Journal of Ginseng Research

The Korean Society of Ginseng (고려인삼학회)
권호 표지
DOI QR코드

DOI QR Code

The potential of Panax notoginseng against COVID-19 infection

  • Yeye Hu (Institute of Translational Medicine, School of Medicine, Yangzhou University) ;
  • Ziliang He (School of Life Sciences, Huaiyin Normal University) ;
  • Wei Zhang (School of Life Sciences, Huaiyin Normal University) ;
  • Zhiqiang Niu (Institute of Translational Medicine, School of Medicine, Yangzhou University) ;
  • Yanting Wang (Institute of Translational Medicine, School of Medicine, Yangzhou University) ;
  • Ji Zhang (School of Life Sciences, Huaiyin Normal University) ;
  • Ting Shen (Institute of Translational Medicine, School of Medicine, Yangzhou University) ;
  • Hong Cheng (Institute of Translational Medicine, School of Medicine, Yangzhou University) ;
  • Weicheng Hu (Institute of Translational Medicine, School of Medicine, Yangzhou University)
  • Received : 2022.11.19
  • Accepted : 2023.04.05
  • Published : 2023.09.01
Download PDF
⟨ Previous Next ⟩

Abstract

The COVID-19 pandemic has changed the world and has presented the scientific community with unprecedented challenges. Infection is associated with overproduction of proinflammatory cytokines secondary to hyperactivation of the innate immune response, inducing a cytokine storm and triggering multiorgan failure and significant morbidity/mortality. No specific treatment is yet available. For thousands of years, Panax notoginseng has been used to treat various infectious diseases. Experimental evidence of P. notoginseng utility in terms of alleviating the cytokine storm, especially the cascade, and improving post-COVID-19 symptoms, suggests that P. notoginseng may serve as a valuable adjunct treatment for COVID-19 infection.

Keywords

Acknowledgement

This study was financially supported by Natural Science Foundation of Jiangsu Province (BK20201480).

