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Medicinal Plants in Targeting Tuberculosis II
Abstract
Tuberculosis is a highly contagious infectious disease triggered by Mycobacterium tuberculosis, which is widely spread by aerosol. The major site of infection is usually the lungs however the disease can attack any extra-pulmonary site as well, which is further diagnosis by necrotizing granulomatous inflammation. World Health Organization reported almost 8.9–10 million people are suffering from tuberculosis in 2019, including 56% men and 32% women, and 12% children. Multidrug-resistant tuberculosis (MDR-TB) is a medical condition in which Mycobacterium tuberculosis strains resistant to at least isoniazid and rifampicin. In-vitro studies suggest that several bioactive compounds and their synthetic derivatives obtained from plants, fungi, and marine organism possesses antimycobacterial affinity. Phenolic compounds such as dihydrocubebin, hinokinin, ethoxycubebin possess the antimycobacterial activity. Mycobacterial cell envelope antagonists have been shown to obstruct the synthesis of mycolic acids, arabinogalactan, and peptidoglycan, essential components of the mycobacterial cell wall. The paramount antituberculous drugs hamper the development of mycolic acids or the aid mechanism which links them to the cell membrane. Medicines targeting RNA synthesis encompass those that restrict the assembly of bacterial DNA-dependent RNA polymerases, that are indispensable enzymes for RNA synthesis. Various molecular pathways for the target to cure tuberculosis entail the targets of M. tuberculosis cell wall synthesis, energy metabolism, folate metabolism, DNA replication, and RNA synthesis. Interestingly, in preserving the health of patients diagnosed with tuberculosis, medicinal plants have tremendous advantages with limited side effects as compare to the standard drugs.
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Virus disease is transmitted disease caused by recently discovered a group of viruses infecting respiratory tract, most of the infected people have major clinical signs such as; cough, sneezes, cold, fever and sore throat. The virus can be transmitted among people through the generated droplets when an infected person (coughing and exhales) or physical contact. Natural herbal remedies has been used for a long periods of ancient human history for different purposes. The desirable properties of herbal medicine are low toxicity and natural origin, as well as it is causes few side effects due to the use of additives and preservatives in a very small quantities and this made it a favorite as an alternative treatment. The current study shows the antiviral properties of natural herbal oils such as; Lavender, Peppermint, Cinnamon, Eucalyptus and Thyme oils for the purpose of treating Virus disease.
The term 'Antiviral agents' has been defined in very broad terms as substances other than a virus or virus containing vaccine or specific antibody which can produce either a protective or therapeutic effect to the clear detectable advantage of the virus infected host. The herbal medicine has a long traditional use and the major advantage over other medicines is their wide therapeutic window with rare side effects. There are some disadvantages of synthetic drugs like narrow therapeutic window and more importantly the various adverse side effects which occur quite frequently. Due to these disadvantages and other limitations, there is an increasing trend in the field of research for discovering new and noble drugs based on various herbal formulations. This review attempts to address the importance of developing therapeutic herbal formulations from various medicinal plants using the knowledge based on traditional system of medicines, the Ayurveda. Although natural products have been used by civilization since ancient times, only in recent decades has there been growing research into alternative therapies and the therapeutics use of natural products, especially those derived from plants. Plants synthesize and preserve a variety of biochemical products, many of which are extractable and used for various scientific investigations. Therefore, medicinal plants proved to be a major resort for the treatment of diseases and sicknesses by traditional healers in many societies.
COVID-19, a new pandemic caused by SARS-CoV-2, was first identified in 2019 in Wuhan, China. The novel corona virus SARS-CoV-2 and the 2002 SARS-CoV have 74% identity and use similar mechanisms to gain entry into the cell. Both the viruses enter the host cell by binding of the viral spike glycoprotein to the host receptor, angiotensin converting enzyme 2 (ACE2). Targeting entry of the virus has a better advantage than inhibiting the later stages of the viral life cycle. The crystal structure of the SARS-CoV (6CRV: full length S protein) and SARS-CoV-2 Spike proteins (6M0J: Receptor binding domain, RBD) was used to determine potential small molecule inhibitors. Curcumin, a naturally occurring phytochemical in Curcuma longa, is known to have broad pharmacological properties. In the present study, curcumin and its derivatives were docked, using Autodock 4.2, onto the 6CRV and 6M0J to study their capability to act as inhibitors of the spike protein and thereby, viral entry. The curcumin and its derivatives displayed binding energies, ΔG, ranging from −10.98 to −5.12 kcal/mol (6CRV) and −10.01 to −5.33 kcal/mol (6M0J). The least binding energy was seen in bis-demethoxycurcumin with: ΔG = −10.98 kcal/mol (6CRV) and −10.01 kcal/mol (6M0J). A good binding energy, drug likeness and efficient pharmacokinetic parameters suggest the potential of curcumin and few of its derivatives as SARS-CoV-2 spike protein inhibitors. However, further research is necessary to investigate the ability of these compounds as viral entry inhibitors.
Communicated by Ramaswamy H. Sarma
COVID-19 is the most recently discovered coronavirus infectious disease and leads to pandemic all over the world. The clinical continuum of COVID-19 varies from mild illness with non-specific signs and symptoms of acute respiratory disease to extreme respiratory pneumonia and septic shock. It can transmit from animal to human in the form of touch, through the air, water, utensils, fomite and feco-oral route blood. The pathogenesis and clinical features of COVID-19 be the same as the clinical manifestation associated epidemic Fever. In Unani medicine, various herbal drugs are described under the caption of epidemic disease. Great Unani scholar also Avicenna (980-1037 AD) recommended that during epidemic condition movement should be restricted, self-isolation, fumigation around the habitant with perfumed herbs (Ood, Kafoor, Sumbuluttib, Saad Kofi, Loban, etc.), and use of appropriate antidotes (Tiryaqe Wabai) and vinegar (Sirka) as prophylaxis. Herbal approach is based on single (Unnab-Ziziphus jujuba, Sapistan-Cordia myxa, Bahidana-Cydonia oblonga, Khatmi-Althea officinalis, Khubazi-Malva sylvestris, Zafran-Crocus sativus, Sibr-Aloe barbedensis, Murmuki-Commiphora myrrha, Darchini-Cinnamomum zeylanicum, Qaranfal-Syzygium aromaticum, Rihan-Oscimum sanctum, Habtus Sauda-Nigella sativa, Aslus Sus-Glycyrrhiza glabra, Maghze Amaltas-Cassia fistula and Adusa-Adhatoda vasica) and compound drugs (Habbe Bukhar, Sharbat Khaksi, Sharbat Zanjabeel, Naqu Nazla, Majoon Chobchini, Jawrish Jalinus and Khamira Marvareed) most of them are claimed for anti-viral, anti-pyretic, blood purifier, cardioprotective and expectorant activities. Traditionally most of the herbal practitioners are using it.
