Stevia Rebaudiana As an Immunity Booster for COVID-19 Aayeena Altaf1, Mohammad Umar Khan1, Bhavna Jha1, Raj Das1, Manzoor Ganai2*

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Saudi Journal of Medical and Pharmaceutical Sciences Abbreviated Key Title: Saudi J Med Pharm Sci ISSN 2413-4929 (Print) |ISSN 2413-4910 (Online) Scholars Middle East Publishers, Dubai, United Arab Emirates Journal homepage: https://saudijournals.com

Review Article

Stevia Rebaudiana as an Immunity Booster for COVID-19 Aayeena Altaf1, Mohammad Umar Khan1, Bhavna Jha1, Raj Das1, Manzoor Ganai2*

1Department of Food Technology, School of Interdisciplinary Science and Technology, Jamia Hamdard, New Delhi-110062, India 2Department of agronomy, Sher-e-Kashmir University of agriculture, sciences and technology of Kashmir, Jammu and Kashmir, India

DOI: 10.36348/sjmps.2021.v07i07.001 | Received: 21.05.2021 | Accepted: 28.06.2021 | Published: 03.07.2021

*Corresponding author: Manzoor Ganai

Abstract

Stevia rebaudiana is a nutrient rich natural sweetest plant of Asteraceae family. The leaves naturally contain diterpene glycosides (Stevioside and Rebaudioside-A), steviobioside and dulcoside, which are responsible for its sweet taste. Along with these compounds it also contains functional compounds like phenolic acids, free radical scavenging and antioxidant capability, flavonoids, condensed tannins, anthocyanins, nutraceutical properties, etc. Stevia exhibits strong antioxidant potential as a sugar substitute owing to the presence of various compounds with medicinal significance. However, in large amounts they also possess several beneficial effects on disease in which radicals are involved. As there is no targeted Covid-19 therapy available, Stevia crude extracts and steviol glycosides are suggested to treat Covid-19 patients. Stevia has many pharmacological and therapeutic applications as suggested by many preclinical and some clinical studies, these are nontoxic and possess antioxidant, antimicrobial, antifungal and anticarcinogenic activity. Antioxidants through their scavenging power are useful for the management of various diseases that aids in combating different chronic diseases as well as increase immunity against the severity of various infections like in case of Covid-19. It is also generally accepted that consumption of 5gm dried Stevia leaves is without health problems. Key words: Covid-19, Stevia rebaudiana, Steviosides, Anti-oxidants and Immunity. Copyright © 2021 The Author(s): This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY-NC 4.0) which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the original author and source are credited.

NTRODUCTION deficiency of selenium (se). Its deficiency has been I related to the higher susceptibility to RNA viral The world population is hitted severely by a infections and other serious disease outcome. Seleno recent outbreak of new corona virus since December proteins are important antioxidant defence systems 2019 which is known as severe acute respiratory maintaining redox homeostasis, which also includes syndrome corona virus-2 (SARS-CoV-2) causing acute Catalase (CAT), Superoxide Dismutase (SOD), respiratory disease with huge number of deaths till now. Glutathione (GSH), Vitamin E and C, and carotenoids. The world health organisation (WHO) alerted the It was shown that an optimal nutritional status is infection epidemic on March 11, 2020. Since then, required for a well-functioning immune system to laboratories around the globe have been observed in the protect against viral infections. Vitamins such as Vit A, growing race of production of efficient vaccine and B6, B12, C, D, E and folate and minerals like zinc, iron, therapeutic treatment which will help the mankind to selenium, magnesium and copper and omega-3 fatty return to their normal lives. There is no treatment found acids play vital and complementary roles in the support till date which is 100 percent efficient in combating the of the immune system (Geuns Jan M.C, 2020). A high different strains of corona virus. People are taking dose of Vitamin C that function as a key antioxidant is various preventive measures against the corona virus. highly recommended for the treatment of Covid-19. There are different factors that determine the severity of The serum level of vitamin C has been correlated with the disease like obesity, hyper tension, cardiovascular its cellular immune function, anti-oxidative capacity disease, diabetes as well as lung disease. The people and neutrophil function (Zarezade et al, 2021). Vitamin free from these problems have low chance of infection D, a steroid hormone is also found to be very effective as they have immunity to fight against the severity of to deal with the severity of this virus. the disease. These diseases are related to the imbalance between radicals and antioxidants (enzymatic and non- Moreover, bioactive compounds like enzymatic, e.g., Vit C, GSH). It was found that the Myricitrin, myricetin, resveratrol, and δ-viniferin, have severity of the disease in China was associated with the been found to be potential anti-Covid-19 therapeutics.

Citation: Aayeena Altaf et al (2021). Stevia Rebaudiana as an Immunity Booster for COVID-19. Saudi J 291 Med Pharm Sci, 7(7): 291-294.

