Immunity through Nutrition and Natural Product

The COVID-19 pandemic was caused by novel enveloped RNA betacoronavirus known as SARS-CoV-2. Studies have shown that severe COVID-19 Infection is characterized by higher levels of inflammatory markers in the blood (such as C-reactive protein, ferritin, and D-dimers), an increased neutrophil-to-lymphocyte ratio and increased serum levels of several inflammatory The hyperinflammatory response caused due to SARS-CoV-2 is responsible for the severity and death in infected patients. Cytokine storm syndrome is due to the activation of innate cells senses and responds to the infections by producing inflammatory molecules that eliminate pathogens and promote tissue repair.^1,2

In emergency cases, the use of anti-inflammatory drugs like NSAIDs has become necessary. But studies have revealed that long term use of NSAIDs delayed muscle regeneration and could decrease the healing rate in ligament, tendon, cartilage and also could adversely affect the functioning of kidneys. Hence, as alternative natural pain-relieving compounds present in different Plant- and animal-derived nutraceutical preparations are gaining attention around the globe because of their relatively few side effects.³

Some herbs which provide anti-inflammatory properties include curcumin present in Turmeric, quercetin present in Centella asiatica, mangiferin from mangoes along with different antioxidants present in amla, orange etc aid in preventing inflammation and provides relief from pain.

Different clinical trial studies have proved the antioxidant, anti-inflammatory, and antineoplastic effects of curcumin. Studies by Zandi and Karin disclose that curcumin could be effective in treating cystic fibrosis because of its anti-inflammatory effect. Curcumin exhibits its anti-inflammatory property by suppressing NF-kB, restricting various activators of NF-kB as well as stemming its expression. It also inhibits COX-1 and COX-2 and thus regulates the activity of several enzymes and cytokines.³ Wang et al reported that curcumin inhibited the inflammatory cells and reduced oxidative stress which caused lung damage due to VILI.^4,5

Quercetin exhibits antioxidant and anti-inflammatory properties. Recent animal studies disclosed that Quercetin prevents the entry of the virus into the host cell and decreases the expression of pro-inflammatory cytokines and lung inflammation. Vitamin C helps in the recycling of quercetin and enhances its effectiveness which helps quercetin to exhibit both antiviral and immunomodulatory properties.^6,7

Mangiferin obtained from the mango has antioxidant, anti-inflammatory, antimicrobial, antidiabetic, antiallergic, anticancer, hypocholesterolemic, and immunomodulatory properties. Studies have shown that inhibiting the infiltration of monocytes and neutrophils and decreasing the production of cytokines resulted in the anti-inflammatory property of magnefrin. ⁸

Centella asiatica exhibits its antioxidative activity by suppressing ROS production and exerts its anti-inflammatory activity by suppressing LPS-induced NO and TNF-α production in BV2 microglial cells. Studies have also shown that Centella asiatica phytosome had an anti-inflammatory effect in a mouse model of phthalic anhydride-induced atopic dermatitis.^9,10

Thus, we see that controlling inflammation using herbal phytoconstituents reduces the chances of side effects, provides significant relief from pain and also reduce the severity of many diseases including COVID-19.

References:

1. Benjamin M Liu , H. R. H. Role of Host Immune and Inflammatory Responses in COVID-19 Cases with Underlying Primary Immunodeficiency: A Review. J Interferon Cytokine Res, 2020, 40(12):, 549-554.
2. Merad, M., Martin, J.C. Pathological inflammation in patients with COVID-19: a key role for monocytes and macrophages. Nat Rev Immunol,  2020, 20, 355–362 (2020). , 355–362
3. Joseph C. Maroon, J. W. B., and Adara Maroon. Natural anti-inflammatory agents for pain relief. Surg Neurol Int. 2010, 1: 80., 1-10.
4. XunWang, X. A., XiaocenWang, ChenBa, JingLi, DongYang, Chunxue Bai. Curcumin ameliorated ventilator-induced lung injury in rats. Biomedicine & Pharmacotherapy., 98, 754-761.
5. Bruna A. C. Rattis, G. R. a. N. C. Curcumin as a Potential Treatment for COVID-19. Front. Pharmacol., 2021, 12, 1-14.
6. Shyamala Ganesan , A. N. F., Adam T Comstock, Qiong Wang, Suparna Nanua, Marc B Hershenson, Uma S Sajjan. Quercetin inhibits rhinovirus replication in vitro and in vivo. Antiviral Res 2012, 94(3), 258-271.
7. Ruben Manuel Luciano Colunga Biancatelli , M. B., John D Catravas , Paul E Marik Quercetin and Vitamin C: An Experimental, Synergistic Therapy for the Prevention and Treatment of SARS-CoV-2 Related Disease (COVID-19). Front Immunol 2020, 11:1451, 1-11.
8. Ramakrishna K. Bulugonda, K. A. k., D. Gangappa, Harshavardhan Beeda, Gundala Harold Philip, Dowlathabad Muralidhara Rao,and Syed M. Faisalb,. Mangiferin from Pueraria tuberosa reduces inflammation via inactivation of NLRP3 inflammasome, Sci Rep. 2017, 7: 42683., 1-14.
9. Mairuae, N.; Cheepsunthorn, P.; Buranrat, B. Anti-inflammatory and anti-oxidative effects of Centella asiatica extract in lipopolysaccharide-stimulated BV2 microglial cells. Pharmacognosy Magazine 2019, 15, 140-146.
10. Park Ju Ho , J. J. S., Kim Ki Cheon , Hong Jin Tae Anti-inflammatory effect of Centella asiatica phytosome in a mouse model of phthalic anhydride-induced atopic dermatitis. Phytomedicine 2018, 43:, 110-119.