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| EDITORIAL |
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| Year : 2020 | Volume
: 8
| Issue : 2 | Page : 55-56 |
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A Paradigm Shift of Herbal Remedies in SARS-COVID-19 Pandemic
Ghanshyam Parmar
Department of Pharmacy, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India
| Date of Submission | 11-Dec-2020 |
| Date of Decision | 20-Dec-2020 |
| Date of Acceptance | 28-Dec-2020 |
| Date of Web Publication | 12-Jan-2021 |
Correspondence Address:
Ghanshyam Parmar
Department of Pharmacy, Sumandeep Vidyapeeth Deemed to be University, Piparia, Waghodia, Vadodara, Gujarat
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/2347-6486.307057
How to cite this article:
Parmar G. A Paradigm Shift of Herbal Remedies in SARS-COVID-19 Pandemic. J Integr Health Sci 2020;8:55-6 |
The present coronavirus outbreak is declared as “severe acute respiratory syndrome coronavirus-2” (SARS-CoV-2) pandemic across the globe. This COVID-19 virus affects the lower respiratory tract and manifests as pneumonia. In the early February 2020, the International Committee for Taxonomy of Virus identified this SARS-CoV-2 virus and named as COVID-19 by the World Health Organization (WHO), as it is highly similar to SARS outbreak that occurred in 2003.[1] The first outbreak of COVID-19 was reported with a total of 27 cases in Wuhan, China, and many more cases in Wuhan Seafood Market from animal to human transmission. The COVID-19 virus rapidly spreads by human-to-human transmission around the world, and due to high mortality rate, the WHO declared as a global pandemic disease on March 11, 2019.[2] Up to the 1st week of December 2020, more than 66 million active cases and 1.5 million deaths have been reported worldwide, while in India, more than 9.7 million active cases and 0.14 million death have been reported.[3] This pandemic has impacted public health and global economy. To combat this pandemic situation and flatten the COVID-19 curve, the authorities issued the lockdown, compulsory use of mask, social distancing, use of sanitizer, repeated washing of hands with soap, screening in initial stage infection and isolation of patients, and restriction in traveling and mobility.[4] In context with the present situation, the authorities are in a tremendous effort to control this pandemic till an effective vaccine candidate has been discovered.[5]
The COVID-19 virus binds with very high affinity to angiotensin-converting enzyme 2 (ACE-2) receptor and manifests the aggravation of primary symptoms such as a common cold in the early stage. The other common symptoms include fever, dry cough, airway obstruction, mucus production, shortness of breathing, and gastric-related symptoms. Hematological parameters include elevation in C-reactive protein, D-dimer, ferritin, and lactate dehydrogenase level. Later stage, the development of pneumonia and acute respiratory distress syndrome, dyspnea, anorexia, and high plasma concentration pro-inflammatory cytokines manifests the cytokine storm, which requires intensive care of the infected patient. To date, the available therapies were antiviral therapy (lopinavir, ritonavir, ribavirin, remdesivir), hydroxychloroquine, corticosteroids, monoclonal antibodies (tocilizumab, bamlanivimab), azithromycin along with adjuvant therapy such as immune-based therapy (convalescent plasma, immunoglobulin products, mesenchymal stem cells, non-SARS-CoV-2-specific intravenous immunoglobulin), immunomodulators such as interleukin-1 inhibitors, interferons (alpha or beta), Bruton's tyrosine kinase inhibitors (acalabrutinib, ibrutinib, zanubrutinib) along with adjunctive therapy (Vitamin C, Vitamin D, zinc) in the management of COVID-19 virus.[6],[7],[8] Unfortunately, these available therapies lack satisfactory outcomes in complete stoppage of this infection. However, as per the US National Library of Medicine ClinicalTrails.gov website (up to date December 10, 2020), 3121 clinical studies are in pipeline. Nevertheless, these new studies will require plenty of time for effective formulation. Hence, there is a paradigm shift in the discovery of new effective therapy from the polyherbal therapy or individual medicinal plant that can play a front role to shatter the COVID-19 virus outbreak.
Nature is flourished with many medicinally valued plant species as “God gift” for the human race. Many medicinal products have been derived from plants. A plenty of medicinal and aromatic plants are recommended to control the COVID-19 virus infection as the front-line candidates. For example, amrita (Tinospora cordifolia), turmeric (Curcuma longa L.), lemon (Citrus limon), Tulsi (Ocimum sanctum L.), vasaka (Adhatoda vasica), ginger (Zingiber officinale Roscoe), licorice (Glycyrrhiza glabra L.), garlic (Allium sativum), lemongrass (Cymbopogon citratus), cinnamon (Cinnamomum cassia), eucalyptus (Eucalyptus globulus), fennel fruit (Foeniculum vulgare), Senega (Polygala senega), kalmegh (Andrographis paniculata), chirata (Swertia chirata Buch), guggul (Commiphora molmol), ajwain (Trachyspermum ammi), moringa (Moringa oleifera Lam), artemisia (Artemisia annua), Triphala (mixture of Emblica officinalis, Terminalia bellirica, and Terminalia chebula), and trikatu (Triphala, including Piper nigrum L., Piper longum L., and Z. officinale). Aforementioned, conventional medicinal plants are prescribed according to the severity of the disease, with an asymptomatic, mild, and moderate condition.[9] The scientists have ample opportunity to derive secondary metabolites of medicinal plants, with their diverse and complex structure as a source of the innumerable possible lead drug molecules for the discovery of the new drug. Many previous studies are in support of these medicinal plants to give therapeutic action with the capability to inhibit the production of pro-inflammatory cytokines (interleukins, tumor necrosis factor, and chemokine) induced by a viral infection and interfere in the molecular pathways for the growth of the virus in host cells. According to the literature review, at present, hundreds of plant constituents were screened using the computer-aided drug discovery tools on various possible targets of COVID-19 virus such as ACE-2, transmembrane serine protease 2, papain-like proteinase, 3C-like main protease, RNA-dependent RNA polymerase, and helicase (nsp13) to discover the drug-like candidate for the possible cure of coronavirus infection. This paradigm shift of the research to find out the suitable drug molecule from the nature is likely due to the unavailability of an exact cure of COVID-19 infection and various fatal side effects of existing allopathic therapeutic regimen.[10]
In my opinion, our Traditional Systems of Medicine have the potential to find out the possible cure and treatment of COVID-19 virus infection. Many medicinal plants are conventionally used to treat respiratory tract infections since ancient times and employed as over-the-counter drugs and food additives with minimum toxicity. Based on recent literature review, the in silico studies of plant secondary metabolites are found highly potent inhibitor on the target site of COVID-19 virus infection along with the reduction in the uncontrolled release of pro-inflammatory cytokines.
In conclusion, there is an urgent need of strategic interventions to reduce morbidity and mortality in association with the COVID-19 infection. However, there must be caution in the irrational and indiscriminate use of medicinal plant-derived products. In addition, major challenges with traditional medicine are the lack of regulatory norms, complete quality control, and standardized analytical protocols for the traditional medicinal plant formulations.
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| 2. | Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382:727-33. |
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| 6. | Gautret P, Lagier JC, Parola P, Hoang VT, Meddeb L, Mailhe M, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: Results of an open-label non-randomized clinical trial. Int J Antimicrob Agents 2020;56:105949. |
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