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 Table of Contents  
REVIEW ARTICLE
Year : 2020  |  Volume : 14  |  Issue : 4  |  Page : 92-99

Rationality and applicability of Jeevaneeya mahakashaya (Rejuvenating and vitality boosting herbs) in prevention and management of COVID-19


Department of Dravyaguna, All India Institute of Ayurveda, New Delhi, India

Date of Submission03-Aug-2020
Date of Decision18-Sep-2020
Date of Acceptance26-Sep-2020
Date of Web Publication28-Dec-2020

Correspondence Address:
Shivani Ghildiyal
Department of Dravyaguna, All India Institute of Ayurveda, New Delhi - 110 076
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joa.joa_153_20

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  Abstract 


Introduction: COVID-19, caused by SARS-CoV-2 or novel corona virus is declared as a global emergency. Researchers are working hard to develop effective remedy and vaccine, but still the challenge to manage the spread and disease progression is existing. In Ayurveda, a good number of herbs are ascribed for health promotion and longevity; many of them are scientifically proven to boost immunity. Jeevaneeya mahakashaya of Charaka Samhita is such group of ten herbs enumerated for longevity and rejuvenation. However, few of the herbs of Jeevaneeya mahakashaya are endangered and not available easily. Thus, in the present article, the herbs of Jeevaneeya mahakashaya having Pratinidhi (substitutes) suggested in Bhavaprakasha Nighantu were reviewed. Objective: The objective of this study is to analyze the rationality and applicability of Jeevaneeya mahakashaya in the prevention and management of COVID-19. Data Source: The data was collected from Charaka Samhita and Bhavaprakasha Nighantu and PubMed database. Review Methods: Jeevaneeya mahakashaya and its Pratinidhi herbs were reviewed from Charaka Samhita and Bhavaprakasha Nighantu, respectively. Herbs of Jeevaneeya mahakashaya were also reviewed from PubMed data base for reported pharmacological activities beneficial in the management of COVID-19 by their botanical name. Results: The literature search revealed that the herbs enumerated in the Jeevaneeya mahakashaya were scientifically evaluated in various preclinical and clinical studies and showed anti-viral, anti-bacterial, immunomodulatory, anti-inflammatory, anti-oxidant, anti-tussive, cardio-protective, neuroprotective, nephroprotective, and hepatoprotective activity. These potential of herbs may help in CD4+ and CD8+ cell proliferation, interleukin 6, tumour necrosis factor alpha, inflammatory markers inhibition. It also protects various organs from damage, and improves respiration. Conclusion: The rational use of plants of Jeevaneeya mahakashaya may help in the prevention and management of SARS-CoV 2.

Keywords: Ayurveda, COVID-19, interleukin-6, immunity, Jeevaneeya mahakashaya, tumor necrosis factor alpha


How to cite this article:
Kumar V, Ghildiyal S, Nesari T. Rationality and applicability of Jeevaneeya mahakashaya (Rejuvenating and vitality boosting herbs) in prevention and management of COVID-19. J Ayurveda 2020;14:92-9

How to cite this URL:
Kumar V, Ghildiyal S, Nesari T. Rationality and applicability of Jeevaneeya mahakashaya (Rejuvenating and vitality boosting herbs) in prevention and management of COVID-19. J Ayurveda [serial online] 2020 [cited 2021 Jan 23];14:92-9. Available from: http://www.journayu.in/text.asp?2020/14/4/92/304895




