Computational and In Vitro Experimental Investigations Reveal Anti-Viral Activity of Licorice and Glycyrrhizin against Severe Acute Respiratory Syndrome Coronavirus 2

Efficacy and safety of licorice (Glycyrrhiza glabra) in moderately ill patients with COVID-19: a randomized controlled trial

Licorice extract (glycyrrhizin), a potent antiviral, anti-inflammatory, and antioxidant remedy, is a potential therapeutic option for COVID-19. We evaluated the efficacy and safety of licorice in patients with moderate COVID-19. In this study, 60 patients with confirmed COVID-19 were randomly assigned in a 1:1 ratio to receive licorice (at a dose of 760 mg three times a day for seven days) or control groups. The primary outcomes were SPO2, body temperature, and respiratory rate (RR) after the end of the intervention. The findings indicated that SPO2, body temperature, and RR had no significant difference between the groups at the end of the intervention. However, CRP and ALT improved in the licorice group toward the baseline. The number of patients with worse prognoses, LOS, mortality, and the incidence of adverse events were not different between the groups at the end of the study. Licorice had no beneficial effect on the clinical symptoms of COVID-19. Moreover, this intervention demonstrated a safe profile of adverse events. The confirmation of the results of this preparatory trial requires more detailed multiple-center trials with a larger sample size.

Licochalcone A protects against LPS-induced inflammation and acute lung injury by directly binding with myeloid differentiation factor 2 (MD2)

BACKGROUND AND PURPOSE

Acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) is a challenging clinical syndrome that leads to various respiratory sequelae and even high mortality in patients with severe disease. The novel pharmacological strategies and therapeutic drugs are urgently needed. Natural products have played a fundamental role and provided an abundant pool in drug discovery.

EXPERIMENTAL APPROACH

A compound library containing 160 natural products was used to screen potential anti-inflammatory compounds. Mice with LPS-induced ALI was then used to verify the preventive and therapeutic effects of the selected compounds.

KEY RESULTS

Licochalcone A was discovered from the anti-inflammatory screening of natural products in macrophages. A qPCR array validated the inflammation-regulatory effects of licochalcone A and indicated that the potential targets of licochalcone A may be the upstream proteins in LPS pro-inflammatory signalling. Further studies showed that licochalcone A directly binds to myeloid differentiation factor 2 (MD2), an assistant protein of toll-like receptor 4 (TLR4), to block both LPS-induced TRIF- and MYD88-dependent pathways. LEU61 and PHE151 in MD2 protein are the two key residues that contribute to the binding of MD2 to licochalcone A. In vivo, licochalcone A treatment alleviated ALI in LPS-challenged mice through significantly reducing immunocyte infiltration, suppressing activation of TLR4 pathway and inflammatory cytokine induction.

CONCLUSION AND IMPLICATIONS

In summary, our study identified MD2 as a direct target of licochalcone A for its anti-inflammatory activity and suggested that licochalcone A might serve as a novel MD2 inhibitor and a potential drug for developing ALI/ARDS therapy.

Investigation of the inhibitory activity of extracts, fractions and secondary metabolites of <i>Silene</i> spp. (<i>Caryophyllaceae</i>) and <i>Serratula cupuliformis</i> (<i>Asteraceae</i>) on the replication of SARS-CoV-2 coronavirus

Aim. In vitro analysis of the inhibitory activity of extracts, fractions and secondary metabolites of plants of the genus Silene [Caryophylaceae] and Serratula cupuliformis [Asteraceae) on the replication of SARS-CoV-2.

Material and Methods. Silene spp. and Serratula cupuliformis of the Siberian Botanical Garden of National Research Tomsk State University were used. Ethanol extracts and butanol fractions of Silene spp. were prepared. The flavonoid shaftoside and the ecdysteroid 20-hydroxyecdysone from Lychnis chalcedonica were isolated. Analysis of BAS was carried out by the HPLC method. In vitro analysis of the inhibitory activity of extracts on SARS-CoV-2 replication was performed in Vero cell culture by direct inactivation [neutralization) of virions. Comparison samples were dry ethanol extracts of chaga [Inonotus obliquus, Basidiomycota), spices of cloves [Syzygium aromaticum, Myrtaceae) and root of licorice [Glycyrrhiza glabra L., Fabaceae).