References

  1. Pollard CA, Morran MP, Nestor-Kalinoski AL. The Covid-19 pandemic: a global health crisis. Physiol Genomics 2020;52:549-57. https://doi.org/10.1152/physiolgenomics.00089.2020. 
  2. Alimadadi A, Aryal S, Manandhar I, Munroe PB, Joe B, Cheng X. Artificial intelligence and machine learning to fight Covid-19. Physiol Genomics 2020;52:200-2. https://doi.org/10.1152/physiolgenomics.00029.2020. 
  3. Costela-Ruiz VJ, Illescas-Montes R, Puerta-Puerta JM, Ruiz C, Melguizo-Rodriguez L. SARS-CoV-2 infection: the role of cytokines in COVID-19 disease. Cytokine Growth Factor Rev 2020;54:62-75. https://doi.org/10.1016/j.cytogfr.2020.06.001. 
  4. Hayden FG. Respiratory viral threats. Curr Opin Infect Dis 2006;19:169-78. https://doi.org/10.1097/01.qco.0000216628.51563.b1. 
  5. Ison MG. Antivirals and resistance: influenza virus. Curr Opin Virol 2011;1:563-73. https://doi.org/10.1016/j.coviro.2011.09.002. 
  6. Cho WK, Weeratunga P, Lee BH, Park JS, Kim CJ, Ma JY, Lee JS. Epimedium koreanum nakai displays broad spectrum of antiviral activity in vitro and in vivo by inducing cellular antiviral state. Viruses 2015;7:352-77. https://doi.org/10.3390/v7010352. 
  7. Lin LT, Hsu WC, Lin CC. Antiviral natural products and herbal medicines. J Tradit Complement Med 2014;4:24-35. https://doi.org/10.4103/2225-4110.124335. 
  8. Parham S, Kharazi AZ, Bakhsheshi-Rad HR, Nur H, Ismail AF, Sharif S, RamaKrishna S, Berto F. Antioxidant, antimicrobial and antiviral properties of herbal materials. Antioxidants 2020;9:1-36. https://doi.org/10.3390/antiox9121309. 
  9. Luo L, Jiang J, Wang C, Fitzgerald M, Hu W, Zhou Y, Zhang H, Chen S. Analysis on herbal medicines utilized for treatment of COVID-19. Acta Pharm Sin B 2020;10:1192-204. https://doi.org/10.1016/j.apsb.2020.05.007. 
  10. Nugraha RV, Ridwansyah H, Ghozali M, Khairani AF, Atik N. Traditional herbal medicine candidates as complementary treatments for COVID-19: a review of their mechanisms, pros and cons. Evidence-Based Complement Altern Med 2020;2020. https://doi.org/10.1155/2020/2560645. 
  11. Panyod S, Ho CT, Sheen LY. Dietary therapy and herbal medicine for COVID-19 prevention: a review and perspective. J Tradit Complement Med 2020;10:420-7. https://doi.org/10.1016/j.jtcme.2020.05.004. 
  12. Zhu S, Zou K, Fushimi H, Cai S, Komatsu K. Comparative study on triterpene saponins of ginseng drugs. Planta Med 2004;70:666-77. https://doi.org/10.1055/s-2004-827192. 
  13. Zhao GR, Xiang ZJ, Ye TX, Yuan YJ, Guo ZX. Antioxidant activities of Salvia miltiorrhiza and Panax notoginseng. Food Chem 2006;99:767-74. https://doi.org/10.1016/j.foodchem.2005.09.002. 
  14. Wang L, Huang Y, Yin G, Wang J, Wang P, Chen ZY, Wang T, Ren G. Antimicrobial activities of Asian ginseng, American ginseng, and notoginseng. Phyther Res 2020;34:1226-36. https://doi.org/10.1002/ptr.6605. 
  15. Ji W, Gong BQ. Hypolipidemic effects and mechanisms of Panax notoginseng on lipid profile in hyperlipidemic rats. J Ethnopharmacol 2007;113:318-24. https://doi.org/10.1016/j.jep.2007.06.022. 
  16. Sun S, Wang CZ, Tong R, Li XL, Fishbein A, Wang Q, He T, Du W, Yuan C. Effects of steaming the root of Panax notoginseng on chemical composition and anticancer activities. Food Chem 2010;118:307-14. https://doi.org/10.1016/j.foodchem.2009.04.122. 
  17. Zhang S, Chen C, Lu W, Wei L. Phytochemistry, pharmacology, and clinical use of Panax notoginseng flowers buds. Phyther Res 2018;32:2155-63. https://doi.org/10.1002/ptr.6167. 
