COVID-19 : is there evidence for the use of herbal medicines as adjuvant symptomatic therapy?

Background: Current recommendations for the self-management of SARS-Cov-2 disease (COVID-19) include self-isolation, rest, hydration, and the use of NSAID in case of high fever only. It is expected that many patients will add other symptomatic/adjuvant treatments, such as herbal medicines. Aims: To provide a benefits/risks assessment of selected herbal medicines traditionally indicated for “respiratory diseases” within the current frame of the COVID-19 pandemic as an adjuvant treatment. Method: The plant selection was primarily based on species listed by the WHO and EMA, but some other herbal remedies were considered due to their widespread use in respiratory conditions. Preclinical and clinical data on their efficacy and safety were collected from authoritative sources. The target population were adults with early and mild flu symptoms without underlying conditions. These were evaluated according to a modified PrOACT-URL method with paracetamol, ibuprofen, and codeine as reference drugs. The benefits/risks balance of the treatments was classified as positive, promising, negative, and unknown. Results: A total of 39 herbal medicines were identified as very likely to appeal to the COVID-19 patient. According to our method, the benefits/risks assessment of the herbal medicines was found to be positive in 5 cases (Althaea officinalis, Commiphora molmol, Glycyrrhiza glabra, Hedera helix, and Sambucus nigra), promising in 12 cases (Allium sativum, Andrographis paniculata, Echinacea angustifolia, Echinacea purpurea, Eucalyptus globulus essential oil, Justicia pectoralis, Magnolia officinalis, Mikania glomerata, Pelargonium sidoides, Pimpinella anisum, Salix sp, Zingiber officinale), and unknown for the rest. On the same grounds, only ibuprofen resulted promising, but we could not find compelling evidence to endorse the use of paracetamol and/or codeine. Conclusions: Our work suggests that several herbal medicines have safety margins superior to those of reference drugs and enough levels of evidence to start a clinical discussion about their potential use as adjuvants in the treatment of early/mild common flu in otherwise healthy adults within the context of COVID-19. While these herbal medicines will not cure or prevent the flu, they may both improve general patient well-being and offer them an opportunity to personalize the therapeutic approaches

Determination of the antimutagenicity of an aqueous extract of Rhizophora mangle L. (Rhizophoraceae), using in vivo and in vitro test systems

An aqueous extract of Rhizophora mangle L. bark is used as raw material in pottery making in the State of Espirito Santo, Brazil. This extract presents large quantities of tannins, compounds possessing antioxidant properties. Tannin antioxidant activity, as a plant chemical defense mechanism in the process of stabilizing free radicals, has been an incentive to studies on anti-mutagenicity. The present work aimed to evaluate possible antimutagenic activity of a R. mangle aqueous extract, using the Allium cepa test-system and micronuclear (MN) assay with blockage of cytokinesis in Chinese hamster ovary cells (CHO-K1). The Allium cepa test-system indicated antimutagenic activity against the damage induced by the mutagenic agent methyl methanesulfonate. A reduction in both MN cell frequency and chromosome breaks occurred in both the pre and post-treatment protocols. The MN testing of CHO-K1 cells revealed anti-mutagenic activity of the R. mangle extract against methyl methanesulfonate and doxorubicin in pre, simultaneous and post-treatment protocols. These results suggest the presence of phyto-constituents in the extract presenting demutagenic and bio-antimutagenic activities. Since the chemical constitution of Rhizophora mangle species presents elevated tannin content, it is highly probable that these compounds are the antimutagenic promoters themselves

Anti-Helicobacter pylori effect of the antioxidant extract from Baccharis trimera Less. (DC)

