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Al-Jamal H, Idriss S, Roufayel R, Abi Khattar Z, Fajloun Z, Sabatier JM. Treating COVID-19 with Medicinal Plants: Is It Even Conceivable? A Comprehensive Review. Viruses 2024; 16:320. [PMID: 38543686 PMCID: PMC10974729 DOI: 10.3390/v16030320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/15/2024] [Accepted: 02/18/2024] [Indexed: 05/23/2024] Open
Abstract
In 2020, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) challenged the world with a global outbreak that led to millions of deaths worldwide. Coronavirus disease 2019 (COVID-19) is the symptomatic manifestation of this virus, which can range from flu-like symptoms to utter clinical complications and even death. Since there was no clear medicine that could tackle this infection or lower its complications with minimal adverse effects on the patients' health, the world health organization (WHO) developed awareness programs to lower the infection rate and limit the fast spread of this virus. Although vaccines have been developed as preventative tools, people still prefer going back to traditional herbal medicine, which provides remarkable health benefits that can either prevent the viral infection or limit the progression of severe symptoms through different mechanistic pathways with relatively insignificant side effects. This comprehensive review provides scientific evidence elucidating the effect of 10 different plants against SARS-CoV-2, paving the way for further studies to reconsider plant-based extracts, rich in bioactive compounds, into more advanced clinical assessments in order to identify their impact on patients suffering from COVID-19.
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Affiliation(s)
- Hadi Al-Jamal
- Faculty of Public Health 3, Lebanese University, Tripoli 1100, Lebanon;
| | - Sara Idriss
- Laboratory of Applied Biotechnology (LBA3B), Azm Center for Research in Biotechnology and Its Applications, EDST, Lebanese University, Tripoli 1300, Lebanon;
| | - Rabih Roufayel
- College of Engineering and Technology, American University of the Middle East, Egaila 54200, Kuwait;
| | - Ziad Abi Khattar
- Faculty of Medicine and Medical Sciences, University of Balamand, Kalhat, Tripoli P.O. Box 100, Lebanon;
| | - Ziad Fajloun
- Laboratory of Applied Biotechnology (LBA3B), Azm Center for Research in Biotechnology and Its Applications, EDST, Lebanese University, Tripoli 1300, Lebanon;
- Department of Biology, Faculty of Sciences 3, Campus Michel Slayman Ras Maska, Lebanese University, Tripoli 1352, Lebanon
| | - Jean-Marc Sabatier
- INP, Inst Neurophysiopathol, Aix-Marseille Université, CNRS, 13385 Marseille, France
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Vuorio A, Kovanen PT, Raal FJ. Coronary microcirculatory dysfunction in hypercholesterolemic patients with COVID-19: potential benefit from cholesterol-lowering treatment. Ann Med 2023; 55:2199218. [PMID: 37068045 PMCID: PMC10116911 DOI: 10.1080/07853890.2023.2199218] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/18/2023] Open
Abstract
Patients with hypercholesterolemia often have coronary microvascular dysfunction (CMD). Viral infections, such as the SARS-CoV-2 infection, may also result in CMD. Three non-randomized studies have shown significant beneficial effects of statins on CMD in non-infected patients. Similarly, in SARS-CoV-2 - infected patients one beneficial mechanism of action of statins may be the amelioration of endothelial dysfunction, which is a major driver of CMD. Apart from statins, lipoprotein apheresis and PCSK9 inhibitors can also improve or even reverse CMD. The potential reversal of CMD by using effective cholesterol-lowering medications during and after COVID-19 infection, especially in hypercholesterolemic COVID-19 patients, is important.KEY MESSAGESCoronary microvascular dysfunction (CMD) is common in patients hospitalized with SARS-CoV-2 infectionThree nonrandomized studies in non-infected patients are showing the beneficial effects of statin treatment on CMDEffective cholesterol-lowering medication during and after SARS-CoV-2 infection, especially in hypercholesterolemic COVID-19 patients, is of great significance.