  Introduction Top


Charaka Samhita, the best Ayurveda classic for medicine has given therapeutic classification of herbs. A group of ten herbs having identical therapeutic use is known as Mahakashaya. In this way, a total of 50 Mahakashayas are enumerated as a ready reference for health promotion and disease management. The very first group of ten herbs mentioned on the theme of therapeutic grouping of herb is named as Jeevaneeya mahakashaya (the group of herbs for vitality).[1] The root meaning of Jeevaneeya is Ayushya or beneficial for life.[2] The herbs enumerated under Jeevaneeya mahakashaya are Jeevaka (Malaxis musifera [Lindl.] Kuntze), Rishabhaka (Crepidium acuminatum [D. Don] Szlach.), Meda (Polygonatum cirrhifolium [Wall.] Royle), Mahameda (Polygonatum verticillatum [L.] All.), Kakoli (Roscoea purpurea Sm.), Ksheerakakoli (Lilium polyphyllum D. Don), Mudagparni (Phaseolus trilobus Aiton.), Mashaparni (Teramnus labialis [L. f.] Spreng.), Jeevanti (Leptadenia reticulata [Retz.] Wight and Arn.) and Madhuka (Glycyrrhiza glabra L.). Among the above ten herbs, six (Jeevaka, Rishbhaka, Kakoli, Ksheerakakoli, Meda, and Mahameda) are endangered and not easily available. Thus, Acharya Bhavaprakasha has mentioned Pratinidhi dravya (substitutes) for those endangered herbs. Thus, by using these Pratinidhi herbs for endangered one, we may constitute a contemporary Jeevaneeya mahakashaya. Therefore, in place of Jeevaka and Rishbhaka, Vidarikanda (Pueraria tuberosa [Willd.] DC.), for Kakoli and Ksheerakakoli, Aswagandha (Withania somnifera [L.] Dunal), and Shatavari (Asparagus racemosus Willd) for Meda and Mahameda can be used.[3]

Thus, Vidarikanda, Aswagandha, Shatavari, Mudagparni, Mashaparni, Jeevanti, and Madhuka are the herbs which may constitute contemporary Jeevaneeya mahakashaya. Most of the herbs of Jeevaneeya mahakashaya are evaluated for various pharmacological activities, i.e., anti-viral, anti-bacterial, anti-tussive, anti-inflammatory, immunomodulatory, anti-oxidant, neuroprotective, cardioprotective, hepatoprotective, and nephroprotective, but their role in the prevention and management of COVID-19 is still not critically appraised.

In the present article, herbs of Jeevaneeya mahakashya were reviewed from PubMed data base and critically analyzed for their possible role in the prevention and management of COVID-19.

The classical Ayurveda review was done manually from Charaka Samhita, Ayurvedadipika commentary of Cakrapanidatta, and Bhavaprakasha Nighantu with commentary of K C Chunekar. The botanical identity of the herbs was taken from “The plant list. Org.”


  Review Results Top


The review reveals that the herbs of contemporary Jeevaneeya mahakashaya have potential pharmacological activities which may be beneficial for COVID-19 prevention and management.The detailed analysis of each herb for their useful pharmacological activities are as follows:

Vidarikanda (Pueraria tuberosa [Willd.] DC.)

Vidarikanda is a herb distributed throughout India from Western Himalaya to Sikkim, up to 4000 feet in Kumaon, tropical and sub-tropical regions. It grows in humid, monsoon forests, and coastal areas.[4] It is accepted substitute of Jeevaka and Rishbhak. The various pharmacological activities exhibited by Vidarikanda are summarized below.

Anti-bacterial activity

The ethyl acetate extract of tuber is reported for inhibitory property against Klebsiella pneumoniae, Micrococcus luteus, Salmonella typhimurium, Bacillus cereus, Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans. Isoflavonoids genistein and genistin of this herb also showed antimicrobial activity against Escherichia coli, S. aureus, Staphylococcus epidermidis, P. aeruginosa, Bacillus anthracis, and C. albicans. The plant phytochemical Puerarin is having antimicrobial activity against Streptococcus mutans, Staphylococcus epidermidis, S. aureus, and C. albicans.[4]

Anti-asthmatic activity

Puerarin iso-flavonoid obtained from the root of the plant inhibited eotaxin-3 in ovalbumin (OVA) induced allergic inflammation in the mouse model of allergic asthma.[5]

Anti-inflammatory activity

The tuber of Vidarikanda is rich in the variety of phytochemicals among them Puerarin inhibit the production of nuclear factor kappa-light-chain-enhancer of activated B-cells (NF-kB), tumour necrosis factor alpha (TNF-α), macrophage inflammatory protein 2, and the expression of induced nitric oxide synthesis (iNOS), C-reactive protein (CRP) and cyclooxygenase 2 (COX-2), genistein suppress pro-inflammatory cytokines (e.g., TNF-α, interleukin-1 beta [IL-1 β], IL-6) production, daidzein reduced the production of inflammatory mediators including CRP, IL-6, and TNF-α and inhibit the activation of NF-kB and genistin suppress the production of TNF-α, IL-1 β, and IL-6.[4]

