Abstract
Whilst Western research for the COVID-19 crisis focuses on vaccination, in East Asia traditional herbal prescriptions are studied for SARS-CoV2 therapy. In Japan, Maoto (Ephedrae herba 4 g, Armeniacae semen 4 g, Cinnamomi cortex 3 g, and Glycyrrhizae radix 2 g, JPXVII) is used based on clinical evidence for its effect on early phase influenza (also caused by RNA viruses) comparable to that of oseltamivir. The Health Ministry of Thailand has approved Andrographis paniculata (Jap. Senshinren) extracts for treatment of COVID-19. Its combination (4 g) with Maoto, Maoto-ka-senshinren, seems most promising for the treatment of viral pandemics. In China, the official guideline for COVID-19 treatment contains TCM medications with antiviral, as well as immunmodulatory and anti-inflammatory effects such as: Qing-Fei-Pai-Du-Tang (Jap. Seihai-haidokuto) contains 21 drugs; Shufeng Jiedu Jiaonang (Bupleuri radix 8 g, Forsythiae fructus 8 g, Glycyrrhizae radix 4 g, Isatidis radix 8 g, Patriniae herba 8 g, Phragmitis rhizoma 6 g, Polygoni cuspidati rhizoma 10 g, Verbenae herba 8 g); Fufang Yuxingcao Heiji (Forsythiae fructus 0.6 g, Houttuyniae herba 6 g, Isatidis radix 1.5 g, Lonicerae flos 0.6 g, Scutellariae radix 1.5 g) first gained prominence during the 2002 SARS epidemic. With no Western medicine available, the following overview discusses efficacy and mechanisms in view of viral entry and replication of different East Asian herbal remedies for COVID-19 treatment.
Highlights
Anti-viral activity has been reported from numerous medicinal plant extracts and preparations
In the Kampo theory, viral infections as well as infections with bacteria and parasites are all subsumed under the concept external noxae
Maoto has the ability to act at all 3 steps important for viral proliferation: It has been shown to enhance the production of antibodies such as IgG, IgM and IgA against influenza virus (Nagai et al 2014)
Summary
Anti-viral activity has been reported from numerous medicinal plant extracts and preparations. In a male ICR mouse model, the mice were treated by gavage with oseltamivir (22 mg/kg), LEP or DPEP (40, 20, 10 mg/kg) solubilized in physiological saline for 7 days, resulting in a significant inhibition of mRNA expression levels of the TLR3, TLR4 and TLR7 signaling pathways and further down-regulated TNF-α levels and up-regulated IFN-β levels (Wei et al 2019) These Ephedra alkaloids exert an antiviral effect in vitro which may be closely related to the inhibition of viral replication and the modulation of inflammatory response by adjusting the host’s TLRs and RIG-1 (Retinoic acid Inducible Gene I)—an intracellular receptor of the innate immune system—pathways.
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