Traditional Chinese medicine herbal remedies offer hope in combating COVID-19 cytokine storms

TCM News: Understanding the Cytokine Storm in COVID-19 and the Role of Chinese Herbal Medicines
The COVID-19 pandemic has posed numerous challenges, especially in managing severe cases where patients experience acute respiratory distress syndrome (ARDS) due to a phenomenon known as a cytokine storm. Researchers from multiple institutions have investigated the potential of Chinese herbal medicines to mitigate the effects of cytokine storms in COVID-19 patients. This TCM News report delves into the pathological mechanisms behind cytokine storms and explores how traditional Chinese remedies could offer therapeutic benefits.


Traditional Chinese medicine herbal remedies offer hope in combating COVID-19 cytokine storms

What is a Cytokine Storm?
A cytokine storm is a severe immune reaction where the body releases an excess of cytokines into the blood too quickly. This overreaction can lead to significant inflammation and tissue damage, particularly in the lungs, resulting in ARDS - a life-threatening condition that complicates COVID-19 infections. The term "cytokine storm" gained widespread attention during the COVID-19 pandemic as a critical factor in the severe respiratory distress seen in many patients.
 
Pathological Mechanisms of Cytokine Storms in COVID-19
SARS-CoV-2, the virus responsible for COVID-19, can disrupt immune activation and lead to a cytokine storm, transforming mild COVID-19 into a severe and often deadly condition. This disruption primarily affects the respiratory system, starting with the infection of ciliated cells in the upper respiratory tract and progressing to the alveoli in the lungs. The immune system's overreaction causes inflammation, fluid buildup, and coagulation, resulting in impaired oxygen exchange and respiratory failure.
 
Key molecular targets in the development of a cytokine storm include pro-inflammatory cytokines like interleukin (IL)-6, IL-1β, and tumor necrosis factor (TNF)-α, which are elevated in severe COVID-19 cases. The JAK-STAT, NF-κB, and NLRP3 inflammasome signaling pathways play significant roles in this process.
 
The Therapeutic Potential of Traditional Chinese Medicine Herbal Preparations
Researchers from the Beijing Key Laboratory of Pharmacology of Chinese Materia Region, Institute of Basic Medical Sciences of Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing University of Chinese Medicine-China, and Western Sydney University's NICM Health Research Institute-Australia have conducted extensive studies on the benefits of Chinese herbal medicines in treating COVID-19-induced cytokine storms. Listed are some of the studied TCM herbal medications with promising efficacy for ARDS with Preclinical and Clinical Evidence includes:
 
Xuebijing Injection
Xuebijing (XBJ) injection is a patented formulation commonly used in China for treating sepsis and systemic inflammatory response syndrome. I ts main ingredients include:
 
-Carthamus tinctorius L. (Honghua): Known for its blood-activating properties, it helps reduce blood stasis and improve circulation.
 
-Paeonia lactiflora Pall. (Chishao): This herb has anti-inflammatory and analgesic effects.
 
-Ligusticum chuanxiong Hort. (Chuanxiong): It promotes blood circulation and is used to treat headaches and pain.
 
Clinical trials and animal studies have shown that XBJ can reduce levels of IL-6 and TNF-α, significantly improving survival rates and reducing the severity of ARDS in COVID-19 patients.
 
Huashi Baidu Formula
The Huashi Baidu (HSBD) formula was developed specifically for COVID-19 and comprises 14 Chinese herbs, including:
 
-Ephedra sinica Stapf (Mahuang): Traditionally used to treat respiratory issues, it helps relieve asthma and cough.
 
-Pogostemon cablin (Blanco) Benth. (Huoxiang): Known for its ability to alleviate nausea and vomiting, it also has antiviral properties.
 
-Hydrated calcium sulphate (Shigao): Used for its cooling properties to reduce fever.
 
Clinical trials have demonstrated that HSBD can shorten recovery times and improve symptoms like fever, cough, and chest discomfort by targeting the inflammatory response associated with a cytokine storm.
 
Lianhua Qingwen Granules/Capsules
Lianhua Qingwen (LHQW) is traditionally used to treat influenza but has shown promise in COVID-19 cases. Its key ingredients include:
 
-Lonicera japonica Thunb. (Jinyinhua): Known for its antiviral and anti-inflammatory properties.
 
-Forsythia suspensa (Thunb.) Vahl (Lianqiao): Used to reduce fever and detoxify the body.
 
