Beneficial role of Indian medicinal plants in COVID-19

Deepti Chopra; Bharti Bhandari; Shridhar Dwivedi

doi:10.4103/mgmj.mgmj_1_21

REVIEW ARTICLE

Year : 2021 | Volume : 8 | Issue : 2 | Page : 166-170

Beneficial role of Indian medicinal plants in COVID-19

Deepti Chopra¹, Bharti Bhandari², Shridhar Dwivedi³
¹ Department of Pharmacology, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India
² Department of Physiology, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India
³ National Heart Institute, East of Kailash, New Delhi, India

Date of Submission	03-Jan-2021
Date of Acceptance	20-Apr-2021
Date of Web Publication	02-Jun-2021

Correspondence Address:
Dr. Shridhar Dwivedi
National Heart Institute, East of Kailash, New Delhi.
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mgmj.mgmj_1_21

Abstract

Coronavirus disease 2019 (COVID-19) pandemic has had a severe impact globally. As of now, very little is available for the cure of this disease. The rapid increase in the number of confirmed cases makes prevention and control extremely important. In view of the success of traditional Indian medicine drugs during the several epidemics in the past, it is logical and essential to examine the contributions of the Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy (AYUSH) in managing the COVID-19 pandemic. The Indian traditional medicines interventions are well known and have several potential drug candidates that can be used as an add-on therapy along with current modern drugs. Herbal medicines containing bioactive compounds that possess anti-inflammatory, anti-pyretic, anti-viral, and immune-modulating properties like Tinospora cordifolia, Ocimum sanctum, Allium sativum, Citrus limon can be explored as therapeutic agents for COVID-19. Health-promoting immunomodulators like Withaniasomnifera, Tinospora cordifolia, Piper longum, Glycyrrhiza glabra may improve host defense and could be an effective prophylaxis approach against COVID-19. The present mini-review is aimed to survey and introduce important medicinal herbs and plants which can be used against Covid-19.

Keywords: Ayurveda, AYUSH, coronavirus, COVID-19, immunomodulators, traditional Indian medicines

How to cite this article:
Chopra D, Bhandari B, Dwivedi S. Beneficial role of Indian medicinal plants in COVID-19. MGM J Med Sci 2021;8:166-70

How to cite this URL:
Chopra D, Bhandari B, Dwivedi S. Beneficial role of Indian medicinal plants in COVID-19. MGM J Med Sci [serial online] 2021 [cited 2023 Mar 29];8:166-70. Available from: http://www.mgmjms.com/text.asp?2021/8/2/166/317440

Introduction

The corona virus-induced disease -19 (COVID-19) pandemic is rapidly progressing with promptly varying presentations. Updates from the Indian Council of Medical Research (ICMR) regarding the spread, treatment, and disease outcome are continuously being provided. The treatment modality is changing every other day. To date, no specific allopathic medicine has been developed and approved for COVID-19. Research for the same is still going on without any significant result. Moreover, the currently repurposed drugs are not devoid of serious adverse effects. At the same time, despite all efforts for the development of a vaccine, it has taken time to reach everyone in the community. In such a situation, the general public has developed an inclination towards available Complementary and Alternative systems of Medicine. Further, evidence from Traditional Chinese Medicine (TCM) has shown the potential to treat and contain the spread of the SARS-CoV 2 virus.^[1],[2] The active ingredients in TCM, which was extensively used for COVID-19 in China are similar to herbal drugs used in Traditional Indian Medicine (TIM). The current review aims at summarizing the commonly available Indian medicinal herbs proposed to be beneficial in COVID-19.

Role of ayurvedic medicine

TIMs have a high potential of preventing and treating various types of inflammation and infections. Many researchers have explored the therapeutic role of these drugs in several diseases.^[3],[4],[5] The herbal medicines containing bioactive compounds that possess anti-inflammatory, anti-pyretic, anti-viral, and immune-modulating properties can be further explored as therapeutic agents for COVID-19.^{[1],[2],[6],[7]} Potential medicinal plants that may be beneficial in the prevention and treatment of COVID-19 are given in [Table 1].