Aayeena Altaf et al., Saudi J Med Pharm Sci, July, 2021; 7(7): 291-294 Given these molecules target different viral proteins at many years by South America and they call it “Kaa- different stages of viral replication, and a majority of hee” (Sweet herb) (Khalid et al, 2021). Initially, 9 them are common ingredients of the food chain (e.g. essential amino acids, i.e., glutamic acid, aspartic acid, Curcumin from turmeric, carnosol from rosemary, lysine, serine, alanine, proline, tyrosine, isoleucine and quercetin in apples, etc), it can be assumed that methionine, were isolated from stevia leaves. Later on, consumption of such foods may positively impact 17 amino acids were isolated. Stevia leaves also contain protection against SARS-CoV-2 infection (Savant et medically and commercially important several natural al,2021). nutrients and vitamins such as chromium, magnesium, manganese, potassium, selenium, zinc, and vitamin B3 Nutraceuticals has always shown its great (Niacin). Phytochemical screening has showed that effectiveness in treating various diseases as well as for tannins are present in higher concentrations followed by the purpose of boosting immunity against different alkaloids, glycosides, saponins, sterols, and triterpenes, diseases. Stevia might be one of the dominant sources anthraquinone, and other reducing compounds. The for boosting immunity against covid-19 as it constitutes chemical composition of stevia leaves changes a good amount of vitamins, protein, lipid, amino acids depending on the degree of their processing (Singh et and minerals. The compounds like alkaloids, al, 2019). Along with these compounds it also contains glycosides, saponins, sterols, and triterpenes, functional compounds like phenolic acids, free radical anthraquinone, and other reducing compounds are also scavenging and antioxidant capability, nutraceutical present along with higher concentration of tannins. properties, etc (Jahangir et al, 2020) .The extract from Stevia glycosides possess many pharmaceutical dried stevia leaves contains 10% amino acids, 18% properties viz; anti-hyperglycaemic, antihypertensive, proteins, 33% carbohydrates and 39% reducing sugars, antioxidant, antimicrobial activity, anticancer effect, while in the extract from fresh leaves the levels are anti-inflammatory and immune-modulatory effect etc 25%, 19%, 31% and 25%, respectively. Fat content in (Singh et al, 2019) dry matter of stevia leaves amounts to 1.9–4.34 g·100 g-1 dm. The chemical composition of this plant is also Botanical description of Stevia Rebaudiana affected by the method of leaf drying (Marcinek et al, Stevia is a branched shrub, which belongs to 2015). Asteraceae family, native to the Amambay region in the north east of Paraguay. It is also found in the IMMUNOLOGICAL COMPONENTS IN STEVIA neighbouring parts of Brazil and Argentina. Presently Minerals and vitamins its cultivation has spread to other regions of the world, Minerals/metals elements are the diet including Canada and some parts of Asia and Europe It components inevitable for the upkeep of life and good grows up 1m tall. (Alahmad, 2018). (Ahsan et al, 2020) health. Metabolic processes need them for proper estimated that more than 250 species of stevia is found functioning; some are required in major quantity while wild around the world. Stevia is a short-day plant that other in minor or trace amount for proper metabolic grows up to 1m tall. It has 3-4 cm long elliptic and processes. Stevia is found to be a good source of sessile leaves. The root system of the plant is extensive, minerals. Major elements that are present include the stem is woody and weak-pubescent at the bottom. It magnesium, potassium, chlorine, sodium, phosphorous, has small white flowers with a pale purple throat Sulphur, calcium are classified as macronutrients. arranged in the form of small corymbs. However micronutrients include iron, cobalt, zinc, copper, selenium, iodine, molybdenum, manganese, etc Taxonomy of Stevia rebaudiana. (Jahangir et al, 2019). Selenium present in the stevia leaves is good source used against the severity of Botanical name: Stevia rebaudiana Covid-19. (Kieliszek et al, 2020) suggested decades ago Kingdom : Plantae that selenium may possess cancer-protecting effects in Division : Angiosperms man, and that the selenium-deficient diet in the Class : Eudicots developed countries may contribute to increased Order : Asterales incidence of malignant tumours as well as to increased Family : Asteraceae viral infections. Genus : Stevia Species : S. rebaudiana Stevia contains many vitamins included vitamins A, C and vitamins of B-complex like thiamine Chemical components of stevia rebaudiana and riboflavin. A previous study was shown that stevia Stevia is chemically composed of protein, fat, contains water-soluble vitamins such as vitamin C and carbohydrate, ash and fibre. The researchers used vitamin B complex. In leaves, folic acid was a major different techniques for the composition of stevia leaves compound and after that vitamin C is found in a major extract such as GC-MS, HPLC, and LCMS etc. The concentration. Vitamin A plays a vital role in sweet leaves of stevia (Stevia rebaudiana Bertoni) have metabolism and immune response and protects against been investigated by many researchers, is used for the severity of the infection. According to (Samad et al, © 2021 |Published by Scholars Middle East Publishers, Dubai, United Arab Emirates 292

