|
 
 |
| REVIEW ARTICLE |
|
| Year : 2020 | Volume
: 14
| Issue : 4 | Page : 100-102 |
|
Herbs and COVID-19 Pandemic
Anubha Chaudhary1, Sandeep Garud2, Mita Kotecha1
1 Department of Dravyaguna, National Institute of Ayurveda, Jaipur, Rajasthan, India
2 Department of Dravyaguna, Sri Ram Ayurveda Medical College and Hospital, Meerut, Uttar Pradesh, India
| Date of Submission | 10-Aug-2020 |
| Date of Decision | 25-Sep-2020 |
| Date of Acceptance | 26-Sep-2020 |
| Date of Web Publication | 28-Dec-2020 |
Correspondence Address:
Anubha Chaudhary
Department of Dravyaguna, National Institute of Ayurveda, Jaipur, Rajasthan
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/joa.joa_133_20
Objective: COVID-19 is the most recently discovered infectious disease by coronavirus. The WHO has declared it a pandemic. Since its outbreak in Wuhan, China, in December 2019, scientists all over the world are working hard to find a treatment modality. However, till now, there has been no definite treatment for COVID-19. The world is looking hopefully towards Ayurveda for the prevention and treatment of COVID-19. Data Source: The data was collected from classical texts of Ayurveda along with modern literature and scientific publications. Review Method: All the data was critically analysed in the context of COVID 19. Result: The Ayurveda herbs with Rasayan, Shwas-Kaashara, Krimighna activity like Haridra, Guduchi, Amalaki, Maricha, Twak, Ashwagandha, and Tulasi are showing promising results in initial experimental studies. Conclusion: Various chemical constituents present in these herbs are responsible for preventing cytokine storm and viral penetration and replication in host cells. These herbs also improve immunological function.
Keywords: Ayurveda, COVID-19, herbs, immunomodulation, pandemic
How to cite this article:
Chaudhary A, Garud S, Kotecha M. Herbs and COVID-19 Pandemic. J Ayurveda 2020;14:100-2 |
| Introduction | |  |
COVID-19 has been declared as Public Health Emergency of International Concern by the WHO.[1] In India, the total number of COVID-19 cases have raised to 2.5 million as of August 14, 2020 with 6.7 lakhs active cases.[2] COVID-19 is an infectious disease caused by the novel coronavirus. The symptoms of COVID-19 vary from person to person. Different people are affected in different ways by novel coronavirus. The common symptoms include fever, dry cough, and tiredness, whereas less common symptoms include aches and pains, sore throat, diarrhea, conjunctivitis, loss of taste or smell, and skin rashes. Severe symptoms include difficulty in breathing, chest pain, and loss of movement.[3]
The biomarkers – the study of biomarkers behave during the progression of disease could help in planning the treatment and subsequently improving the prognosis. The main biomarkers involved in COVID-19 are:
- C-reactive protein (CRP): Studies have shown that the CRP levels were significantly higher than the erythrocyte sedimentation rate in the early stages of severe cases. This proves that CRP is an important biomarker in indicating disease development[4]
- Interleukin-6: Interleukin-6 is the most common type of cytokine released by macrophages. Interleukin-6 levels rise sharply in severe cases of COVID-19[5]
- Lymphopenia: The meta-analysis of 23 articles was associated with poor outcome in COVID-19 patients. The meta-analysis showed that the association of low lymphocyte count with increased mortality, acute respiratory distress syndrome, need for intensive care unit care, and severity of COVID-19 was stronger in younger patients as compared to older ones[6]
- Lactate dehydrogenase: Lactate dehydrogenase enzyme converts pyruvate to lactate in glucose metabolism. During viral infection or lung damage, lactate dehydrogenase secretion is triggered by necrosis of the cell membrane.[7]
The other biomarkers associated with COVID-19 include granulocyte colony-stimulating factor, interferon gamma-inducible protein 10, monocyte chemoattractant protein 1, macrophage inflammation protein 1 alpha, and tumor necrosis factor alpha. All these factors suggest cytokine storm and immunosuppression in COVID-19.
Ayurveda has a specific approach toward treatment. As per Ayurveda, the disease should be treated as early as possible.[8] The same concept applies to infectious diseases as the prevention of spread of infection is a critical step in the treatment of infectious diseases. To prevent infectious diseases from getting worse, it is necessary to improve immunity. Ayurveda has the concept of Sahaja (by birth), Kalaja (by virtue of season or age), and Yuktikrit (acquired immunity) Bala (immunity).[9]
As evident from biomarker evaluation, there is impaired immunological function in COVID-19. The immunomodulating herbs of Ayurveda have a crucial role to play in the prevention and treatment of COVID-19.