One of the main risk factors for the development of stomach ulcers and cancer is infection with Helicobacter pylori bacteria, which is accompanied by considerable oxidative stress. Therefore, the aim of the present study was to assess the anti-Helicobacter pylori activity of B. trimera hydroalcoholic extract (HE) and aqueous (AqF), hexanic (HxF), and acetonitrile/chloroform (ACF) fractions, as well as their oxidant potentials.A preliminary phytochemical screening was carried out. Anti-Helicobacter pylori activity was assessed using a microdilution assay. After exposure to the investigated samples, the bacterial morphology was analysed under a scanning electron microscope (SEM). The antioxidant activity was evaluated in hydrogen peroxide (H 2 O 2 ), superoxide anion (O 2 •- ), hypochlorous acid (HOCl), hydroxyl radical (HO • ) and nitric oxide (NO • ) assays.The highest concentration of polyphenols was found in HE, the highest   concentration of flavonoids was found in ACF, and of tannins was found in AqF. In the anti-H. pylori assay, the MIC 90 was 512 µg/mL for HE and 1024 µg/mL for ACF, which was bactericidal. The SEM showed morphological alterations such as cell lysis in the tested samples. In the O 2 •- inhibition assay, the EC 50 of AqF was 5.85 ± 0.86. In the HOCl, HO • radical, NO • and H 2 O 2 scavenging assays, the best results were in ACF, with an EC 50 of 15.50 ± 0.80, 2.90 ± 0.48, 132.13 ± 7.38 and 66.70 ± 2.30 µg/mL, respectively. The analyses indicate that compounds present in B. trimera, especially in HE and ACF, are promising candidates for the prevention and treatment of diseases caused by H. pylori

Plantas medicinais utilizadas pela população atendida no "Programa de Saúde da Família", Governador Valadares, MG, Brasil

Este trabalho teve como objetivo realizar um estudo sobre a utilização de plantas medicinais pela população atendida no Programa de Saúde da Família em Governador Valadares, Estado de Minas Gerais, a fim de resgatar, preservar e utilizar este conhecimento em trabalhos com a comunidade. Foi usada a metodologia de questionários pré-estabelecidos, que foram aplicados pelos Agentes de Saúde da Família. O estudo foi feito em 27 bairros da cidade, sendo aplicados 2454 questionários, resultando em 232 plantas citadas como medicinais pela população entrevistada. As principais indicações de uso das plantas medicinais foram como calmante (10%), contra gripe (18%) e infecções (9%). A maioria das plantas utilizadas são preparadas na forma de chá (78%) e obtidas em cultivo próprio (57%), sendo que, em geral, o conhecimento sobre o uso e modo de preparo da plantas medicinais foi obtido dos familiares (67%). A maioria das espécies citadas e utilizadas popularmente possui atividade farmacológica já comprovada na literatura necessitando, entretanto, de orientação correta sobre seu cultivo e emprego terapêutico.This study was conducted to evaluate the use of medicinal plants by the population assisted by the "Programa de Saúde da Família" in Governador Valadares -MG, in order to rescue, preserve and use this knowledge in works carried out with the community. The preestablished questionnaire methodology was used. Those questionnaires were applied by the Family Health Agents. The study was accomplished in 27 residential quarters, as being applied 2454 questionnaires, and 232 plants were mentioned as medicinal ones by the interviewed population. The main indications for using the medicinal plants were: as sedative (10%), against influenza (18%) and infections (9%). Most plants under use are prepared as tea (78%) and are obtained in own cropping (57%). In general, the knowledge on the use and preparation of the medicinal plants proceeded from their relatives (67%). Most mentioned and popularly used species have pharmacological activity already proven in the literature. However, this population needs a correct orientation on their cropping and therapeutic use

Plantas medicinais utilizadas pela população atendida no "Programa de Saúde da Família", Governador Valadares, MG, Brasil Medicinal plants used by the population assisted by the "Programa de Saúde da Família" (Family Health Program) in Governador Valadares County - MG, Brazil

