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Bioactive compounds from Huashi Baidu decoction possess both antiviral and anti-inflammatory effects against COVID-19

Xu et al., Proceedings of the National Academy of Sciences, doi:10.1073/pnas.2301775120
Apr 2023  
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Quercetin for COVID-19
24th treatment shown to reduce risk in July 2021, now with p = 0.0031 from 11 studies.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 109 treatments. c19early.org
In Vitro study of compounds from Huashi Baidu (Q-14), showing dose-dependent inhibition of SARS-CoV-2 with quercetin. Authors also perform a mouse study showing that Q-14 decreases SARS-CoV-2 viral load and reduces pulmonary inflammation.
Among 60 compounds, six (magnolol, glycyrrhisoflavone, licoisoflavone A, emodin, echinatin, and quercetin) showed dose-dependent inhibition of SARS-CoV-2, including two Mpro inhibitors (echinatin and quercetin) and two RdRp inhibitors (glycyrrhisoflavone and licoisoflavone A).
Followup studies1,2 collectively show that quercetin and echinatin had only weak SARS-CoV-2 protease inhibition in SDS-PAGE assays2, but false positive FRET results from MCA-AVLQ quenching1,2. Authors note that the compounds may act via other targets to achieve reported anti-COVID-19 effects2, and underscore the importance of meticulous validation with multiple assays when identifying SARS-CoV-2 protease inhibitors1,2.
Bioavailability. Quercetin has low bioavailability and studies typically use advanced formulations to improve bioavailability which may be required to reach therapeutic concentrations.
68 preclinical studies support the efficacy of quercetin for COVID-19:
In Silico studies predict inhibition of SARS-CoV-2, or minimization of side effects, with quercetin or metabolites via binding to the spikeA,8,9,21,23,24,29,37,38,40,41,61,62, MproB,6,8,10,12,14,16,17,19,22,23,29,33,35-37,41,42,44,62,63, RNA-dependent RNA polymeraseC,8,31, PLproD,36,44, ACE2E,21,22,27,36,40,62, TMPRSS2F,21, helicaseG,28,33, endoribonucleaseH,38, NSP16/10I,5, cathepsin LJ,25, Wnt-3K,21, FZDL,21, LRP6M,21, ezrinN,39, ADRPO,37, NRP1P,40, EP300Q,15, PTGS2R,22, HSP90AA1S,15,22, matrix metalloproteinase 9T,30, IL-6U,20,34, IL-10V,20, VEGFAW,34, and RELAX,34 proteins. In Vitro studies demonstrate inhibition of the MproB,14,45,50,58 protein, and inhibition of spike-ACE2 interactionY,46. In Vitro studies demonstrate efficacy in Calu-3Z,49, A549AA,20, HEK293-ACE2+AB,57, Huh-7AC,24, Caco-2AD,48, Vero E6AE,18,41,48, mTECAF,51, and RAW264.7AG,51 cells. Animal studies demonstrate efficacy in K18-hACE2 miceAH,54, db/db miceAI,51,60, BALB/c miceAJ,59, and rats64. Quercetin reduced proinflammatory cytokines and protected lung and kidney tissue against LPS-induced damage in mice59, inhibits LPS-induced cytokine storm by modulating key inflammatory and antioxidant pathways in macrophages4, and inhibits SARS-CoV-2 ORF3a ion channel activity, which contributes to viral pathogenicity and cytotoxicity53.
Xu et al., 24 Apr 2023, China, peer-reviewed, 33 authors. Contact: gaof@im.ac.cn, huangluqi01@126.com.
In Vitro studies are an important part of preclinical research, however results may be very different in vivo.
This PaperQuercetinAll
Bioactive compounds from Huashi Baidu decoction possess both antiviral and anti-inflammatory effects against COVID-19
Haiyu Xu, Shufen Li, Jiayuan Liu, Jinlong Cheng, Liping Kang, Weijie Li, Yute Zhong, Chaofa Wei, Lifeng Fu, Jianxun Qi, Yulan Zhang, Miaomiao You, Zhenxing Zhou, Chongtao Zhang, Haixia Su, Sheng Yao, Zhaoyin Zhou, Yulong Shi, Ran Deng, Qi Lv, Fengdi Li, Feifei Qi, Jie Chen, Siqin Zhang, Xiaojing Ma, Zhijian Xu, Shao Li, Yechun Xu, Ke Peng, Yi Shi, Hualiang Jiang, George F Gao, Luqi Huang
Proceedings of the National Academy of Sciences, doi:10.1073/pnas.2301775120
Significance Huashi Baidu decoction (Q-14), a famous traditional Chinese medicine decoction for COVID-19, has good effects on SARS-CoV-2 RNA clearance, promoting lung lesion opacity absorption, reducing inflammation, and ameliorating flu-like symptoms based on a series of clinical trials, having potent antiviral and antiinflammatory effects. However, due to the lack of systematic and in-depth research, little significant progress has been made in the study of TCMT-NDRD of HBF for COVID-19 management. Therefore, the aim of the current study was to identify key antiviral and anti-inflammatory bioactive compounds from HBF based on an integrative pharmacological strategy. These findings will greatly stimulate the traditional Chinese medicine theory-driven natural drug discovery against COVID-19 and promote the modern research of Chinese medicine.
