Shufeng Jiedu, a promising herbal therapy for moderate COVID-19:Antiviral and anti-inflammatory properties, pathways of bioactive compounds, and a clinical real-world pragmatic study

Abstract

Background Shufeng Jiedu capsules (SFJDC), a patented herbal drug composed of eight medicinal plants, is used for the treatment of different viral respiratory tract infectious diseases. Based on its antiviral, anti-inflammatory and immunoregulatory activity in acute lung injury, SFJDC might be a promising candidate for the treatment of COVID-19. Purpose To evaluate the antiviral and anti-inflammatory properties and to discover the mechanism of action of SFJDC as a potential drug for the treatment of COVID-19. Furthermore, the study should determine the clinical effectiveness of SFJDC for the treatment of COVID-19. Design We analyzed the antiviral and anti-inflammatory effects of SFJDC in a HCoV-229E mouse model on lung index, virus load in the lung, the release of cytokines, and on T- and B-lymphocytes. The mechanism of action was further investigated by network analysis. Additionally, we investigated data from a clinical pragmatic real-world study for patients with confirmed COVID-19, to evaluate the clinical effect of SFJDC and to determine the best time to start the treatment. Results SFJDC significantly reduced the virus load in the lung of HCoV-229E mice (from 1109.29±696.75 to 0±0 copies/ml), decreased inflammatory factors IL-6, IL-10, TNF-α, and IFN-γ in the lung, and increased the amount of CD4 + and CD8 + cells in the blood compared to the model group. Network analysis revealed that SFJDC reduces the activity of NFκB via several signaling pathways. Quercetin, wogonin, and polydatin bind directly to the main protease (M pro ) of SARS-CoV-2. Clinical data showed that SFJDC, added to standard antiviral therapy (AVD), significantly reduced the clinical recovery time of COVID-19 and fatigue (from 3.55±4.09 to 1.19±2.28 days) as well as cough (from 5.67±5.64 to 3.47±3.75) days compared to AVD alone. SFJDC therapy was significantly more effective when used within the first 8 days after the onset of symptoms. Conclusion SFJDC might be a promising drug for the treatment of COVID-19, but large-scale randomized, double-blinded, placebo-controlled clinical trials are needed to complement the real-world evidence. It might be beneficial to start SFJDC treatment as early as possible in suspected cases of COVID-19.

Epigallocatechin-3-gallate, an active ingredient of Traditional Chinese Medicines, inhibits the 3CLpro activity of SARS-CoV-2

“…Following reports of good clinical efficacy, several TCMs were officially endorsed for clinical use in China and were adopted as part of the treatment plan for COVID-19 [ [31] , [32] , [33] ]. An increasing number of clinical and experimental evidences have proved that TCMs inhibit viral replication owing to specific active ingredients [ [34] , [35] , [36] ]. Herein, we retrospectively analyzed 123 COVID-19 patients who received a combination of western and Traditional Chinese Medicines from the hospitals in Guizhou Province, China.…”

Scutellaria barbata D. Don Inhibits the Main Proteases (Mpro and TMPRSS2) of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection

“…Additionally, Xia et al found that Shufeng Jiedu capsules can reduce the activity of NFκB in the lungs of HCoV-229E mice. Its active components, wogonin, quercetin, and polydatin, bind directly to the SARS-CoV-2 M pro [ 49 ].…”

Research progress of traditional Chinese medicine against COVID-19

“… anti-inflammatory, anti-SARS-CoV-2 MAPK14, TNF, IL-6, IL-10, PTGS2, etc. 100 fever, dry cough, fatigue, lung CT 88.0% [ [50] , [51] , [52] ] LHQW 13 herbs, including Forsythia suspensa, Lonicera japonica, Ephedra sinica Stapf, Prunus armeniaca L, Isatis indigotica Fort, etc. neochlorogenic acid, amygdalin, prunasin, forsythoside I, rutin, forsythoside A, etc anti-SARS-CoV-2, anti-inflammatory, IL-6, TNF, MAPK1, IL-1B, MAPK8 122 fever, cough, sputum, polypnea, fatigue, anorexia 98.0% [ 53 , 54 ] HXZQ 10 herbs, including Areca catechu L, Angelica dahurica, Perilla frutescens, Pinellia ternata, Atractylodes macrocephala, etc.…”

“…confirmed that SFJD significantly reduces the virus load in the lung from 1109.29 ± 696.75 to 0 ± 0 copies/mL, decreases levels of inflammatory factors (IL-6, IL-10, TNF-α, and IFN-γ), and increases amount of CD4+ and CD8+ cells in the blood, compared to the model group. Importantly, Quercetin, wogonin, and polydatin could directly bind to the key protease of SARS-CoV-2 [ 52 ].…”