Ashwagandha could help fight COVID-19, says IIT-Delhi

Indian Institute of Technology, Delhi (IIT-D) and National Institute of Advanced Industrial
Science and Technology, Japan in a collaborative study discovered that Ashwagandha may hold
an efficient natural compound that could be effective in developing a drug for the coronavirus.

The researchers discovered that Withanone (Wi-N), a natural compound derived from Ashwagandha (Withania somnifera) and Caffeic Acid Phenethyl Ester (CAPE), an active ingredient of New Zealand propolis, has the potential to interact with and block the activity of Mpro.

According to the team, the findings will save time and cost required for screening of anti-COVID-19 drugs and will also offer some preventive and therapeutic value for the management of the fatal 19 pandemic. Hence they warrant prioritised validation in laboratory and clinical tests.

“The drug development may take a while and in the current scenario, these natural resources (Ashwagandha and Propolis) may offer some preventive or even therapeutic value. However, although they are easily available and affordable, one has to be cautious about the content of bioactive ingredients. CAPE, while is a major component of propolis, its amount and stability are critical factors that could be managed by generating its complex with cyclodextrins,” said a scientist.

Prof. D. Sundar, coordinator of DAILAB, IIT-D and Head of the Department of Biochemical Engineering and Biotechnology said, “The traditional medicine system ‘Ayurveda’ has been practised for thousands of years in India. Unlike modern medicine, the mechanism of action of natural drugs has not been resolved so far. IIT-Delhi and AIST researchers have been working together for more than a decade and trying to contribute to strengthening this avenue by merging the traditional knowledge with modern technologies.”

A potential game changer?
The researchers discovered that Withanone (Wi-N), a natural compound derived from Ashwagandha (Withania somnifera) and Caffeic Acid Phenethyl Ester, an active ingredient of New Zealand propolis, has the potential to interact with and block the activity of Mpro.

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

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Could the Heartburn Drug Famotidine Help Fight COVID-19? Here's What We Know Right Now

Scientists continue to look into potential treatments for COVID-19, and the latest to be touted is famotidine, which is the active ingredient in the popular over-the-counter heartburn medication Pepcid.

Kevin Tracey, MD, president of Feinstein Institutes for Medical Research at Northwell Health in New York City, told Science that preliminary results of a clinical trial of famotidine could be ready in the next few weeks. The trials have been underway since April 7 at Northwell, one of the largest hospital systems in New York City. As of April 25, 1,174 patients—including 187 who were critically ill—have taken part.

Dr. Tracey said that earlier in the outbreak, doctors who worked with coronavirus patients in Wuhan, China discovered that although one in five COVID-19 patients over the age of 80 died, many of those who survived had been taking heartburn meds. Studies on the Chinese patients have not yet been published, but the findings were enough to encourage US scientists to explore famotidine’s potential. 
Trialling an OTC drug intended to relieve heartburn might seem a bit out of left field, considering that COVID-19 is a disease affecting the lungs and airways. But Dr. Tracey pointed out in the Science interview that there are “many examples in the history of medicine where a drug that was designed for one purpose turns out to have an effect in another disease.”

The case for trialling famotidine was bolstered by a computer model used by Florida-based Alchem Laboratories to compile a list of existing drugs that might fight coronavirus. Famotidine showed up near the top of the list, and the company received a $20.7 million contract to conduct the trial at Northwell from the US Biomedical Advanced Research and Development Authority (BARDA).

According to Dr. Tracey, famotidine was flagged because—in theory—the drug is structured in a way that could prevent the coronavirus from replicating, in the same way that protease inhibitors, which are used to treat HIV, stop that virus from replicating.

“Famotidine is a histamine receptor blocker,” Solomon L. Lerer, MD, a gastroenterologist in Aventura, Florida, tells Health. Specifically, the compound blocks the H2 receptors that play a role in producing acid in the stomach, which can lead to heartburn, a main symptom of gastroesophageal reflux disease (GERD). Famotidine is considered a relatively safe drug, Dr. Lerer adds, but side effects can include diarrhea, muscle aches, and headaches. 

