Azadirachta indica (Neem) should be studied and explored as a potential adjuvant in Mpox (Monkeypox) treatments

Medical News: The recent resurgence of Monkeypox (Mpox) has triggered global concern due to its high transmission rates and the severe complications it can cause, particularly in vulnerable populations. With limited treatment options available, researchers are exploring alternative and complementary therapies to bolster existing treatment protocols. Among these, Azadirachta indica, commonly known as Neem, has emerged as a promising candidate due to its wide range of medicinal properties, including antiviral, anti-inflammatory, and immunomodulatory effects. This Medical News report explores the potential role of Neem as an adjuvant in Mpox treatment protocols, drawing on recent studies and traditional knowledge.


Azadirachta indica (Neem) should be studied and explored as a potential adjuvant in Mpox
(Monkeypox) treatments

Therapeutic Properties of Neem
Neem, a tree native to the Indian subcontinent, has been used in traditional medicine for centuries. It is rich in bioactive compounds and phytochemicals such as azadirachtin, nimbolide, quercetin, and various limonoids, which contribute to its therapeutic effects. Neem has been traditionally used for its antiviral, antibacterial, antifungal, and anti-inflammatory properties, making it a versatile agent in the treatment of various infectious diseases.
 
In India, as part of treatment protocols that are based on ayurvedic traditions, Neem has been used to treat both smallpox and chickenpox and besides its noted antiviral properties, it has been found to aid with the resolution of the skin lesions and also in the prevention of dermal scars during the recovery period of smallpox and chickenpox.
 
Antiviral Activity
One of the most compelling reasons to consider Neem in Mpox treatment is its potent antiviral activity. Research has shown that Neem extracts can inhibit the replication of several viruses, including herpes simplex virus, coxsackievirus, and others. This antiviral effect is primarily attributed to the presence of compounds like quercetin and azadirachtin, which interfere with viral entry and replication in host cells.
 
One past study highlighted Neem bark extract significantly blocked HSV-1 entry into cells at concentrations ranging from 50 to 100 µg/mL, indicating a direct anti-viral property of Neem. Although specific studies on Mpox are yet to be conducted, the mechanism of action observed in other viruses suggests that Neem could similarly inhibit the Monkeypox virus.
 
Anti-Inflammatory and Immunomodulatory Effects
In addition to its antiviral properties, Neem is renowned for its anti-inflammatory and immunomodulatory effects. Mpox, like many viral infections, can trigger a severe inflammatory response in the body, leading to complications. Neem's ability to modulate the immune response and reduce inflammation could be crucial in managing these complications.

Studies have shown that Neem extract suppresses the production of pro-inflammatory cytokines and inhibits the activity of inflammatory enzymes like cyclooxyge nase (COX) and lipoxygenase (LOX). In animal models, Neem leaf extract was found to reduce paw edema and granuloma formation, both indicators of inflammation, by significant margins. By modulating the inflammatory response, Neem could help mitigate the severe symptoms associated with Mpox.
 
Antioxidant and Hepatoprotective Properties
Mpox infection is often accompanied by oxidative stress and liver damage, which complicates the course of the disease. Neem is rich in antioxidants that can neutralize free radicals and protect the liver from damage. Studies have demonstrated that Neem extracts enhance the activity of antioxidant enzymes and reduce oxidative stress markers in various disease models.
 
In a study on hepatoprotective activity, Neem's active compound azadirachtin-A was found to significantly reduce liver damage induced by carbon tetrachloride in rats. Given that liver complications are a concern in viral infections like Mpox, Neem’s hepatoprotective effects could offer additional support in the management of the disease.
 
Potential Role in Mpox Treatment
Given its broad spectrum of biological activities, Neem could serve as a valuable adjuvant in Mpox treatment protocols. While conventional antiviral drugs remain the cornerstone of Mpox treatment, integrating Neem into the treatment regimen could enhance the overall efficacy of the therapy, particularly in cases where the virus has caused significant inflammation or oxidative stress.
 
Supporting Evidence from Traditional Medicine
The use of Neem in traditional medicine, particularly in Ayurvedic practices, supports its potential application in Mpox. Traditionally, Neem has been used to treat skin conditions, viral infections, and inflammatory diseases, all of which are relevant to Mpox. Its use in managing smallpox in ancient times also suggests that Neem could be effective against similar viral infections like Mpox.
 
Challenges and Future Research
While the potential benefits of Neem are promising, several challenges remain before it can be widely adopted in Mpox treatment protocols. The primary challenge is the lack of specific clinical studies on Neem’s efficacy against the Monkeypox virus. Additionally, the optimal dosage and formulation of Neem for use in humans need to be determined through rigorous clinical trials.
 
Future research should focus on:
-Conducting in vitro and in vivo studies to assess Neem's efficacy against the Monkeypox virus.

-Investigating the synergistic effects of Neem with existing antiviral drugs.

-Determining the safety and optimal dosing of Neem in different populations.

-Conducting prepper observational clinical studies and ultimately large cohort based randomized clinical trials.
 
Conclusion
Azadirachta indica, or Neem, holds significant potential as an adjuvant in Mpox treatment protocols due to its antiviral, anti-inflammatory, antioxidant, and hepatoprotective properties. While more research is needed to confirm its efficacy against the Monkeypox virus specifically, the existing evidence suggests that Neem could enhance the management of Mpox, particularly in severe cases. Integrating traditional knowledge with modern medicine could pave the way for more effective and holistic treatment strategies for Mpox and other emerging viral diseases.
 
References:
Therapeutics Role of Azadirachta indica (Neem) and Their Active Constituents in Diseases Prevention and Treatment
https://onlinelibrary.wiley.com/doi/10.1155/2016/7382506
 
Traditional medicinal plants used for treating emerging and re-emerging
viral diseases in northern Nigeria
https://www.sciencedirect.com/science/article/pii/S187638202100812X’
 
Role of phytocompounds as the potential anti-viral agent: an overview
https://link.springer.com/article/10.1007/s00210-023-02517-2
 
Monkeypox: A disturbing viral outbreak in non-endemic region in 2022 : Herbal treatment options
https://www.academia.edu/82346044/Monkeypox_A_disturbing_viral_outbreak_in_non_endemic_Region_in_2022_Herbal_treatment_options
 
Investigating Multi-Target Antiviral Compounds by Screening of Phytochemicals From Neem (Azadirachta indica) Against PRRSV: A Vetinformatics Approach
https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2022.854528/full
 
The Antimicrobial Potential of the Neem Tree Azadirachta indica
https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.891535/full
 
'In vitro' antiviral activity of neem (Azadirachta indica. A. Juss) leaf extract against group B coxsackieviruses
https://pubmed.ncbi.nlm.nih.gov/10810594/
 
Traditional Herbal Medicines As a Complementary Treatment for Monkeypox
https://www.researchgate.net/publication/372425138_Traditional_Herbal_Medicines_As_a_Complementary_Treatment_for_Monkeypox

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