Arthritis is a chronic condition that affects nearly a quarter of the United States population. Osteoarthritis (OA) and rheumatoid arthritis (RA) are two major forms of arthritis associated with severe joint pain and reduced quality of life. Various pharmacological interventions may be utilized for arthritis treatment when non-pharmacological therapy is insufficient. However, pharmacological therapy can be associated with serious side effects and high costs. Therefore, alternative therapies have been under investigation. Herbal medications have shown the potential for safe and effective management of arthritis. For this review, we attempt to summarize the mechanisms, safety, and efficacy of herbal treatments for OA and RA. After searching electronic databases, we identified nine herbs among 23 clinical trials used for the treatment of OA or RA patients. Improvement of OA and RA symptoms, pain, and inflammation was demonstrated. The herbs exhibited strong anti-inflammatory and anti-oxidant activities, contributing to a reduction in inflammation and tissue damage. Several herbs elucidated new mechanisms for OA and RA treatment as well. Though these herbs have shown promise for OA and RA treatment, more studies and clinical trials are required for determining safety and efficacy, bioactivity, and optimal bioavailability.
Arisen in China, COVID-19 (SARS-CoV-II) is a novel coronavirus that has been expan-
ding fast worldwide. Till now, no definite remedial drug or vaccine has been identified
for COVID-19 treatment. Still, for a majority of infected patients, supportive therapy
is the cornerstone of the management plan. To the importance of managing the
COVID-19 pandemic, this article proposed to collecting capable medicinal plants and
bioactive components in both treat and supportive therapy of this novel viral infection.
Clinical points in the pathogenesis, symptoms, and complications of COVID-19
were considered. The effective plants and bioactives that may play a role in supportive
therapy/management of COVID-19 were searched, collected through the
“Scopus” database and listed in three sections. Numerous medicinal plants such as
Citrus Spp., Camellia sinensis, and Glycyrrhiza glabra can interference with COVID-19
pathogenesis via inhibition of virus replication and entry to its host cells. Also, some
anti-inflammatory herbal medicine such as Andrographis paniculata, Citrus spp.,
and Cuminum cyminum can relieve fever and cough in COVID-19 patients. Medicinal
plants such as G. glabra, Thymus vulgaris, Allium sativum, Althea officinalis, and Panax
ginseng may modulate the immune system and possess prevention and supportive
therapy. However, more clinical data are required to confirm these hypotheses.
Nigella sativa seed and its active compounds have been historically recognized as an effective herbal panacea that can establish a balanced inflammatory response by suppressing chronic inflammation and promoting healthy immune response. The essential oil and other preparations of N. sativa seed have substantial therapeutic outcomes against immune disturbance, autophagy dysfunction, oxidative stress, ischemia, inflammation, in several COVID-19 comorbidities such as diabetes, cardio-vascular disorders, Kawasaki-like diseases, and many bacterial and viral infections. Compelling evidence in the therapeutic efficiency of N. sativa along with the recent computational findings is strongly suggestive of combating emerged COVID-19 pandemic. Also, being an available candidate in nutraceuticals, N. sativa seed oil could be immensely potential and feasible to prevent and cure COVID-19. This review was aimed at revisiting the pharmacological benefits of N. sativa seed and its active metabolites that may constitute a potential basis for developing a novel preventive and therapeutic strategy against COVID-19. Bioactive compounds of N. sativa seed, especially thymiquinone, α-hederin, and nigellidine, could be alternative and promising herbal drugs to combat COVID-19. Preclinical and clinical trials are required to delineate detailed mechanism of N. sativa's active components and to investigate their efficacy and potency under specific pathophysiological conditions of COVID-19.
Context
Despite the abundance of knowledge regarding high-altitude pulmonary edoema (HAPE) and high-altitude pulmonary hypertension (HAPH), their prevalence continues to be on the rise. Thus, there is an urgent need for newer safe, effective, and relatively economic drug candidates. China is particularly known for the use of medicinal plants.
Objective
This review summarizes the medicinal plants used for HAPE and HAPH in the past 30 years, as well as some potential plants.
Methods
Publications on HAPE and HAPH from 1990 to 2020 were identified using Web of Science, PubMed, SCOPUS, Springer Link, Google Scholar databases, Chinese Clinical Trial Registry and CNKI with the following keywords: ‘medicinal plants,’ ‘hypoxia,’ ‘high altitude pulmonary edema,’ ‘high altitude pulmonary hypertension,’ ‘pathophysiology,’ ‘mechanisms,’ ‘prevention,’ ‘treatment,’ ‘human,’ ‘clinical,’ ‘safety,’ and ‘pharmacokinetics.’
Results
We found 26 species (from 20 families) out of 5000 plants which are used for HAPE and HAPH prevention or treatment. Rhodiola rosea Linn. (Crassulaceae) is the most widely utilized. The most involved family is Lamiaceae, which contains 5 species.
Discussion and Conclusions
We mainly reviewed the medicinal plants and mechanisms for the treatment of HAPE and HAPH, and we also assessed related toxicology experiments, pharmacokinetics and bioavailability. Potential medicinal plants were also identified. Further research is needed to determine the pharmacological effects and active ingredients of these potential medicinal plants.
Corona virus SARS-CoV-2, otherwise known as COVID-19 has since its outbreak in late December 2019, till as of June 23, 2020 has infected 9,162,375 people throughout the world and caused deaths of 473,087 persons. The Bangladesh statistics for COVID-19 are 122,660 infections and 1,582 deaths. Although the figures seem low for Bangladesh, it can surge anytime because of the high density of the population and limited practice of social distancing. Moreover, treatment of COVID-19 is costly and proper medical services not adequately available in rural areas of the country. As a result, many people who cannot afford to visit modern doctors rely on home remedies/folk medicine for treatment. In this article, we report several such cases of home remedies where the patient got cured with or without use of other types of treatment. Since most home remedies utilized plant(s), the possible significance of the phytochemicals in the plant(s) are discussed.
Thrombosis, especially venous thromboembolism, is a complication often associated with COVID-19. However, there have been relatively few reports of arterial thrombosis. Here, we describe a case of non-severe COVID-19 in a patient with dilated cardiomyopathy. After admission, symptoms, laboratory data, and imaging findings improved, but D-dimer levels gradually increased. Contrast computed tomography (CT) and echocardiography revealed a left ventricular thrombus. Anti-coagulant treatment diminished the thrombus, and the patient recovered and was discharged. Although a left ventricular thrombus is a rare COVID-19 complication, performing appropriate diagnostic tests could improve COVID-19 mortality in patients with dilated cardiomyopathy.
Despite the frightening mortality rate associated with COVID-19, there is no known approved drug to effectively combat the pandemic. COVID-19 clinical manifestations include fever, fatigue, cough, shortness of breath, and other complications. At present, there is no known effective treatment or vaccine that can mitigate/inhibit SARS-CoV-2. Available clinical intervention for COVID-19 is only palliative and limited to support. Thus, there is an exigent need for effective and non-invasive treatment. This article evaluates the possible mechanism of actions of SARS-CoV-2 and present Nigeria based medicinal plants which have pharmacological and biological activities that can mitigate the hallmarks of the pathogenesis of COVID-19. SARS-CoV-2 mode of actions includes hyper-inflammation characterized by a severe and fatal hyper-cytokinaemia with multi-organ failure; immunosuppression; reduction of angiotensin-converting enzyme 2 (ACE2) to enhance pulmonary vascular permeability causing damage to the alveoli; and further activated by open reading frame (ORF)3a, ORF3b, and ORF7a via c-Jun N- terminal kinase (JNK) pathway which induces lung damage. These mechanisms of action of SARS-CoV-2 can be mitigated by a combination therapy of medicinal herbs based on their pharmacological activities. Since the clinical manifestations of COVID-19 are multifactorial with co-morbidities, we strongly recommend the use of combined therapy such that two or more herbs with specific therapeutic actions are administered to combat the mediators of the disease.