Immunomodulatory activity

Puerarin a conspicuous phytochemical of Vidarikanda which increases antibody production, phagocytosis and suppress delayed type hypersensitivity (DTH) reaction, genistein suppresses DTH response, antibody production, T-helper (CD4+) and T-killer cells (CD8+) population, daidzein increases lymphocyte proliferation, phagocytosis, and immunoglobulin M production.[4]

Anti-oxidant activity

The Puerarin, daidzein, genistein, and tuberosin phytochemicals reported in Vidarikanda play an important role in free radical scavenging. Puerain promotes oestrogen receptor-dependent haeme oxygenase-1induction, genistein induces the expression of antioxidant enzymes, genistein upregulates the transcription of metallothionein antioxidant genes by the activity of metal-responsive transcription factor-1, daidzein stimulate the activity of antioxidant enzymes and act as direct scavenging of reactive oxygen species (ROS), tuberosin also directly scavenges various species of free radicals.[4]

Neuro-protective activity

Puerarin inhibit neuronal apoptosis, hypoxia-inducible factor 1-alpha and TNF-α activation, iNOS expression and the expression of metabotropic glutamate receptors, genistein inhibits neuronal apoptosis and suppress ROS-induced NF-kB activation, daidzein increases the activity of peroxisome proliferator-activated receptor gamma and stimulate neurite outgrowth of dorsal root ganglia neurons.[4]

Cardioprotective activity

Puerarin activates protein kinase C and potassium channels, increases vasodilation and cerebral blood flow, and genistein decreases myocardial necrosis, myeloperoxidase activity and the expression of cardiac intercellular adhesion molecule 1 (ICAM-1), and increase myocardial contractility.[4]

Hepatoprotective activity

Puerarin inhibits lipid peroxidation (LPO) and increase the activity of antioxidant enzymes, genistein induce degradation of type I collagen and matrigel in animals with liver fibrosis, daidzein reduces apoptosis, expression of caspase-3, and increase the activity of antioxidant enzymes in liver and daidzin attenuates the apoptosis of hepatocytes and reduce oxidative stress.[4]

Nephroprotective activity

Puerarin increases antioxidant activity and signalling of the phosphatidyl inositol 3-kinase/serine/threonine protein kinase (Akt)/endothelial nitric oxide (NO) pathway and genistein reduces renal apoptosis, oxidative stress, and the expression of ICAM-1 and glycoprotein 91.[4]

Aswagandha (Withania somnifera [L.] Dunal)

Aswagandha is a small 0.5–2.0 m woody shrub of Solanaceae family. The plant is widely distributed in the drier parts of tropical and subtropical zones ranging from the Canary Islands, South Africa, Middle East, Sri Lanka, India, and to China. However, in India, it is grown as a medicinal crop which is widely used in Ayurveda.[6]

Antiviral activity

Ashwagandha is having Withaferin A compound and proven for antiviral activity against Influenza virus. It has also shown strong ability to bind with surface antigen of influenza viruses and check the replication of virus.[7]

Antimicrobial activity

The 80% methanolic extracts of all parts (leaf, root, and fruit) of Ashwagandha possess antibacterial activity against pathogenic Gram-negative bacteria, namely E. coli, S. typhi, C. freundii, P. aeruginosa, and K. pneumoniae. The antimicrobial potential of Ashwagandha is due to hyperacidification at the plasma membrane which interfere the pathogen entry, leading to the disruption of the H+-ATPase required for adenosine triphosphate synthesis.[8]

Anti-tussive activity

Aswaghandha root extract showed 61% antitussive activity in citric acid-induced cough in awake male TRIK strain guinea-pigs on oral administration.[9]

Anti-inflammatory activity

Aswaghandha root extract showed anti-inflammatory and muco-restorative activity in trinitro-benzyl-sulfonic acid-induced inflammatory bowel disease by resolving necrosis, edema, and neutrophil infiltration. Powder of Ashwagandha roots was found effective against inflammatory markers such as cytokines including IL-6 and TNF-α, NO and ROS in a mouse model of lupus on proteinuria and nephritis.[6]

Immunomodulatory activity

The plant root extract stimulated the immunological activity in the treatment of Balb/c mice. Mice treated with five doses of root extract of the plant enhanced the WBC, bone marrow cellularity and alpha-esterase positive cell number, circulating antibody titer and number of plaque forming cells in the spleen. In treated mice, the extract also inhibited DTH reaction and improved the phagocytic activity of peritoneal macrophages.[10]

