Potential Mechanisms for Traditional Chinese Medicine in Treating Airway Mucus Hypersecretion Associated With Coronavirus Disease 2019

Abstract

BackgroundThe rapid development of coronavirus disease 2019 (COVID-19) pandemic has become a great threat to global health. Its mortality is associated with inflammation-related airway mucus hypersecretion and dysfunction of expectoration, and the subsequent mucus blockage of the bronchioles at critical stage is attributed to hypoxemia, complications, and even death. Traditional Chinese medicine (TCM) has rich experience in expectorant, including treatment of COVID-19 patients with airway mucus dysfunction, yet little is known about the mechanisms. This study is aiming to explore the potential biological basis of TCM herbal expectorant for treating COVID-19.ObjectiveTo get core herbs with high used frequency applications in the actions of expectoration by using association rule algorithm and to investigate the multitarget mechanisms of core herbs in expectorant formulae for COVID-19 therapies.MethodsForty prescriptions for expectorant were retrieved from TCM Formulae. The ingredient compounds and targets of core herbs were collected from the TCMSP database, Gene-Cards, and NCBI. The protein interaction network (PPI) was constructed by SRING, and the network analysis was done by Cytoscape software. Bioconductor was applied for functional enrichment analysis of targets.ResultsThe core herbs of expectorant could regulate core pathways (MAP kinase activity, cytokine receptor binding, G-protein-coupled receptor binding, etc.) via interactions of ingredients (glycyrol, citromitin, etc.) on mucin family to eliminate phlegm.ConclusionTCM herbal expectorant could regulate MAPK and cytokine-related pathways, thereby modulating Mucin-family to affect mucus generation and clearance and eventually retarding the deterioration of COVID-19 disease.

Nursing diagnoses in hospitalized patients with COVID-19 in Indonesia

“…The infection causes systemic endothelial dysfunction in COVID-19, which causes hemostasis disorders accompanied by platelet adhesion and aggregation activity, resulting in death due to blood clots in COVID-19 patients (Petrishchev et al, 2020). Furthermore, spontaneous circulation disorder is partly due to a cytokine syndrome that is closely related to a decrease in lymphocyte levels which triggers a significant decrease in CD8+ T cells and is positively correlated with mortality and morbidity rates of COVID-19 patients (Guan et al, 2020;Lu et al, 2020;Debuc & Smadja, 2021). This decrease in circulation has a significant effect on the circulation of nutrient supply for tissue metabolism, which results in a reduction of the distribution of blood circulation, which results in organ damage (Noris et al, 2020;Ostergaard, 2021).…”

Abnormal Airway Mucus Secretion Induced by Virus Infection

“…Therefore, modulating IL-4/IL-13/IL-17 signaling pathways may be a therapeutic strategy for SARS-CoV-2-induced mucus hypersecretion. Also, Zhang et al found that traditional Chinese medicine expectorants regulate MUC5AC expression via IL-17 and TNF signaling pathways, which are related to virus infection such as influenza virus A and human cytomegalovirus infections (95). They speculated that core herbs of the phlegm-eliminating recipe is a potential therapy in COVID-19-induced mucus hypersecretion as well.…”

Nanotechnology to the Rescue: Treatment Perspective for the Immune Dysregulation Observed in COVID-19

“…All this makes hypersecretion of airway mucus and mucus plugging one of the major causes of death in critically ill COVID-19 patients. A study on critically-ill COVID-19 patients assessed the levels of mucin proteins MUC1 (membrane-tethered) and MUC5AC (secreted) in the airway mucus and reported higher levels of both MUC1 and MUC5AC than healthy controls (Bikdeli et al, 2020;Carsana et al, 2020;Deshpande, 2020;Farooqi et al, 2020;Lax et al, 2020;Liu et al, 2020;Menter et al, 2020;Wang et al, 2020a;Zhang Y. et al, 2020;Lu et al, 2021).…”