A COMPREHENSIVE REVIEW ON ANTI-HYPERLIPIDEMIC DRUGS IN AYURVEDA
Main Article Content
Keywords
Ayurvedic Medicine, Hyperlipidemia Management, Phytoconstituents, Molecular Pathways, Polyherbal Formulations, Lipid Profile Modulation
Abstract
Dyslipidemia continues to be a leading cause of cardiovascular morbidity, and Ayurvedic system therapy reports many plant therapies with major lipid-lowering properties. Systematic evaluation of important plants, such as Commiphora mukul, Berberis aristata, Curcuma longa, Picrorhiza kurroa, Plumbago zeylanica, Cyperus rotundus, and the polyherbaceous preparation Triphala, underscores their pharmacognostic qualities and bioactive constituents. These drugs work by complementary biochemical mechanisms like inhibition of HMG-CoA reductase, activation of the AMP-activated protein kinase, stimulation of bile acid secretion, modulation of the peroxisome proliferator-activated receptors, and enhancement of the antioxidant defense systems. Together, these mechanisms promote reduced cholesterol synthesis, enhanced fatty acid oxidation, improved lipid clearance, and protection against Low-Density Lipoprotein (LDL) oxidation. Preclinical trials and clinical trial evidence show consistent decreases in total cholesterol, LDL, and triglycerides and moderate increases in High-Density Lipoprotein (HDL). Polyphenols, terpenoids, and alkaloids have synergistic action, which is important in metabolic control and oxidative stress reduction. The majority of these compounds are largely free from side effects, and therefore, they can be used for long-term metabolic control. The integration of Ayurvedic concepts with molecular pharmacology makes them useful as adjuncts or alternatives to standard hypolipidemic drugs, especially in statin-intolerant populations. Ongoing standardization of the phytoconstituents, incorporation of network pharmacology, and strong multicentric clinical trials will be critical in realizing worldwide acceptance and formal integration of these plant therapeutics into evidence-based dyslipidemia management plans.
References
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14. Gothwal, S., Tomar, B. S., & Chawla, S. K. (2023). Ayurvedic and contemporary views of Vishaghana Mahakashya. Journal of Ayurveda and Integrated Medical Sciences, 8(9), 140-144.
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19. Kaur, S., Singh, S., Anand, N., & Sabharwal, S. (2021). Terminalia Arjuna: A Potential Anti-Hyperlipidemic Drug. Plant Archives, 21(1), 333-337.
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21. Kumar, J., & Pundir, M. (2022). Phytochemistry and pharmacology of the Saussurea genus (Saussurea lappa, Saussurea costus, Saussurea obvallata, Saussurea involucrata). Materials Today: Proceedings, 56, 1173-1181.
22. Kumar, M., Bhardwaj, R., Kumar, A., & Kumar, D. (2025). New Insights into the Quality Control Strategies of Inula racemosa Hook. F.(Pushkarmula) and Saussurea lappa Decne.(Kuth): Medicinal Crops of Alpine Himalaya. Journal of Chromatographic Science, 63(2), bmaf009.
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24. Mali, S. S., & Shekokar, S. S. (2023). A PHYTOPHARMACOLOGICAL REVIEW OF VALUABLE AYURVEDIC HERB MUSTA-CYPERUS ROTUNDUS LINN.
25. Manpreet, K., Anita, S., & Piyush, G. (2017). Phytochemical and pharmacological study of dhatura: A review. International Journal of Research in AYUSH and Pharmaceutical Sciences, 113-118.
26. Nalla, S., Mathala, N., Sahithi, P. S., Krishna, M. E., Anuradha, N., Sri, P. N. U., & Bhavani, C. (2023). A brief report on hyperlipidemia and its inducing models. Systematic Reviews in Pharmacy, 14(6).
27. Padhar, B. C., Dave, A. R., & Nariya, M. (2021). Acute toxicity and anti-dyslipidemic activity of Arogyavardhini compound in fructose-induced dyslipidemia in albino rats. Indian Journal of Natural Products and Resources (IJNPR)[Formerly Natural Product Radiance (NPR)], 12(3), 384-390.
28. Panda, V., Deshmukh, A., Singh, S., Shah, T., & Hingorani, L. (2021). An Ayurvedic formulation of Emblica officinalis and Curcuma longa alleviates insulin resistance in diabetic rats: involvement of curcuminoids and polyphenolics. Journal of Ayurveda and Integrative Medicine, 12(3), 506-513.
