Clinical Application and Advantages of Sanjiao Theory in Sanren Decoction.

Sanrentang,originally contained in the Regulations on Febrile Diseases written by WU Ju-tong in the Qing dynasty,was composed of eight traditional Chinese herbs to treat damp-warm diseases. It is a treatment method of gradually clearing away damp heat of tri-jiao,with characteristics of separating dispersion and mobilizing discharge. "Separating dispersion" means dispersion in separated ways,with different ways to eliminate dampness to export the dampness,heat,evil and turbid out of the body. "Mobilizing discharge" means discharge to stretch and unblock the Qi,to get rid of dampness and evil. It can be seen,Sanrentang,as a desiccating formula,taking "separating dispersion and mobilizing discharge" as the cubic basis,has a significant effect on both internal and external dampness associated with pathogenic heat syndrome,and its clinical application is quite extensive. After consulting the data of the past 10 years,the authors gave a brief overview on the syndrome theory,clinical application and pharmacological effects of Sanrentang, and elaborated the therapeutic effect and pharmacological effect of Sanrentang in the clinical application of upper,middle and lower Tri-jiao respectively,providing theoretical reference for effective development and utilization of Sanrentang. Coronavirus disease-2019(COVID-19)swept the world in early 2020 and it is a great challenge for the medical community to seek for effective prevention and treatment methods. For COVID-19,although the cause of the disease belongs to the Qi of "pestilence",many doctors have different opinions on the pathogenic characteristics. However,they all agree with the clinical characteristics of "dampness". COVID-19,which has the attribute of "dampness evil",is so sticky that it can't be cured at once. In addition to the main symptoms such as fever and cough,it is also characterized by the middle-jiao dampness symptoms such as poor appetite,fullness of abdomen,loose stool and diarrhea. It is worthy to further explore the application prospect of Sanrentang in COVID-19 prevention and treatment.Copyright © 2021, China Academy of Chinese Medical Sciences Institute of Chinese Materia Medica. All rights reserved.

Molecular Docking and Dynamics of Phytochemicals From Chinese Herbs With SARS-CoV-2 RdRp

The novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is causing coronavirus disease 2019 (COVID-19) pandemic. Ancient Chinese herbal formulas are effective for diseases caused by viral infection, and their effects on COVID-19 are currently being examined. To directly evaluate the role of Chinese herbs in inhibiting replication of SARS-CoV-2, we investigated how the phytochemicals from Chinese herbs interact with the viral RNA-dependent RNA polymerase (RdRP). Total 1025 compounds were screened, and then 181compounds were selected for molecular docking analysis. Four phytochemicals licorice glycoside E, diisooctyl phthalate, (-)-medicocarpin, and glycyroside showed good binding affinity with RdRp. The best complex licorice glycoside E/RdRp forms 3 hydrogen bonds, 4 hydrophobic interactions, 1 pair of Pi-cation/stacking, and 4 salt bridges. Furthermore, docking complexes licorice glycoside E/RdRp and diisooctyl phthalate/RdRp were optimized by molecular dynamics simulation to obtain the stable conformation. These studies indicate that they are promising as antivirals against SARS-CoV-2.Copyright © The Author(s) 2022.

Clinical Application and Advantages of Sanjiao Theory in Sanren Decoction.

Sanrentang,originally contained in the Regulations on Febrile Diseases written by WU Ju-tong in the Qing dynasty,was composed of eight traditional Chinese herbs to treat damp-warm diseases. It is a treatment method of gradually clearing away damp heat of tri-jiao,with characteristics of separating dispersion and mobilizing discharge. "Separating dispersion" means dispersion in separated ways,with different ways to eliminate dampness to export the dampness,heat,evil and turbid out of the body. "Mobilizing discharge" means discharge to stretch and unblock the Qi,to get rid of dampness and evil. It can be seen,Sanrentang,as a desiccating formula,taking "separating dispersion and mobilizing discharge" as the cubic basis,has a significant effect on both internal and external dampness associated with pathogenic heat syndrome,and its clinical application is quite extensive. After consulting the data of the past 10 years,the authors gave a brief overview on the syndrome theory,clinical application and pharmacological effects of Sanrentang, and elaborated the therapeutic effect and pharmacological effect of Sanrentang in the clinical application of upper,middle and lower Tri-jiao respectively,providing theoretical reference for effective development and utilization of Sanrentang. Coronavirus disease-2019(COVID-19)swept the world in early 2020 and it is a great challenge for the medical community to seek for effective prevention and treatment methods. For COVID-19,although the cause of the disease belongs to the Qi of "pestilence",many doctors have different opinions on the pathogenic characteristics. However,they all agree with the clinical characteristics of "dampness". COVID-19,which has the attribute of "dampness evil",is so sticky that it can't be cured at once. In addition to the main symptoms such as fever and cough,it is also characterized by the middle-jiao dampness symptoms such as poor appetite,fullness of abdomen,loose stool and diarrhea. It is worthy to further explore the application prospect of Sanrentang in COVID-19 prevention and treatment.Copyright © 2021, China Academy of Chinese Medical Sciences Institute of Chinese Materia Medica. All rights reserved.

