Review Curr. Pers. MAPs, (2021); 4(1): 66-86 Current Perspectives on Medicinal and Aromatic Plants An International Journal ISSN: 2619-9645 | e-ISSN: 2667-5722 Prevention of Viral Effect and Enhancement of Immune System with the help of Herbal Plants and Himalayan Crude Drugs in SAR-COV-2 Patient: A Review Rishiram BARAL1,2 1Department of Pharmaceutical Sciences, School of Health and Allied Sciences, Faculty of Health Science, Pokhara University, Pokhara, Nepal 2Research Institute of Pharmaceutical Sciences, Department of Pharmacy, Kyungpook National University, Daegu, South Korea *Corresponding author: [email protected] Received : 07/06/2021 https://doi.org/ 10.38093/cupmap.948975 Accepted : 30/06/2021 Abstract After December 2019, Severe Acute Respiratory Syndrome (SAR-COV-2) become a life-threatening issue to the entire human society when it started to spread exponentially all over the world from Wuhan city of China. The virus directly hits the upper and lower respiratory tract of human airways and causes severe damage to the human lung, leading to multiorgan failure, hypoxemia, and dyspnea. Similarly, studies revealed that SAR-COV-2 severely hit the younger and aged population in which the immune system is seriously compromised. The cell of the immune system such as T-cells, B-cells, NK cells, etc. helps to fight against such viral antigen and resist critical viral damage. Therefore, enhancement of the immune system could also be an effective approach to prevent viral infection and even aid in the reduction of the death count. Nowadays, dietary, and herbal remedies are being integrated into the mainstream of the healthcare systems because of their multi-ingredient character, and some of them are known to render efficacy comparable to that of synthetic drug substances. Several studies have also revealed the immune enhancement, the immunomodulatory and antiviral activity of these herbal products in SAR-COV-2 patients. This study was carried out by using Google Scholar, Web of Science, PubMed, Science direct to search the literature related to the use of the herbal product and their actively isolated compound to fight against SAR-COV-2. The study has highlighted the role of several active phytoconstituents present in Himalayan crude drugs that helps to reduce the viral titer in the respiratory system as well as aid in immune enhancement. Key Words: Severe Acute Respiratory Syndrome (SAR-COV-2), Immune enhancement, Human respiratory system, Herbal medicine, and Himalayan crude Drugs, Phytoconstituents © CUPMAP. All rights reserved. 1. Introduction Though the disease was expected to spread After the first diagnosis of coronavirus from the bat at the beginning, the patient in Wuhan China in December 2019, intermediate host for the disease is still Severe Respiratory Syndrome Coronavirus 2 unclear. WHO declared the disease a (SAR-COV-2) has spread exponentially all pandemic on 11th March 2020. The clinical over the world and became a life- sign and symptoms of the patient suffering threatening issue to entire human society. from SAR-COV-2 range from asymptomatic Curr. Pers. MAPs 66 Baral Research Article cases to severe acute respiratory distress of pharmaceutical remedies for treating syndrome, multi-organ failure (MOF), COVID19 is becoming more challenging hypoxemia, dyspnea, severe pneumonia, etc. (Wise et al., 2020). Therefore, until the (Infusino et al., 2020). SAR-COV-2 is a single- discovery of effective drugs and vaccines stranded positive-sense RNA virus that against coronavirus, complementary and shares a genomic sequence similarity of 96% alternative therapeutic approach with the with bat coronavirus and 79.6% sequence use of herbal product, Himalayan crude identity to SAR-COV. Upon entry into the drug, dietary remedies etc. should be human cells through Angiotensin Converting encouraged for the prevention and control Enzyme (ACE2), and less likely by TMPRSS2, of disease. Traditional herbal remedies help SAR-COV-2 takeover the protein synthesis to enhance the person’s immunity, keep in pathway of human cells, start synthesizing check the symptoms of COVID19, and viral protein, and assemble the protein for sometimes even showed curative effects as subsequent viral replication (Chen et al.). well. Government of Pakistan have urged This virus directly hits the upper and lower their citizen to use garlic, turmeric, ginger, respiratory tract of human airways and cinnamon, black pepper, and honey as home causes severe damage to the human lung. remedies. On the other hand, Bangladesh Damage to the alveolar cell causes inefficient news suggested the public consume warm exchange of oxygen and carbon dioxide water with ginger and clove extracts, black between blood and lungs leading towards cumin seeds, honey and fruit with vitamin C, the shortage of oxygen in human blood. This etc. (Azam et al., 2020). Various primary and is the main reason behind hypoxemia, secondary metabolic products from plants dyspnea, MOF as well as death in SAR-COV-2 are well known for different patients (Chilvers et al., 2001). pharmacological