Este trabalho teve como objetivo realizar um estudo sobre a utilização de plantas medicinais pela população atendida no Programa de Saúde da Família em Governador Valadares, Estado de Minas Gerais, a fim de resgatar, preservar e utilizar este conhecimento em trabalhos com a comunidade. Foi usada a metodologia de questionários pré-estabelecidos, que foram aplicados pelos Agentes de Saúde da Família. O estudo foi feito em 27 bairros da cidade, sendo aplicados 2454 questionários, resultando em 232 plantas citadas como medicinais pela população entrevistada. As principais indicações de uso das plantas medicinais foram como calmante (10%), contra gripe (18%) e infecções (9%). A maioria das plantas utilizadas são preparadas na forma de chá (78%) e obtidas em cultivo próprio (57%), sendo que, em geral, o conhecimento sobre o uso e modo de preparo da plantas medicinais foi obtido dos familiares (67%). A maioria das espécies citadas e utilizadas popularmente possui atividade farmacológica já comprovada na literatura necessitando, entretanto, de orientação correta sobre seu cultivo e emprego terapêutico.<br>This study was conducted to evaluate the use of medicinal plants by the population assisted by the "Programa de Saúde da Família" in Governador Valadares -MG, in order to rescue, preserve and use this knowledge in works carried out with the community. The preestablished questionnaire methodology was used. Those questionnaires were applied by the Family Health Agents. The study was accomplished in 27 residential quarters, as being applied 2454 questionnaires, and 232 plants were mentioned as medicinal ones by the interviewed population. The main indications for using the medicinal plants were: as sedative (10%), against influenza (18%) and infections (9%). Most plants under use are prepared as tea (78%) and are obtained in own cropping (57%). In general, the knowledge on the use and preparation of the medicinal plants proceeded from their relatives (67%). Most mentioned and popularly used species have pharmacological activity already proven in the literature. However, this population needs a correct orientation on their cropping and therapeutic use

Chemical evaluation and anticholinesterase activity of Hippeastrum puniceum (Lam.) Kuntz bulbs (Amaryllidaceae)

Hippeastrum puniceum is a species that belongs to the Amaryllidaceae family. A particular characteristic of this family is the consistent and very specific presence of isoquinoline alkaloids, which have demonstrated a wide range of biological activities such as antioxidant, antiviral, antifungal, antiparasitic, and acetylcholinesterase inhibitory activity, among others. In the present work, fifteen alkaloids were identified from the bulbs of Hippeastrum puniceum (Lam.) Kuntz using a GC-MS approach. The alkaloids 9-O-demethyllycoramine, 9-demethyl-2α-hydroxyhomolycorine, lycorine and tazettine were isolated through chromatographic techniques. The typical Amaryllidaceae alkaloids lycorine and tazettine, along with the crude and ethyl acetate extract from bulbs of the species were evaluated for their inhibitory potential on α-amylase, α-glucosidase, tyrosinase and acetylcholinesterase activity. Although no significant inhibition activity was observed against α-amylase, α-glucosidase and tyrosinase from the tested samples, the crude and ethyl acetate extracts showed remarkable acetylcholinesterase inhibitory activity. The biological activity results that correlated to the alkaloid chemical profile by GC-MS are discussed herein. Therefore, this study contributed to the knowledge of the chemical and biological properties of Hippeastrum puniceum (Lam.) and can subsidize future studies of this species

<i>Cereus jamacaru</i> D.C. Hydroalcoholic Extract Promotes Anti-Cytotoxic and Antitumor Activity

Cereus jamacaru D.C. (mandacaru) is a cactus used as food and in the traditional medicine. In the present study, hydroalcoholic extract of C. jamacaru was evaluated for its chemical composition, antioxidant activity, cytotoxic and anti-cytotoxic effects in human lymphocytes and sarcoma 180 cells in vitro by MTT assay and antitumoral, mutagenic and cytotoxic effects on mice sarcoma-induced in vivo. Phytochemical characterization showed positive reactions for coumarin, flavanol and tyramine and total flavonoid content of 0.51 &#181;g/mL. C. jamacaru showed antioxidant activity following DPPH (EC50 = 427.74 &#181;g/mL), ABTS (EC50 = 270.57 &#181;g/mL) and Fe2+ chelating ions assays (EC50 = 41.18 &#181;g/mL). C. jamacaru induced significant decrease of sarcoma 180 viability at 24 h and 48 h of treatment, did not induce cytotoxicity in human lymphocytes and inhibits the cytotoxicity of cisplatin in vitro. Following in vivo assays, C. jamacaru promoted tumor reduction (86.07% of tumor inhibition), without inducing mutagenic or cytotoxic damage on mice blood cells. We propose that phenolic and alkaloid compounds in the extract are related to antioxidant activity, increasing its ability in metal chelating activity and promoting anti-cytotoxic activity against cisplatin, as well as these compounds may act on the cell cycle of the tumor cells in vitro and in vivo, leading to anticancer effects and tumor reduction