Anti-oxidant activity

Root extract of the plant conserved the anti-oxidant status in 1-methyl-4-phenyl-1, 2, 3, 6 tetra hydropyridine intoxicated parkinsonian mice by reducing the oxidant stress in the mid brain. Root extract also resolved rotenone-induced parkinsonism in Drosophila melanogaster by the restoration of dopamine levels and neurotransmitter functions in cerebellum and striatum in the brain.[11]

Neuroprotective activity

Root extract of Ashwagandha is having neuroprotective activity in the rat. The neuroprotective activity is due to the inhibition of LPO, improve catalase (CAT), and glutathione peroxidase (GPx) levels in rat striatum and frontal cortex area. It may be due to the presence of glycowithanolides, withanolides, and sitoindosides constituents.[11]

Cardioprotective activity

A polyherbal compound formulation containing Aswagandha has showed cardioprotective activity in the animal models by activating nuclear factor-erythroid-2-related transcription factor (Nrf)-2, stimulating phase-II detoxification enzymes, and abrogating apoptosis in a Nrf-2-dependent manner. It improved hematopoiesis and restored the myocardial anti-oxidant balance, anti-apoptotic/pro-apoptotic effects.[6]

Hepatoprotective activity

The herb has shown hepatoprotective activity against gamma radiation-induced toxicity in rodents by reducing the malondialdehyde (MDA) levels, hemeoxygenase levels, hepatic serum enzymes, and total nitrate/nitrite activity in the liver. Aswagandha also showed improvement in biomarkers levels such as alanine transaminase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and bilirubin when treated with hepatotoxic dose of paracetamol. Further MDA and nitrate/nitrite (NO) levels were found to be significantly decreased along with the downregulation of mRNA expression of TNF-α, IL-1 β, COX-2, and iNOS genes.[11]

Nephroprotective activity

The root extract of the plant has shown nephroprotective effect in gentamicin-induced nephrotoxicity. It reversed the increase in kidney weight, urea, creatinine, urinary protein, and glucose, and significant reduction in body weights and potassium toxicity markers.[12]

Shatavari (Asparagus racemosus Willd.)

It is a much-branched spiny under shrub having the number of tuberous roots. The plant is widely grown in the tropical and subtropical parts of India and in the Himalayas up to an altitude of 1500 m. The plant also grows in various parts of Sri Lanka, Indonesia, Australia and tropical Africa.[13]

Anti-bacterial activity

Methanol extract of the roots showed in vitro antibacterial activity against E. coli, Shigella dysenteriae, Shigella sonnei, Shigella flexneri, Vibrio cholerae, Salmonella typhi, S. typhimurium, Pseudomonas putida, Bacillus subtilis, and S. aureus.[14]

Anti-tussive activity

Methanolic extract of Shatavari root showed significant antitussive activity on sulphur dioxide-induced cough in mice. The anti-tussive potential was comparable to the codeine phosphate.[15]

Anti-inflammatory activity

Liposomes of Shatavari have showed anti-inflammatory activity by the inhibition of TNF-α, in the monocyticleukemia cell line THP-1, which is used as a formulation for topical and/or transdermal drug delivery to provide anti-inflammatory activity.[16]

Immunomodulatory activity

Root aqueous extract of Shatavari has shown upregulated CD3 and CD4/CD8 in peripheral blood suggesting its immune adjuvant potential. It was found to upregulate IL-2, interferon gamma (IFN-gamma [Th1]) and IL-4 (Th2) cytokines.[17] 2→1 linked fructo-oligosaccharides (FOS) from the herb have potential the natural killer cell activity.[18]

Anti-oxidant activity

The methanolic root extract of Shatavari in indomethacin-treated rats with daily dose of 100 mg/kg/body weight using oral feeding tube was found to increase superoxide dismutase, CAT, and ascorbic acid levels appreciably, while decreasing lipid peroxidase products. This showed anti-oxidant potential of Shatavari roots.[14]

