Role of Ashwagandha (Withania Somnifera) as Immunomodulator in Coronavirus in a pandemic – A systemic review


Department of Panchakarma, Mahatma Gandhi Ayurved College Hospital and Research Center, Salod Wardha, Datta Meghe Institute of Medical Sciences (Deemed University) Nagpur, Maharashtra, India
Department of Physiology, Ashwini Rural Medical College Hospital and Research Center Solapur, Maharashtra University of Health Sciences, Nashik, Maharashtra, India, +919423276429
Centre for Applied Linguistics and Translation Studies, University of Hyderabad, Hyderabad, India

Abstract

The novel coronavirus has been transmitted all over the world. Many deaths were occurred due to Coronavirus. The main symptoms are pyrexia, fatigue, and dry cough. Some individual also develops a headache, running nose, congestion, sore throat, shortness of breath. At present, no vaccines or medicines available for the prevention and management of Coronavirus disease. Prevention is better than cure. This verse is famous and all known about it. So now the time has come to used or implement this. Prevention is the only measure to fight against Coronavirus. Ayurveda can offer the best option having preventive as well as curative measures. Many herbs have been mentioned in the Ayurvedic texts, which have immunomodulatory action or works as immunobusting drugs. Ashwagandha is well-known or a far old drug which said in Ayurvedic text as a Rasayan and Immunomodulatory activity. Ashwagandha can be used for the prevention of Coronavirus due to it has property like promoting betterment for health and longevity by an increase defence mechanism. Many kinds of research are conducted on Ashwagandha to prove its immunomodulatory, antioxidant, anti-inflammatory, Neuroprotective. Anti-stress properties. We concluded, in Systemic review to know the role of Ashwagandha in the prevention and curing symptoms of Coronavirus its efficacy and mechanism in Coronavirus. Some more research studies should be on COVID -19 for experimental and clinical validation to needed.

Keywords

Ashwagandha, Coronavirus, COVID -19, Immunomodulator, Rasayan

Introduction

The novel Coronavirus Disease (nCOVID – 19) is a virus which is spread all over the country through the transmission of human to human. Many populations younger, as well as older, suffered. Many deaths have occurred; many hospitals filled (Parwe, Nisargandha, & Thakre, 2020; Wu & McGoogan, 2020). It spreads by coughing, sneezing, personal contact, infected material, mass gatherings. It can avoid by regular hand wash and covering of mouth and by maintaining social distance (Nizame et al., 2011). No particular medicine is available for the treatment of COVID -19. So many studies are going on for treatment and prevention. Government has been taking so many efforts to prevent and control the COVID -19 (Zhang, Deng, & Zhang, 2020). Traditional herbs are very famous in India and used for COVID -19. The Indian government also published advisory by AYUSH department for COVID -19.

Ayurveda is an ancient science, and so many measures mentioned in Ayurveda for treating and controlling such type of worldwide spreading virus. These measures for improving the good immune system and curative disease.

Ashwagandha is very famous herbs in Ayurveda and well-known for its action as Aphrodisiac. Ashwagandha is commonly known as his Latin name Withania Somnifera, herbs are known as well as Indian ginseng and Winter cherry (Bharti, Malik, & Gupta, 2016). It is a shrub found in the drier area of India and widely cultivated in different states Gujarat and Haryana, Madhya Pradesh, Punjab and Uttar Pradesh.

In Ayurveda it is mentioned as Rasayana (Rejuvenate), used for promoting physical and mental health and providing defence against different disease, slowing the ageing process, revitalizing the body in such severe conditions, it increases the capability of the individual to resist adverse environmental factors and by creating a sense of physical and mental well being (Bhattacharya, Bhattacharya, Sairam, & Ghosal, 2002).

Botanical Description

Ashwagandha is a small shrub being Solanaceae family. It grows up to the two feet height in drier parts of India. Roots are the main which used in therapeutically. The fruit is bright red in colour, seeds are dried for cultivating as a medicinal plant and Table 1 contain Phytochemistry of Ashwagandha. All parts of plants used in medicine, each part like roots, leaves, stem, green berries, fruits, seeds, bark have different activity.

