ABSTRACT
COVID-19 is a global epidemic. Developing adjuvant therapies which could prevent the virus from binding to cells may impair viral infection. This study produces a traditional Chinese medicine formula, Jing Guan Fang (JGF), based on ancient medical texts, and examines the efficacy and the mechanism by which JGF prevents viral infections. JGF reduces COVID-19 like symptoms. Functional studies show that JGF inhibits the formation of syncytium and reduces the formation of viral plaque. JGF is not toxic in vitro and in vivo. Mechanistically, JGF induces lysosomal-dependent ACE2 degradation and suppresses mRNA and the protein levels of TMPRSS2 in human lung WI-38 and MRC-5 cells. Mice that inhale JGF exhibit reduced ACE2 and TMPRSS2 protein levels in lung tissues. Together, these findings suggest that JGF may improve the COVID-19 like symptoms and inhibit viral infection. Moreover, JGF may be applicable as an adjuvant preventive strategy against SARS-CoV-2 infection in addition to the use of vaccines.
ABSTRACT
Due to the significantly negative impact of the coronavirus (CoV) disease (COVID-19) pandemic on the health of the community and the economy, it remains urgent and necessary to develop a safe and effective treatment method for COVID-19. Huang-Lian-Shang-Qing-Wan (HLSQW) is a herbal formula of traditional Chinese medicine (TCM) that has been applied extensively for treating ?wind-heat-associated? symptoms in the upper parts of the body. The objective of the present in silico study was to investigate the potential effects of HLSQW in the context of severe acute respiratory syndrome (SARS)-CoV-2 infection. We analyzed the possible interactions between bioactive compounds within HLSQW on targets that may confer antiviral activity using network pharmacology and pharmacophore-based screening. HLSQW was found to potentially target a number of pathways and the expression of various genes to regulate cell physiology and, consequently, the anti-viral effects against SARS-CoV-2. Bioactive compounds contained within HLSQW may exert combined effects to reduce the production of proinflammatory factors, which may trigger the ?cytokine storm? in patients with severe COVID-19. Results from molecular modeling suggested that the bioactive HLSQW components puerarin, baicalin, and daidzin exhibit high binding affinity to the active site of 3-chymotrypsin-like cysteine protease (3CLpro) to form stable ligand-protein complexes, thereby suppressing SARS-CoV-2 replication. In addition, our results also demonstrated protective effects of the HLSQW extract against cell injury induced by the proinflammatory cytokines tumor necrosis factor-α, interleukin (IL)-1?, and IL-6, against reactive oxygen species production and nuclear factor-?B activity in normal human lung cells in vitro. To conclude, HLSQW is a potential TCM remedy that warrants further study with the aim of developing an effective treatment for COVID-19 in the future.
ABSTRACT
BACKGROUND: Coronavirus disease 2019 (COVID-19) is an acute respiratory infectious disease, which is pandemic, infectious, and high mortality. Many commonly discussed medications being used to treat COVID-19 are not without potentially harmful side effects such as heart, liver, kidney problems, or other clinical symptoms. Acupuncture is a nonpharmacological method. When a needle is inserted into an acupuncture point, traumatic physical stimulation occurs, and then the neuroendocrine immune regulation network is activated. This study aimed to evaluate the efficacy of acupuncture for improving the side effects of COVID-19 western medicine treatments. METHODS: From their inception to December 10, 2020, the following electronic databases will be searched to identify relevant studies: MEDLINE, PubMed, EMBASE, the Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), and the Chinese Biomedical Literature Database (CBM), without any language restrictions. Randomized controlled trials and credible clinical observations without randomization include patients diagnosed with COVID-19, and receiving western medicine treatments or acupuncture, with no restrictions on disease stage, age, sex, or ethnicity. Primary outcomes would be used to evaluate the mortality rate, C-reactive protein (CRP), creatine, troponin, liver enzymes (aspartate aminotransferase and alanine aminotransferase), blood pressure, clinical symptoms (including fever, fatigue, myalgia, cough, skin rash, nausea, vomiting, and diarrhea), and serum cytokine levels. Secondary outcome would be used to evaluate the adverse events of acupuncture. Risk of bias will be assessed by 2 review authors independently according to the guidelines set out in the Cochrane Handbook for Systematic Reviews of Interventions. DISCUSSION: This is the first to evaluate the efficacy of acupuncture for improving the side effects of COVID-19 western medicine treatments. A longer follow-up should be considered in future studies. CONCLUSION: This systematic review and meta-analysis would provide evidence of acupuncture specifically focused on its effectiveness and safety for patients with COVID-19 western medications adverse effects. REGISTRATION: Registered in the PROSPERO database (CRD42020189494).