Analysis of the molecular mechanism of Huangqi herb treating COVID-19 with myocardial injury by pharmacological tools, programming software and molecular docking.

BACKGROUND: Huangqi with the capacity to resist virus and preserve myocardium is a potential herb for treating patients with COVID-19 and related myocardial injury. METHOD: We applied network pharmacology method and programming software including R and Perl to explore the probable mechanism of Huangqi fighting against the disease. Ingredients and target gene names of Huangqi were obtained from TCMSP database. Disease-associated genes were mined by searching GeneCards database. Venny online software was applied to draw Venn diagram of intersection genes. Cytoscape software was used to set up the network of disease, drug, compounds and targets. STRING database was applied to set up protein protein interaction (PPI) network. With intersection genes imported into WEBGESALT database, gene ontology (GO) analysis was completed. An R script basing on Kyoto Encyclopedia of Genes and Genomes (KEGG) database was applied to obtain KEGG pathways. Finally, we used AutoDockTools 1.5.6 software for molecular docking and PyMOL to visualize the docking details. RESULTS: We obtained 20 active components and 18 potential target genes to construct a network, and found out quercetin and kaempferol were core ingredients. Key targets included EGFR, MAPK8, IL6, CASP3, RELA and PPARG. Huangqi showed its potential to can reduce inflammatory response to prevent cytokine storm by inhibiting EGFR, IL6 and MAPK and protect myocardium by inhibiting apoptosis and oxidant stress. Huangqi may also work by adjusting ubiquitin and regulating multiple viral pathways. CONCLUSIONS: Huangqi may play a therapeutic role in treating COVID-19 with myocardial injury by the effects of resisting virus and protecting myocardium concurrently.

Acupuncture and Chinese herbs in the integrative management of post-COVID syndrome

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an RNA-type virus causing an acute respiratory infection (ARI) with different levels of severity ranging from a mild condition, like a common cold, to severe pneumonia and death. A clinical condition presenting 4-12 weeks after coronavirus disease 19 (COVID-19) infection, with persistent symptoms such as fatigue, cough, dyspnea, headache, myalgia, brain fog, and diarrhea, has been frequently recognized and is known today as post-COVID syndrome or long-COVID-19. Without a clear pathophysiology, research studies have proposed some secondary theories of SARS-CoV-2 infection. This entity has also been studied from the perspective of traditional Chinese medicine, recognizing syndromes or patterns in the different stages or phases of the disease and emphasizing a more individualized treatment according to the predominant pathological condition. It is concluded that the integrative and complementary use of acupuncture and Chinese herbal medicine is highly effective and could be a main resource for the treatment of this syndrome. Copyright © 2022, The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.

Feasibility analysis and mechanism exploration of Rhei Radix et Rhizome-Schisandrae Sphenantherae Fructus (RS) against COVID-19.

Introduction. As a novel global epidemic, corona virus disease 2019 (COVID-19) caused by SARS-CoV-2 brought great suffering and disaster to mankind. Recently, although significant progress has been made in vaccines against SARS-CoV-2, there are still no drugs for treating COVID-19. It is well known that traditional Chinese medicine (TCM) has achieved excellent efficacy in the treatment of COVID-19 in China. As a treasure-house of natural drugs, Chinese herbs offer a promising prospect for discovering anti-COVID-19 drugs.Hypothesis/Gap Statement. We proposed that Rhei Radix et Rhizome-Schisandrae Sphenantherae Fructus (RS) may have potential value in the treatment of COVID-19 patients by regulating immune response, protecting the cardiovascular system, inhibiting the production of inflammatory factors, and blocking virus invasion and replication processes.Aim. We aimed to explore the feasibility and molecular mechanisms of RS against COVID-19, to provide a reference for basic research and clinical applications.Methodology. Through literature mining, it is found that a Chinese herbal pair, RS, has potential anti-COVID-19 activity. In this study, we analysed the feasibility of RS against COVID-19 by high-throughput molecular docking and molecular dynamics simulations. Furthermore, we predicted the molecular mechanisms of RS against COVID-19 based on network pharmacology.Results. We proved the feasibility of RS anti-COVID-19 by literature mining, virtual docking and molecular dynamics simulations, and found that angiotensin converting enzyme 2 (ACE2) and 3C-like protease (3 CL pro) were also two critical targets for RS against COVID-19. In addition, we predicted the molecular mechanisms of RS in the treatment of COVID-19, and identified 29 main ingredients, 21 potential targets and 16 signalling pathways. Rhein, eupatin, (-)-catechin, aloe-emodin may be important active ingredients in RS. ALB, ESR1, EGFR, HMOX1, CTSL, and RHOA may be important targets against COVID-19. Platelet activation, renin secretion, ras signalling pathway, chemokine signalling pathway, and human cytomegalovirus infection may be important signalling pathways against COVID-19.Conclusion. RS plays a key role in the treatment of COVID-19, which may be closely related to immune regulation, cardiovascular protection, anti-inflammation, virus invasion and replication processes.