Table 1: Phytochemistry of Ashwagandha

Sr. No.

Class

Chemical constituents

Activity

1.

Alkaloids

Ashwagandhine, cuscohygrine, anahygrine, tropine

antispasmodic effects

anti-microbial activity

sedative effects

Root

2.

Steroidal activity

Ergostane, steroidal lactones, withaferin A, withasomniferin-A.

The antioxidant as well as Aphrodisiac reduces cholesterol levels, affects the immune system and tumor cells

Root

3.

Saponins

Sitoindoside IX and X

Sitoindosides-VII and VIII

Antioxidant

Adaptogenic

Root

Root

4.

Aqueous Extract

Withanolides, Glycowithanolides

Immunomodulatory

Root

5.

Bioactive compounds

Withanolide sulfoxide

Antimicrobial activity

carcinogens tumor promoters, and inflammatory agents

Root, Leaf

6.

Ethanolic

Ethanol

anti-proliferative activity against cancer cell, Anti-bacterial

leaf, stem and root

7.

Root Extract

Anti-Parkinson’s, cardioprotective, neuroprotective,

Root

https://typeset-prod-media-server.s3.amazonaws.com/article_uploads/dbb2eef2-0488-4eac-84af-ce2c1c817cc7/image/739dfd4e-b9aa-403d-ac99-559c299e0d4b-upicture1.png
Figure 1: Flow chart of all articles Identified, Screen, Included for review, according to PRISMA guidelines

This herb was used to treat especially osteoarthritis, rheumatoid arthritis, and gout. Ashwagandha has green leaves, branched limbs with seeded yellow flowers. Ashwagandha is an essential herb in Ayurvedic context and also used in a variety of infectious diseases and inflammation conditions (Akram, Mohiuddin, Hannan, & Usmanghani, 2011).

The pharmacological action of Ashwagandha mentioned which used in various disorders of the central nervous system specifically indicated in Neurodegenerative diseases. In Drugs addiction, cerebral ischemia and dyskinesia too (Kulkarni & Dhir, 2008).

The extracted compound of “W. somnifera is the phytochemical mixture which has active constitute of phenolic and flavonoid compound. The roots of these compound have a pharmacological effect of W. somnifera, which attributed to with anolides (Chen, Wang, & Chen, 1987; Dhanani, Shah, Gajbhiye, & Kumar, 2017).

The constituents of with anolides are a sequence of steroids, which is naturally occurring. It contains a lactone with a side chain of nine carbon; in which, richest sources of steroidal lactones. (Ksebati & Schmitz, 1988; Srivastava, Siddiqui, Singh, & Tiwari, 1992).

Materials and Methods

The article published in PubMed.gov research online portal were analyzed for this review article. The keywords used for database search which include "Ashwagandha and Withania somnifera”. All articles published in the English language only were included in this review. No other exclusion criteria were applied as regarding journal, years, authors etc. A comprehensives list of all articles published until September 2020 was prepared. In the next stage, all the articles obtained from searching the databases were compiled and screened by reading their "title" and then the "abstract." Studies that satisfied the inclusion criteria, i.e. immunomodulator, anti-viral and COVID-19 studies were only included at this stage and others excluded.

Observation

All selected articles were screened finally by reading the full -text or abstract as per availability and were analyzed further. This search process for systemic review was done as per “Preferred Reporting Items for Systemic Review and Meta-Analysis (PRISMA) guidelines” (Moher et al., 2009) , (Figure 1).

Results and Discussion

The PubMed research portal search keyword “Ashwagandha” and found 1220 articles; while keyword of ‘Withania somnifera’ yielded 1161 articles. The PubMed online database search for all articles on the screening regarding anti-viral and immunomodulatory properties. The Ashwagandha and its immunomodulatory properties show article were 56 and Ashwagandha along with anti-viral properties shows 14 articles. Final inclusion of the articles for a systemic review of Immunomodulatory and anti-viral properties for COVID-19 was 07.