  18. Ng TB. Pharmacological activity of sanchi ginseng (Panax notoginseng). J Pharm Pharmacol 2010;58:1007-19. https://doi.org/10.1211/jpp.58.8.0001. 
  19. Wang T, Guo R, Zhou G, Zhou X, Kou Z, Sui F, Li C, Tang L, Wang Z. Traditional uses, botany, phytochemistry, pharmacology and toxicology of Panax notoginseng (Burk.) F.H. Chen: a review. J Ethnopharmacol 2016;188:234-58. https://doi.org/10.1016/j.jep.2016.05.005. 
  20. Committee for the pharmacopoeia of China. Pharmacopoeia of China, Part I. Beijing: China Medical Science And Technology Press; 2010. 
  21. Shi J, Lu J, Liu R, Guo J, Deng Z, Li L. Analysis on dosage form and technology of Chinese patent medicine containing Panax notoginseng in Chinese pharmacopoeia (2010 edition). Pharm Today 2012;22:392-4. 
  22. Sun Z, Tan X, Ye H, Zou C, Ye C, Wang A. Effects of dietary Panax notoginseng extract on growth performance, fish composition, immune responses, intestinal histology and immune related genes expression of hybrid grouper (Epinephelus lanceolatus ♂ × Epinephelus fuscoguttatus ♀) fed high lipid die. Fish Shellfish Immunol 2018;73:234-44. https://doi.org/10.1016/j.fsi.2017.11.007. 
  23. Choi JG, Jin YH, Lee H, Oh TW, Yim NH, Cho WK, Ma JY. Protective effect of Panax notoginseng root water extract against influenza a virus infection by enhancing antiviral interferon-mediated immune responses and natural killer cell activity. Front Immunol 2017;8:1542. https://doi.org/10.3389/fimmu.2017.01542. 
  24. Choi JG, Jin YH, Kim JH, Oh TW, Yim NH, Cho WK, Ma JY. In vitro anti-viral activity of psoraleae semen water extract against influenza a viruses. Front Pharmacol 2016;7:460. https://doi.org/10.3389/fphar.2016.00460. 
  25. Romero-Perez GA, Egashira M, Harada Y, Tsuruta T, Oda Y, Ueda F, Tsukahara T, Tsukamoto Y, Inoue R. Orally administered Salacia reticulata extract reduces H1N1 influenza clinical symptoms in murine lung tissues putatively due to enhanced natural killer cell activity. Front Immunol 2016;7:1-9. https://doi.org/10.3389/fimmu.2016.00115. 
  26. Li M, Guo K, Adachi Y, Ikehara S. Immune dysfunction associated with abnormal bone marrow-derived mesenchymal stroma cells in senescence accelerated mice. Int J Mol Sci 2016;17:8-15. https://doi.org/10.3390/ijms17020183. 
  27. Rhule A, Navarro S, Smith JR, Shepherd DM. Panax notoginseng attenuates LPS-induced pro-inflammatory mediators in RAW264.7 cells. J Ethnopharmacol 2006;106:121-8. https://doi.org/10.1016/j.jep.2005.12.012. 
  28. Kim B, Kim EY, Lee EJ, Han JH, Kwak CH, Jung YS, Lee SO, Chung TW, Ha KT. Panax notoginseng inhibits tumor growth through activating macrophage to M1 polarization. Am J Chin Med 2018;46:1369-85. https://doi.org/10.1142/S0192415X18500726. 
  29. Rhule A, Rase B, Smith JR, Shepherd DM. Toll-like receptor ligand-induced activation of murine DC2.4 cells is attenuated by Panax notoginseng. J Ethnopharmacol 2008;116:179-86. https://doi.org/10.1016/j.jep.2007.11.019. 
  30. Tang L, Yin Z, Hu Y, Mei H. Controlling cytokine storm is vital in COVID-19. Front Immunol 2020;11:1-14. https://doi.org/10.3389/fimmu.2020.570993. 
  31. Channappanavar R, Perlman S. Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology. Semin Immunopathol 2017;39:529-39. https://doi.org/10.1007/s00281-017-0629-x. 
  32. Yang L, Liu S, Liu J, Zhang Z, Wan X, Huang B, Chen Y, Zhang Y. COVID-19: immunopathogenesis and immunotherapeutics. Signal Transduct Target Ther 2020;5:128. https://doi.org/10.1038/s41392-020-00243-2. 
  33. Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med 2020;46:846-8. https://doi.org/10.1007/s00134-020-05991-x. 
