Chinese Medicine Treatment of Cytokine Storm Caused by COVID-19

2020 ◽  
Vol 22 (7) ◽  
Author(s):  
Youfu Ke ◽  
Jianli Cui
Keyword(s):  
Immune Response ◽  
Chinese Medicine ◽  
Blood Stasis ◽  
The Body ◽  
Cochrane Library ◽  
Complex Signal ◽  
Cytokine Storm ◽  
China National Knowledge Infrastructure ◽  
Multiple Targets ◽  
Chinese Medicine Treatment

Context: COVID-19 has turned into a pandemic, threatening the lives of millions of people worldwide. Research has found that some COVID-19 patients will suddenly aggravate, resulting in a cytokine storm, respiratory distress syndrome, and death. It is necessary to articulate the mechanism of cytokine storm and propose a Chinese medicine treatment strategy for COVID-19. Evidence Acquisition: A literature search was conducted using five databases on April 30, 2020, including PubMed, Google Scholar, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Data with the keywords of “cytokine storm AND Chinese medicine AND COVID-19 “, “cytokine storm AND Chinese medicine AND SARS-CoV-2”. The outcome of interest was the concept and mechanism of cytokine storm, the characteristics, and the Chinese medicine treatment of COVID-19 cytokine storm, etc. A total of 43 articles were retrieved after removing duplicate articles. Results: The cytokine storm is also called cytokine cascade. The body overreacts with positive feedback without negative feedback, making a variety of abnormal cytokines accumulations, triggering a cytokine storm. COVID-19 cytokine storm does not occur in the early stages, but only after a period of development, it attacks not only the lungs but also the heart, kidneys, and other organs. The key pathogenesis is “toxins and blood stasis, lung failure” in Chinese medicine. The treatment is detoxification, removing blood stasis, and nourishing the lung. Chinese medicine should comprehensively regulate multiple targets and multiple pathways to intervene in the immune regulation of the body to intercept the progress of inflammation and focus on the integration of Chinese medicine with Western medicine to combine anti-virus and anti-inflammatory therapy. Conclusions: The immune response caused by cytokine storm is a complex signal network with multiple targets and pathways and various cytokines acting together. Immunomodulation can balance the excessive inflammatory response and effectively control the replication and spread of SARS-CoV-2. Returning the immune response to a balanced state is an ideal method for treating COVID-19 cytokine storm. Chinese medicine can achieve overall coordination and balance. Nevertheless, the pharmacology of Chinese medicine must be further studied, and the mechanism of cytokine storm treatment should be thoroughly clarified.

scholarly journals On the Treatment of Kidney Fibrosis from the Theory of Internal Deficiency of Qi and the Coexistence of Phlegm and Blood Stasis

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Liu Min ◽  
Leng Wei
Keyword(s):  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Theoretical Basis ◽  
Renal Fibrosis ◽  
Blood Stasis ◽  
Point Of View ◽  
Kidney Fibrosis ◽  
Cause And Effect ◽  
Pathological Characteristics ◽  
Chinese Medicine Treatment

Traditional Chinese medicine believes that the etiology and pathogenesis of renal fibrosis are characterized by deficiency of the lung, spleen and kidney, and phlegm, blood stasis, dampness and poison. The positive and the evil can influence each other and cause and effect each other, forming the pathological characteristics of the deficiency, the deficiency, the deficiency and the reality. Chinese medicine treatment of the disease has its unique advantages, external and internal injury equal emphasis, correction and dispelling evil and regulation. From the point of view of "deficiency of qi and coexistence of phlegm and blood stasis", the treatment of renal fibrosis can provide theoretical basis for the treatment of the disease.