“Famotidine is most commonly used to treat gastroesophageal reflux disease,” Abraham Khan, MD, director of the Center for Esophageal Diseases at NYU Langone Health, tells Health. “Often, it works best in patients with mild GERD symptoms that do not need a daily stronger acid suppressive medication, such as a proton pump inhibitor (PPI).”

Dr. Khan says that “it is not intuitive to think that famotidine would be a successful treatment for COVID-19 patients.” However, based on the limited retrospective evidence on outcomes made available so far, as well as the possibility that the drug may bind to a viral enzyme to interfere with its replication, he believes it’s worth an official trial study to see if it can be a treatment option for COVID-19.

“The evidence from China is anecdotal, and a double-blind study is needed to really determine the effectiveness of famotidine," adds Dr. Lerer.

The patients participating in the clinical trial at Northwell Health include a group who are also taking the anti-malarial drug hydroxychloroquine, as well as patients who are on hydroxychloroquine only. Hundreds of patients treated early on in the COVID-19 outbreak are also part of the trial.

Hydroxychloroquine is the drug hailed as a “game changer” by President Trump in a coronavirus task force briefing on March 20. However, preliminary results from a study sponsored by the New York State Department of Health, which looked at about 600 patients at 22 hospitals in the greater New York City area, suggest that hydroxychloroquine "didn't really have much of an effect on the recovery rate,” according to New York Governor Andrew Cuomo, as reported by CNN.

The same discouraging result could come out of the famotidine study. Keep in mind that this is a trial, and no drug treatment—famotidine or something else—will be approved to treat COVID-19 anytime soon.

In the meantime, Dr. Lerer warns that people should absolutely not rush out to buy the drug from their local drugstore. “It's important to be aware that in this current Northwell study, patients are taking mega doses of famotidine intravenously and are not taking pills orally. There is always a possibility that mega doses of any drug can have potential negative long-term side effects,” he says. And if the general public starts stockpiling Pepcid, heartburn patients who really need it could suffer.

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.

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Arthritis drug Tocilizumab joins list of drugs that may help fight COVID-19

Since the beginning of the COVID-19 pandemic, scientists are trying desperately to find a cure for the disease. But despite many false hopes, they have not been able to zero in on any potential cure. Trials of possible cures have started in different parts of the world. But it may still be a long time before we see a vaccine in the market for the general public. Besides trying to find a new drug, scientists are also trying to figure out if any existing drug can be used to fight the pandemic. Examples include the malaria drug hydroxychloroquine and the tuberculosis vaccine. The latest drug to join the list is the rheumatoid arthritis medication Tocilizumab.

Researchers from UC San Diego Health have started a Phase III clinical trial to see if this medication has any therapeutic value for COVID-19 patients who develop or at high risk of developing serious lung damage from SARS-CoV-2 infections. Doctors commonly use this drug to treat rheumatoid arthritis and other inflammatory disorders. This endeavor is part of a global effort to find a cure for the ongoing pandemic at the earliest.Also Read - Scientists identify mobile phones as 'Trojan horses' for COVID-19

About the trial

This randomized, double-blind, placebo-controlled interventional trial will enroll around 330 participants at nearly 70 sites across the world. In UC San Diego, researchers will recruit around 20 participants who are 18 years or older. All participants are in hospital with COVID-19 pneumonia and have evidence of impaired gas exchange. They will receive one intravenous infusion of either tocilizumab or the placebo, with a possible second infusion if clinical symptoms worsen or show improvement. At the end of it, researchers are hopeful of being able to answer questions on whether tocilizumab can improve the health and clinical status of treated COVID-19 patients or if it can reduce the mortality rate due to COVID-19 pneumonia.  

About the drug

Tocilizumab is an immunosuppressive drug, which doctors use in the treatment of rheumatoid arthritis and systemic juvenile idiopathic arthritis. It is basically a monoclonal antibody-based therapy, which blocks cellular receptors for interleukin-6 (IL-6), a protein or cytokine that is known to trigger inflammation.

