Can Echinacea be a potential candidate to target immunity, inflammation, and infection - The trinity of coronavirus disease 2019

Abstract

Coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an ongoing public health emergency. The pathogenesis and complications advanced with infection mainly involve immune-inflammatory cascade. Therefore, the therapeutic strategy relies on immune modulation, reducing infectivity and inflammation. Given the interplay of infection and immune-inflammatory axis, the natural products received attention for preventive and therapeutic usage in COVID-19 due to their potent antiviral and anti-immunomodulatory activities. Recently, Echinacea preparations, particularly E. purpurea, have been suggested to be an important antiviral agent to be useful in COVID-19 by modulating virus entry, internalization and replication. In principle, the immune response and the resultant inflammatory process are important for the elimination of the infection, but may have a significant impact on SARS-CoV-2 pathogenesis and may play a role in the clinical spectrum of COVID-19. Considering the pharmacological effects, therapeutic potential, and molecular mechanisms of Echinacea , we hypothesize that it could be a reasonably possible candidate for targeting infection, immunity, and inflammation in COVID-19 with recent recognition of cannabinoid-2 (CB2) receptors and peroxisome proliferator-activated receptor gamma (PPARγ) mediated mechanisms of bioactive components that make them notable immunomodulatory, anti-inflammatory and antiviral agent. The plausible reason for our hypothesis is that the presence of numerous bioactive agents in different parts of plants that may synergistically exert polypharmacological actions in regulating immune-inflammatory axis in COVID-19. Our proposition is to scientifically contemplate the therapeutic perspective and prospect of Echinacea on infection, immunity, and inflammation with a potential in COVID-19 to limit the severity and progression of the disease. Based on the clinical usage for respiratory infections, and relative safety in humans, further studies for the evidence-based approach to COVID-19 are needed. We do hope that Echinacea could be a candidate agent for immunomodulation in the prevention and treatment of COVID-19.

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“…The need of the hour is to consider a holistic approach and render supportive care, as per the presenting severity of the case. While combating a pandemic, it is of utmost importance for health care professionals to keep themselves updated with the current and emerging therapeutic trends for treating the disease with greater effectiveness [206][207][208][209][210]. A multidisciplinary team must mitigate the secondary waves of the pandemic with all the necessary precautions.…”

Prospective Medicinal Plants and Their Phytochemicals Shielding Autoimmune and Cancer Patients Against the SARS-CoV-2 Pandemic: A Special Focus on Matcha

“…E. purpurea seems to augment its antiviral response by influencing PRRs on the innate immune cells, pathogen-associated molecular pattern PAMPs on the virus ( 220 ). Such interaction triggers phagocytosis and initiation of other antiviral responses by the immune system ( 221 ).…”

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“…Echinacea purpurea extracts available as the commercial product Echinaforce ® showed dose-dependent inhibition of 229E infectivity in respiratory epithelial cells and this extract irreversibly inactivated the virus with an IC 50 of 3.2 μg/mL [ 101 ] and 9 ± 3 μg/mL in another study [ 76 ]. The multicomponent extract non-specifically and irreversibly interfered with viral docking receptors to block the infectivity of pathogens [ 102 ]. Similarly, inhibition for MERS-CoV was observed with 10 μg/mL of Echinaforce ® , reducing viral infectivity by 99.9% at 50 μg/mL [ 41 ].…”

“…However, the anthocyanins concentrations used for the anti-inflammatory activity tests cannot be achieved physiologically [ 107 ]. Similarly, Echinacea has also been proposed as a suppressor of the immunoinflammatory cascades observed in COVID-19, thanks to the plant’s ability to activate the anti-inflammatory cannabinoid-2 (CB2) receptors and peroxisome proliferator-activated receptors gamma (PPARγ) [ 102 ].…”