Neuro-protective activity

Methanolic extract of Shatavari roots was used against kainic acid-induced hippocampal and striatal neuronal damage in mice causing increased LPO, protein carbonyl content, decreased GPx activity, and reduced glutathione (GSH) content. Extract treated mice showed enhancement in GPx activity and GSH content, and reduction in membrane LPO and protein carbonyl content due to reduction of free radical-induced oxidative damage by its anti-oxidant property.[12]

Hepatoprotective activity

Root extract of the plant prevented isoniazid-induced hepatotoxicity in male albino rats through inhibition of hepatic cytochrome P450 2E1 (CYP2E1). The hepatoprotective activity was found due to the inhibition of the production of free radicals. It acts as a scavenger, reducing the free radicals.[19] Root extracts also showed hepatoprotective activity against carbon tetra chloride (CCl4)-induced hepatotoxicity in rats.[20]

Mudgparni (Phaseolus trilobus Aiton.)

P. trilobus Aiton. is plant of fabaceae family.[21] It is widely used in jaundice and other liver diseases in Nandurbar (Maharashtra, India) district.[21] The herb is least explored in preclinical and clinical studies for its beneficial pharmacological activities beneficial in the prevention and management of COVID-19.

Anti-oxidant activity

Methanol and aqueous extracts of the plant have shown free radical-scavenging potential using anti-LPO, superoxide radical scavenging, and GSH assays.[21]

Hepatoprotective activity

Methanol and aqueous extract of P. trilobus has shown hepatoprotective activity in bile duct ligated Wistar rats by the significant reduction in the elevated level of alanine aminotransferase (ALT), AST, and ALP. The hepatoprotective potential may be due to the presence of flavonoids.[21]

Mashaparni (Teramnus labialis [L. f.] Spreng

T. labialis (Roxb.) Benth. is a herbaceous plant of the Fabaceae family.[22] This plant is not explored extensively for various pharmacological activities in PubMed database.

Antibacterial activity

A flavonoid compound (C26 H28 O17) isolated from the ethanol extract of the plant stem has shown anti-bacterial activity.[23]

Jeevanti (Leptadenia reticulata [Retz.] Wight andArn.)

The plant belongs to family Asclepiadaceae. It is found in the hot and subtropical parts of Madagascar, Mauritius, Peninsula, Philippines, Sri Lanka, Asia and Africa, and Burma. In India, it originates from Sikkim, Nilgiris, South India, Himalayan ranges, Gujarat, Konkan, Punjab, Khasia hills, Deccan, and Karnataka.[24]

Antibacterial activity

Chloroform, alcohol and petroleum extracts of Jeevanti showed antibacterial activity against ten different strains of microorganisms. It was reported that chloroform extract was effective against E. coli and Staphylococcus. E. coli, Proteus bulgaris, B. cereus, and Klebsiella pneumonae were sensitive to the petroleum ether extract. Alcohol extracts have strong antibacterial activity against P. aeruginosa, B. cereus, S. epidermidus, and P. vulgaris.[24]

Anti-asthmatic activity

The plant is reported for its anti-asthmatic activity in the experimental model of rat and guinea pig through inhibiting histamine release and further cascade of asthma.[24]

Anti-inflammatory

Water, methanol, and ethyl acetate extracts of Jeevanti root showed anti-inflammatory activity in rats by using λ-carrageenan, and formalin-induced paw edema test. Among all, the ethyl acetate has shown the best results.[24]

Immunomodulatory activity

Immunomodulatory effect of Jeevanti was proved in chromate (VI)-induced immunosuppressant, and oxidative stress on mouse splenic lymphocytes and bone marrow derived macrophages. The study revealed that the plant extracts are able to defend with chromate (VI)-induced immune toxicity on splenic lymphocytes with respect to cell proliferation and cytotoxicity.[24]

Anti-oxidant activity

2,2-diphenyl-1-picrylhydrazyl (DPPH), ferric chloride (FeCl3) reducing and hydrogen peroxide (H2O2) scavenging methods were used for the determination of antioxidant potential of the plant. The result showed that the percent DPPH free radical-scavenging activity was found to be the highest in ethyl acetate extract. Moderate antioxidant activity is found in methanolic extract. In hydrogen peroxide scavenging method, ethyl acetate extract also exhibited strong antioxidant potential.[25]

Hepatoprotective activity

Aqueous and ethanolic extracts of the plant were used in carbon tetrachloride (CCl4)-induced hepatotoxicity in rats. The reduced symptoms of liver injury and liver damage by restoration of the architecture of liver is indicated by the lower levels of serum bilirubin and protein. The plant extracts prevented damage induced by CCl4 and showed normal hepatic cord and the absence of necrosis and fatty infiltration.[24]

Madhuka (Glycyrrhiza glabra L.)