How it may help COVID-19 patients

The immune system of some COVID-19 patients seem to go haywire. There is an overexpression of IL-6 and this generates a ‘cytokine storm’. This can cause severe and fatal damage to the lungs and other organs of the body. Scientists have known for a long time that cytokine storms can lead to many serious inflammatory diseases including respiratory ailments caused by coronaviruses, influenza, multiple sclerosis and also pancreatitis.

Now, to control the COVID-19 outbreak in Wuhan, China, doctors there had used this drug to treat a few patients with serious lung damage. They were surprised to see promising results. Because of this, the Chinese National Health Commission now includes tocilizumab in its guidelines for treating COVID-19-related pneumonia and other lung issues.

What experts say

Many voices from the scientific community warn that this must not be seen as a cure for COVID-19. It is important to reiterate again and again right now that there are no approved therapies for COVID-19. Doctors treat the patient only for the symptoms that he or she may exhibit. Moreover, COVID-19 affects patients in many different ways and inflammation of lungs is just one of the symptoms. Tocilizumab can suppress this inflammatory response and it may reduce the need for more extreme medical interventions like mechanical ventilation and greater risk of chronic injury and death, say UC San Diego researchers.

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New combination treatment could help fight advanced melanoma

A study by researchers at the UCLA Jonsson Comprehensive Cancer Center suggests that using an immunotherapy drug called NKTR-214, also known as bempegaldesleukin, in combination with an infusion of anti-tumor immune cells, or T cells, may produce a stronger immune response that could help fight advanced melanoma.

When tested in mice with melanoma tumors that were unlikely to stimulate an immune response, the approach increased the number of anti-tumor immune cells, and those immune cells lived longer and functioned better than the standard therapy, empowering the cells to destroy the tumor.

Background
Adoptive cell therapy is a type of immunotherapy that has had promising results for treating people with advanced cancers. The approach involves extracting and harvesting immune cells from a patient and engineering them in the laboratory to attack specific antigens on the surface of tumors. One challenge is that it requires giving patients interleukin 2, a protein signaling molecule in the immune system, to promote the development and expansion of the infused immune cells. But interleukin 2 can also activate cells to suppress the immune system, and because it is highly toxic, it can have serious adverse side effects.

Researchers have been seeking ways to produce large number of immune cells without exposing patients to those negative side effects -- including by combining adoptive cell therapy with other treatments.

Method

Researchers used mice to test NKTR-214 in combination with adoptive cell therapy. Using bioluminescence imaging, the researchers tracked the movement of T cells in the mice that received the combination therapy. The team observed an expansion of T cells in the spleen, the organ that helps accelerate the activation and expansion of T cells throughout the body. The T cells then migrated to the tumor, where they continued to have a long-lasting effect. The in vivo expansion and T cell accumulation in tumors was greatly improved when using NKTR-214 compared to using interleukin-2.

Impact
While immunotherapy has changed the face of cancer treatment for people with advanced cancers, it still only works in a small subset of patients. The results of the UCLA study suggest that using NKTR-214 in combination with adoptive cell therapy could be effective for more people with advanced solid tumors.

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That humble cabbage in your vegetable shelf can help you fight diabetes

We all know that the burden of diabetes is growing all over the world and it will keep increasing. The 2019 facts and figures about this hormonal disorder alone is more than a wake-up call. This year’s data by the International Diabetes Foundation come up with the following statistics:

• 463 million adults in the age bracket of 20-79 years, were affected by diabetes
• This figure will escalate to 700 million by 2045 this will rise to 700 million
• People between 40 and 59 years of age are mostly affected by diabetes
• 232 million: The number of people with undiagnosed diabetes
• The death toll of diabetes was 4.2 million

A diet rich in vegetables and fruits is a powerful weapon against high blood sugar levels and cabbage is known to be one of the best veggies for tackling this condition. Cabbage isn’t your favourite vegetable, we know and the reasons are valid too: It’s smelly, it’s unappealing and if not cooked right, can be very tasteless too. But if you are a diabetic or suffering from metabolic syndrome, then cabbage is that one vegetable that should be on your grocery list without fail. Yes, cabbage can do wonders to treat diabetes naturally, and probably get you off medications too (if you are lucky enough). Did you know okra/ ladies finger/ bhindi can also help fight diabetes naturally?