In the present scenario of COVID-19 strike and lack of potential antiviral medicines/vaccines against this extremely contagious lethal infection, identifying potential natural plant sources that can help in fighting this disease either by being viricidal or by boosting the immune system can provide significant therapeutic support. Around the globe as of 26th July 2020, there is ~15.78 million confirmed cases and 0.64 million deaths. The COVID-19 infection is produced by virulent Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) virus, which belongs to large corona virus family. These viruses are responsible for many recent infection outbreaks, SARS in 2003, MERS (Middle East Respiratory Syndrome) in 2012 and recent most fatal COVID-19. Also, mortality rate related to COVID-19 is found to be very high in case of people with weak immune system e.g. elderly patients, children or patients with pre-existing health problems. In this relevance, medicinal plants can act as potential healing agents that can help people to fight against this infection by boosting their immune system or by posing viricidal effect. And thus, can contribute in reducing mortality rate related to SARS-CoV-2 infections. In this review, we attempted to compile and discuss different traditional medicinal plants and their bioactive components that help in strengthening our immune system and also play key role in combatting microbial infections including COVID-19. This article will help researchers and industries to identify and scrutinize potential medicinal plants that can meet their interests for various applications including development of herbal/Ayurvedic antiviral drugs, designing antimicrobial/antiviral materials, development of immunopotentiator, preparation of potential sanitizer systems etc.
Cystic fibrosis (CF) is a disease characterized by bacterial chronic infection of the respiratory tract and inflammation, which leads to a progressive decrease in lung function. Pseudomonas aeruginosa is commonly isolated from the sputum of patients and their presence is associated with a predominant airway inflammation with neutrophils, causing chronic colonization and higher mortality rates. Neutrophil extracellular traps (NETs) have been observed in response against Pseudomonas, however, these cannot eliminate the pathogen from the respiratory tract, so one possibility is that the bacteria could promote their production to use them as a scaffold to colonize the lungs and as a nutrient source, however, their overproduction could also lead to increased damage to the lungs. In this work, we evaluated NETs formation by Pseudomonas clinical isolates obtained from CF patients and found that these induced NETs formation with globular or spread morphologies, of note, we found that there is a trend by which the spread forms were induced mainly by isolates obtained from patients with severe disease, whereas, the globular morphologies were observed for isolates obtained from patients with mild/moderate disease. Finally, we screened for bacterial molecules implicated in NETs formation and found that Exotoxin S, pyocin S2 and pyoverdine could participate in the process.
Dryopteris crassirhizoma (DC ) has a wide range of
pharmacological effects, including antibacterial, anti‑influenza
virus, anti‑tumor, anti‑reverse transcriptase and antioxidant
effects. However, the inhibitory effect of DC on allergic
inflammatory response remains unclear; therefore, the current
study used an experimental ovalbumin (OVA)‑induced allergic
asthma mouse model and phorbol myristate acetate (PMA)‑ and
A23187‑stimulated HMC‑ 1 cells to reveal the effects of DC in
regulating airway inflammation and its possible mechanism.
Allergic asthma was initiated in BAL B/c mice via exposure
to OVA emulsified in aluminum, on days 1 and 14. Thereafter,
the mice were treated with DC or dexamethasone (Dex) orally,
before being challenged, from days 15 to 26. Subsequently, the
mice were challenged with OVA on days 27, 28 and 29. The
results of histological analysis indicated that the administration
of DC decreased the number of inflammatory cells in the
bronchoalveolar lavage fluid (BALF) and suppressed eosinophilic
infiltration, mucus production and collagen deposition
in the lung tissue. DC treatment increased the level of T helper
type 1 (Th1) cytokines (IL‑10 and interferon (IFN)‑γ) and
decreased the levels Th2 cytokines (IL‑4, IL‑5 and IL‑13) and
proinflammatory cytokines (IL‑6 and TNF‑α). Furthermore,
DC treatment inhibited the activation of NF‑κB signaling
(NF‑κB, p‑NF‑κB, IκB and p‑I κB), both in BALF and lung
homogenates. Serum levels of total IgE and OVA‑specific IgE
and IgG1 were significantly lower after DC treatment compared
with after OVA treatment. However, the anti‑inflammatory
effect of OVA‑ specific IgG2a was higher after DC treatment.
In addition, DC treatment attenuated the production of
proinflammatory cytokines, including IL‑6 and TNF‑α, and
the activation of NF‑κB signaling (NF‑κB and p‑NF‑κB), in
PMA and calcium ionophore A23187‑stimulated HMC‑ 1 cells.
In summary, the current study demonstrated that DC acts a
potent anti‑allergic and anti‑inflammatory drug by modulating
the Th1 and Th2 response and reducing the allergic inflammatory
reaction in PMA and A23187‑stimulated HMC‑ 1 cells via
NF‑κB signaling in an OVA‑ induced allergic asthma model.
SARS-CoV-2 infection associated respiratory disease- COVID-19 has evolved into a pandemic but, being a new form of virus, pathogenesis of disease causation is not fully understood and drugs and vaccines against this virus are still being tested so that no effective drugs or vaccines have been advised by regulatory authority. In this context, the Ministry of AYUSH, Government of India has recommended ‘Ayush Kwath’ to improve the immunity and combat the infection. Our objective of this literature review is to review the role of immunity in pathogenesis of COVID-19 and role of Ayush Kwath against the virus and regulation of immunity. Current review was conducted using a search of available literature on COVID-19 and immunity, Vyadhikshamatwa, Ayurveda and COVID-19, Rasayana, Coronavirus, SARS-CoV-2, immunomodulatory effects of medicinal plants; Tulsi/Holy Basil/Ocimum sanctum, Dalchini/Cinnamon/Cinnamomum zeylanicum, Sunthi/Ginger/Zingiber officinale and Marich/Black Pepper/Piper nigrum. Ayurveda, being an ancient science have both medicinal and cultural values and had stimulated our kitchen and influenced what we ate in different seasons and the remedies we used for common ailments. Herbs such as Tulsi, Marich, Sunthi, Dalchini are the most commonly used and easily available drugs in home. Thus, Ayush Kwath due to its immune-modulatory, antiviral, anti-oxidant, anti-inflammatory, anti-platelet, anti-atherosclerotic, hepato-protective, reno-protective properties; seems to be effective in immuno-regulation for controlling viral infections like COVID-19. Further pre-clinical and clinical trials need to be done for the evaluation of safety and efficacy of this polyherbal formulation.