29. Pasam, S., Pragada, V. R., Bakshi, V., & Boggula, N. (2023). Cyperus Rotundus L. Plant in Traditional Medicine: A Review. Journal of Advancement in Pharmacognosy, 3(1), 7.
30. Pathak, K., Das, A., Shakya, A., Saikia, R., & Sarma, H. (2021). Evaluation of Anti-Diabetic and Anti-Hyperlipidemic Activity of Isolated Bioactive Compounds of Leaves of Annona reticulata Linn. The Natural Products Journal, 11(3), 414-421.
31. Prakash, J., Singh, D. C., Vashisht, K., Rawat, N., & Rawat, K. (2023). COMPREHENSIVE REVIEW OF ATIVISHA–ACONITUM HETEROPHYLLUM.
32. Pundir, M., Singh, C., Adlakha, M. K., & Gocher, G. (2024). A COMPREHENSIVE REVIEW ON THE CONCEPT OF PANCHAMAHABHUTA SIDDHANT AND DRUG ACTION IN AYURVEDA.
33. Rachitha, P., Krishnaswamy, K., Lazar, R. A., Gupta, V. K., Inbaraj, B. S., Raghavendra, V. B., ... & Sridhar, K. (2023). Attenuation of hyperlipidemia by medicinal formulations of Emblica officinalis synergised with nanotechnological approaches. Bioengineering, 10(1), 64.
34. Rahmat, S., Mannan, A. B., Prottasha, M. K., Shakil, F. A., Shawon, S. J., Nafsan, M. N. R., & Chowdhury, M. M. (2024). Hepatoprotective and Anti-hyperlipidemic Effects of Ethanolic Extract of Terminalia arjuna in a High-fat-induced Hyperlipidemic Rat Model. Asian Journal of Advanced Research and Reports, 18(9), 200-209.
35. Raina, D., Raina, S., & Singh, B. (2021). Katuki (Picrorhiza Kurroa)-A promising Ayurvedic Herb. Biomed J Sci Tech Res, 36(1), 28238-28242.
36. Rana, S., Palatty, P. L., Benson, R., Kochikuzhyil, B. M., & Baliga, M. S. (2022). Evaluation of the anti-hyperlipidemic effects of Triphala in high-fat diet-fed rats: Studies with two combinations. AYU (An International Quarterly Journal of Research in Ayurveda), 43(3), 98-104.
37. Sahu, N., Bansal, C., & Zainab, S. (2023). A Critical Review on the Impact of Ayurvedic Dietetics (Pathya Apathya) in the Management of Dyslipidemia. International Journal of Ayurveda and Pharma Research, 33-38.
38. Saklani, S., Yadav, S., Bisht, G., Rishishwar, S., & Rishishwar, P. (2024). PHARMACOTHERAPEUTIC USES OF MEDICINAL AYURVEDIC HERB DARUHARIDRA (BERBERIS ARISTATA): AN UPDATED REVIEW.
39. Sethi, H. K., & Gupta, R. (2023). A clinical study to evaluate the efficacy of Vacha (Acorus calamus) in the management of Sthaulya with special reference to Hyperlipidemia. Journal of Ayurveda and Integrated Medical Sciences, 8(2), 30-38.
40. Sheik, S. M., Bakthavatchalam, P., Shenoy, R. P., Hadapad, B. S., Nayak, D., Biswas, M., & Suryakanth, V. B. (2022). Anti-hyperglycemic, anti-hyperlipidemic, and anti-inflammatory effect of the drug Guggulutiktaka ghrita on high-fat diet-induced obese rats. Journal of Ayurveda and Integrative Medicine, 13(3), 100583.
41. Singh, B., Rastogi, R., Singh, L. R., Singhal, A., & Singh, R. (2025). An analytical study of Kalmegh (Andrographis paniculata) and Kiratikta (Swertia chirayita): an economic substitution for metro cities in the global pandemic with Healthcare 4.0. International Journal of Sustainable Society, 17(2), 113-140.
42. Talreja, S., & Tiwari, S. (2023). A comprehensive review of Aconitum heterophyllum. Journal of Ayurveda and Integrated Medical Sciences, 8(10), 195-201.