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Affiliation(s)
- Alpo Vuorio
- Forensic Medicine, Mehiläinen Airport Health Centre, Vantaa, Finland
- Department of Forensic Medicine, University of Helsinki, Helsinki, Finland
| | - Petri T Kovanen
- Atherosclerosis Research Laboratory, Wihuri Research Institute, Helsinki, Finland
| | - Frederick J Raal
- Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
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Kovanen PT, Vuorio A. SARS-CoV-2 reinfection: Adding insult to dysfunctional endothelium in patients with atherosclerotic cardiovascular disease. ATHEROSCLEROSIS PLUS 2023; 53:1-5. [PMID: 37293388 PMCID: PMC10238112 DOI: 10.1016/j.athplu.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/24/2023] [Accepted: 06/02/2023] [Indexed: 06/10/2023]
Abstract
In this short narrative review, we aim at defining the pathophysiological role endothelial dysfunction in the observed COVID-19-associated rise in risk of cardiovascular disease. Variants of the SARS-CoV-2 virus have caused several epidemic waves of COVID-19, and the emergence and rapid spread of new variants and subvariants are likely. Based on a large cohort study, the incidence rate of SARS-CoV-2 reinfection is about 0.66 per 10 000 person-weeks. Both the first infection and reinfection with SARS-CoV-2 increase cardiac event risk, particularly in vulnerable patients with cardiovascular risk factors and the accompanying systemic endothelial dysfunction. By worsening pre-existing endothelial dysfunction, both the first infection and reinfection with ensuing COVID-19 may turn the endothelium procoagulative and prothrombotic, and ultimately lead to local thrombus formation. When occurring in an epicardial coronary artery, the risk of an acute coronary syndrome increases, and when occurring in intramyocardial microvessels, scattered myocardial injuries will ensue, both predisposing the COVID-19 patients to adverse cardiovascular outcomes. In conclusion, considering weakened protection against the cardiovascular risk-enhancing reinfections with emerging new subvariants of SARS-CoV-2, treatment of COVID-19 patients with statins during the illness and thereafter is recommended, partly because the statins tend to reduce endothelial dysfunction.
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Affiliation(s)
| | - Alpo Vuorio
- Mehiläinen, Airport Health Center, Vantaa, Finland
- University of Helsinki, Department of Forensic Medicine, Helsinki, Finland
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Vuorio A, Raal F, Kovanen PT. Familial hypercholesterolemia: The nexus of endothelial dysfunction and lipoprotein metabolism in COVID-19. Curr Opin Lipidol 2023; 34:119-125. [PMID: 36924390 DOI: 10.1097/mol.0000000000000876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
PURPOSE OF REVIEW Patients with heterozygous familial hypercholesterolemia (HeFH) are at increased risk for COVID-19 cardiovascular complications in the acute phase of the infection. Elevated levels of LDL-C and often lipoprotein(a) are present from birth and lead to endothelial dysfunction, which is aggravated by a direct viral attack of the endothelial cells and their exposure to the toxic levels of circulating proinflammatory and prothrombotic mediators during the hyperinflammatory reaction typical of COVID-19. RECENT FINDINGS Evidence to date shows the benefit of lipid-lowering therapy in patients with COVID-19. In HeFH patients who are at much higher cardiovascular risk, the focus should, therefore, be on the effective lowering of LDL-C levels, the root cause of the greater cardiovascular vulnerability to COVID-19 infection in these patients. The ongoing use of statins and other lipid-lowering therapies should be encouraged during the ongoing COVID pandemic to mitigate the risk of cardiovascular complications from COVID-19, particularly in HeFH patients. SUMMARY Epidemiologic registry data show that the incidence of myocardial infarction is increased in SARS-CoV-2-infected HeFH patients. There is a need to study whether the risk for acute cardiovascular events is increased in the long-term and if there are changes in lipid metabolism after SARS-CoV infection(s) in patients with HeFH.