The War Against SARS-CoV-2: The Immune Giant Collapsing Under Its Own Rampaging Cytokine Storm

2021 ◽  
Author(s):  
Xanya Sofra
Keyword(s):  
Skeletal Muscle ◽  
Immune Response ◽  
Immune Cells ◽  
Preventive Intervention ◽  
Inflammatory Marker ◽  
The Body ◽  
Alternative Methods ◽  
Cytokine Storm ◽  
Protective Function ◽  
Age Related

We examined SARS-CoV-2 (Covid-19) available treatments and prophylactic methods that included interventions associated with inhibiting the ‘type II transmembrane serine protease’ (TMPRSS2) to limit the fusion between the Covid-19 Spike proteins and ACE2 receptors, or newly developed therapeutics like Remdesivir that interferes with the viral RNA replication. We explored the dilemma of ACE2 receptors that have a protective function against high blood pressure associated disorders, yet, they serve as the viral points of entry, elevating the probability of infection. Human tissues’ analysis reveals a higher ACE2 expression in adipose tissue, placing obesity-related conditions in the eye of the pandemic storm. It primarily exposes males due to the surge of ACE2 receptors in the testes along with other tissues. Males manifest a relatively higher positive ACE2 correlation with certain immune cells in the lungs, thyroid, adrenals, liver and colon, while females evidence higher ACE2 correlations with immune cells in the heart. The remaining tissues’ ACE2/immunity expressions are equivalent in both sexes, indicating that despite its preference for males, the threat of Covid-19 can easily target females. Recent reports indicate that Covid-19 is empowered by hindering the critical process of viral recognition during the adaptive immune response leading to the “cytokine storm,” the aggravated immune response that indiscriminately perseveres, rampaging the host’s vital organs. Sedentary lifestyle, age-related hormonal imbalance, and adiposity induced inflammation predispose the body to the immune collapse following Covid-19 invasion, spotlighting the detrimental aftermath of metabolic dysfunction, and excess food consumption, provoked by elevated cortisol and dysregulated appetite hormones. ACE2 expression is suppressed in the skeletal muscle, rendering fitness and weight management an effective Covid-19 preventive intervention, along with social distancing, hygiene, and facial coverings. Physical activity, or exercise alternative methods have recently demonstrated statistically significant reductions of the inflammatory marker C-Reactive Protein (CRP), triglycerides, visceral fat, cortisol and the orexigenic hormone ghrelin, juxtaposed by optimal increases of IGF-1, skeletal muscle mass, Free T3, HDL, and the anorexic hormone leptin.

scholarly journals MECHANISMS OF CYTOKINE STORM DEVELOPMENT IN COVID-19 AND NEW POTENTIAL TARGETS OF PHARMACOTHERAPY

2021 ◽  
Vol 8 (6) ◽  
pp. 380-391
Author(s):  
V. I. Petrov ◽  
A. A. Amosov ◽  
A. S. Gerasimenko ◽  
O. V. Shatalova ◽  
A. V. Ponomareva ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Complement System ◽  
The Body ◽  
The Other ◽  
Cochrane Library ◽  
Cochrane Central Register ◽  
Cytokine Storm ◽  
Renin Angiotensin ◽  
Other Hand ◽  
The One

