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In vivo evaluation of Andrographis paniculata and Boesenbergia rotunda extract activity against SARS-CoV-2 Delta variant in Golden Syrian hamsters: Potential herbal alternative for COVID-19 treatment

Kongsomros et al., Journal of Traditional and Complementary Medicine, doi:10.1016/j.jtcme.2024.05.004
Nov 2024  
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Syrian hamster study showing that Andrographis paniculata extract improves survival without reducing viral load in SARS-CoV-2 Delta variant infection, likely through anti-inflammatory effects. Treatment with A. paniculata extract led to 100% survival versus 0% with vehicle control or Boesenbergia rotunda extract. A. paniculata extract significantly reduced IL-6 levels in lung tissue and decreased IL-6 and IP-10 mRNA in peripheral blood mononuclear cells, but did not affect lung viral titers or RNA levels. Histopathology showed reduced lung damage with A. paniculata treatment. In Vitro, andrographolide, a major component of A. paniculata, dose-dependently inhibited replication of Alpha, Delta and Omicron BA.2 variants in ACE2/TMPRSS2-expressing A549 cells. Authors note that improved formulations may improve in vivo antiviral activity.
24 preclinical studies support the efficacy of andrographolide for COVID-19:
In Vitro studies demonstrate inhibition of the MproA,17 protein. In Vitro studies demonstrate efficacy in Calu-3B,17, A549C,13, and HUVECD,17 cells. Animal studies demonstrate efficacy in Sprague Dawley miceE,17 and Golden Syrian hamstersF,13. Andrographolide inhibits Mpro in a dose-dependent manner17, reduces ACE2 levels in the lung tissue of mice in combination with baicalein17, inhibits binding between the SARS-CoV-2 spike protein and ACE217, alleviates lung inflammation and cytokine storm in mice17, and improves survival and reduces lung inflammation via anti-inflammatory effects in Syrian hamsters13.
a. The main protease or Mpro, also known as 3CLpro or nsp5, is a cysteine protease that cleaves viral polyproteins into functional units needed for replication. Inhibiting Mpro disrupts the SARS-CoV-2 lifecycle within the host cell, preventing the creation of new copies.
b. Calu-3 is a human lung adenocarcinoma cell line with moderate ACE2 and TMPRSS2 expression and SARS-CoV-2 susceptibility. It provides a model of the human respiratory epithelium, but many not be ideal for modeling early stages of infection due to the moderate expression levels of ACE2 and TMPRSS2.
c. A549 is a human lung carcinoma cell line with low ACE2 expression and SARS-CoV-2 susceptibility. Viral entry/replication can be studied but the cells may not replicate all aspects of lung infection.
d. HUVEC (Human Umbilical Vein Endothelial Cells) are primary endothelial cells derived from the vein of the umbilical cord. They are used to study vascular biology, including inflammation, angiogenesis, and viral interactions with endothelial cells.
e. An outbred multipurpose breed of albino mouse used extensively in medical research.
f. A rodent model widely used in infectious disease research due to their susceptibility to viral infections and similar disease progression to humans.
Kongsomros et al., 30 Nov 2024, Thailand, peer-reviewed, 18 authors. Contact: arunee.thi@mahidol.edu, phisit.khe@mahidol.ac.th.
This PaperAndrographol..All
In vivo evaluation of Andrographis paniculata and Boesenbergia rotunda extract activity against SARS-CoV-2 Delta variant in Golden Syrian hamsters: Potential herbal alternative for COVID-19 treatment
Supasek Kongsomros, Tussapon Boonyarattanasoonthorn, Wallaya Phongphaew, Chaiyan Kasorndorkbua, Piyanate Sunyakumthorn, Rawiwan Im-Erbsin, Luis A Lugo-Roman, Teetat Kongratanapasert, Jiraporn Paha, Suwimon Manopwisedjaroen, Pakakrong Kwankhao, Kittitach Supannapan, Nittaya Ngamkhae, Nitipol Srimongkolpithak, Pornpun Vivithanaporn, Suradej Hongeng, Arunee Thitithanyanont, Phisit Khemawoot
Journal of Traditional and Complementary Medicine, doi:10.1016/j.jtcme.2024.05.004
The ongoing COVID-19 pandemic has triggered extensive research, mainly focused on identifying effective therapeutic agents, specifically those targeting highly pathogenic SARS-CoV-2 variants. This study aimed to investigate the in vivo antiviral efficacy and anti-inflammatory activity of herbal extracts derived from Andrographis paniculata and Boesenbergia rotunda, using a Golden Syrian hamster model infected with Delta, a representative variant associated with severe COVID-19. Hamsters were intranasally inoculated with the SARS-CoV-2 Delta variant and orally administered either vehicle control, B. rotunda, or A. paniculata extract at a dosage of 1000 mg/kg/day. Euthanasia was conducted on days 1, 3, and 7 post-inoculation, with 4 animals per group. The results demonstrated that oral administration of A. paniculata extract significantly alleviated both lethality and infection severity compared with the vehicle control and B. rotunda extract. However, neither extract exhibited direct antiviral activity in terms of reducing viral load in the lungs. Nonetheless, A. paniculata extract treatment significantly reduced IL-6 protein levels in the lung tissue (7278 ± 868.4 pg/g tissue) compared to the control (12,495 ± 1118 pg/g tissue), indicating there was a decrease in local inflammation. This finding is evidenced by the ability of A. paniculata extract to reduce histological lesions in the lungs of infected hamsters. Furthermore, both extracts significantly decreased IL-6 and IP-10 mRNA expression in peripheral blood mononuclear cells of infected hamsters compared to the control group, suggesting systemic anti-inflammatory effects occurred. In conclusion, A. paniculata extract's potential therapeutic application for SARS-CoV-2 arises from its observed capacity to lessen inflammatory cytokine concentrations and mitigate lung pathology.
Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Appendix A. Supplementary data Supplementary data to this article can be found online at https://doi. org/10.1016/j.jtcme.2024.05.004 .
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