The world faces an unprecedented situation. A novel virus, SARS-CoV-2, combines a long incubation time with serious danger to those it infects, and it has spread around the world at harrowing speed. The resulting crisis has inspired large interventions into ordinary life and major economic reorganizations, and the full extent of its fallout remains to be seen. As a new pathogen, SARS-CoV-2 does not have an established treatment or vaccine and has rightly spawned a wholesale effort to identify and implement one. One of the less obvious ways that this search is unfolding is by checking traditional and alternative medicines for potential efficacy.
Numerous modern medicines have their origins in traditional medicines that predate the scientific methods currently used to validate new treatments. Perhaps the most famous example is aspirin, whose chemical name (acetylsalicylic acid) hints at its origin in the bark of willow trees (genus Salix). People without access to scientific tools can still record the results of trial and error, and traditional medicine is a record of those successes. That means that traditional medicines often, but not always, have biochemical activity relevant to the conditions they claim to treat. Science, with its advanced array of analytical techniques and commitment to statistical rigor and reproducibility, can both refine these knowledge bases and eventually incorporate them into worldwide medical practice. Indeed, investigating traditional medicines from various societies, from Indigenous American groups to Finland’s Sámi peoples to traditional Chinese medicine (TCM), has yielded a variety of compounds that are currently being researched for even more precise applications. This article highlights a few examples of this process in action, showing that a few traditional medicines may have possible utility for treating SARS-CoV-2 infections.
Liu Shen capsules: More than meets the eye?
Ma et al. undertook an investigation of Liu Shen (LS), a common TCM, as a potential agent against SARS-CoV-2. LS consists of a blend of natural ingredients, including toad venom, plant terpenes and mother-of-pearl. Although LS’s exact mode of action remains unclear and some of the ingredients may be superfluous, research has shown it is effective in easing symptoms of some infections, providing reason to study whether it could potentially be effective against SARS-CoV-2.
Ma et al. exposed standard human and monkey cell lines to a SARS-CoV-2 isolate from Guangzhou and compared the effects of LS at various concentrations to the effects of an established antiviral drug, remdesivir. In particular, they compared the influence of LS and remdesivir on the expression of pro-inflammatory cytokines induced by SARS-CoV-2, detecting protein and mRNA expression by ELISA (for protein expression) and RT-PCR using an Applied Biosystems PRISM 7500 Real-Time PCR System (for mRNA expression). In Ma et al.’s study, LS showed dose-dependent effects similar to those of remdesivir, reducing inflammatory cytokine production and viral replication. This finding shows that that this traditional remedy is worth further investigation for potential use against SARS-CoV-2, including research into which components are creating these effects and how to enable more precise dosing than traditional herbal preparations allow.
Echinacea in the age of SARS-CoV-2
Investigating herbal remedies may also be of value. Declerck et al. studied a specific echinacea preparation to understand its mode of action. Echinacea has complex effects on the immune system that are well-substantiated in literature, and that complexity makes it challenging to judge its effectiveness against any specific situation. Like many other herbal medicines, echinacea would benefit from work to isolate its cocktail of bioactive agents and investigate their effects on their own and in various combinations.
In the meantime, Declerck et al. performed gene expression microarray analysis to look at the pathways being activated by their echinacea preparation of interest. They verified the results with RT-PCR using the Applied Biosystems StepOnePlus Real-Time PCR System to investigate expression changes in innate immunity genes and pathways. Their findings suggest that echinacea phytochemicals strengthen antiviral innate immunity by JAK1 responsive gene expression and epigenetic regulation of HERVs in monocytes. This pathway suggests that echinacea may be a viable prophylactic against common cold coronaviruses (CoV), severe acute respiratory syndrome (SARS)-CoV, and new strains such as SARS-CoV-2. Further research is required to isolate particular compounds of interest and otherwise refine this compound into a potential treatment.
Further research in traditional medicine
It is important to note that traditional medicines and herbal remedies are complex mixtures whose components interact in sometimes-unclear ways. In addition, most countries’ regulatory authorities consider them supplements, which do not require the regulatory approval and evidence of efficacy that are required for pharmaceuticals. Traditional bodies of medical knowledge are valuable, but their value is multiplied when the full breadth of science’s toolbox is brought to bear to verify, isolate and understand how they work—or don’t work. This is how willow-bark tea became aspirin and how other traditional medicines may yet become common, widespread treatments for various conditions, including SARS-CoV-2, in the future.
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Read the papers
- Ma, Q., et al. (2020) “Liu Shen capsule shows antiviral and anti-inflammatory abilities against novel coronavirus SARS-CoV-2 via suppression of NF-κB signaling pathway.” Pharmacol Res 158: 104850.
- Declerck, K., et al. (2020) “Standardized Echinacea purpurea extract primes an IFN specific innate immune monocyte response via JAK1-STAT1 dependent gene expression and epigenetic control of endogenous retroviral sequences.” Preprint at Research Square (DOI: 10.21203/rs.3.rs-28886/v1).
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