43. Tanwar, A. K., Chatterjee, D., Jain, N., Sharma, S., Tikoo, K., & Singh, I. P. (2025). Chemical basis of the traditional ayurvedic detoxification process of the toxic medicinal plant Plumbago zeylanica. Journal of Natural Products, 88(1), 15-23.
44. Tiwari, A., Shukla, A., & Kumar Samal, P. (2025). Evaluation of Anti‐Hyperlipidemic and Anti‐Atherogenic Activity of Asiatic Acid and Its Effect on Lipid Peroxidation in Hyperlipidemic Rats. Journal of Biochemical and Molecular Toxicology, 39(5), e70255.
45. Tyagi, T., Sharma, S., & Sharma, R. (2022). EVIDENCE-BASED CLASSICAL AND ETHANOMEDICINAL REVIEW ON HOLOPTELEA INTEGRIFOLIA (ROXB.) PLANCH.(CHIRABILVA).
46. Upadhyay, R. K. (2021). Antihyperlipidemic and cardioprotective effects of plant natural products: A review. International Journal of Green Pharmacy (IJGP), 15(1).
47. Vikhe, S., Kunkulol, R., & Raut, D. (2023). In Silico and In Vivo Studies of Decursin Isolated From the Ethanolic Extract of Feronia elephantum Correa (Rutaceae) Bark as a Potential Antidiabetic and Antihyperlipidemic Agent in STZ-induced Diabetic Rats. Letters in Drug Design & Discovery, 20(5), 517-535.
48. Wani, T. A., Kaloo, Z. A., & Dangroo, N. A. (2022). Aconitum heterophyllum Wall. ex Royle: A critically endangered medicinal herb with rich potential for use in medicine. Journal of Integrative Medicine, 20(2), 104-113.
49. Yadav, N., & Singh, A. K. (2023). Amalaki (Emblica officinalis Gaertn.): A review on its therapeutic properties. Journal of Ayurveda and Integrated Medical Sciences, 8(8), 155-162.
2. Ahmad, I., Patel, N., Tyagi, C. K., & Khan, F. (2024). EVALUATION OF ANTI-HYPERLIPIDEMIC ACTIVITY OF LEAVES EXTRACT OF AEGLE GLUTINOSA PLANT.
3. Akhilraj, A. R., & Rukmini, S. (2021). A systematic review on synonyms and properties of Citraka (Plumbago zeylanica Linn. and Plumbago rosea Linn.) from Saṁhitās (Ayurvedic classics) and Nighaṇṭus (Ayurvedic drug lexicons). J Medicinal Plants, 9(3), 33-40.
4. Banerjee, S., Banerjee, S., Bose, S., Das, A., & Mitra, C. (2024). Saussurea lappa (Kushta): An Indian Spice and Its Potential Health Benefits. In Medicinal Spices and Herbs from India (pp. 345-373). Apple Academic Press.
5. Chandran, A., Salvamani, S., Ulaganathan, V., Lim, S. Y., & Gunasekaran, B. (2025). Polyherbal Formulation Approaches for Managing Hypercholesterolemia: Insights from Traditional Chinese Medicine and Ayurveda. Current Traditional Medicine, E22150838314259.
6. Chatterjee, D., Kumar, A., & Singh, I. P. (2024). Qualitative and quantitative studies on the chemical changes during the Ayurvedic detoxification process of Acorus calamus Linn.(Indian Vacha). Phytomedicine Plus, 4(2), 100574.
7. Choudhari, G., Choudhari, V., Pawar, A., & More, C. (2024). Evaluation of antidiabetic, antihyperlipidemic potential and herb-drug interaction of Saptarangi plus Kadha and Saptarangi tablet in streptozotocin-induced diabetic rats. Research Journal of Pharmacy and Technology, 17(5), 2164-2174.
8. Choudhary, S., Kaurav, H., Madhusudan, S., & Chaudhary, G. (2021). Daruharidra (Berberis aristata): review based upon its ayurvedic properties. International Journal for Research in Applied Sciences and Biotechnology, 8(2), 98-106.
9. Das, A., Thanvi, H. A., Jena, N., & Kumar, S. (2025). Phytochemical profiling of fruits of Holoptelea integrifolia (Roxb.) Planch. Plants and Secondary Metabolites, 5.
