal risk of P450-mediated drug interactions by these components.

Bioavailability Considerations

Oral use in humans typically suffers from low bioavailability due to poor water solubility and rapid metabolism of the triterpene components. Topical use avoids systemic metabolism and has shown superior local tissue concentrations.

FDA and Regulatory Adverse Event Context

Despite its presence in dietary supplements in the United States, there are no reports of adverse events associated with Centella asiatica found in the FDA CFSAN Adverse Event Reporting System (CAERS, accessed 2017).

References

• NIH LiverTox® — Centella asiatica (NCBI Bookshelf)
• Centella asiatica (L.) Urban: From Traditional Medicine to Modern Medicine with Neuroprotective Potential — PMC
• Biotechnological Intervention and Secondary Metabolite Production in Centella asiatica L. — PMC
• Centella asiatica: Advances in Extraction Technologies, Phytochemistry, and Therapeutic Applications — PMC
• Effects of Centella asiatica (L.) Urb. on cognitive function and mood related outcomes: A Systematic Review and Meta-analysis — PMC
• A Systematic Review of the Efficacy of Centella asiatica for Improvement of the Signs and Symptoms of Chronic Venous Insufficiency — PMC
• A Systematic Review of the Effect of Centella asiatica on Wound Healing — PMC
• Centella asiatica and Its Metabolite Asiatic Acid: Wound Healing Effects and Therapeutic Potential — PMC
• Pharmacological Effects of Centella asiatica on Skin Diseases: Evidence and Possible Mechanisms — PMC
• Topical Application of Centella asiatica in Wound Healing: Recent Insights into Mechanisms and Clinical Efficacy — PMC
• Pharmacokinetics and Pharmacodynamics of Key Components of a Standardized Centella asiatica Product in Cognitively Impaired Older Adults: Phase 1 RCT — PMC
• Centella asiatica Improves Memory and Promotes Antioxidative Signaling in 5XFAD Mice — PMC
• Centella asiatica (Gotu kola) ethanol extract up-regulates hippocampal BDNF, TrkB, and ERK1/2 signaling — PMC
• Bradwejn J et al. A double-blind, placebo-controlled study on the effects of Gotu Kola on acoustic startle response in healthy subjects. J Clin Psychopharmacol. 2000 — PubMed
• Effects of TTFCA in venous hypertensive microangiopathy: a prospective, placebo-controlled, randomized trial — PubMed
• Total triterpenic fraction of Centella asiatica in the treatment of venous hypertension: a clinical, prospective, randomized trial — PubMed
• Activity of Centella asiatica in venous insufficiency — PubMed
• Centella asiatica Water Extract Shows Low Potential for Cytochrome P450-Mediated Drug Interactions — PubMed
• EMA Assessment Report on Centella asiatica (L.) Urban, herba — European Medicines Agency
• EMA Draft Assessment Report on Centella asiatica (L.) Urb., herba (Revision 1) — European Medicines Agency
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• Hepatoprotective effect of Centella asiatica 50% ethanol extract against acetaminophen-induced acute liver injury in BALB/c mice — PMC
• Pharmacokinetics of Centella asiatica Product (CAP) in Mild Cognitive Impairment — ClinicalTrials.gov Protocol
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