Coronavirus disease 2019 (COVID-19) is an infection caused by a newly discovered coronavirus which was identified in Wuhan, China. The race is on globally to repurpose drugs for COVID-19 and develop a safe and effective vaccine against the disease. There is an urgent need to search for effective remedies against COVID-19 from the rich and extensive flora of Africa and the world. A literature search was conducted to obtain information on drugs with the potential for effectiveness in the treatment of COVID-19 based mostly on outcomes of preclinical studies and a few clinical investigations. This was considered important to this perspective as some of the identified mechanisms of action may be related to potential anti-COVID-19 actions of phytomedicines. The findings from the literature search were also used to establish the need for exploration of phytomedicines in the fight against COVID-19. This perspective identifies the need to preserve the rich tradition of herbal medicine in Africa, repositioning it by inculcating all aspects of discovery, development, and chemical evaluation of pharmaceuticals from medicinal plants for effective management of prevalent diseases. The identified mechanisms of action of current drugs under consideration for the treatment of COVID-19 include preventing fusion of SARS-CoV-2 with human cells; decrease acidity in endosomes, cell membrane-derived vesicles for transportation of the virus within the host cell and within which the virus can replicate; and blockade of the production of proinflammatory cytokines. Phytomedicines may possibly elicit either one or a combination of these effects. The case for the exploration of phytomedicines against COVID-19 is strengthened by the emergence of a number of conventional drugs from medicinal plants and the emergence of botanicals with proven efficacy for some medical conditions. Caution against indiscriminate use of medicinal plants in the guise of treating COVID-19 has been highlighted and the need for reliable preclinical and clinical studies.
The outbreaks of viruses with wide spread and mortality in the world population have motivated the research for new therapeutic approaches. There are several viruses that cause a biochemical imbalance in the infected cell resulting in oxidative stress. These effects may be associated with the development of pathologies and worsening of symptoms. Therefore, this review is aimed at discussing natural compounds with both antioxidant and antiviral activities, specifically against coronavirus infection, in an attempt to contribute to global researches for discovering effective therapeutic agents in the treatment of coronavirus infection and its severe clinical complications. The contribution of the possible action of these compounds on metabolic modulation associated with antiviral properties, in addition to other mechanisms of action, is presented.
The Severe Acute Respiratory Syndrome-related Coronavirus 2 (SARS-CoV-2) or novel coronavirus (COVID-19) infection has been declared world pandemic causing a worrisome number of deaths, especially among vulnerable citizens, in 209 countries around the world. Although several therapeutic molecules are being tested, no effective vaccines or specific treatments have been developed. Since the COVID-19 outbreak, different traditional herbal medicines with promising results have been used alone or in combination with conventional drugs to treat infected patients. Here, we review the recent findings regarding the use of natural products to prevent or treat COVID-19 infection. Furthermore, the mechanisms responsible for this preventive or therapeutic effect are discussed. We conducted literature research using PubMed, Google Scholar, Scopus, and WHO website. Dissertations and theses were not considered. Only the situation reports edited by the WHO were included. The different herbal products (extracts) and purified molecules may exert their anti-SARS-CoV-2 actions by direct inhibition of the virus replication or entry. Interestingly, some products may block the ACE-2 receptor or the serine protease TMPRRS2 required by SARS-CoV-2 to infect human cells. In addition, natural products were shown to inhibit the SARS-CoV-2 life-cycle related proteins such as papain-like or chymotrypsin-like proteases. In conclusion, we suggest that natural products could be used alone or in combination as alternative medicines to treat/prevent COVID-19 infection. Moreover, their structures may offer clues for the development of anti-SARS-CoV-2 drugs.
The outbreak of Covid-19 disease caused by SARS-CoV-19, along with the lack of targeted medicaments and vaccines, forced the scientific world to search for new antiviral formulations. In this review, we describe the current knowledge about plant extracts containing polyphenols that inhibit Covid-19. Many plant-derived natural compounds (polyphenols) might provide a starting point for the research on the use of plant extracts in coronavirus treatment and prevention. Antivirus polyphenolic drugs can inhibit coronavirus enzymes, which are essential for virus replication and infection. This group of natural substances (betulinic acid, indigo, aloeemodine, luteolin, and quinomethyl triterpenoids, quercitin or gallates) is a potential key to designing antiviral therapies for inhibiting viral proteases. The known pharmacophore structures of bioactive substances can be useful in the elaboration of new anti-Covid-19 formulations. The benefit of using preparations containing phytochemicals is their high safety for patients and no side effects.
On December 31, 2019, a novel coronavirus, being the third highly infective CoV and named as coronavirus disease 2019 (COVID-19) in the city of Wuhan, was announced by the World Health Organization. COVID-19 has a 2% mortality rate, is known as the third extremely infective CoV infection, and has a mortality rate less than MERS-CoV and SARS-CoV. The CoV family comprises a chief number of positive single-stranded ss (+) RNA viruses that are recognized in mammals. The 2019-nCoV patients showed that the angiotensin-converting enzyme II (ACE2) was the same for SARS-CoV. Structural proteins have an essential role in virus released and budding to various host cells. Notably, evidence indicated human-to-human transmission, along with several exported patients of virus infection worldwide. Nowadays, no licensed antivirals drugs or vaccines for being utilized against these coronavirus infections are recognized. There is an urgent requirement for an extensive research of CoV infections to disclose the route of extension, pathogenesis, and diagnosis and then to recognize the therapeutic targets to facilitate disease control and surveillance. In this article, we present an overview of the common biological criteria of CoVs and explain pathogenesis with a focus on the therapeutic approach to suggest potential goals for treating and monitoring this emerging zoonotic disease.
In the recent years, there was an increasing demand for discovering antiviral agents from medicinal plants having high activity and economically cheap. The medicinal plants have become very important because they have a main importance for determination, isolation and purification of natural chemical compounds in order to use them in many medicinal application. The scientific researches proved that plants extracts have antiviral activity against corona virus . The explanation of this activity belongs to presence of active chemical compounds act to stop the viruses in living body by multi different mechanisms. This review will provide an overview about the perspective of used some various medicinal plants against corona virus as antiviral drug and compared with antibiotics to reduce/prevent corona virus risk. In conclusion of this review, some medicinal herbs required urgent extensive work to develop natural antiviral agents to fight corona virus (COVID-19).
Since the outbreak of Coronavirus disease (COVID-19) caused by SARS-CoV-2 in December 2019, there has been no vaccine or specific antiviral medication for treatment of the infection where supportive care and prevention of complications is the current management strategy. In this work, the potential use of medicinal plants and more than 16 500 of their constituents was investigated within two suggested therapeutic strategies in the fight against SARS-CoV-2 including prevention of SARS-CoV-2 RNA synthesis and replication, through targeting vital proteins and enzymes as well as modulation of the host's immunity through production of virulence factors. Molecular docking studies on the viral enzymes 3Clpro, PLpro and RdRp suggested rocymosin B, verbascoside, rutin, caftaric acid, luteolin 7-rutinoside, fenugreekine and cyanidin 3-(6 00-malonylglucoside) as promising molecules for further drug development. Meanwhile, the medicinal plants Glycyrrhiza glabra, Hibiscus sabdariffa, Cichorium intybus, Chrysanthemum coronarium, Nigella sativa, Anastatica hierochuntica, Euphorbia species, Psidium guajava and Epilobium hirsutum were enriched in compounds with the multi-targets PTGS2, IL2, IL1b, VCAM1 and TNF such as quercetin, ursolic acid, kaempferol, isorhamnetin, luteolin, glycerrhizin and apigenin. Enriched pathways of the molecular targets included cytokine-cytokine receptor interaction, TNF signaling pathway, NOD-like receptor signaling pathway, Toll-like receptor signaling pathway, NF-kappa B signaling pathway and JAK-STAT3 signaling pathway which are all closely related to inflammatory, innate and adaptive immune responses. The present study identified natural compounds targeting SARS-CoV-2 for further in vitro and in vivo studies and emphasizes the potential role of medicinal plants in the mitigation of SARS-CoV-2.
