Joshi Manjunath B, Kamath Archana, Nair Aswathy S, Yedehali Thimmappa Pooja, Sriranjini Sitaram J, Gangadharan G G, Satyamoorthy Kapaettu
Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, 576104, India.
Ramaiah Indic Speciality Ayurveda-Restoration Hospital, MSR Nagar, Mathikere, Bengaluru, 560 054, India.
J Ayurveda Integr Med. 2022 Jan-Mar;13(1):100424. doi: 10.1016/j.jaim.2021.03.006. Epub 2021 Mar 16.
For centuries, traditional medicines of Ayurveda have been in use to manage infectious and non-infectious diseases. The key embodiment of traditional medicines is the holistic system of approach in the management of human diseases. SARS-CoV-2 (COVID-19) infection is an ongoing pandemic, which has emerged as the major health threat worldwide and is causing significant stress, morbidity and mortality. Studies from the individuals with SARS-CoV-2 infection have shown significant immune dysregulation and cytokine overproduction. Neutrophilia and neutrophil to lymphocyte ratio has been correlated to poor outcome due to the disease. Neutrophils, component of innate immune system, upon stimulation expel DNA along with histones and granular proteins to form extracellular traps (NETs). Although, these DNA lattices possess beneficial activity in trapping and eliminating pathogens, NETs may also cause adverse effects by inducing immunothrombosis and tissue damage in diseases including Type 2 Diabetes and atherosclerosis. Tissues of SARS-CoV-2 infected subjects showed microthrombi with neutrophil-platelet infiltration and serum showed elevated NETs components, suggesting large involvement and uncontrolled activation of neutrophils leading to pathogenesis and associated organ damage. Hence, traditional Ayurvedic herbs exhibiting anti-inflammatory and antioxidant properties may act in a manner that might prove beneficial in targeting over-functioning of neutrophils and there by promoting normal immune homeostasis. In the present manuscript, we have reviewed and discussed pathological importance of NETs formation in SARS-CoV-2 infections and discuss how various Ayurvedic herbs can be explored to modulate neutrophil function and inhibit NETs formation in the context of a) anti-microbial activity to enhance neutrophil function, b) immunomodulatory effects to maintain neutrophil mediated immune homeostasis and c) to inhibit NETs mediated thrombosis.
几个世纪以来，阿育吠陀传统医学一直被用于治疗感染性和非感染性疾病。传统医学的关键体现是在人类疾病管理中采用的整体系统方法。严重急性呼吸综合征冠状病毒2（SARS-CoV-2，即新冠病毒）感染是一场持续的大流行疾病，已成为全球主要的健康威胁，并造成了巨大的压力、发病率和死亡率。对感染SARS-CoV-2的个体的研究表明，存在显著的免疫失调和细胞因子过度产生。中性粒细胞增多以及中性粒细胞与淋巴细胞的比例与该疾病的不良预后相关。中性粒细胞是固有免疫系统的组成部分，受到刺激后会排出DNA以及组蛋白和颗粒蛋白，形成细胞外陷阱（NETs）。尽管这些DNA晶格在捕获和消除病原体方面具有有益作用，但NETs也可能通过在包括2型糖尿病和动脉粥样硬化等疾病中诱导免疫血栓形成和组织损伤而产生不良影响。SARS-CoV-2感染患者的组织显示有微血栓形成以及中性粒细胞-血小板浸润，血清中NETs成分升高，这表明中性粒细胞大量参与且不受控制地激活，导致发病机制及相关器官损伤。因此，具有抗炎和抗氧化特性的阿育吠陀传统草药可能以一种有利于针对中性粒细胞功能亢进的方式发挥作用，从而促进正常的免疫稳态。在本手稿中，我们回顾并讨论了NETs形成在SARS-CoV-2感染中的病理重要性，并讨论了如何探索各种阿育吠陀草药来调节中性粒细胞功能并抑制NETs形成，具体涉及以下方面：a）抗菌活性以增强中性粒细胞功能；b）免疫调节作用以维持中性粒细胞介导的免疫稳态；c）抑制NETs介导的血栓形成。