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Traditional Chinese medicine ' 'theory-driven natural drug research and development (TCMT-NDRD) is a feasible method to ' 'address this issue as the traditional Chinese medicine formulae have been shown effective in ' 'the treatment of COVID-19. Huashi Baidu decoction (Q-14) is a clinically approved formula for ' 'COVID-19 therapy with antiviral and anti-inflammatory effects. Here, an integrative ' 'pharmacological strategy was applied to identify the antiviral and anti-inflammatory ' 'bioactive compounds from Q-14. Overall, a total of 343 chemical compounds were initially ' 'characterized, and 60 prototype compounds in Q-14 were subsequently traced in plasma using ' 'ultrahigh-performance liquid chromatography with quadrupole time-of-flight mass spectrometry. ' 'Among the 60 compounds, six compounds (magnolol, glycyrrhisoflavone, licoisoflavone A, ' 'emodin, echinatin, and quercetin) were identified showing a dose-dependent inhibition effect ' 'on the SARS-CoV-2 infection, including two inhibitors (echinatin and quercetin) of the main ' 'protease (M\n' ' <jats:sup>pro</jats:sup>\n' ' ), as well as two inhibitors (glycyrrhisoflavone and licoisoflavone A) of the ' 'RNA-dependent RNA polymerase (RdRp). Meanwhile, three anti-inflammatory components, including ' 'licochalcone B, echinatin, and glycyrrhisoflavone, were identified in a SARS-CoV-2-infected ' 'inflammatory cell model. In addition, glycyrrhisoflavone and licoisoflavone A also displayed ' 'strong inhibitory activities against cAMP-specific 3′,5′-cyclic phosphodiesterase 4 (PDE4). ' 'Crystal structures of PDE4 in complex with glycyrrhisoflavone or licoisoflavone A were ' 'determined at resolutions of 1.54\xa0Å and 1.65\xa0Å, respectively, and both compounds bind ' 'in the active site of PDE4 with similar interactions. 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Traditional Chinese Medicine-X, Ministry of ' 'Education Key Laboratory of Bioinformatics/Bioinformatics ' 'Division, Beijing National Research Center for Information ' 'Science and Technology, Department of Automation, Tsinghua ' 'University, Beijing 100084, China'}]}, { 'given': 'Yechun', 'family': 'Xu', 'sequence': 'additional', 'affiliation': [ { 'name': 'State Key Laboratory of Drug Research, Shanghai Institute of ' 'Materia Medica, Chinese Academy of Sciences, Shanghai 201203, ' 'China'}]}, { 'given': 'Ke', 'family': 'Peng', 'sequence': 'additional', 'affiliation': [ { 'name': 'State Key Laboratory of Virology, Center for Antiviral Research, ' 'Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan ' '430207, China'}]}, { 'given': 'Yi', 'family': 'Shi', 'sequence': 'additional', 'affiliation': [ { 'name': 'Chinese Academy of Sciences (CAS) Key Laboratory of Pathogen ' 'Microbiology and Immunology, Institute of Microbiology, Chinese ' 'Academy of Sciences, Beijing 100101, China'}, {'name': 'Beijing Life Science Academy, Beijing 102209, China'}]}, { 'given': 'Hualiang', 'family': 'Jiang', 'sequence': 'additional', 'affiliation': [ { 'name': 'State Key Laboratory of Drug Research, Shanghai Institute of ' 'Materia Medica, Chinese Academy of Sciences, Shanghai 201203, ' 'China'}]}, { 'ORCID': 'http://orcid.org/0000-0002-3869-615X', 'authenticated-orcid': False, 'given': 'George F.', 'family': 'Gao', 'sequence': 'additional', 'affiliation': [ { 'name': 'Chinese Academy of Sciences (CAS) Key Laboratory of Pathogen ' 'Microbiology and Immunology, Institute of Microbiology, Chinese ' 'Academy of Sciences, Beijing 100101, China'}, {'name': 'Beijing Life Science Academy, Beijing 102209, China'}]}, { 'given': 'Luqi', 'family': 'Huang', 'sequence': 'additional', 'affiliation': [ { 'name': 'State Key Laboratory of Dao-di Herbs, National Resource Center ' 'for Chinese Materia Medica, China Academy of Chinese Medical ' 'Sciences, Beijing 100700, China'}]}], 'member': 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Natl. Acad. Sci. U.S.A.', 'published': {'date-parts': [[2023, 4, 24]]}, 'assertion': [ { 'value': '2023-02-02', 'order': 0, 'name': 'received', 'label': 'Received', 'group': {'name': 'publication_history', 'label': 'Publication History'}}, { 'value': '2023-03-14', 'order': 1, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'publication_history', 'label': 'Publication History'}}, { 'value': '2023-04-24', 'order': 2, 'name': 'published', 'label': 'Published', 'group': {'name': 'publication_history', 'label': 'Publication History'}}]}
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