The world is facing one of the biggest public health tragedies of our time, both in terms of socio-economic loss and death tolls due to the coronavirus COVID-19 pandemic. In a frantic race to find treatment for COVID-19, many interventions to discover drugs and vaccines are being expedited. Similarly, traditional herbal medicines are also being explored to find a cure for COVID-19. There are many traditional medicines that have exhibited promising antiviral and immuno-modulating properties against a plethora of infectious diseases like influenza, malaria, tuberculosis, and even COVID-19. Traditional medicine is an integral part of culture and practices in many countries with a vast and rich history of treating diseases. However, scientific research-based drug development approaches and effective regulatory mechanisms, on par with modern medicine, should be implemented to ensure safety, efficacy and overall validity of traditional medicine. Incorporating evidence-based traditional medicines in modern drug development paradigms can help assure affordability, accessibility and acceptability of the treatment approach. Furthermore, it can create pharmacological synergism to tackle drug resistance. Altogether, every country should create a roadmap for modernization and revival of traditional knowledge to improve the health care system and be better prepared for health crises.
The recent novel coronavirus disease (COVID-19) outbreak, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is seeing a rapid increase in infected patients worldwide. The host immune response to SARS-CoV-2 appears to play a critical role in disease pathogenesis and clinical manifestations. SARS-CoV-2 not only activates antiviral immune responses, but can also cause uncontrolled inflammatory responses characterized by marked pro-inflammatory cytokine release in patients with severe COVID-19, leading to lymphopenia, lymphocyte dysfunction, and granulocyte and monocyte abnormalities. These SARS-CoV-2-induced immune abnormalities may lead to infections by microorganisms, septic shock, and severe multiple organ dysfunction. Therefore, mechanisms underlying immune abnormalities in patients with COVID-19 must be elucidated to guide clinical management of the disease. Moreover, rational management of the immune responses to SARS-CoV-2, which includes enhancing anti-viral immunity while inhibiting systemic inflammation, may be key to successful treatment. In this review, we discuss the immunopathology of COVID-19, its potential mechanisms, and clinical implications to aid the development of new therapeutic strategies against COVID-19.
The world is currently facing a novel COVID-19 pandemic caused by SARS-CoV-2 that, as of July 12, 2020, has caused a reported 12,322,395 cases and 556,335 deaths. To date, only two treatments, remdesivir and dexamethasone, have demonstrated clinical efficacy through randomized controlled trials (RCTs) in seriously ill patients. The search for new or repurposed drugs for treatment of COVID-19 continues. We have witnessed anecdotal use of herbal medicines, including Artemisia spp. extracts, in low-income countries, and exaggerated claims of their efficacies that are not evidence based, with subsequent political controversy. These events highlight the urgent need for further research on herbal compounds to evaluate efficacy through RCTs, and, when efficacious compounds are identified, to establish the active ingredients, develop formulations and dosing, and define pharmacokinetics, toxicology, and safety to enable drug development. Derivatives from the herb Artemisia annua have been used as traditional medicine over centuries for the treatment of fevers, malaria, and respiratory tract infections. We review the bioactive compounds, pharmacological and immunological effects, and traditional uses for Artemisia spp. derivatives, and discuss the challenges and controversies surrounding current efforts and the scientific road map to advance them to prevent or treat COVID-19.
Background
Coronavirus disease 2019 (COVID-19) is caused by infection with severe acute respiratory syndrome coronavirus 2. COVID-19 has devastating effects on people in all countries and getting worse. We aim to investigate an in-silico docking analysis of phytochemical compounds from medicinal plants that used to combat inhibition of the COVID-19 pathway. There are several phytochemicals in medicinal plants, however, the mechanism of bioactive compounds remains unclear. These results are obtained from in silico research provide further information to support the inhibition of several phytochemicals.
Methods
Molecular docking used to determine the best potential COVID-19 M pro inhibitor from several bioactive compounds in Moringa oleifera, Allium cepa, Cocos nucifera, Psidium guajava, and Eucalyptus globulus. Molecular docking was conducted and scored by comparison with standard drugs remdesivir. ADME properties of selected ligands were evaluated using the Lipinski Rule. The interaction mechanism of the most recommended compound predicted using the STITCH database.
Results
There was no recommended compound in Moringa oleifera as a potential inhibitor for COVID-19. Oleanolic acid in Allium cepa, α-tocotrienol in Cocos nucifera, asiatic acid in Psidium guajava and culinoside in Eucalyptus globulus were the most recommended compound in each medicinal plant. Oleanolic acid was reported to exhibit anti-COVID-19 activity with binding energy was − 9.20 kcal/mol. This score was better than remdesivir as standard drug. Oleanolic acid interacted through the hydrogen bond with HIS41, THR25, CYS44, GLU166. Oleanolic acid binding with CASP-3, CASP-9, and XIAP signaling pathway.
Conclusions
Oleanolic acid in Allium cepa found as a potential inhibitor of COVID-19 M-pro that should be examined in future studies. These results suggest that oleanolic acid may be useful in COVID-19 treatment.
Medicinal plants are used from ancient times for treatment of various ailments. Aesculus hippocastanum (Horse chestnut), is the popular and most valuable tree native to the South East Europe. It's seed extracts and their concentrates contain phytocompounds like flavonoids, polyphenols, triterpenoid saponin glycosides (escin), epicatechin, tannins, kaempferol, esculin, fraxin, carbohydrate, essential fatty acids (linoleic acid), oleic acid and purine bases (adenine and guanine). Due to these vital phyto-constituents, horse chestnut is used in phytomedicine for the prevention and treatment of diverse disorders as in venous congestion in leg ulcers, bruises, arthritis, rheumatism, diarrhoea, phlebitis etc. We collected the pharmacological applications of Aesculus hippocastanum L. extracts and escin as the cheif bioactive compound and their uses in traditionally and clinically for the management of various disorders. This review describes the efficacy of A. hippocastanum L. extracts and their bioactive compounds. So in the furtue this plant may be useful for the alternative treatment measure for various ailments via incorporating either extract or escin into novel delivery systems for improving the social health in future and would provide improved quality of life.
Pulmonary arterial hypertension (PAH) is a severe disease characterized by the loss and obstructive remodeling of the pulmonary arterial wall, causing a rise in pulmonary arterial pressure and pulmonary vascular resistance, which is responsible for right heart failure, functional decline, and death. Although many drugs are available for the treatment of this condition, it continues to be life-threatening, and its long-term treatment is expensive. On the other hand, many natural compounds present in food have beneficial effects on several cardiovascular conditions. Several studies have explored many of the potential beneficial effects of natural plant products on PAH. However, the mechanisms by which natural products, such as nutraceuticals, exert protective and therapeutic effects on PAH are not fully understood. In this review, we analyze the current knowledge on nutraceuticals and their potential use in the protection and treatment of PAH, as well as whether nutraceuticals could enhance the effects of drugs used in PAH through similar mechanisms.