10. Dewangan, C., Kashyap, R., Patel, S., & Sahu, G. (2025). Acorus Calamus: An Ancient Remedy with Modern Medicinal Applications. International Journal of Scientific Research and Technology.
11. Fuloria, S., Mehta, J., Chandel, A., Sekar, M., Rani, N. N. I. M., Begum, M. Y., ... & Fuloria, N. K. (2022). A comprehensive review on the therapeutic potential of Curcuma longa Linn. in relation to its major active constituent curcumin. Frontiers in Pharmacology, 13, 820806.
12. Ghosh, A., Das, R., Mohanty, J. P., & Roy, S. (2025). An updated review on therapeutic and phytochemical profiling of Acorus calamus Linn. A natural remedy is explored. Journal of Pharmacognosy and Phytochemistry, 14(3), 738-746.
13. Ghosh, S., Murthy, P. N., & Joshi, H. (2021). Different methods of preparation, evaluation, and comparison of a traditional oral liquid formulation for potential antihyperlipidemic activity in hyperlipidemic Wistar rats. Research Journal of Pharmacy and Technology, 14(5), 2426-2433.
14. Gothwal, S., Tomar, B. S., & Chawla, S. K. (2023). Ayurvedic and contemporary views of Vishaghana Mahakashya. Journal of Ayurveda and Integrated Medical Sciences, 8(9), 140-144.
15. HERB, A. P. (2017). International Journal of Ayurveda and Pharma Research. Int. J. Ayur. Pharma Research, 5(5), 47-53.
16. Huddar, S. H., Anupkumar, E., & Jadhav, A. (2023). Classical review of Haridra (Curcuma longa). Journal of Ayurveda and Integrated Medical Sciences, 8(4), 122-127.
17. Jatav, R., Gour, R., & Patel, A. K. (2023). FERONIA LIMONIA NOVEL PLANT: A REVIEW ON HISTORY, GEOGRAPHY, MORPHOLOGY, PHYTOCHEMISTRY, PHARMACOLOGY AND TRADITIONAL USES.
18. Kandikattu, H. K., Amruta, N., Khanum, F., Narayana, V. V. P. C., & Srinivasulu, D. (2022). A review on Cyperus rotundus: ancient weed to modern elixir of life phytochemistry and therapeutic uses of Cyperus rotundus (Mustaka). Pharmaceutical and Biomedical Research.
19. Kaur, S., Singh, S., Anand, N., & Sabharwal, S. (2021). Terminalia Arjuna: A Potential Anti-Hyperlipidemic Drug. Plant Archives, 21(1), 333-337.
20. Khatib, S., Faraloni, C., & Bouissane, L. (2022). Exploring the use of iris species: Antioxidant properties, phytochemistry, medicinal and industrial applications. Antioxidants, 11(3), 526.
21. Kumar, J., & Pundir, M. (2022). Phytochemistry and pharmacology of the Saussurea genus (Saussurea lappa, Saussurea costus, Saussurea obvallata, Saussurea involucrata). Materials Today: Proceedings, 56, 1173-1181.
22. Kumar, M., Bhardwaj, R., Kumar, A., & Kumar, D. (2025). New Insights into the Quality Control Strategies of Inula racemosa Hook. F.(Pushkarmula) and Saussurea lappa Decne.(Kuth): Medicinal Crops of Alpine Himalaya. Journal of Chromatographic Science, 63(2), bmaf009.
23. Kumar, V., Singh, S. B., & Singh, S. (2021). Pharmacological perspectives of ayurvedic herbs, viz. Alstonia scholaris L., Picrorhiza kurroa, Swertia chirata, and Caesalpinia crista against COVID-19: A mini-review. Mini-Reviews in Organic Chemistry, 18(7), 841-849.
24. Mali, S. S., & Shekokar, S. S. (2023). A PHYTOPHARMACOLOGICAL REVIEW OF VALUABLE AYURVEDIC HERB MUSTA-CYPERUS ROTUNDUS LINN.
25. Manpreet, K., Anita, S., & Piyush, G. (2017). Phytochemical and pharmacological study of dhatura: A review. International Journal of Research in AYUSH and Pharmaceutical Sciences, 113-118.
