Therapeutic options of TCM for organ injuries associated with COVID-19 and the underlying mechanism

Abstract

Background Coronavirus disease-2019 (COVID-19) caused by infection with severe acute respiratory coronavirus-2 (SARS-CoV-2) has been spreading rapidly throughout China and in other countries since the end of 2019. The World Health Organization (WHO) has declared that the epidemic is a public health emergency of international concerns. The timely and appropriate measures for treating COVID-19 in China, which are inseparable from the contribution of traditional Chinese medicine (TCM), have won much praise of the world. Purpose This review aimed to summarize and discuss the essential role of TCM in protecting tissues from injuries associated with COVID-19, and accordingly to clarify the possible action mechanisms of TCM from the perspectives of anti-inflammatory, antioxidant and anti-apoptotic effects. Methods Electronic databases such as Pubmed, ResearchGate, Science Direct, Web of Science, medRixv and Wiley were used to search scientific literatures. Results The present review found that traditional Chinese herbs commonly used for the clinical treatment of organ damages caused by COVID-19, such as Scutellaria baicalensis, Salvia miltiorrhizaSalvia miltiorrhiza , and ginseng, could act on multiple signaling pathways involved in inflammation, oxidative stress and apoptosis. Conclusion TCM could protect COVID-19 patients from tissue injuries, a protection that might be, at least partially, attributed to the anti-inflammatory, antioxidant and anti-apoptotic effects of the TCM under investigation. This review provides evidence and support for clinical treatment and novel drug research using TCM.

Chinese herbal medicine: Fighting SARS-CoV-2 infection on all fronts

“…4 E), ( Zhang et al, 2020e ). SA exerts an important role in the neuroprotection of traumatic brain injury ( via the nuclear factor erythroid 2-related factor 2/antioxidant-response element pathway) ( Zhang et al, 2020d ), protecting the liver ( via decreasing aspartate aminotransferase and alanine aminotransferase activities) ( Peng et al, 2016 ), promoting cardiopulmonary resuscitation ( via increasing the expression of hypoxia-inducible factor-1α in the cerebral cortex) ( Du et al, 2011 ), and protecting acute lung injury ( via increasing myeloperoxidase activity and nitric oxide level in the lung ( Tian et al, 2011 ), and decreasing malondialdehyde and matrix metalloproteinase gelatinase B levels ( Du et al, 2012 )). Importantly, no observable cytotoxicity or adverse events both in vivo and in vitro with SA treatment have been reported to date.…”

“…To better understand the activity of Chinese herbal medicine, more validation studies, with high-quality evidence (both in vitro and in vivo ), are now needed to systematically explore the underlying mechanisms. Furthermore, there is currently very little direct data associated with the protective effect of Chinese herbal medicines against extrapulmonary organ injuries during SARS-CoV-2 infection ( Zhang et al, 2020d ; He et al, 2020 ; Zhao et al, 2020 ). Nonetheless, Chinese herbal medicine has its own advantages.…”

Toxicity as prime selection criterion among SARS-active herbal medications

“… Shang et al (2011) reviewed in detail the antiviral, antibacterial and antioxidative activities of Lonicera japonica as well as the isolation and characterization of more than 140 of its chemical constituents . Since then many further compounds were isolated from Lonicera japonica and characterized with respect to their pharmacological activities such as antiviral activities ( Yu et al, 2008 ; Ding et al, 2017 ; Li et al, 2018 ; Ge et al, 2019 ), suppression of inflammation-stimulating signaling pathways ( Kang et al, 2010 ; Kao et al, 2015 ; Kwon et al, 2015 ; Lee et al, 2015 ; Han et al, 2016 ; Zhang et al, 2020 ) or terminal enzymes ( Xu et al, 2007 ). As already stated in the Introduction, Lonicera japonica is one of the herbal medicines which were successfully used for the therapy of the SARS-CoV infected patients in the 2002/2003 SARS epidemic ( Liu et al, 2006 ; 2012a , 2012b ; Wang et al, 2014 ; Luo et al, 2020 ).…”

“…While specific reviews on the toxic effects are rare or even absent as of yet, a tremendous number of investigations on antivirally active Chinese plants to inhibit SARS-CoV-2 and to cure COVID-19 have been published in the year 2020 (Huang et al, 2020 ; Luo et al, 2020 ; Li et al, 2020 ; Yang et al, 2020 ). Therefore, in the present review we focused only on toxicology and refer the reader to the excellent reviews on the pharmacology of anti-COVID-19 Chinese plants and clinical trials performed with Chinese herbal medicine to treat this pandemic that appeared in parallel in this special issue of Phytomedicine ( Hu et al, 2020 ; Wang et al, 2020 ; Xia et al, 2020 ; Zhang et al, 2020 ; Zhao et al, 2020 a; Zhao et al, 2020b ; Zheng et al, 2020 ).…”

Efficacy and safety of acupuncture for elderly patients with coronavirus disease 2019 (COVID-19)

“…As is known to all, COVID-19 has been well controlled in China, mainly due to the joint efforts of Chinese and western medicine, especially Chinese medicine, which has made outstanding contributions to improving patients’ symptoms and promoting recovery. [ 15 – 18 ] Acupuncture, as one of the traditional Chinese medicine treatment, has the advantage of quick effect, simple operation, and less pain, etc. Studies have shown that it can improve symptoms of dyspnea, relieve anxiety, treat insomnia, vomiting, and diarrhea, etc.…”