The development of a "cytokine storm", characteristic of severe COVID-19 forms, can be defined as a state of uncontrolled release of a large number of inflammatory mediators.The attachment of SARS-CoV-2 S-glycoprotein to angiotensin-converting enzyme 2 is considered a process that triggers complex molecular interactions that lead to hyperinflammation. In its turn, it is realized through several systems: renin-angiotensin-aldosterone, kallikrein-kinin and a complement system. Knowledge of these mechanisms suggests potential therapeutic interventions that can be targeted by existing therapeutic agents to counter the cytokine storm and treat the acute respiratory distress syndrome associated with COVID-19.The aim of the review article is to summarize the currently known data on the molecular processes underlying the uncontrolled "cytokine storm" in the patients with severe COVID-19, and possible options for their pharmacological correction.Materials and methods. The data base was represented by such systems as Medline, Cochrane Central Register of Controlled Trials, Scopus, Web of Science Core Collection, Cochrane Library, ClinicalTrials.gov, Elibrary, Google-Academy. A search was carried out for the following keywords and combinations: COVID-19, renin-angiotensin-aldosterone system, bradykinin, complement system, hyaluronic acid, pharmacotherapy.Results. The development of a "cytokine storm" in COVID-19 is mediated by pathogenetic changes in the body in response to the penetration of SARS-CoV-2 into the cell. In the RAAS, suppression of ACE2 leads to a decrease in its ability to degrade ATII, which, on the one hand, leads to a decrease in the amount of AT1-7, and, on the other hand, to the effect of ATII on AT1R with the subsequent development of vasoconstriction and lung damage. The disturbances in the kallikrein-kinin system are associated, on the one hand, with the increased expression of kallikrein and an increase in the formation of bradykinin and its metabolite des-Arg 9-bradykinin. On the other hand, the disturbances are associated with the suppression of the expression of the C1-esterase inhibitor which prevents the formation of kallikrein, and impaired inactivation of des-Arg 9-bradykinin under the action of ACE 2. The nucleocapsid protein SARS-CoV-2 triggers the activation of the complement system through the lectin pathway. It leads to the production of anaphylatoxins C3a and C5a, which stimulate the synthesis of pro-inflammatory cytokines. Proinflammatory cytokines are potent inducers of the HAS 2 gene in the endothelium, which encodes the membrane enzymes of hyaluronate synthase. The sweating of the fluid into the alveoli caused by the "bradykinin storm" in combination with the overproduction of hyaluronic acid, which accumulates water 1000 times its own mass, can lead to the formation of a dense jelly-like substance that prevents gas exchange.Conclusion. Promising areas of pharmacotherapy for "cytokine storm" are associated with its impact on the dysfunction of the listed above systems. However, the efficacy and safety of most drugs for the treatment of COVID-19, is to be studied through carefully designed clinical trials.

scholarly journals Coronavirus Disease (COVID-19) Outbreak and Adaptive Immune System of the Body: A Review

2020 ◽  
Author(s):  
Amar Deep ◽  
Suchit Swaroop ◽  
Ajay Kumar ◽  
Sumit Rungta
Keyword(s):  
Immune Response ◽  
Immune System ◽  
Viral Infection ◽  
Severe Disease ◽  
The Body ◽  
World Health ◽  
Cochrane Library ◽  
Research Database ◽  
First Line ◽  
Adaptive Immune

In December 2019, a severe disease with an unknown aetiology has appeared in a Wuhan City, Hubei province, China. Immediately, it was identified as novel Coronavirus Disease (COVID-19) that has spread globally and also called Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), and was characterised in China. As we know the presence of viruses with new genetic diversity in nature, it is unclear from where this virus has evolved and transmitted to humans at the first place. As the outbreak of COVID-19 progresses, epidemiological data is essential to guide situational awareness, and intervention strategies and also immune response in COVID-19. That’s why treatments dealing with the immune-pathology of SARS-CoV-2 infection is a major issue for focus now-a-days, while a rapid and well-coordinated immune response represent the first line of defence against the viral infection. Presently, limited data and information is available on the host innate and adaptive immune status of SARS-CoV-2 infected patients. Here, authors described that how the immune system plays the first line of defence against viral infection, and attempt to compile, accumulate and disseminate the immune response information on COVID-19 from the World Health Organisation (WHO), MEDLINE, Embase, Cochrane Library, Centers for Disease Control and Prevention COVID-19 Research Database and trials registries for the recognition in progress and finished studies, cohort, and from Randomised Controlled Trials (RCTs).

scholarly journals SARS-CoV-2-the Unforeseen Peril of David Winning Against Goliath: the Immune Giant Collapsing Under Its Own Rampaging Cytokine Storm

2021 ◽  
Vol 2 (1) ◽  
pp. 26
Author(s):  
Xanya Sofra
Keyword(s):  
Skeletal Muscle ◽  
Immune Response ◽  
Immune Cells ◽  
Preventive Intervention ◽  
Inflammatory Marker ◽  
The Body ◽  
Alternative Methods ◽  
Cytokine Storm ◽  
Protective Function ◽  
Age Related