26. Nalla, S., Mathala, N., Sahithi, P. S., Krishna, M. E., Anuradha, N., Sri, P. N. U., & Bhavani, C. (2023). A brief report on hyperlipidemia and its inducing models. Systematic Reviews in Pharmacy, 14(6).
27. Padhar, B. C., Dave, A. R., & Nariya, M. (2021). Acute toxicity and anti-dyslipidemic activity of Arogyavardhini compound in fructose-induced dyslipidemia in albino rats. Indian Journal of Natural Products and Resources (IJNPR)[Formerly Natural Product Radiance (NPR)], 12(3), 384-390.
28. Panda, V., Deshmukh, A., Singh, S., Shah, T., & Hingorani, L. (2021). An Ayurvedic formulation of Emblica officinalis and Curcuma longa alleviates insulin resistance in diabetic rats: involvement of curcuminoids and polyphenolics. Journal of Ayurveda and Integrative Medicine, 12(3), 506-513.
29. Pasam, S., Pragada, V. R., Bakshi, V., & Boggula, N. (2023). Cyperus Rotundus L. Plant in Traditional Medicine: A Review. Journal of Advancement in Pharmacognosy, 3(1), 7.
30. Pathak, K., Das, A., Shakya, A., Saikia, R., & Sarma, H. (2021). Evaluation of Anti-Diabetic and Anti-Hyperlipidemic Activity of Isolated Bioactive Compounds of Leaves of Annona reticulata Linn. The Natural Products Journal, 11(3), 414-421.
31. Prakash, J., Singh, D. C., Vashisht, K., Rawat, N., & Rawat, K. (2023). COMPREHENSIVE REVIEW OF ATIVISHA–ACONITUM HETEROPHYLLUM.
32. Pundir, M., Singh, C., Adlakha, M. K., & Gocher, G. (2024). A COMPREHENSIVE REVIEW ON THE CONCEPT OF PANCHAMAHABHUTA SIDDHANT AND DRUG ACTION IN AYURVEDA.
33. Rachitha, P., Krishnaswamy, K., Lazar, R. A., Gupta, V. K., Inbaraj, B. S., Raghavendra, V. B., ... & Sridhar, K. (2023). Attenuation of hyperlipidemia by medicinal formulations of Emblica officinalis synergised with nanotechnological approaches. Bioengineering, 10(1), 64.
34. Rahmat, S., Mannan, A. B., Prottasha, M. K., Shakil, F. A., Shawon, S. J., Nafsan, M. N. R., & Chowdhury, M. M. (2024). Hepatoprotective and Anti-hyperlipidemic Effects of Ethanolic Extract of Terminalia arjuna in a High-fat-induced Hyperlipidemic Rat Model. Asian Journal of Advanced Research and Reports, 18(9), 200-209.
35. Raina, D., Raina, S., & Singh, B. (2021). Katuki (Picrorhiza Kurroa)-A promising Ayurvedic Herb. Biomed J Sci Tech Res, 36(1), 28238-28242.
36. Rana, S., Palatty, P. L., Benson, R., Kochikuzhyil, B. M., & Baliga, M. S. (2022). Evaluation of the anti-hyperlipidemic effects of Triphala in high-fat diet-fed rats: Studies with two combinations. AYU (An International Quarterly Journal of Research in Ayurveda), 43(3), 98-104.
37. Sahu, N., Bansal, C., & Zainab, S. (2023). A Critical Review on the Impact of Ayurvedic Dietetics (Pathya Apathya) in the Management of Dyslipidemia. International Journal of Ayurveda and Pharma Research, 33-38.
38. Saklani, S., Yadav, S., Bisht, G., Rishishwar, S., & Rishishwar, P. (2024). PHARMACOTHERAPEUTIC USES OF MEDICINAL AYURVEDIC HERB DARUHARIDRA (BERBERIS ARISTATA): AN UPDATED REVIEW.
39. Sethi, H. K., & Gupta, R. (2023). A clinical study to evaluate the efficacy of Vacha (Acorus calamus) in the management of Sthaulya with special reference to Hyperlipidemia. Journal of Ayurveda and Integrated Medical Sciences, 8(2), 30-38.
40. Sheik, S. M., Bakthavatchalam, P., Shenoy, R. P., Hadapad, B. S., Nayak, D., Biswas, M., & Suryakanth, V. B. (2022). Anti-hyperglycemic, anti-hyperlipidemic, and anti-inflammatory effect of the drug Guggulutiktaka ghrita on high-fat diet-induced obese rats. Journal of Ayurveda and Integrative Medicine, 13(3), 100583.