  34. Chen G, Wu D, Guo W, Cao Y, Huang D, Wang H, Wang T, Zhang X, Chen H, Yu H. et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest 2020;130:2620-9. https://doi.org/10.1172/JCI137244. 
  35. Coperchini F, Chiovato L, Croce L, Magri F, Rotondi M. The cytokine storm in COVID-19: an overview of the involvement of the chemokine/chemokine-receptor system. Cytokine Growth Factor Rev 2020;53:25-32. https://doi.org/10.1016/j.cytogfr.2020.05.003. 
  36. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA - J Am Med Assoc 2020;323:1061-9. https://doi.org/10.1001/jama.2020.1585. 
  37. Shimabukuro-Vornhagen A, Godel P, Subklewe M, Stemmler HJ, Schl € osser HA, Schlaak M, Kochanek M, Boll B, Bergwelt-Baildon MS. Cytokine release syndrome. J Immunother Cancer 2018;6:56. https://doi.org/10.1186/s40425-018-0343-9. 
  38. Chousterman BG, Swirski FK, Weber GF. Cytokine storm and sepsis disease pathogenesis. Semin Immunopathol 2017;39:517-28. https://doi.org/10.1007/s00281-017-0639-8. 
  39. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506. https://doi.org/10.1016/S0140-6736(20)30183-5. 
  40. Wan S, Yi Q, Fan S, Lv J, Zhang X, Guo L, Lang C, Xiao Q, Xiao K, Yi Z, et al. Characteristics of lymphocyte subsets and cytokines in peripheral blood of 123 hospitalized patients with 2019 novel coronavirus pneumonia (NCP). MedRxiv 2020:20021832. https://doi.org/10.1101/2020.02.10.20021832. 
  41. Jung HW, Seo UK, Kim JH, Leem KH, Park YK. Flower extract of Panax notoginseng attenuates lipopolysaccharide-induced inflammatory response via blocking of NF-κB signaling pathway in murine macrophages. J Ethnopharmacol 2009;122:313-9. https://doi.org/10.1016/j.jep.2008.12.024. 
  42. Ma LJ, Liu F, Zhong ZF, Wan JB. Comparative study on chemical components and anti-inflammatory effects of Panax notoginseng flower extracted by water and methanol. J Sep Sci 2017;40:4730-9. https://doi.org/10.1002/jssc.201700641. 
  43. Xiong Y, Chen L, Man J, Hu Y, Cui X. Chemical and bioactive comparison of Panax notoginseng root and rhizome in raw and steamed forms. J Ginseng Res 2019;43:385-93. https://doi.org/10.1016/j.jgr.2017.11.004. 
  44. Zhang Z, Chen L, Cui X, Zhang Y, Hu Y, Wang C, Xion Y. Identification of anti-inflammatory components of raw and steamed: Panax notoginseng root by analyses of spectrum-effect relationship. RSC Adv 2019;9:17950. https://doi.org/10.1039/c9ra00906j.-8. 
  45. Peerapornratana S, Manrique-Caballero CL, Gomez H, Kellum JA. Acute kidney injury from sepsis: current concepts, epidemiology, pathophysiology, prevention and treatment. Kidney Int 2019;96:1083-99. https://doi.org/10.1016/j.kint.2019.05.026. 
  46. Shou DW, Yu ZL, Meng JB, Lai ZZ, Pang LS, Dai MH, Yang X, Tu YX. Panax notoginseng alleviates sepsis-induced acute kidney injury by reducing inflammation in rats. Evidence-Based Complement Altern Med 2022;2022:9742169. https://doi.org/10.1155/2022/9742169. 
  47. Chang SH, Choi Y, Park JA, Jung DS, Shin J, Yang JH, Ko SY, Kim SW, Kim JK. Anti-inflammatory effects of BT-201, an n-butanol extract of Panax notoginseng, observed in vitro and in a collagen-induced arthritis model. Clin Nutr 2007;26:785-91. https://doi.org/10.1016/j.clnu.2007.07.008. 
  48. Geier MS, Butler RN, Howarth GS. Inflammatory bowel disease: current insights into pathogenesis and new therapeutic options; probiotics, prebiotics and synbiotics. Int J Food Microbiol 2007;115:1-11. https://doi.org/10.1016/j.ijfoodmicro.2006.10.006. 