Tcm for hemostatic derangement: A scoping review of herb-based molecules active against COVID-19 coagulopathy

Background: COVID-19 is a multiple-system inflammatory disease with a wide range of symptoms: from none at all or resembling a mild cold, to severe fatigue, pain, and shortness of breath. Severe cases are often fatal, and usually involve multiorgan failure, myocardial infarction, venous thromboembolisms, cerebral vascular accident, and other ischemic events. Systemic hypercoagulability and thrombosis are caused by catastrophic dysregulation of the immune, inflammatory, and coagulation responses to SARS-COVID-2. The pressures of variable mask wearing agreement, slow vaccine distributions, and new, more transmissible variants obstructing herd immunity motivate the search for therapeutic solutions within traditional Chinese medicine. Methods: We conducted a PubMed systematic review for citations assessing effects of a pre-determined set of candidate herbs on a pre-determined set of molecular markers involved in COVID-19 associated coagulopathy. Candidate blood moving herbs were those included in 28 published traditional medicine COVID-19 treatment guidelines. Pathomechanisms and molecular markers were cross-referenced against herbal actives, and by functional strategies. Results: Of particular interest are those herbs acting on the receptor protein (NLRP3) inflammasome pathway, neutrophil extracellular trap (NET) formation and release of active coagulation factors, and endothelial dysfunction. Many Chinese herbs are active against COVID-19 coagulopathy: cinnamon twig (Gui Zhi), schizonepata herb ( Jing Jie) and hawthorn fruit (Shan Zha) downregulate the IL-18 inflammasome;ginseng (Ren Shen), peony root (Paeonia alba) and Japanese knotweed (Polygonum cuspidatum) down-regulate the NLRP-3 inflammasome formation. Both the IL-18 and NLRP-3 inflammasomes are upregulated by and play a role in COVID-19 coagulopathy. Attenuating these inflammasomes inhibits the systemic inflammatory response syndrome, by down-regulating IL-1β, IL-6 and TNF-α. Interpretation: Coagulopathy is a key driver of the systemic damage caused by COVID-19 infection. The potential relevance of Chinese herbal medicines playing a significant role in COVID-19 may rest on their ability to attenuate the inflammasomes driving the systemic inflammatory response syndrome.

Recent advances of traditional Chinese medicine on the prevention and treatment of COVID-19.

Coronavirus disease-2019 (COVID-19) is a new highly infectious disease caused by a novel coronavirus. Recently, the number of new cases infected pneumonia in the world continues to increase, which has aroused great concern from the international community. At present, there are no small-molecule specific anti-viral drugs for the treatment. The high mortality rate seriously threatens human health. Traditional Chinese medicine (TCM) is a unique health resource in China. The combination of TCM and Western medicine has played a positive and important role in combating COVID-19 in China. In this review, through literature mining and analysis, it was found that TCM has the potential to prevent and treat the COVID-19. Then, the network pharmacological studies demonstrated that TCM played roles of anti-virus, anti-inflammation and immunoregulation in the management of COVID-19 via multiple components acting on multiple targets and multiple pathways. Finally, clinical researches also confirmed the beneficial effects of TCM on the treatment of patients. This review may provide meaningful and useful information on further drug development of COVID-19 and other viral infectious diseases.

Chinese herbal compounds against SARS-CoV-2: Puerarin and quercetin impair the binding of viral S-protein to ACE2 receptor.

The outbreak of COVID-19 raises an urgent need for the therapeutics to contain the emerging pandemic. However, no effective treatment has been found for SARS-CoV-2 infection to date. Here, we identified puerarin (PubChem CID: 5281807), quercetin (PubChem CID: 5280343) and kaempferol (PubChem CID: 5280863) as potential compounds with binding activity to ACE2 by using Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP). Molecular docking analysis showed that puerarin and quercetin exhibit good binding affinity to ACE2, which was validated by surface plasmon resonance (SPR) assay. Furthermore, SPR-based competition assay revealed that puerarin and quercetin could significantly affect the binding of viral S-protein to ACE2 receptor. Notably, quercetin could also bind to the RBD domain of S-protein, suggesting not only a receptor blocking, but also a virus neutralizing effect of quercetin on SARS-CoV-2. The results from network pharmacology and bioinformatics analysis support a view that quercetin is involved in host immunomodulation, which further renders it a promising candidate against COVID-19. Moreover, given that puerarin is already an existing drug, results from this study not only provide insight into its action mechanism, but also propose a prompt application of it on COVID-19 patients for assessing its clinical feasibility.