COVID-19 is associated with 5.1% mortality. Although the virological, epidemiological, clinical, and management outcome features of COVID-19 patients have been defined rapidly, the inflammatory and immune profiles require definition as they influence pathogenesis and clinical expression of COVID-19. Here we show lymphopenia, selective loss of CD4+ T cells, CD8+ T cells and NK cells, excessive T-cell activation and high expression of T-cell inhibitory molecules are more prominent in severe cases than in those with mild disease. CD8+ T cells in patients with severe disease express high levels of cytotoxic molecules. Histochemical studies of lung tissue from one fatality show sub-anatomical distributions of SARS-CoV-2 RNA and massive infiltration of T cells and macrophages. Thus, aberrant activation and dysregulation of CD8+ T cells occur in patients with severe COVID-19 disease, an effect that might be for pathogenesis of SARS-CoV-2 infection and indicate that immune-based targets for therapeutic interventions constitute a promising treatment for severe COVID-19 patients.
The recent outburst of novel Coronavirus disease (COVID-19), now a global pandemic highlights an urgent need for therapeutics targeting severe acute respiratory syndrome' (SARS-CoV-2). In Nigeria, infection cases are on daily rise with death rate of ~3 %. Therefore, slowing the spread of the virus will significantly reduce the strain on the healthcare system and governments. Here, we presented local medicinal plants cultivated in Nigeria as possible therapeutic approaches, exclusively targeting SARS-CoV-2 and its pathways. The study focused on some plants containing bioactive compounds that showed promising results against previous coronaviruses. Potential plants identified include Zingiber officinale, Allium cepa, Allium sativum, echinacea, euphorbia hirta, Garcenea kola, Curcuma longa, Aleo vera and olea europaea. Although inhibition of viral replication is seen as the possible mechanism for antiviral activity of most of the natural compounds, recent research has shown that some natural compounds can interact with major viral proteins associated with virulence. Thereby, showing they could be a valuable tool for possible inhibition, management and treatment of SARS-CoV-2. However, further research is required to investigate and validate their potential use as anti-SARS-CoV-2.
Background
The aim of the present review is to provide basic knowledge about the treatment of Coronavirus via medicinal plants. Coronavirus (COVID-19, SARS-CoV, and MERS-CoV) as a viral pneumonia causative agent, infects thousands of people in China and worldwide. There is currently no specific medicine or vaccine available and it is considered a threat to develop effective novel drug or anti-coronavirus vaccine treatment. However, natural compounds to treat coronaviruses are the most alternative and complementary therapies due to their diverse range of biological and therapeutic properties.
Methods
We performed an open-ended, English restricted search of Scopus database, Web of Science, and Pubmed for all available literature from Jan-March, 2020, using terms related to phytochemical compounds, medicinal plants and coronavirus.
Results
The view on anti-coronavirus (anti-CoV) activity in the plant derived phytochemicals and medicinal plants give the strong base to develop a novel treatment of corona virus activity. Various phytochemicals and medicinal plant extracts have been revised and considered to be the potential anti-CoV agents for effective control and future drug development. We discuss some important plants (Scutellaria baicalensis, Psorothamnus arborescens, Glycyrrhiza radix, Glycyrrhiza uralensis , Lycoris radiate, Phyllanthus emblica, Camellia sinensis, Hyptis atrorubens Poit, Fraxinus sieboldiana, Erigeron breviscapus, Citri Reticulatae Pericarpium, Amaranthus tricolor, Phaseolus vulgaris, Rheum palmatum, Curcuma longa and Myrica cerifera) emerged to have broad spectrum antiviral activity.
Conclusion
Nigella sativa has potent anti-SARS-CoV activity and it might be useful souce for developing novel antiviral therapies for coronaviruses.
Background: Airway inflammation plays a pivotal role in cold asthma. Winyanghuayin decoction and Xiaoqinglong decoction can significantly improve airway inflammation. The aim of the present study was to explore the therapeutic effect and mechanism of Winyanghuayin decoction and Xiaoqinglong decoction on OVA-induced cold asthma in rat and compare the effects of Winyanghuayin decoction and Xiaoqinglong decoction for treatment of cold asthma rats
Methods: The cold asthma rat model was induced by OVA and ice water swim stress, treated with Winyanghuayin decoction and Xiaoqinglong decoction respectively. The pulmonary function of asthmatic rats was detected by MIR Spirolab; The pathological changes of lung tissue were observed by HE staining; The autophagy in the lung of rats were observed by transmission electron microscopy; The eosinophils, lymphocytes, macrophages and total cells in bronchoalveolar lavage fluid (BALF) were counted under light microscope. The expression of IL-10\IL-13\TNF-α and TGF-β1 in serum were measured by enzyme-linked immunosorbent assay (ELISA); The protein level of LC3-II\I, ATG, PI3K and mTOR expression in lung tissues were detected by Western blot; Real-time polymerase chain reaction (RT-PCR) detected the expression of autophagy gene ATG3\ATG5\ATG7 and ATG12.
Results: Winyanghuayin decoction and Xiaoqinglong decoction can alleviate airway inflammation and improve airway hyper-responsiveness, significantly increased the level of autophagy in lung tissue and decreased the protein level of PI3K and mTOR in lung tissue of cold asthma rats. Winyanghuayin decoction have better regulation ability on autophagy and PI3K-mTOR signaling pathway.
Conclusion: Winyanghuayin decoction and Xiaoqinglong decoction may alleviate the airway inflammation symptoms by enhancing autophagy in lung tissue dependent on the PI3K-mTOR signaling pathway. Winyanghuayin decoction was more effective than Xiaoqinglong decoction for treatment of cold asthma.
Tuberculosis (TB), caused by the bacterial organism Mycobacterium tuberculosis, pose a major threat to public health, especially in middle and low-income countries. Worldwide in 2018, approximately 10 million new cases of TB were reported to the World Health Organization (WHO). There are a limited number of medications available to treat TB; additionally, multi-drug resistant TB and extensively-drug resistant TB strains are becoming more prevalent. As a result of various factors, such as increased costs of developing new medications and adverse side effects from current medications, researchers continue to evaluate natural compounds for additional treatment options. These substances have the potential to target bacterial cell structures and may contribute to successful treatment. For example, a study reported that green and black tea, which contains epigallocatechin gallate (a phenolic antioxidant), may decrease the risk of contracting TB in experimental subjects; cumin (a seed from the parsley plant) has been demonstrated to improve the bioavailability of rifampicin, an important anti-TB medication, and propolis (a natural substance produced by honeybees) has been shown to improve the binding affinity of anti-TB medications to bacterial cell structures. In this article, we review the opportunistic pathogen M. tuberculosis, various potential therapeutic targets, available therapies, and natural compounds that may have anti-TB properties. In conclusion, different natural compounds alone as well as in combination with already approved medication regimens should continue to be investigated as treatment options for TB.
Coronavirus disease 2019 (COVID-19) is an infectious disease initially reported in China and currently worldwide dispersed caused by a new coronavirus (SARS-CoV-2 or 2019-nCoV) affecting more than seven million people around the world causing more than 400 thousand deaths (on June 8th, 2020). The diagnosis of COVID-19 is based on the clinical and epidemiological history of the patient. However, the gold standard for COVID-19 diagnosis is the viral detection through the amplification of nucleic acids. Although the quantitative Reverse-Transcription Polymerase Chain Reaction (RT-PCR) has been described as the gold standard for diagnosing COVID-19, there are several difficulties involving its use. Here we comment on RT-PCR and describe alternative tests developed for the diagnosis of COVID-19.