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Affiliation(s)
- Alpo Vuorio
- Mehiläinen Airport Health Centre, Vantaa
- Department of Forensic Medicine, University of Helsinki, Helsinki, Finland
| | - Frederick Raal
- Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Petri T Kovanen
- Wihuri Research Institute, Atherosclerosis Research Laboratory, Helsinki, Finland
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Vuorio A, Kovanen PT, Raal F. Statin Needs to be Continued During Paxlovid Therapy in COVID-19. Clin Infect Dis 2022; 75:2281-2282. [PMID: 35975652 PMCID: PMC9494321 DOI: 10.1093/cid/ciac667] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 08/12/2022] [Indexed: 01/19/2023] Open
Affiliation(s)
- Alpo Vuorio
- Mehiläinen Airport Health Centre, Vantaa, Finland
- Department of Forensic Medicine, University of Helsinki, Helsinki, Finland
| | | | - Frederick Raal
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Vuorio A, Ramaswami U, Holven KB. Editorial: Genetics of familial hypercholesterolemia: New insight—Volume II. Front Genet 2022; 13:1041342. [DOI: 10.3389/fgene.2022.1041342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
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Vuorio A, Raal F, Ijäs P, Kaste M, Kovanen PT. Long-Term Cardiovascular and Cerebrovascular Challenges Posed by COVID-19 in Patients With Familial Hypercholesterolemia. Front Pharmacol 2022; 13:890141. [PMID: 35645833 PMCID: PMC9131188 DOI: 10.3389/fphar.2022.890141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Alpo Vuorio
- Mehiläinen, Airport Health Center, Vantaa, Finland.,Department of Forensic Medicine, University of Helsinki, Helsinki, Finland
| | - Frederick Raal
- Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Petra Ijäs
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Markku Kaste
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Del C Reyes-Vázquez N, de la Rosa LA, Morales-Landa JL, García-Fajardo JA, García-Cruz MÁ. Phytochemical content and potential health applications of pecan [Carya illinoinensis (Wangenh) K. Koch] nutshell. Curr Top Med Chem 2022; 22:150-167. [PMID: 34986772 DOI: 10.2174/1568026622666220105104355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 11/11/2021] [Accepted: 11/22/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The pecan nutshell contains phytochemicals with various biological activities that are potentially useful in the prevention or treatment of diseases such as cancer, diabetes, and metabolic imbalances associated with heart diseases. OBJECTIVE To update this topic by means of a literature review and include those that contribute to the knowledge of the chemical composition and biological activities of pecan nutshell, particularly of those related to the therapeutic potential against some chronic degenerative diseases associated with oxidative stress. METHOD Exhaustive and detailed review of the existing literature using electronic databases. CONCLUSION The pecan nutshell is a promising natural product with pharmaceutical uses in various diseases. However, additional research related to the assessment of efficient extraction methods and characterization, particularly the evaluation of the mechanisms of action in new in vivo models, is necessary to confirm these findings and development of new drugs with therapeutic use.
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Affiliation(s)
- Nohemí Del C Reyes-Vázquez
- Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco A. C. Subsede Noreste. 66629 Apodaca-66629, Nuevo León, México
| | - Laura A de la Rosa
- Departamento de Ciencias Químico Biológicas. Instituto de Ciencias Biomédicas. Universidad Autónoma de Ciudad Juárez. Ciudad Juárez-32310, Chihuahua, México
| | - Juan Luis Morales-Landa
- Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco A. C. Subsede Noreste. 66629 Apodaca-66629, Nuevo León, México
- Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco A. C. Subsede Noreste. 66629 Apodaca-66629, Nuevo León, México
| | - Jorge Alberto García-Fajardo
- Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco A. C. Subsede Noreste. 66629 Apodaca-66629, Nuevo León, México
| | - Miguel Ángel García-Cruz
- Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza-66450, Nuevo León, México
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Prevention of Cardiovascular Burden in COVID-19 Patients Suffering from Familial Hypercholesterolemia: A Global Challenge. Cardiol Ther 2021; 11:1-7. [PMID: 34787816 PMCID: PMC8596860 DOI: 10.1007/s40119-021-00245-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Indexed: 01/01/2023] Open
Abstract
A recent meta-analysis of over 20,000 individuals showed that hospitalized COVID-19 patients with acute myocardial injury had more than fourfold higher mortality than those without such injury. Since the COVID-19 pandemic exacerbates already existing health inequalities, there is an urgent need to create measures to protect the most vulnerable patient groups, including those with a pre-existing increased risk of atherosclerotic cardiovascular disease (ASCVD). A typical example is familial hypercholesterolemia (FH), a common genetic disease affecting over 30 million individuals worldwide. If left untreated or undertreated, FH patients suffer from complications of premature ASCVD, such as acute coronary syndromes, resulting in acute myocardial injury/infarction. A recent population-based analysis provided strong evidence suggesting that COVID-19 poses an even higher risk for myocardial injury in FH patients. From the long-term preventive point of view, it is important to note that, in addition to the acutely elevated risk of myocardial injury, an elevated risk of ASCVD and its complications will persist after COVID-19. The decline in outpatient preventive care during the pandemic is likely to influence ASCVD risk and outcomes, particularly in high-risk patients, such as those with FH. This commentary aims to raise global awareness of the challenges that clinicians treating FH patients continue to face during the COVID-19 pandemic, with two low- to middle-income countries, South Africa and Brazil, serving as examples.
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