-Rheum palmatum L. (Dahuang): It has laxative properties and helps clear heat from the body.
 
Studies indicate that LHQW can reduce SARS-CoV-2 replication and lower the production of pro-inflammatory cytokines, helping prevent mild cases from progressing to severe ARDS.
 
Qingfei Paidu Decoction
Qingfei Paidu Decoction (QFPD) was formulated to combat COVID-19 and includes key ingredients such as:
 
-Ephedra sinica Stapf (Mahuang): Relieves asthma and promotes sweating.
 
-Glycyrrhiza uralensis Fish. (Zhigancao): Known for its soothing and anti-inflammatory properties.
 
-Prunus armeniaca L. var. ansu Maxim. (Kuxingren): Used to alleviate cough and asthma.
 
Meta-analyses and clinical studies suggest that QFPD, when combined with conventional treatments, can significantly reduce inflammation and improve clinical outcomes in COVID-19 patients.
 
Xuanfei Baidu Decoction
Xuanfei Baidu (XFBD) is a comprehensive formula used in treating COVID-19 patients. It consists of 13 herbal ingredients including:
 
-Prunus sibirica L. (Kuxing ren): Helps relieve cough and asthma.
 
-Verbena officinalis L. (Mabiancao): Known for its anti-inflammatory and fever-reducing properties.
 
-Ephedra sinica Stapf (Mahuang): Promotes sweating and relieves asthma.
Clinical trials have shown that XFBD can effectively reduce clinical symptoms and suppress systemic inflammation, making it a valuable adjunctive therapy.
 
Reduning Injection
Reduning (RDN) injection, used for respiratory infections, includes:
 
-Lonicera japonica Thunb. (Jinyinhua): Antiviral and anti-inflammatory properties.
 
-Artemisia annua L. (Qinghao): Known for its antimalarial and anti-inflammatory effects.
 
-Gardenia jasminoides Ellis (Zhizi): Used to clear heat and promote urination.
 
RDN has demonstrated efficacy in reducing inflammatory cytokines and improving survival rates in animal models. Its anti-inflammatory action is linked to the inhibition of key signaling pathways involved in the cytokine storm.
 
Other Promising Chinese Herbal Medicines
 
Curcumin
Curcumin, derived from Curcuma longa L., has broad anti-inflammatory and anti-cytokine activities. Studies have shown that curcumin can regulate pro-inflammatory and anti-inflammatory cytokines, improve survival rates in animal models, and inhibit key signaling pathways involved in inflammation.
 
Babaodan
Babaodan (BBD), a traditional Chinese herbal formula, has shown potential in treating viral and non-infectious diseases. Clinical observations in COVID-19 patients suggest that BBD can control excessive immune responses and prevent ARDS progression.
 
Qiang-Xin 1 Formula
Qiang-Xin 1 (QX1), used for treating heart failure, has shown promise in reducing inflammatory cytokines in sepsis models. Its multi-component approach targets multiple signaling pathways, offering a broad-spectrum anti-inflammatory effect.
 
Cardamonin
Cardamonin, found in Alpinia katsumadai seeds, has shown significant anti-inflammatory and anti-cytokine activities. Studies have demonstrated its ability to inhibit the NLRP3 inflammasome, making it a potential therapeutic agent for COVID-19-induced cytokine storms.
 
Yam Glycoprotein
Yam glycoprotein, derived from traditional Chinese yam, has demonstrated anti-inflammatory and immunomodulatory effects. In animal models, it has been shown to reduce pro-inflammatory cytokines and inhibit key signaling pathways involved in inflammation.
 
The Future of Chinese Herbal Medicines in COVID-19 Treatment
The multi-component and multi-target approach of Chinese herbal medicines provides a promising alternative or adjunct to conventional therapies in managing COVID-19-induced cytokine storms. The comprehensive nature of these traditional remedies allows for the simultaneous targeting of multiple pathways involved in the disease process.
 
Conclusion
The integration of Chinese herbal medicines into the treatment regimen for COVID-19, particularly in managing cytokine storms, holds significant promise. These traditional remedies, with their multi-component and multi-target approaches, provide a holistic solution to the complex pathogenesis of ARDS. Continued research and well-designed clinical trials are essential to fully understand and validate their therapeutic potential.
 
The study findings were published in the peer-reviewed journal: Medicines.
https://www.mdpi.com/2305-6320/11/7/14
 
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