Controls blood sugar

Cabbage has a lot of antioxidant and antihyperglycemic properties that make it a medicine for diabetes. In a study done on rats in 2008, cabbage extracts fed to them for 60 days lowered blood sugar levels and also helped to control fluctuations and keep the readings in the safe range.

It helps to lose weight

Cabbage is low in calories and high in fibre content, so it becomes an ideal vegetable to choose for diabetics. It is also low on glycemic index with a rank of 10 (anything below 55 is considered low). GI is an indicator of how fast the carbohydrates will raise the blood glucose levels in your blood. A food item with a high GI means it will raise the levels quickly as compared to food with low GI. So bring cabbage to your table as often as you can.

Improves kidney functions

Since cabbage can help keep blood sugar level in control, it also helps to maintain the kidney functions. When a diabetic has extremely high blood sugar levels (over 600 mg/dl), the kidneys try to get rid of the extra blood sugar by eliminating it through urine. This leads to excessive loss of body fluids, resulting in dehydration. Dehydration causes the blood to become thicker and further increases the blood sugar levels which makes it difficult for the kidneys to rectify it. This is why diabetics are more prone to kidney failures.

How to eat it:

• A simple way to include cabbage in your diet is to prepare the vegetable as a side dish at least thrice a week.
• If you dislike the preparation, add cabbage to your dals and soups to reap its benefits.
• Prepare cabbage juice by chopping the vegetable and blending it on a high speed.
• Add boiled cabbage to your salads with a dash of salt and lemon.

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Green tea could help fight tuberculosis

An antioxidant found in the green tea could become key to tackling tuberculosis, a new research has found.

Through laboratory investigations, the research team from Nanyang Technological University, Singapore (NTU) discovered how the prominent compound, known as epigallocatechin gallate (EGCG), can inhibit the growth of a tuberculosis-causing bacteria strain.

The EGCG does so by binding to an enzyme that provides biological energy for cellular activity.
The process results in a dip in the amount of energy the bacteria has for its cellular processes vital for growth and stability, such as cell wall formation.

“Our discovery of the EGCG’s ability to inhibit the growth of M. tuberculosis will allow us to look at how we can improve the potency of this compound in green tea, and other similar compounds, to develop new drugs to tackle this airborne disease,” said study lead researcher.

According to the researchers, cells require energy for vital processes such as cell wall formation to take place. They get their energy from an energy storage molecule made by an enzyme called Adenosine triphosphate (ATP) synthase.

Without energy for essential cellular activity, a cell loses its stability and eventually dies.

To determine the factors affecting the production of ATP synthase, and thus, the amount of energy a bacterial cell has for growth, the research team studied mycobacterium smegmatis and mycobacterium bovis, both of which belong to the same family as M. tuberculosis.
These mycobacterial strains share a similar structural composition.

The team first found that alterations to the genetic code for ATP synthase resulted in an enzyme that produced fewer energy storage molecules in the bacterial cells, slower cell growth, and an altered colony shape.

With this data, the scientists then screened for and found 20 compounds that could possibly bind to ATP synthase and cause the same blocking effect, and then tested them for their efficacy.

Only EGCG, a natural antioxidant that occurs in a large amount in green tea, showed it had the same crucial effect of reducing energy storage molecules in the bacterial cell, the study said.

The research team is now looking at optimising the activity of EGCG for increased efficiency and potency in fighting the tuberculosis bacteria.

Their ultimate goal is to develop a drug cocktail that will tackle multi-drug resistant tuberculosis.

The findings, could pave the way for the creation of novel drugs to combat tuberculosis, one of the most deadly infectious diseases in the world.

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