Results. The inhibitory activity of ethanol extracts and butanol fractions of Silene spp., as well as individual compounds [shaftozide and 20-E) was revealed in the range of 50% effective concentrations [EC50) when dissolved in water from 339.85±83.92 pg/ml to 1.59±0.39 pg/ml and when dissolved in DMSO from 119.34±26.34 pg/ml to 2.22±0.57 pg/ml, respectively. The butanol fraction of Serratula cupuliformis was active with EC50=21.74±4.80 and 27.42±6.05 pg/mL. These results for some samples of Silene spp. and Serratula cupuliformis are comparable to the EC50 values of the comparators.

Conclusion. The results obtained suggest the presence of biologically active substances in the herbal preparations studied that act destructively on virions of SARS-CoV-2 and affect one of the main stages of its "life" cycle - on the attachment to receptors of sensitive cells.

Traditional Tibetan medicine to fight against COVID-19: Basic theory and therapeutic drugs

The Coronavirus Diseases 2019 (COVID-19) has been rapidly spreading globally and has caused severe harm to the health of people and a substantial social burden. In response to this situation, experts around the world have considered various treatments, including the use of traditional medicine. Traditional Tibetan medicine (TTM), one of the traditional medicines in China, has played an important role in the treatment of infectious diseases in history. It has formed a solid theoretical foundation and accumulated rich experience in the treatment of infectious diseases. In this review, we provide a comprehensive introduction to the basic theory, treatment strategies, and commonly used drugs of TTM for the treatment of COVID-19. In addition, the efficacies and potential mechanisms of these TTM drugs against COVID-19 are discussed based on available experimental data. This review may provide important information for the basic research, clinical application and drug development of traditional medicines for the treatment of COVID-19 or other infectious diseases. More pharmacological studies are needed to reveal the therapeutic mechanisms and active ingredients of TTM drugs in the treatment of COVID-19.

Inhibitory activity of dry ethanol extracts of <i>Artemisia</i> spp. on SARS‐CoV‐2 replication <i>in vitro</i>

Aim. In vitro analysis of the inhibitory activity of dry ethanol extracts of some Artemisia spp. growing in the Novosibirsk region for SARS‐CoV‐2 replication.

Materials and Methods. The laboratory strain SARS‐CoV‐2/human/RUS/Nsk‐FRCFTM‐1/2020 was passed on Vero cell culture. Dry ethanol extracts of plant parts (stems, flowers, leaves) of six types of Artemisia were prepared. The types used were: A. vulgaris L.; A. glauca (Pall. Ex Willd.); A. dracunculus L. (from three growth locations); A. absinthium L.; A. frigida Willd.; and A. sieversiana Ehrh. ex Willd. Dry extracts were dissolved in DMSO. In vitro analysis of the inhibitory activity of extracts against SARS‐CoV‐2 (an infectious titer of 103 TCID50/ml) replication was performed in a Vero E6 cell culture. To do this, the method of direct inactivation (neutralization) of virions, as well as schemes of “preventive” and “therapeutic” of cells, were used. Comparison samples were dry ethanol extracts of Inonotus obliquus, Syzygium aromaticum L. and Camellia sinensis L.

Results. Extracts of leaves of Artemisia spp. proved to be most effective in direct inactivation of virions. By equal and decreasing activity these are the species: A. vulgaris; A. dracunculus*; A. absinthium; A. dracunculus***; A. dracunculus**; A. frigidа; A. glauca; and A. sieversiana with a 50% effective concentration of range 1.10±0.24 – 11.72±2.89 μg/ml. Extracts of flowers of A. vulgaris, A.glauca, A. dracunculus*, A. dracunculus**, A. dracunculus***, A. frigida and A. sieversiana also contain biologically active substances which act both destructively on virions and after the virus has entered cells. For extracts of stems consistently high values of EC50 were found for A. glauca (6.84±1.35; 7.81±2.00 and 14.06±3.06 μg/ml) according to the results of three experimental schemes.

Conclusion. The results obtained can become the basis for the development of inexpensive domestic drugs for the treatment and/or prevention of COVID‐19.

In vitro screening of anti-viral and virucidal effects against SARS-CoV-2 by Hypericum perforatum and Echinacea