It is one of the most popular medicinal plants belongs to fabaceae family. It is a native of Mediterranean areas, but it is also found in India, Russia, and China.[26]

Anti-viral activity

Madhuka is having Glycyrrhizin and 18 β-glycyrrhetinic acid triterpenoids both inhibits the adsorption and penetration of the virus in the early stage of replication and responsible for its anti-viral activity against different viruses including Herpes simplex, Varicella zoster, Japanese encephalitis, influenza, and vesicular stomatitis virus. These compounds have the ability to inhibit virus gene expression and replication, decreasing the adhesion force and stress.Glycyrrhizin has excellent immune-stimulant properties and induces a synergistic effect with duck hepatitis virus vaccine by activating T-lymphocyte proliferation.[26]

Anti-microbial activity

Aqueous and ethanolic extracts of Madhuka have an inhibitory activity on Streptococcus pyogenes in vitro model. The plant is having anti-tubercular phenolic compounds, lico isoflavone, and licochalcone A. Anti-microbial activity of plant is also reported against Helicobacter pylori.[26]

Antitussive and expectorant activity

Glycyrrhizin molecule expels congestion in the upper respiratory tract and enhances tracheal mucus secretion while liquiritinapioside compound has the ability to inhibit capsaicin, a compound that induces cough of carbenoxolone. These compounds are responsible for anti-tussive and expectorant effects of the plant. It is useful in the treatment of sore throat, cough, and bronchial catarrh.[27] Oral administration of Arabinogalacatan samples extracted from the herb showed 81% antitussive activity in citric acid-induced cough in awake male TRIK strain guinea-pigs, which was higher than codeine and other samples.[9]

Anti-inflammatory activity

The anti-inflammatory activity of the plant in male rats showed a significant decrease in the total cholesterol, triglyceride, and serum liver enzymes levels. glycyrrhizin which is reported to increase production of lymphocytes and macrophages from human granulocytes.[26]

Immunomodulatory activity

The immunomodulatory activity of aqueous root extract of plant is due to the presence of the phenolic compound glycyrrhizin which is reported to the increase production of lymphocytes and macrophages from human granulocytes.[26]

Anti-oxidant activity

The antioxidant activity and protective effect of Madhuka on biological systems against stress is probably due to its phenolic compound flavonoids, isoflavones, such as glabridin, hispaglabridin A, and 30-hydroxy-4-O-methyl glabridin.[26]

Neuroprotective activity

Significant improvement of learning and memory in mice was reported by the use of Madhuka extract, which suggest a possible neuroprotective role of the herb. The anti-inflammatory activity might contribute to the memory-enhancing effects. The antioxidant activity also contributes in reduced brain damage and improvement of neuronal function and memory. The combination of anti-inflammatory and antioxidant activities with neuroprotective role leads to memory enhancing effects.[26]

Cardioprotective activity

Cardioprotective effect of Madhuka against oxidative stress in myocardial ischemia reperfusion injury in rats was reported. Licochalcone A present in Madhuka was found to have antiangiogenic activity in different models of angiogenesis.[27]

Hepatoprotective activity

The hepatoprotective activity of glycyrrhizin and 18 β-glycyrrhetic acid through free radical inhibition and LPO has been reported. The root extract (hydro-methanolic) of the plant has hepatoprotective activity against hepatotoxicity induced by carbon tetrachloride in the liver tissue of mice. The herb is also effective in nonalcoholic fatty liver disease. Glycyrrhetinic acid has been reported for anti- inflammatory and hepatoprotective potential. Glycyrrhizin also prevents the development of hepatocellular carcinoma in chronic hepatitis C patients and also found to be responsible in the reduction of serum enzymes, bilirubin, and pro-inflammatory cytokines in the liver.[26]

Consolidated pharmacological activities of all herbs of Jeevaneeya mahakashaya are mentioned in [Figure 1].
Figure 1: Showing consolidated pharmacological activities of Jeevaneeya mahakashaya herbs useful in the prevention and management of COVID-19