Anti-viral effect and Immuno-modulatory effect of Ashwagandha

They evaluate in their study by adopting a computational approach, a natural chemical constituent of Ashwagandha to explore a possible inhibitor against the main protease of SARS-COV-2. In this article on docking, a study was carried out on four constituents of Ashwagandhaswhich shows these selected natural constituents have the highest docking energy. In his study they concluded, withanoside V in Ashwagandha may serve as potent compound inhibitors of in COVID-19and may have the effect of anti-viral on nCOVID-19 (Nisargandha & DadaraoParwe, 2020; Tripathi et al., 2020).

Another study was done on molecular docking analysis data of the cellular receptor Glucose regulated protein (GRP78) with with aferin A from With ania somnifera in COVID -19. They reported that the optimal interaction feature of with aferin A with the GRP78 receptor and COVID -19 Mpro and mentioned more research required for validating the properties of anti-viral in with aferin A against COVID -19 (Sudeep, 2020).

The study, Chikhle R.V., et al., observed in his work plant w.somniferais well established as anti-viral, immunomodulatory, anti-inflammatory, antioxidant plant using molecular docking and dynamic studies. They mentioned in molecular docking study, pointed out some phytoconstituents properties from Ashwagandha. It could be an alternative as an anti-viral agent in the management of coronavirus (Chikhale et al., 2020).

Three ayurvedic medicinal plants used in their study, in “molecular docking study shows six inhibitors against SARS-CoV-2 Mpro. They suggested that active constituents from this medicinal plant could potentially inhibit Mpro of SARS-CoV-2” (Shree et al., 2020).

This article is on the withaferin A (WFA) potential therapeutic agent against Coronavirus infection. It suggests that the anti-inflammatory & antitumorigenic “properties may bind the viral spike (S) protein of SARS-CoV-2. WFA does not alter the expression of ACE2 in the lung of tumor bearing female mice” (Dhuley, 2001; Straughn & Kakar, 2020).

It was observed in their study; phytochemicals exhibit remarkable pendency on “various human biological pathways in cancer. They suggest that there should be some clinical and experimental evidence in vitro for observing its potency (Parida, Paul, & Chakravorty, 2020).

Two studies carried out by Vipul Kumar et al. In one study they mentioned that binding with an one -N (Wi-N), with none-A (Wi-A) and caffeic acid phenethyl ester (CAPE) highly conserved protein, Mrpo of COVID -19. They found only WI-N and CAPE bind the substrate-binding pocket of SARS-CoV-2 MPro with efficacy, not the Wi-A. Data presented in his study these are the natural compound for actively inhibit the functional activity of SARS -CoV-2 protease (Kumar, Dhanjal, Kaul, Wadhwa, & Sundar, 2020). In his other study Wi-A and Wi -N could bind and stably interact with the catalytic site of trans membrane protease serine 2 (TMPRSS2). They observe the effect of Wi-N on TMPRSS2 expression in MCF7 cell and found remarkable reduce into the host cell. They may offer therapeutic and preventive value in the management of nCOVID-19. They also make attention to the alert about the use of different parts of Ashwagandha. (Kumar et al., 2020)

Conclusion

In the Indian system of Ayurveda, Withania somnifera, also known as Ashwagandha. The roots of W. somnifera have been extensively used as a valuable drug in Ayurveda. However, its therapeutic potential as immunomodulatory, apoptogenic, antioxidant, hypoglycemic and anti-cancer activities have been reported. The systemic review of the articles available from the PubMed database shows confirming to the current situation of COVID -19 and role of Ashwagandha as immunomodulatory and anti-viral activity articles. The seven full articles are available on SARS- CoV-2 and Ashwagandha emphasis mainly on their therapeutic use as an anti-viral and immunomodulatory activity. Out of seven articles, five articles mentioned anti-viral, and two reported as immunomodulatory action. We conclude, there needs some experimental and clinical validation to know the reliability and preventive measurement in COVID-19.