Herbs for COVID-19:
- Haridra: The rhizome of Curcuma longa Linn. belonging to the family Zingiberaceae is used medicinally as Haridra. Haridra pacifies Kapha and Vaat Dosha while balances Pitta Dosha.[10] Haridra is Shothanashak (anti-inflammatory).[11] Haridra is also Vishanashak (eliminates toxins) and Peenasanashini (treats coryza).[12] The main phytochemical present in Haridra is curcumin. Curcumin possesses antioxidant, anti-inflammatory, gastroprotective, and hepatoprotective activities.[13] Many preclinical studies have shown that curcumin inhibits viral infection, checks cytokine storm and thus prevents severe lung injury, and inhibits subsequent fibrosis.[14] The anti-SARS-CoV replication and 3CL protease activity of curcumin have been reported in an in vitro study[15]
- Guduchi: The botanical source of Guduchi is Tinospora cordifolia Willd. Miers ex Hookf. and Thomas, belonging to the family Menispermaceae. Guduchi is a Rasayan (rejuvenator) drug and balances the Tri-Dosha.[16] As per Ayurveda, Guduchi is Jwarhara (antipyretic) and prevents Shwas (dyspnea) and Kaas (cough).[17] Tinospora cordifolia has found to be effective in preventing the attachment of the SARS-CoV-2 virus with host cells as well as replication of virus. Tinocordiside and isocolumbin have shown high efficacy in preventing SARS-CoV-2 attachment to host cells and replication[18]
- Aamalaki: The fruits of Emblica officinalis Gaertn. belonging to the family Euphorbiaceae are used as medicine in Ayurveda. Aamalaki is also a Rasayan (rejuvenator) drug and balances the Tri-Dosha.[19] Apart from this, Aamalaki is known for its antipyretic action.[20] The phytochemicals such as anthocyanins, flavonoids, ellagic acid, and gallic acid present in Emblica officinalis exhibit many biological activities such as anti-oxidant, anti-inflammatory, and immunomodulatory activities.[21]
- Maricha:Botanically, the fruits of Piper nigrum Linn. (family – Piperaceae) are used as Marich in Ayurveda. Marich balances Kapha and Vaat Dosha. Marich is extensively used in Ayurveda for the treatment of Shwas (dyspnea) and Kaas (cough).[22] The in silico study has shown that the chemical constituents of Piper nigrum such as piperdardiine and piperanine are active against COVID-19 with significant glide score[23]
- Twak: The bark of Cinnamomum zeylanica Blume (C. Verum J. S) is used as Twak in Ayurveda. It balances Vaat and Kapha while increases Pitta.[24] Dhanwantari Nighantu had indicated that Twak eliminates toxins out of the body.[25] Kaidev Nighantu has mentioned that Twak is Peenashara (alleviates coryza).[26] The experimental studies have proved that cinnamon at high dose increases both cell-mediated and humoral immunity and at low dose shows effect only on humoral immunity[27]
- Ashwagandha: The botanical source of Ashwagandha is Withania somnifera Linn. Dunal. It pacifies Vaat and Kapha. Ashwagandha is a Rasayan (rejuvenator) drug.[28] Ashwagandha is also indicated for the treatment of Shwas (dyspnea) and Kaas (cough).[27] Studies by molecular modeling tools have shown that withaferin-A and withanone present in Ashwagandha could bind and stably interact at the catalytic site of TMPRSS2. Withanone is also able to induce changes in the allosteric site of TMPRSS2. Withanone by blocking TMPRSS2 blocks the entry of SARS-CoV-2 to the host cell[29]
- Tulasi: Tulasi is a sacred plant in Indian culture. Tulasi is also extensively used in Ayurveda. The botanical source of Tulasi is Ocimum sanctum Linn. (family – Lamiaceae). Tulasi pacifies Vaat and Kapha and is a famous drug for diseases of the respiratory system.[30] The study on Ocimum sanctum seed oil has shown that it can modulate both humoral and cell-mediated responses in both stressed and nonstressed experimental animals. This could be attributed to the effect on the GABA pathway.[31] The methanolic and aqueous extracts of Tulasi leaves have also shown the ability to stimulate humoral activity.[32]
| Conclusion | | |
Many of the herbs have the potential to fight against COVID-19. The herbs which have been mentioned in classics of Ayurveda as Rasayan, Shwas-Kaashara, Vishaghna, and Kriminashak should be screened for potential activity against the novel coronavirus. The drugs with these pharmacological actions generally improve the immune response. The above mentioned drugs have proved their efficacy against novel coronavirus in the initial screening. Further clinical studies will prove the role of Ayurveda in the prevention and treatment of COVID-19.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | |
| 2. | |
| 3. | |
| 4. | Tan C, Huang Y, Shi F, Tan K, Ma Q, Chen Y. C-reactive protein correlates with computed tomographic findings and predicts severe Covid-19 early. J Med Virol 2020; 92(7):856-862.  |
| 5. | Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. Lancet 2020;395:507-13. |
| 6. | Huang I, Pranata R. Lymphopenia in severe coronavirus disease-2019 (COVID-19): Systematic review and meta-analysis. J Intensive Care 2020;8:36. |
| 7. | Muhammed K, Khalsa RK, Pillai K, Ismail Z, Harky A. The role of biomarkers in diagnosis of COVID-19 - A systematic review Life Sci 2020;254:117788. |
| 8. | Ambika K, Shashtri D, editor. Sushrut Samhita, Sutra Sthan, Vranprashna Adhyaya, 21/37. Varanasi: Chaukhambha Sanskrit Sansthan, Reprint; 2009. p. 121. |
| 9. | Trieshaniyaadhyaya. Trieshaniyaadhyaya. Charak Samhita with Vidyotini Hindi Commentary. Varanasi: 11/36, Chaukhambha Vishvabharti, Reprint; 2005. p. 228. |
| 10. | Sharma PV. Dravyaguna Vigyan-vol-II. Varanasi: Chaukhambha Bharti Academy, reprint; 2013. p. 162. |
| 11. | Chunekar KC, editor. Bhavmishra, Haritakyadi Varga, Bhavprakash Nighantu with Commentary. Varanasi: Chaukhambha Bharti Academy, reprint; 2013. p. 111. |
| 12. | Sharma PV, editor. Mahendra Bhogik, Guduchyadi Varga, Dhanvantari Nighantu. Varanasi: Chaukhambha Orientalia, reprint; 2016. p. 26. |
| 13. | Khare CP., Indian Medicinal Plants - An Illustrated Dictionary. Delhi: Springer; 2007. p. 187. |
| 14. | Liu Z, Ying Y. The inhibitory effect of curcumin on virus-induced cytokine storm and its potential use in the associated severe pneumonia. Front Cell Dev Biol 2020;8:479. |
| 15. | Wen CC, Kuo YH, Jan JT, Liang PH, Wang SY, Liu HG, et al. Specific plant terpenoids and lignoids possess potent antiviral activities against severe acute respiratory syndrome coronavirus. J Med Chem 2007;50:4087-95. |
| 16. | Sharma PV. Dravyaguna Vigyan-vol-II. Varanasi: Chaukhambha Bharti Academy, Reprint; 2013. p. 761. |
| 17. | Chunekar KC. Bhavmishra, Guduchyadi Varga, Bhavprakash Nighantu with Commentary. Varanasi: Chaukhambha Bharti Academy, Reprint; 2013. p. 257. |
| 18. | Sagar V, Kumar AH. Efficacy of natural compounds from Tinospora cordifolia against SARS-CoV-2 protease, surface glycoprotein and RNA polymerase. BEMS Rep 2020;6:6-8. |
| 19. | Sharma PV. Dravyaguna Vigyan-vol-II. Varanasi: Chaukhambha Bharti Academy, Reprint; 2013. p. 758. |
| 20. | Sharma PV, editor. Mahendra Bhogik, Guduchyadi Varga, Dhanvantari Nighantu. Varanasi: Chaukhambha Orientalia, Reprint; 2016. p. 55. |
| 21. | Sai Ram M, Neetu D, Yogesh B, Anju B, Dipti P, Pauline T, et al. Cyto-protective and immunomodulating properties of Amla (Emblica officinalis) on lymphocytes: An Invitro study. J Ethnopharmacol 2020;81:5-10. |
| 22. | Sharma PV. Dravyaguna Vigyan-vol-II. Varanasi: Chaukhambha Bharti Academy, Reprint; 2013. p. 362. |
| 23. | Rajagopal K, Byran G, Jupudi S, Vadivelan R. Activity of phytochemical constituents of black pepper, ginger and garlic against coronavirus (COVID-19): An in silico approach. Int J Health Allied Sci 2020;9 Suppl S1:43-50. |
| 24. | Sharma PV. Dravyaguna Vigyan-vol-II. Varanasi: Chaukhambha Bharti Academy, reprint; 2013. p. 250. |
| 25. | Sharma PV, editor. Mahendra Bhogik, Shatpushpadi Varga, Dhanvantari Nighantu. Varanasi: Chaukhambha Orientalia, reprint; 2016. p. 79. |
| 26. | Sharma PV, editor. Kaidev, Aushadhi Varga, Kaidev Nighantu. Varanasi: Chaukhambha Orientalia, reprint; 2016. |
| 27. | Niphade SR, Asad MD, Gowda KC, Emmanuel T, Deshmukh P. Immunomodulatory activity of Cinnamomum zeylanicum bark. J. Pharm Biol 2009:1168-73. |
| 28. | Sharma PV. Dravyaguna Vigyan-vol-II. Varanasi: Chaukhambha Bharti Academy, Reprint; 2013. p. 763. |
| 29. | Kumar V, Dhanjal JK, Bhargava P, Kaul A, Wang J, Zhang H, et al. Withanone and Withaferin-A are predicted to interact with transmembrane protease serine 2 (TMPRSS2) and block entry of SARS-CoV-2 into cells. J Biomol Struct Dyn 2020:1-3. |
| 30. | Sharma PV. Dravyaguna Vigyan-vol-II. Varanasi: Chaukhambha Bharti Academy, reprint; 2013. p. 709. |
| 31. | Mitra SK, Gupta M, Shrama DN. Immunomodulatory effect of IM-133. Phytother Res 1999;13:341-3. |
| 32. | Mediratta PK, Dewan V, Bhattacharya SK, Gupta VS, Maiti PC, Sen P. Effect of Ocimum sanctum Linn. On humoral immunity response. Indian J Med Res 1988;87:384-6. |
|
Search Pubmed for