Table 1: Therapeutic uses of some common traditional plants

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Putative mechanisms of actions of proposed herbal medicines for COVID-19:

Stimulation of the production of immune cells that can fight the infection of the Covid-19 virus (immune-modulator)

Cidal effects on viruses (virucidal)

Preventing rise in body temperature (antipyretic)

Preventing inflammation (anti-inflammatory)

Stimulation of red cell production (hematopoietic)

Brief description of some of the plants recommended for COVID-19

Withaniasomnifera

Commonly known as Ashwagandha, Indian ginseng is a small shrub that is native to India and North Africa and one of the most important herbs in Ayurveda. Ashwagandha has been shown to have beneficial effects in a variety of disorders such as stress, anxiety, inflammation, infections, etc. The role of Ashwagandha in improving physical and mental health has been extensively studied.^[8],[9],[10] Ashwagandha contains alkaloids (ashwagandha, isopelletierine, cuseohygrine, trpine, anaferine), sterols (withaferins, withasomniferin-A, withasomidienone, withanolides, and withanone), saponins, aminoacids, and polysaccharides.^[8],[9] Ashwagandha enhances nitric oxide synthaseactivity of the macrophages and also helps to restore immune homeostasis by modulation of host Th-1/Th-2 immunity. Ashwagandha possesses anti-inflammatory activity and can reduce Interleukin -1, Interleukin -6, and Tumor necrosis factor.^[8],[9],[10]

One of the bioactive compounds of Ashwagandha, Withaferin-A has been shown to possess antiviral activity against Human Papilloma and influenza viruses.^[5] It may have a role in inhibiting viral replication by its ability to stop the functional activity of SARS-CoV-2 protease.^[5] Since Ashwagandha containing Ayurvedic formulation has shown to have similar effectiveness as hydroxychloroquine in a Randomized Controlled Trial for treating rheumatoid arthritis, it may be useful for COVID patients also.^[11] Many herbal drugs including Ashwagandha have been shown to prevent cytokine storms in other viral infections. The probable mechanisms studied are downregulation of inflammatory mediators, selective Th1 up-regulation, downregulation of COX, and decreased prostaglandin synthesis.^[12]

Thus, owing to its immune-modulatory, anti-viral and anti-inflammatory properties, Withaniasomnifera can be a potential candidate for COVID-19 management.

Solanum species

There are many species of Solanum, and some of the species including S. torvum, S. americanum, S. bulbocastanum, S. nigrum. etc have been used in TIM for the prevention and treatment of various ailments.^[13] Some of the species are effective in diseases with inflammation of the upper respiratory tract like asthma and cold.^[14] Beneficial effects of solanum have also been observed against viral infections like human herpesvirus type 1, Influenza viruses A and B, viral hepatitis C, HIV, etc.^[15] The active ingredients of Solanum species responsible for their antiviral actions are glycoalkaloids (solasonin, solamargine), anthocyanins, and saponins. In-silico studies by various researchers have shown that certain polyphenolic compounds (Kaempferol, quercetin, catechin, and its derivatives) may interact with SARS-CoV-2 protease.^{[14],[16],[17]} Similarly, other active compounds, namely alkaloids, saponins, flavonoids, terpenoids, have shown to be effective to treat Covid-19 in-silico.^[18]

Due to their anti-viral and anti-inflammatory actions, Solunum species can be considered for COVID-19 treatment. Among these, S. nigrum is said to be the most effective in COVID-19.

Citrus fruits

Citrus fruits or their derived phytochemicals may be helpful in the prevention and treatment of COVID-19 as they are presumed to possess antiviral activities and enhance the host’s immunity. Citrus fruits are rich in flavonoids, the most important ones documented to be beneficial in coronavirus infection are hesperetin, hesperidin, naringin, and naringenin.^[19],[20] Naringin may have a possible role in preventing cytokine storms as in-vitro and in-vivo experiments with naringin have shown to inhibit the expression of the proinflammatory cytokines (COX-2, iNOS, IL-1β, and IL-6) in the macrophage cell line.^[20] Evidence from the literature has shown that hesperetin could act as a highly potent inhibitor of SARS-CoV 3CLpro.^[20],[21] Naringin was found to exhibit a potent anti-inflammatory and anti-viral activity in the study by Tutunchi et al.^[21] Naringin, Naringenin, Hesperetin Hesperidin, Baicalin, Neohesperidin, etc. are said to be natural ACE-II inhibitors.^[22],[23]

Curcumin

Curcumin is a natural polyphenolic compound that is extracted from the roots of Curcuma longa belonging to the family Zingiberaceae. It displays a wide variety of therapeutic properties like antioxidant, anti-microbial, anti-inflammatory, and antiviral activities. Curcumin is being used extensively as traditional herbal medicine in India for treating infection and inflammation for ages.