Hypericum perforatum and Echinacea are reported to have antiviral activities against several viral infections. In this study, H. perforatum (St. John's Wort) and Echinacea were tested in vitro using Vero E6 cells for their anti-viral effects against the newly identified Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) through its infectious cycle from 0 to 48 h post infection. The hypericin of H. perforatum and the different parts (roots, seeds, aerial) of two types of Echinacea species (Echinacea purpurea and Echinacea angustifolia) were tested for their anti-viral activities to measure the inhibition of viral load using quantitative real-time polymerase chain reaction (qRT-PCR) on cell culture assay. Interestingly, the H. perforatum-Echinacea mixture (1:1 ratio) of H. perforatum and Echinacea was tested as well on SARS-CoV-2 and showed crucial anti-viral activity competing H. perforatum then Echinacea effects as anti-viral treatment. Therefore, the results H. perforatum and Echinacea species, applied in this study showed significant anti-viral and virucidal effects in the following order of potency: H. perforatum, H. perforatum-Echinacea mixture, and Echinacea on SARS-CoV-2 infectious cycle. Additionally, molecular simulation analysis of the compounds with essential proteins (Mpro and RdRp) of the SARS-CoV-2 revealed the most potent bioactive compounds such as Echinacin, Echinacoside, Cyanin, Cyanidin 3-(6''-alonylglucoside, Quercetin-3-O-glucuronide, Proanthocyanidins, Rutin, Kaempferol-3-O-rutinoside, and Quercetin-3-O-xyloside. Thus, based on the outcome of this study, it is demanding the setup of clinical trial with specific therapeutic protocol.

Glycyrrhizin and boswellic acids, the golden nutraceuticals: multitargeting for treatment of mild-moderate COVID-19 and prevention of post-COVID cognitive impairment

Breakthrough infections have been reported in fully vaccinated persons. Furthermore, rebound symptoms have been reported following the new FDA granted emergency use to combat SARS-CoV-2. Glycyrrhizin (GR) and boswellic acids (BAs) combination has been shown to have highly successful actions against COVID-19 in our recent clinical trial. However, the study is limited by the small sample size, and therefore, the aim of this article is to comprehensively evaluate recent evidence on the efficacy of GR and BAs in preventing the development of COVID-19 in patients with mild and moderate infections and in preventing post-COVID-19 cognitive impairment, which is the most important symptom after recovery from Covid-19 disease. We have reviewed and discussed information published since the outbreak of the COVID-19 pandemic until July 2022 on preclinical (in vivo, in vivo and bioinformatics) and clinical studies related to the antiviral, anti-inflammatory and immunomodulatory activity of Gr and BAs. Sixteen studies were performed to determine the efficacy of GR against SARS-CoV-2. Ten studies were used primarily for in vitro and in vivo assays and six used molecular docking studies. However, the antiviral activity of BAs against SARS-CoV-2 was determined in only five studies using molecular modeling and bioinformatics. All these studies confirmed that GR n and BAs have strong antiviral activity and can be used as a therapeutic agent for COVID-19 and as a protective agent against SARS-CoV-2. They may act by inhibiting the main protease SARS-CoV-2 (Mpro) responsible for replication and blocking spike protein-mediated cell entry. Only seven rigorously designed clinical trials regarding the usefulness of GR, BAs or their combinations in the treatment of COVID-19 have been published as of July 2022. Although there is no clinical study regarding the treatment of cognitive impairment after COVID-19 that has been published so far, several preclinical and clinical studies have demonstrated the potential effect of GR and BAs in the prevention and treatment of cognitive impairment by inhibiting the activity of several molecules that activate inflammatory signaling pathway. In conclusion, the findings of our study documented the beneficial use of GR and BAs to treat SARS-CoV-2 and its variants and prevent post-COVID cognitive impairment. However, it warrants further studies with a larger randomized sample size to ensure that the studies have sufficient evidence of benefits against COVID-19 and post-COVID-19 symptoms.

Methodology-Centered Review of Molecular Modeling, Simulation, and Prediction of SARS-CoV-2

Despite tremendous efforts in the past two years, our understanding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), virus-host interactions, immune response, virulence, transmission, and evolution is still very limited. This limitation calls for further in-depth investigation. Computational studies have become an indispensable component in combating coronavirus disease 2019 (COVID-19) due to their low cost, their efficiency, and the fact that they are free from safety and ethical constraints. Additionally, the mechanism that governs the global evolution and transmission of SARS-CoV-2 cannot be revealed from individual experiments and was discovered by integrating genotyping of massive viral sequences, biophysical modeling of protein-protein interactions, deep mutational data, deep learning, and advanced mathematics. There exists a tsunami of literature on the molecular modeling, simulations, and predictions of SARS-CoV-2 and related developments of drugs, vaccines, antibodies, and diagnostics. To provide readers with a quick update about this literature, we present a comprehensive and systematic methodology-centered review. Aspects such as molecular biophysics, bioinformatics, cheminformatics, machine learning, and mathematics are discussed. This review will be beneficial to researchers who are looking for ways to contribute to SARS-CoV-2 studies and those who are interested in the status of the field.