41. Singh, B., Rastogi, R., Singh, L. R., Singhal, A., & Singh, R. (2025). An analytical study of Kalmegh (Andrographis paniculata) and Kiratikta (Swertia chirayita): an economic substitution for metro cities in the global pandemic with Healthcare 4.0. International Journal of Sustainable Society, 17(2), 113-140.
42. Talreja, S., & Tiwari, S. (2023). A comprehensive review of Aconitum heterophyllum. Journal of Ayurveda and Integrated Medical Sciences, 8(10), 195-201.
43. Tanwar, A. K., Chatterjee, D., Jain, N., Sharma, S., Tikoo, K., & Singh, I. P. (2025). Chemical basis of the traditional ayurvedic detoxification process of the toxic medicinal plant Plumbago zeylanica. Journal of Natural Products, 88(1), 15-23.
44. Tiwari, A., Shukla, A., & Kumar Samal, P. (2025). Evaluation of Anti‐Hyperlipidemic and Anti‐Atherogenic Activity of Asiatic Acid and Its Effect on Lipid Peroxidation in Hyperlipidemic Rats. Journal of Biochemical and Molecular Toxicology, 39(5), e70255.
45. Tyagi, T., Sharma, S., & Sharma, R. (2022). EVIDENCE-BASED CLASSICAL AND ETHANOMEDICINAL REVIEW ON HOLOPTELEA INTEGRIFOLIA (ROXB.) PLANCH.(CHIRABILVA).
46. Upadhyay, R. K. (2021). Antihyperlipidemic and cardioprotective effects of plant natural products: A review. International Journal of Green Pharmacy (IJGP), 15(1).
47. Vikhe, S., Kunkulol, R., & Raut, D. (2023). In Silico and In Vivo Studies of Decursin Isolated From the Ethanolic Extract of Feronia elephantum Correa (Rutaceae) Bark as a Potential Antidiabetic and Antihyperlipidemic Agent in STZ-induced Diabetic Rats. Letters in Drug Design & Discovery, 20(5), 517-535.
48. Wani, T. A., Kaloo, Z. A., & Dangroo, N. A. (2022). Aconitum heterophyllum Wall. ex Royle: A critically endangered medicinal herb with rich potential for use in medicine. Journal of Integrative Medicine, 20(2), 104-113.
49. Yadav, N., & Singh, A. K. (2023). Amalaki (Emblica officinalis Gaertn.): A review on its therapeutic properties. Journal of Ayurveda and Integrated Medical Sciences, 8(8), 155-162.
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Sep 30, 2025
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Dr. Akash Meghwal, Dr. Prem kumar, Dr. Nikita panwar, Dr. Manoj Adlakha, & Dr. Chandan Singh. (2025). A COMPREHENSIVE REVIEW ON ANTI-HYPERLIPIDEMIC DRUGS IN AYURVEDA. Journal of Population Therapeutics and Clinical Pharmacology, 32(8), 1276-1289. https://doi.org/10.53555/54yjpx53
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Author Biographies
Dr. Akash Meghwal
MD Scholar, PG Dept Of Dravyaguna Vigyan PGIA DSRRAU Jodhpur
Dr. Prem kumar
Assistant Professor, PG Dept Of Shalya Tantra, PGIA DSRRAU Jodhpur
Dr. Nikita panwar
Assistant professor, PG Dept of Dravyaguna vigyan PGIA DSRRAU Jodhpur
Dr. Manoj Adlakha
Associate Professor, PG Dept Of Dravyaguna Vigyan PGIA DSRRAU Jodhpur
Dr. Chandan Singh
Professor And Head, PG Dept Of Dravyaguna Vigyan PGIA DSRRAU Jodhpur
How to Cite
Dr. Akash Meghwal, Dr. Prem kumar, Dr. Nikita panwar, Dr. Manoj Adlakha, & Dr. Chandan Singh. (2025). A COMPREHENSIVE REVIEW ON ANTI-HYPERLIPIDEMIC DRUGS IN AYURVEDA. Journal of Population Therapeutics and Clinical Pharmacology, 32(8), 1276-1289. https://doi.org/10.53555/54yjpx53