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Kapepula PM, Kabengele JK, Kingombe M, Van Bambeke F, Tulkens PM, Sadiki Kishabongo A, Decloedt E, Zumla A, Tiberi S, Suleman F, Tshilolo L, Muyembe-TamFum JJ, Zumla A, Nachega JB. Artemisia Spp. Derivatives for COVID-19 Treatment: Anecdotal Use, Political Hype, Treatment Potential, Challenges, and Road Map to Randomized Clinical Trials. Am J Trop Med Hyg 2020; 103:960-964. [PMID: 32705976 PMCID: PMC7470522 DOI: 10.4269/ajtmh.20-0820] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The world is currently facing a novel COVID-19 pandemic caused by SARS-CoV-2 that, as of July 12, 2020, has caused a reported 12,322,395 cases and 556,335 deaths. To date, only two treatments, remdesivir and dexamethasone, have demonstrated clinical efficacy through randomized controlled trials (RCTs) in seriously ill patients. The search for new or repurposed drugs for treatment of COVID-19 continues. We have witnessed anecdotal use of herbal medicines, including Artemisia spp. extracts, in low-income countries, and exaggerated claims of their efficacies that are not evidence based, with subsequent political controversy. These events highlight the urgent need for further research on herbal compounds to evaluate efficacy through RCTs, and, when efficacious compounds are identified, to establish the active ingredients, develop formulations and dosing, and define pharmacokinetics, toxicology, and safety to enable drug development. Derivatives from the herb Artemisia annua have been used as traditional medicine over centuries for the treatment of fevers, malaria, and respiratory tract infections. We review the bioactive compounds, pharmacological and immunological effects, and traditional uses for Artemisia spp. derivatives, and discuss the challenges and controversies surrounding current efforts and the scientific road map to advance them to prevent or treat COVID-19.
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Affiliation(s)
- Paulin M Kapepula
- Faculty of Pharmaceutical Sciences, Centre d'Etudes des Substances Naturelles d'Origine Végétale (CESNOV), University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Jimmy K Kabengele
- Faculty of Pharmaceutical Sciences, Centre d'Etudes des Substances Naturelles d'Origine Végétale (CESNOV), University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Micheline Kingombe
- National Program for the Promotion of Traditional Medicine and Medicinal Plants (PNMT-PM), Ministry of Public Health, Kinshasa, Democratic Republic of Congo
| | - Françoise Van Bambeke
- Pharmacologie Cellulaire et Moléculaire, Louvain Drug Research Institute, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Paul M Tulkens
- Pharmacologie Cellulaire et Moléculaire, Louvain Drug Research Institute, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Antoine Sadiki Kishabongo
- Department of Clinical Biology, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Eric Decloedt
- Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Adam Zumla
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Simon Tiberi
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Fatima Suleman
- Pharmaceutical Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Léon Tshilolo
- Department of Pediatrics, Official University of Mbuji-Mayi (UOM), Kinshasa, Democratic Republic of Congo.,Le Centre de Formation et d'Appui Sanitaire (CEFA), Centre Hospitalier Monkole, Kinshasa, Democratic Republic of Congo.,Unit of Sickle Cell Disease and Clinical Research, Monkole Hospital Center, Kinshasa, Democratic Republic of Congo
| | - Jean-Jacques Muyembe-TamFum
- Department of Medical Microbiology and Virology, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo.,National Institute of Biomedical Research (INRB), Kinshasa, Democratic Republic of Congo
| | - Alimuddin Zumla
- National Institute for Health Research Biomedical Research Centre, University College London, Hospitals, London, United Kingdom.,Division of Infection and Immunity, Department of Infection, Centre for Clinical Microbiology, University College London, London, United Kingdom
| | - Jean B Nachega
- Department of Medicine and Centre for Infectious Diseases, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Center for Global Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.,Departments of Epidemiology, Infectious Diseases, and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.,Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.,Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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