We examined SARS-CoV-2 (Covid-19) available treatments and prophylactic methods that included interventions associated with inhibiting the “type II transmembrane serine protease” (TMPRSS2) to limit the fusion between the Covid-19 Spike proteins and ACE2 receptors, or newly developed therapeutics like Remdesivir that interferes with the viral RNA replication. We explored the dilemma of ACE2 receptors that have a protective function against high blood pressure associated disorders, yet,they serve as the viral points of entry, elevating the probability of infection. Human tissues’ analysis reveals a higher ACE2 expression in adipose tissue, placing obesity-related conditions in the eye of the pandemic storm. It primarily exposes males due to the surge of ACE2 receptors in the testes along with other tissues. Males manifest a relatively higher positive ACE2 orrelations with certain immune cells in the lungs,thyroid, adrenals, liver and colon, while females evidence higher ACE2 correlations with immune cells in the heart. The remaining tissues’ ACE2/immunity expressions are equivalent in both sexes, indicating that despite its preference for males, the threat of Covid-19 can easily target females.Recent reports indicate that Covid-19 is empowered by hindering the critical process of viral recognition during the adaptive immune response leading to the “cytokine storm”, the aggravated immune response that indiscriminately perseveres, rampaging the host’s vital organs. Sedentary lifestyle, age-related hormonal imbalance, and adiposity induced inflammation predispose the body to the immune collapse following Covid-19 invasion, spotlighting the detrimental aftermath of metabolic dysfunction,and excess food consumption provoked by elevated cortisol and dysregulated appetite hormones. ACE 2 expression is suppressed in the skeletal muscle, rendering fitness and weight management an effective Covid-19 preventive intervention, along with social distancing, hygiene, and facial coverings. Physical activity, or exercise alternative methods have recently demonstrated statistically significant reductions of the inflammatory marker C-Reactive Protein (CRP), triglycerides, visceral fat, cortisol and the orexigenic hormone ghrelin, juxtaposed by optimal increases of IGF-1, skeletal muscle mass, Free T3, HDL, and the anorexic hormone leptin.

scholarly journals Traditional Chinese Medicine Constitution Correlated with Ischemic Stroke: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Tianyi Zhang ◽  
Hui Luo ◽  
Dawei Wei ◽  
Xiaolong Xie ◽  
Cinyu Yang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
General Population ◽  
Meta Analysis ◽  
Blood Stasis ◽  
China National Knowledge Infrastructure ◽  
Knowledge Infrastructure ◽  
Body Constitution ◽  
The Common

Objective. To investigate the correlation between traditional Chinese medicine (TCM) body constitution and ischemic stroke (IS). Methods. Literature search was conducted in databases including Wanfang database, Chongqing VIP, China National Knowledge Infrastructure, Embase, and PubMed from inception to November 16, 2020. Observational studies evaluating the association between TCM body constitution and IS were included for analysis. The distribution of body constitutional types in IS patients was pooled into meta-analysis. The correlation between constitution and IS was presented by the odds ratio (OR) and 95% CI through the comparison between IS and the general population. Results. 41 studies involving 11,211 participants were included. Among the nine constitution types, qi-deficiency constitution (QDC), phlegm-dampness constitution (PDC), and blood stasis constitution (BSC) are the common types, accounting for 25% [0.22, 0.29], 23% [0.20, 0.29], and 17% [0.13, 0.22], respectively, in IS patients. The proportion of PDC and QDC among IS patients is 2.34 times and 3.47 times higher than that in the general population, respectively (OR and 95% CI: 2.34 [1.39, 3.94], 3.47 [1.61, 7.50], respectively). Conclusion. PDC and QDC are the common constitutions in IS patients and may have a potential correlation with the incidence of IS. Due to the low or moderate quality of included studies, more well-designed prospective studies are warranted to further evaluate the relationship between TCM constitutions and IS.