Lindera obtusiloba is widespread in northeast Asia and used for treatment of improvement of blood circulation and anti-inflammation. In this study, we investigated anti-inflammatory and anti-oxidant effects of the methanolic extract of L. obtusiloba leaves (LOL) in an ovalbumin (OVA)-challenged allergic asthma model and tumor necrosis factor (TNF)-α-stimulated NCI-H292 cell. Female BALB/c mice were sensitized with OVA by intraperitoneal injection on days 0 and 14, and airway-challenged with OVA from days 21 to 23. Mice were administered 50 and 100 mg/kg of LOL by oral gavage 1 h before the challenge. LOL treatment effectively decreased airway hyper-responsiveness and inhibited inflammatory cell recruitment, Th2 cytokines, mucin 5AC (MUC5AC) in bronchoalveolar lavage fluid in OVA-challenged mice, which were accompanied by marked suppression of airway inflammation and mucus production in the lung tissue. LOL pretreatment inhibited the phosphorylation of mitogen-activated protein kinases (MAPKs) and nuclear factor-kappa B (NF-κB) with suppression of activator protein (AP)-1 and MUC5AC in the lung tissue. LOL also down-regulated expression of inflammatory cytokines, and inhibited the activation of NF-κB in TNF-α-stimulated NCI-H292 cells. LOL elevated the translocation of nuclear factor-erythroid 2-related factor (Nrf-2) into nucleus concurrent with increase of heme oxyngenase-1 (HO-1) and NAD(P)H quinine oxidoreductase 1 (NQO1). Moreover, LOL treatment exhibited a marked increase in the anti-oxidant enzymes activities, whereas effectively suppressed the production of reactive oxygen species and nitric oxide, as well as lipid peroxidation in lung tissue of OVA-challenged mice and TNF-α-stimulated NCI-H292 cells. These findings suggest that LOL might serve as a therapeutic agent for the treatment of allergic asthma.
The current outbreak of coronavirus disease 2019 (COVID-19) has been defined as a pandemic by the World Health Organization. We aimed to evaluate the clinical features and virological course of non-severe COVID-19 patients with or without symptoms who were admitted to a Chinese cabin hospital. In this retrospective single center study, we reviewed 252 laboratory-confirmed COVID-19 patients treated at one temporary cabin hospital in Wuhan, China. Demographic, clinical, serial chest computed tomography (CT), and serial viral test data were compared between asymptomatic and symptomatic patients. The association between clinical features and symptomatic status or patient referral status was analyzed. Among all 252 patients, 74 (29.4%) were asymptomatic and 138 (54.76%) had more than two family members who developed COVID-19. The probability for family clustering was similar between asymptomatic and symptomatic patients (59.70 vs. 61.64%, P = 0.79). Asymptomatic patients and symptomatic patients were equally likely to reach a virus-free state during their stay at the cabin hospital (93.15 vs. 86.44%, P = 0.13). The initial chest CT screening showed that 81 (32.1%) patients had no visible pneumonia, 52 (20.6%) had unilateral pneumonia, and 119 (47.2%) had bilateral pneumonia. Symptomatic patients had a higher chance to have bilateral pneumonia (P < 0.0001) and were less likely to show improvement on the follow-up CT scan (P = 0.0002). In total, 69 (27.4%) patients were referred to the designated hospital and only 23 (9.1%) patients were referred due to the progression of pneumonia. Non-severe COVID-19 patients can transmit the disease regardless of their symptomatic status. It is highly recommended that asymptomatic patients be identified and quarantined to eliminate the transmission of COVID-19.
Objective: Many studies on the treatment of tuberculosis (TB) using herbal medicines have been undertaken in recent decades in East Africa. The details, however, are highly fragmented. The purpose of this study was to provide a comprehensive overview of the reported medicinal plants used to manage TB symptoms, and to analyze scientific reports on their effectiveness and safety.
Method: A comprehensive literature search was performed in the major electronic databases regarding medicinal plants used in the management of TB in East Africa. A total of 44 reports were retrieved, and data were collected on various aspects of the medicinal plants such as botanical name, family, local names, part (s) used, method of preparation, efficacy, toxicity and phytochemistry. The data were summarized into percentages and frequencies which were presented as tables and graphs. Results: A total of 195 species of plants belonging to 68 families and 144 genera were identified. Most encountered species were from Fabaceae (42.6%), Lamiaceae (19.1%), Asteraceae (16.2%) and Euphorbiaceae (14.7%) families. Only 36 medicinal plants (18.5%) have been screened for antimycobacterial activity. Out of these, 31 (86.1%) were reported to be bioactive with minimum inhibitory concentrations ranging from 47-12500 µg/ml. Most tested plant extracts were found to have acceptable acute toxicity profiles with cytotoxic concentrations on normal mammalian cells greater 200 µg/ml. The most commonly reported phytochemicals were flavonoids, terpenoids, alkaloids, saponins, cardiac glycosides and phenols. Only Tetradenia riparia, Warburgia ugandensis and Zanthoxylum leprieurii have further undergone isolation and characterization of the pure bioactive compounds.
Conclusion: East Africa has a rich diversity of medicinal plants that have been reported to be effective in the management of symptoms of TB. More validation studies are required to promote the discovery of antimycobacterial drugs and to provide evidence for standardization of herbal medicine use.
After its recent discovery in patients with serious pneumonia in Wuhan (China), the 2019 novel coronavirus (2019-nCoV), named also Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has spread quickly. Unfortunately, no drug or vaccine for treating human this coronavirus infection is available yet. Numerous options for controlling or preventing emerging 2019-nCoV infections may be predicted, including vaccines, interferon therapies, and small-molecule drugs. However, new interventions are likely to require months to years to develop. In addition, most of the existing antiviral treatments frequently lead to the development of viral resistance combined with the problem of side effects, viral re-emergence, and viral dormancy. The pharmaceutical industry is progressively targeting phytochemical extracts, medicinal plants, and aromatic herbs with the aim of identifying lead compounds, focusing principally on appropriate alternative antiviral drugs. Spices, herbal medicines, essential oils (EOs), and distilled natural products provide a rich source of compounds for the discovery and production of novel antiviral drugs. The determination of the antiviral mechanisms of these natural products has revealed how they interfere with the viral life cycle, i.e., during viral entry, replication, assembly, or discharge, as well as virus-specific host targets. Presently, there are no appropriate or approved drugs against CoVs, but some potential natural treatments and cures have been proposed. Given the perseverance of the 2019-nCoV outbreak, this review paper will illustrate several of the potent antiviral chemical constituents extracted from medicinal and aromatic plants, natural products, and herbal medicines with recognized in vitro and in vivo effects, along with their structure-effect relationships. As this review shows, numerous potentially valuable aromatic herbs and phytochemicals are awaiting assessment and exploitation for therapeutic use against genetically and functionally different virus families, including coronaviruses.
Background
To face the current COVID-19 pandemic, diagnostic tools are essential. It is recommended to use real-time RT-PCR for RNA viruses in order (i) to perform a rapid and accurate diagnostic, (ii) to guide patient care and management and (iii) to guide epidemiological strategies. Further studies are warranted to define the role of serological diagnosis and a possible correlation between serological response and prognosis.
Objectives
To guide clinical microbiologists in the use of these diagnostic tests and clinicians in the interpretation of their results.
Sources
A research of literature was performed through PubMed and Google Scholar using the keywords SARS-CoV-2, SARS-CoV-2 molecular diagnosis, SARS-CoV-2 immune response, SARS-CoV-2 serology/antibody testing, coronavirus diagnosis.