  49. Wen XD, Wang CZ, Yu C, Zhao L, Zhang Z, Matin A, Wang Y, Li P, Xiao S, Du W, et al. Panax notoginseng attenuates experimental colitis in the azoxymethane/dextran sulfate sodium mouse model. Phyther Res 2014;28:892-8. https://doi.org/10.1002/ptr.5066. 
  50. Diao H, Tan R-Z, Li J-C, Zhong X, Wen D, Fan J-M, Li W. Astragalus propinquus Schischkin and Panax notoginseng (A&P) compound relieved cisplatin-induced acute kidney injury through inhibiting the mincle maintained macrophage inflammation. J Ethnopharmacol 2020;252:112637. https://doi.org/10.1016/j.jep.2020.112637. 
  51. Tan R-Z, Diao H, Li J-C, Zhong X, Wang X-J, Wen D, Fan J, Wang L. Astragalus mongholicus Bunge and Panax notoginseng formula (A&P) combined with Bifidobacterium contribute a renoprotective effect in chronic kidney disease through inhibiting macrophage inflammatory response in kidney and intestine. Front Physiol 2020;11:1-17. https://doi.org/10.3389/fphys.2020.583668. 
  52. Lin X, qin Lei X, Yang J ke, Jia J, Zhong X, Tan R, Wang L. Astragalus mongholicus Bunge and Panax notoginseng formula (A&P) improves renal mesangial cell damage in diabetic nephropathy by inhibiting the inflammatory response of infiltrated macrophages. BMC Complement Med Ther 2022;22:1-16. https://doi.org/10.1186/s12906-021-03477-x. 
  53. Mizrahi B, Shilo S, Rossman H, Kalkstein N, Marcus K, Barer Y, Keshet A, Shamir-Stein N, Shalev V, Zohar AE, et al. Longitudinal symptom dynamics of COVID-19 infection. Nat Commun 2020;11:6208. https://doi.org/10.1038/s41467-020-20053-y. 
  54. Mo P, Xing Y, Xiao Y, Deng L, Zhao Q, Wang H, Xiong Y, Cheng Z, Gao S, Liang K, et al. Clinical characteristics of refractory coronavirus disease 2019 in Wuhan, China. Clin Infect Dis 2021;73:e4208-13. https://doi.org/10.1093/cid/ciaa270. 
  55. Lee SA, Jobe MC, Mathis AA, Gibbons JA. Incremental validity of coronaphobia: coronavirus anxiety explains depression, generalized anxiety, and death anxiety. J Anxiety Disord 2020;74:102268. https://doi.org/10.1016/j.janxdis.2020.102268. 
  56. Wei F, Zou S, Young A, Dubner R, Ren K. Effects of four herbal extracts on adjuvant-induced inflammation and hyperalgesia in rats. J Altern Complement Med 1999;5:429-36. https://doi.org/10.1089/acm.1999.5.429. 
  57. Ng TB. Pharmacological activity of sanchi ginseng (Panax notoginseng). J Pharm Pharmacol 2006;58:1007-19. https://doi.org/10.1211/jpp.58.8.0001. 
  58. Xiang H, Liu Y, Zhang B, Huang J, Li Y, Yang B, Xiang F, Zhang H. The antidepressant effects and mechanism of action of total saponins from the caudexes and leaves of Panax notoginseng in animal models of depression. Phytomedicine 2011;18:731-8. https://doi.org/10.1016/j.phymed.2010.11.014. 
  59. Liang MTC, Podolka TD, Chuang WJ. Panax notoginseng supplementation enhances physical performance during endurance exercise. J Strength Cond Res 2005;19:108-14. https://doi.org/10.1519/00124278-200502000-00019. 
  60. Pumpa KL, Fallon KE, Bensoussan A, Papalia S. The effects of Panax notoginseng on delayed onset muscle soreness and muscle damage in well-trained males: a double blind randomised controlled trial. Complement Ther Med 2013;21:131-40. https://doi.org/10.1016/j.ctim.2012.12.007. 
  61. Cicero AF, Bandieri E, Arletti R. Orally administered Panax notoginseng influence on rat spontaneous behaviour. J Ethnopharmacol 2000;73:387-91. https://doi.org/10.1016/s0378-8741(00)00277-4. 
  62. Li Y, Guo Q, Huang J, Wang Z. Antidepressant active ingredients from Chinese traditional herb Panax notoginseng: a pharmacological mechanism review. Front Pharmacol 2022;13:1-17. https://doi.org/10.3389/fphar.2022.922337.