actions. Phenol, flavonoid, saponin, terpenoids, glycosides, tannins, Currently, many nations are showing their polysaccharides, alkaloids, etc. are some best effort for the implementation of secondary metabolites that can be used appropriate preventive and control effectively in the prevention and cure of measures. Neither vaccines nor direct anti- various bodily ailment. Based on these, the viral drugs are well established still now for pandemic world due to COVID-19 is even the treatment of SAR-COV-2 in humans and encouraged towards the use of herbal and animals (Wang et al., 2020). Though few dietary products. This review provides a attempts have been made by different brief overview of the use of the traditional American Pharmaceutical and herbal product and Himalayan crude drugs biotechnological companies like Pfizer to fight against SAR-COV-2. The review is (Pfizer vaccine), Oxford University more focused on highlighting the mechanism (AstraZeneca), their efficacy cannot last for of action of some isolated active chemical long, shows multiple side effects, and patient constituents against SAR-COV-2 from even after vaccination also caught by Himalayan crude drugs. coronavirus disease (Hunter et al., 2021, (Chagla et al., 2021). Similarly, in the late 2. Methods 2020s, after the recognition of mutant type Data related to medicinal plants, their active SAR-COV-2 virus in the UK, the development constituents, mechanism of action were Curr. Pers. MAPs 67 Baral Research Article obtained using different search engines envelop (E) proteins. The S1 subunit of S including Web of Science, PubMed, Google protein facilitates the attachment of the SAR- Scholar, and Science direct. The reference COV-2 virus with the host cell through article includes only those that were Angiotensin Converting Enzyme (ACE2) published in English-language journals and receptor. The amino acid sequence of the S1 meet required quality standards concerning subunit involved in the viral attachment is the information. During the study, only those glutamine, asparagine, leucine, medicinal plants which are being commonly phenylalanine, and serine. The S2 subunit used as local and traditional medicine for the promotes membrane fusion (Satarker et al., treatment of various ailments were selected. 2020). On the other hand, the viral genome Different keywords which were used for of SAR-COV-2 is encapsulated by the N data search include, ‘herbal and dietary protein. The main role of N protein in SAR- remedies’, ‘COVID-19’, ‘immunomodulatory COV-2 is to enhance the efficiency of viral action’, ‘anti-viral activity, and ‘active RNA transcription and is even essential for phytoconstituents’. The data were organized viral replication. The nucleocapsid protein of and analyzed using Microsoft Excel (2010) human coronavirus is produced at a high software and then summarized into tables level in the infected cell and is critically and figures. important for virion assembly (Savastano et al., 2020). Followingly, the M glycoprotein is Severe Acute Respiratory Syndrome the most abundant structural protein of Coronavirus 2 (SAR-COV-2): Structure and SAR-COV-2. M protein binds to all other Genomic: Coronaviruses have four genera: structural proteins and this binding helps in alpha(α), beta(β), gamma (γ), and delta (δ) the stabilization of N proteins and promotes of which SAR-COV-2 belong to the β- completion of viral assembly by stabilizing coronavirus family. This novel coronavirus the N-protein RNA complex, inside the known as Severe Acute Respiratory internal virion. Even the host cell entry of Syndrome Coronavirus 2 (SAR-COV-2) is the virus with the aid of S protein is mediated by cause of Coronavirus disease 2019 (COVID- the M protein (Bianchi et al., 2020 & Thomas 2019) and declared as a pandemic by World et al., 2020). Health Organization (WHO) on March 11, 2020 (Astuti et al., 2020). SAR-COV-2 are Meanwhile, upon the viral entry into the enveloped, single-stranded RNA viruses host cell, the virus translates its replicase whose surface is covered by protein spikes. gene (ORF1) which is further divided into The genome sequence identity of SAR-COV-2 ORF1a and ORF1ab. At the end of ORF1a, a is 79% identical with SAR-COV, 50% ribosome frame-shifting sequence consisting identical with MERS-COV, and genome of two large polyprotein precursors of organization is shared with other beta different lengths, pp1a and pp1ab are coronaviruses as well (Lu et al., 2020). Open present. Polyprotein pp1a consists of non- reading frames (ORFs) having positive viral structural proteins (Nsp) 1 -11, and RNA genome organization in SAR-COV-2 polyprotein pp1ab comprises the complete code for structural and non-structural translated coding region Nsp 1-16 (Ziebuhr proteins. The structural protein is a spike et al., 2000 & Lee et al., 1991). (S), nucleocapsid (N), membrane (M), and Curr. Pers. MAPs 68 Basnet and Kalauni Research Article Figure 1. Severe Acute Respiratory Syndrome Coronavirus 2 (SAR-COV-2). (Astuti et al., 2020) . Figure 2: SAR-COV-2 polyproteins ORF1a.