Content
The present review discusses performances, limitations and use of current and future diagnostic tests for SARS-CoV-2.
Implications
Real-time RT-PCR remains the reference method for diagnosis of SARS-CoV-2 infection. On the other hand, notwithstanding its varying sensitivity according to the time of infection, serology represents a valid asset (i) to try to solve possible discrepancies between a highly suggestive clinical and radiological presentation and negative RT-PCR, (ii) to solve discrepancies between different PCR assays, and (iii) for epidemiological purposes.
Background:
Coronavirus disease 2019 (COVID-19) is a respiratory illness that can spread from person to person. The virus that causes COVID-19 is a novel coronavirus that was first identified during an investigation into an outbreak in Wuhan, China. The clinical spectrum of SARS-CoV-2 infection appears to be wide, encompassing asymptomatic infection, mild upper respiratory tract illness, and severe viral pneumonia with respiratory failure and even death, with many patients being hospitalised with pneumonia. In China and East Asia, Chinese medicine has been widely used to treat diverse diseases for thousands of years. As an important means of treatment now, Chinese medicine plays a significant role in the treatment of respiratory diseases in China. The aim of this study is to assess the efficacy and safety of Chinese medicine for COVID-19.
Methods:
We will search the following sources for the identification of trials: The Cochrane Library, PubMed, EMBASE, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure Database (CNKI), Chinese Science and Technique Journals Database (VIP), and the Wanfang Database. All the above databases will be searched from the available date of inception until the latest issue. No language or publication restriction will be used. Randomized controlled trials will be included if they recruited participants with COVID-19 for assessing the effect of Chinese medicine vs control (placebo, no treatment, and other therapeutic agents). Primary outcomes will include chest CT and nucleic acid detection of respiratory samples. Two authors will independently scan the articles searched, extract the data from articles included, and assess the risk of bias by Cochrane tool of risk of bias. Disagreements will be resolved by consensus or the involvement of a third party. All analysis will be performed based on the Cochrane Handbook for Systematic Reviews of Interventions. Dichotomous variables will be reported as risk ratio or odds ratio with 95% confidence intervals (CIs) and continuous variables will be summarized as mean difference or standard mean difference with 95% CIs.
Results and conclusion:
The available evidence of the treatment of COVID-19 with traditional Chinese medicine will be summarized, and evaluation of the efficacy and the adverse effects of these treatments will be made. This review will be disseminated in print by peer-review.
COVID-19 is a viral disease caused by a new severe acute respiratory syndrome (SARS-CoV-2), which has quickly resulted in a pandemic. As a great threat to global public health, the development of a treatment has become vital, and a rush to find a cure has mobilized researchers from all areas across the world. Synthetic drugs, such as hydroxychloroquine, have gained attention. However, the efficacy of repositioned drugs is still under evaluation, and besides, some severe side effects are a cause for concern. This emphasizes the urgency for treatment options, which can be both safe and effective. With this in mind, natural products could be an important resource in the development of COVID-19 treatment, as they have already contributed in the past to treatments against other viruses, such as HIV, MERS-CoV, and influenza. Natural products are described long term as bioactive substances and some phytochemical classes such as flavonoids, alkaloids, and peptides are known antiviral bioproducts, and have been virtually tested with success against COVID-19. However, important issues still need to be addressed as to their bioavailability and true efficacy in vivo. This review intends to systematically evaluate the natural metabolites that could potentially be used against this new disease looking at their natural sources, mechanism of action and previous pharmacological usages. The aim is to provide a starting point for this research area in order to speed up the establishment of anti-SARS-CoV-2 bioproducts.
Ethnopharmacological relevance:
Daphne pseudomezereum var. koreana Hamaya is distributed in the Gangwon-do of South Korea and is traditionally used to treat chronic inflammatory diseases, including rheumatoid arthritis.
Aim of the study:
We investigated the anti-inflammatory effect of biflavonoid-rich fraction (BF) obtained from an extract of D. pseudomezereum leaves on lipopolysaccharide (LPS)-stimulated RAW264.7 macrophages and mouse model of ovalbumin (OVA)-induced allergic asthma.
Materials and methods:
Neochamaejasmin B (NB) and chamaejasmin D (CD) were spectroscopically characterized as major components of BF obtained from the leaves of D. pseudomezereum. RAW264.7 cells pretreated with NB, CD and BF and activated by LPS (500 ng/ml) were used to assess the anti-inflammatory effects of these materials in vitro. To evaluate the protective effect of BF on allergic asthma, female BALB/c mice were sensitized to OVA by intraperitoneal (i.p.) injection and treated with BF by oral administration (15 or 30 mg/kg).
Results:
Pretreatment with BF inhibited LPS-stimulated nitric oxide (NO), TNF-α and IL-6, and led to upregulation of heme oxygenase-1 (HO-1) in RAW264.7 macrophages. Orally administered BF significantly inhibited the recruitment of eosinophils and the production of IL-5, IL-6, IL-13 and MCP-1 as judged by the analysis of BALF from OVA-induced asthma animal model. BF also decreased the levels of IgE in the serum of asthmatic mice. BF suppressed the influx of inflammatory cells into nearby airways and the hypersecretion of mucus by the airway epithelium of asthmatic mice. In addition, the increase in Penh in asthmatic mice was reduced by BF administration. Furthermore, BF led to Nrf2 activation and HO-1 induction in the lungs of mice.
Conclusions:
These data have shown the anti-asthmatic effects of BF, and therefore we expect that BF may be a potential candidate as a natural drug/nutraceutical for the prevention and treatment of allergic asthma.
At the end of 2019, a novel flu‐like coronavirus named COVID‐19 (coronavirus disease 2019) was recognized by World Health Organization. No specific treatments exist for COVID‐19 at this time. New evidence suggests that therapeutic options focusing on antiviral agents may alleviate COVID‐19 symptoms as well as those that lead to the decrease in the inflammatory responses. Flavonoids, as phenolic compounds, have attracted considerable attention due to their various biological properties. In this review, the promising effects and possible mechanisms of action of naringenin, a citrus‐derived flavonoid, against COVID‐19 were discussed. We searched PubMed/Medline, Science direct, Scopus, and Google Scholar databases up to March 2020 using the definitive keywords. The evidence reviewed here indicates that naringenin might exert therapeutic effects against COVID‐19 through the inhibition of COVID‐19 main protease, 3‐chymotrypsin‐ like protease (3CLpro), and reduction of angiotensin converting enzyme receptors activity. One of the other mechanisms by which naringenin might exert therapeutic effects against COVID‐19 is, at least partly, by attenuating inflammatory responses. The antiviral activity of the flavanone naringenin against some viruses has also been reported. On the whole, the favorable effects of naringenin lead to a conclusion that naringenin may be a promising treatment strategy against COVID‐19.
Commonly used drugs for treating many conditions are either natural products or derivatives. In silico modelling has identified several natural products including quercetin as potential highly effective disruptors of the initial infection process involving binding to the interface between the SARS-CoV-2 (Covid-19) Viral Spike Protein and the epithelial cell Angiotensin Converting Enzyme-2 (ACE2) protein. Here we argue that the oral route of administration of quercetin is unlikely to be effective in clinical trials owing to biotransformation during digestion, absorption and metabolism, but suggest that agents could be administered directly by alternative routes such as a nasal or throat spray.