Click here to view



  Discussion Top


SARS-CoV-2 is a member of the family Coronaviridae. Patients infected with SARS-CoV-2 are reported to have higher plasma levels of proinflammatory cytokines including IL1 β, IL-2, IL7, TNF-α, etc. Further SARS-CoV-2 infects lung alveolar epithelial cells and may use host receptor angiotensin-converting enzyme 2 (ACE2) to enter the cells. The host immune system response to viral infection by mediating inflammation and cellular antiviral activity is critical to inhibit viral replication and dissemination. Fever and dry cough are common symptoms at onset of illness.[28] Neurological symptoms such as headache, dizziness, myalgia and anosmia as well as cases of encephalopathy, encephalitis, necrotizing hemorrhagic encephalopathy, stroke, epileptic seizures, rhabdomyolysis, and Guillain–Barre syndrome are associated with SARS-CoV-2 infection.[29] Among herbs of Jeevanyee mahakashaya, Aswagandha and Madhuka are highly reported for anti-viral potential. Thus, these drugs might be useful to minimize the viral load and combat COVID infection. The immune system is an important defensive system to protect the human body from invasion by various pathogens such as virus, bacteria, and allergens.[14] CD4+ T-cells stimulates B-cells to produce virus-specific antibodies and CD8+ T-cells provides key cytotoxic function to limit local infection.[30] The reported data reveal that in COVID-19 patients decrease in the number of (CD4+) and T-killer cells (CD8+) and immunoglobulin have been observed. The attributes of Jeevaneeya mahakashaya (Vidarikanda and Shatavari) indicate immunomodulatory effect of the herbs by the stimulation of CD4+ and CD8+ T-cells.[4],[18] Therefore, to minimize the virulence of COVID-19 and to rejuvenate the patient in post-COVID stage administration of herbs of Jeevaneeya mahakashaya may be helpful. Further the immunomodulatory potential of herbs Vidarikanda,[4] Aswagandha,[10] Shatavari,[18] Jeevanti,[24] and Madhuka[26] may help to prevent secondary infections and reinfection in patients of COVID-19. Antibiotics are also essential to prevent secondary bacterial infections in COVID-19.[28] Jeevaneeya mahakashya herbs (Vidarikanda, Aswagandha, Satavari, Jeevanti, and Madhuka) are also proven for their antibacterial or anti-microbial activity against various pathogens.[4],[8],[14],[24],[26] Thus, the administration of these herbs may prevent patients of COVID-19 from secondary infections. Acute lung injury, shock, and acute kidney injury are the complications and life-threatening consequences reported in COVID-19.[30] In this regard, anti-tussive and expectorant activity of Aswagandha, Shatavari and Madhuka,[14],[20],[29] anti-asthmatic activity of Vidarikanda and Jeevanti,[11],[28] cardioprotective activity and nephroprotective activity of Vidarikanda and Aswagandha[9],[11],[17] might be able to curb the complications of COVID-19. Liver damage in patients with coronavirus infections is possibly due to viral infection of liver cells.[31] The herbs Vidarikanda, Aswagandha, Shatavari, Mudagparni, Jeevanti, and Madhuka are reported for hepatoprotective and anti-oxidant activity.[9],[16],[19],[24],[25],[27],[28],[29] These potential herbs may be used to protect the liver and free radical induced damage.

Thus, the rational use of various herbs mentioned under Jeevaneeya mahakashya may be used singly and in combinations according to the stage and need of the patients. A proposed stage wise use of herbs of Jeevaneeya mahakashaya is presented in [Figure 2] [32,33].
Figure 2: Showing proposed stage-wise use of herbs of Jeevaneeya mahakashaya

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  Conclusion Top


As COVID-19 is a novel infection and no line of treatment is fully approved for the prevention and management of this pandemic. To prevent its infection, immunity plays an important role. The proposed contemporary Jeevaneeya mahakashya herbs are cost effective and easily available. Therefore, the rational use of herbs of Jeevaneeya mahakashaya may be practiced to prevent and manage COVID-19 illness. Further preclinical and clinical studies can be carried out to generate scientific evidences for Ayurveda wisdom of Jeevaneeya mahakashaya herbs as immunity booster, rejuvenator, and asset for the prevention and management of COVID-19.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.





 
  References Top

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