Das et al.^[24] demonstrated in their study that curcumin can act as a potential inhibitory agent by antagonizing the entry of SARS-CoV2 viral protein. The probable mechanism according to them could be the binding of curcumin to receptor-binding domain site of viral S protein and also to the viral attachment sites of ACE2 receptor.

Studies have shown that curcumin has inhibitory actions on inflammatory cytokines. It attenuates the proinflammatory effects induced by the Angiotensin II-AT1R axis leading to a significant decrease in the level of pro-inflammatory cytokines like TNF-a, IL-6, and reactive oxygen species. Curcumin also reduces the infiltration of immune cells and the expression of adhesion molecules and proinflammatory mediators in vascular cells. Curcumin may also suppress pulmonary edema and fibrosis in COVID-19 patients.^[25],[26] Owing to these actions, curcumin may be helpful as an adjunct in reversing the fatal cytokine storm that occurs in serious cases of COVID-19.

Ginger, garlic, and black pepper

Ginger (Z. officinale) has been shown to possess antioxidant, anti-platelet, and anti-inflammatory properties.Ginger contains chemicals called sesquiterpenes that target cold viruses. This immune-boosting spice also has antibacterial properties that can help prevent nausea similarly raisins are packed with energy and are rich in fiber, vitamins, and minerals, due to these it has also tremendous medicinal applications. Garlic (A. sativum) possesses antioxidant, anti-inflammatory, and anti-stress properties, and is being used commonly for treating abdominal discomfort, diarrhea, and respiratory tract infections. It is also an immunity booster. Black pepper (P. nigrum) is a strong antioxidant that is found to be useful in respiratory congestion.^[27],[28] Rajagopal et al.^[27] have performed in silico study to explore the binding modes of chemical constituents for natural remedies such as pepper, ginger, and garlic against COVID-19. It has been shown that the chemical constituents from pepper and ginger have a mode of interactions similar to hydroxychloroquine against COVID-19.^[27]

Ministry of AYUSH initiative

To combat the COVID-19 crisis, the Ministry of AYUSH has issued an advisory on preventive practices primarily focusing on boosting immunity.^[29] It emphasizes simple measures like drinking warm water throughout the day, more use of spices like Haldi (Turmeric), Jeera (Cumin), Dhaniya (Coriander), and Lahsun (Garlic) in cooking, intake of Chyavanprash in the morning, and drinking Golden Milk (milk with turmeric) once or twice a day.

Drinking herbal tea/decoction (Kadha) made from Tulsi (Basil), Dalchini (Cinnamon), Kalimirch (Black pepper), Shunthi (Dry Ginger), and Munakka (Raisin) with or without sugar once or twice a day is also recommended.^[29],[30] Basil leaves are rich in phytonutrients chlorophyll, vitamins, and minerals, as well as eugenol, a bioactive compound, and having various medicinal applications that are very beneficial in respiratory ailments such as allergic bronchitis, cough, asthma, tuberculosis.^[28],[31] Procyanidins and catechins in Cinnamon possess tremendous antioxidant capacity.^[32]

The immunity enhancers advised by the Ministry of AYUSH in the guidelines for Ayurvedic practitioners are given in [Table 2].^[28]

Table 2: Immunity enhancers (Ministry of AYUSH)

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Conclusion

As of now, allopathic medicines do not seem to offer the cure for Covid -19. Given the successful and rational use of TCM in managing the COVID-19 pandemic in China, it is reasonable and indispensable to explore how medicinal drugs are mentioned in the Indian System of Medicine which may help address the COVID-19 challenge in India. One of the approaches of TIM is to promote host immunity against various diseases. Traditional medicine employs a holistic approach to the prevention of disease with this approach; our focus could be on prevention till a definite cure for COVID-19 is made available. Henceforth, the best possible practice in such a situation could be integrating the benefits of modern as well traditional medicine.

Financial support and sponsorship

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Conflicts of interest

There are no conflicts of interest.

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