Aayeena Altaf et al., Saudi J Med Pharm Sci, July, 2021; 7(7): 291-294 2021), the three primary active forms of vitamin A Steviol compounds include retinol, retinoic acid, and retinal. Hence, they Several medical problems like diabetes, are regarded as anti-infective as many of the body’s obesity, high blood pressure coronary heart disease défense mechanisms against infections depend on their arises due to more intake of sucrose content as it is constant supply. Vitamin E administration among associated with negative impact on human health. elderly patients is likely to help the immune function, Diterpene glycosides, Ent-kaurene derivatives found in which increases the chances of infection resistance and sweet leaf, are responsible for its high sweetening decreases mortality that could be triggered by infection. potential. Hence there is an urgent need to substitute Multiple studies regarding vitamin E’s potential sugar with natural low-calorie sweetener like stevia benefits to Covid-19 patients indicated that vitamin E rebaudiana leaves powder which will increase and C in combination could be a beneficial antioxidant nutritional profile of the product. (Singh et al, 2019). In therapy for cardiac implications of Covid-19.likewise, Europe and the United States, stevia has been approved vitamin D and folic acid present in stevia leaves also as a natural sweetener and a food additive with an acts as a defensive source against Covid-19. acceptable daily intake of 4 mg/kg body weight declared by the European Food Safety Authority and Anti-oxidants and phenolic compounds the US Food and Drug Administration (FDA), and it Oxidation is an important biological process was granted generally recognized as safe status in 2008 essential for the production of energy in the human by the FDA (Jiang et al, 2020).As diabetes is known to organism. During metabolism molecular oxygen is be the risk factor of Covid-19 severity , steviol reduced to water. In the course of electron transfer free glycosides as known as diterpene compound acts as a reactive oxygen species (ROS), such as hydrogen vital source in preventing related health issues. peroxide, hydroxyl and peroxide radicals. Free radicals are considered to be the causative agents in the PHYTOCHEMICALS development of neurological diseases, ageing, The results on preliminary phytochemical ischaemic heart disease, stroke, Alzheimer’s and screening of dry leaves extract of Stevia revealed the Parkinson’s disease, cancer as well as inflammation and presence of alkaloids, tannins, flavonoids, cardiac reduced immunity. Leaves of Stevia rebaudiana Bertoni glycosides, steroids, saponins. Presence of alkaloids were found to contain polyphenolic compounds was confirmed through Hager’s, Wagner’s and exhibiting antioxidant properties. (Marcinek et al, Dragendroff’s test. The presence of phenol, flavonoids 2015). Stevia exhibits strong antioxidant potential as a and tannins was comparatively high except for aqueous sugar substitute owing to the presence of various extract which was negative for phenols. Steroids and compounds with medicinal significance such as cardiac glycosides were found to be higher amount in phenolic compounds, flavonoids, diterpene glycosides all the extracts. The highest amount of saponin was (stevioside and rebaudioside-A), condensed tannins, observed in aqueous and methanolic extract where anthocyanins, and phenolic acids (Jiang et al, 2020). traces of saponin were found in the ethanolic extract. The alcoholic and aqueous extracts of S. rebaudiana The major symptoms observed in Covid-19 contained steroids, glycosides, tannins, alkaloids and that is reduced immunity and inflammation can be saponins like phytochemicals. (Howlander et al, 2016). treated with the use of anti-oxidant present in stevia These phytochemicals present in stevia have multiple rebaudiana. (Kobus et al, 2015) found that the health benefits like resistance to infections, boosts Polyphenols play an important role in the prevention of immunity, reduced risk of cardiovascular diseases and many diet-dependent diseases. It has been recognized so on. that flavonoids show antioxidant activity and their effects on human nutrition and health are considerable. ONCLUSION Flavonoids and phenolic compounds have been recently C correlated with antioxidant properties of Stevia This review showed that the Stevia rebaudiana rebaudiana. The mechanisms of action of flavonoids are consists many functional compounds which has been through scavenging or chelating process. The proved as an utmost source for various health benefits. compounds such as flavonoids, which contain The components found in stevia such as anti-oxidant hydroxyls, are responsible for the radical scavenging and polyphenols, phytochemicals, vitamins, minerals effect in the plants. Phenolic compounds are a class of and steviol compounds influence the above cited antioxidant agents which act as free radical terminators diseases, as these are related with the immune boosting (Mutmainah et al, 2019), Antioxidants through their source. At the present situation of Covid-19 prevalence scavenging power are useful for the management of around the globe, immunity boosting has become a various diseases. Thus, it aids in combating different major concern. As there is no therapeutic treatment chronic diseases as well as increase immunity against discovered which is fully efficient in combating the the severity of various infections. severity of virus infection, a good immunity is key factor which reduces the chances to get infected. Researchers have found that stevia has many medicinal

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