Basic and clinical application progression of invigorating blood and dissolving stasis Chinese medicine in ophthalmology

2020 ◽  
Vol 1 (1) ◽  
pp. 62-66
Author(s):  
Ying Wang ◽  
◽  
Gen-Yan Qin ◽  
Yu Xiang ◽  
Jia-Qi Liu ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Clinical Application ◽  
Fibrous Tissue ◽  
Blood Stasis ◽  
Vitreous Body ◽  
Basic Research ◽  
Cure Rate ◽  
Definition Of ◽  
Chinese Medicine Treatment ◽  
Unique Therapy

Invigorating blood and dissolving stasis method is a kind of unique therapy of traditional Chinese medicine treatment, which efficacy has become increasingly prominent in the treatment of ophthalmology, with the further studies of blood stasis and invigorating blood and dissolving stasis therapy, it is widely used in clinical ophthalmology, and get good effects beyond thought, especially when western medicine has no curative effects, which improve the cure rate of fundus oculi disease from the eyelids, conjunctiva, lacrimal sac, vitreous body to the choroid and retina, optic nerve and macula lutea, from surface to fundus. Pathological changes related to inflammation, degeneration, necrosis, atrophy, hyperplasia of fibrous tissue hyperplasia. This paper is aim to explain the definition of invigorating blood and dissolving stasis and make a summary of basic research and clinical application about it in several diseases.

scholarly journals Traditional Chinese Medicine Oral Liquids Combined With Azithromycin for Mycoplasma pneumoniae Pneumonia in Children: A Bayesian Network Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Zhe Chen ◽  
Qingyang Shi ◽  
Yingying Peng ◽  
Yongjie Chen ◽  
Lujia Cao ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Mycoplasma Pneumoniae ◽  
Meta Analysis ◽  
Random Effect ◽  
Credible Interval ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Service Platform ◽  
Disappearance Time

Background:Mycoplasma pneumoniae pneumonia (MPP) causes flu-like symptoms in children, increasing the burden on the health and education systems. In China, traditional Chinese medicine oral liquids (TCMOLs) combined with azithromycin (TCMOLs + Azithromycin) is commonly used to treat MPP in children. However, TCMOLs with the optimal clinical applicability remain unknown. Here, we evaluated the clinical effectiveness and safety of TCMOLs + Azithromycin in children with MPP.Methods: We searched PubMed, Embase, Cochrane Library, Ovid, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, and VIP information resource integration service platform databases for eligible randomized controlled trials (RCTs) published from database inception to October 2020. Two reviewers independently performed data extraction and risk of bias assessment. After Bayesian random effect modeling and surface under the cumulative ranking curve (SUCRA) scoring, we ranked each intervention. We assessed heterogeneity using multivariate meta-regression for potential modifiers and used the Grading of Recommendations, Assessment, Development, and Evaluation to rate pooled evidence’s certainty.Results: In the 63 included RCTs with 6,410 children, five different TCMOLs were combined with azithromycin. TCMOLs + Azithromycin had significantly better primary outcomes than did azithromycin alone. Of all TCMOLs, Xiaoer Xiaoji Zhike (XEXJZK)+Azithromycin showed the best effectiveness with respect to the response rate (odds ratio [OR] = 6.5, 95% credible interval [CrI] = 4.3–10; low certainty) and pulmonary rales disappearance time (mean difference [MD] = −2.1, 95% CrI: −2.9 to −1.2; low certainty) with SUCRA 85 and 80%, respectively. Pudilan Xiaoyan + Azithromycin showed the highest effectiveness with respect to cough disappearance time (MD = −2.6, 95% CrI: −3.4 to −1.7; very low certainty) and fever disappearance time (MD = −1.8, 95% CrI: −2.3 to −1.3; very low certainty) with SUCRA 87 and 87%, respectively. The difference in the adverse effects between TCMOLs + Azithromycin and azithromycin alone was nonsignificant.Conclusion: Of the different TCMOLs, XEXJZK may be the best option to combine with azithromycin to treat children with MPP. However, our results should be interpreted with caution due to the low certainty of evidence. In general, TCMOLs’ safety remains unclear because of a lack of evidence. More high-quality RCTs are needed to further evaluate efficacy and safety of these TCMOLs.

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