Covid-19: Überlegungen zu Voraussetzungen von phytotherapeutischen Empfehlungen

Zusammenfassung

In der Beratung von Patienten stellen sich sowohl wegen der Möglichkeit einer zweiten Welle sowie der Langzeitprophylaxe insbesondere für Risikopersonen für naturheilkundlich praktizierende Ärzte weiterhin zwei Fragen: Gibt es Möglichkeiten einer primären Prävention im Sinne einer Abhärtung, durch pflanzliche Immunstimulantien, Adaptogene etc.? Und kann man leichtere Infektionen durch Atemwegstherapeutika günstig beeinflussen?

Dieser Artikel soll vorläufige Empfehlungen zur Phytotherapie geben. Wir sind uns sehr wohl der Problematik bewusst, dass sich diese zunächst sowohl in der präklinischen wie in der klinischen Evaluation nur an Analogiemodellen orientieren können. Verschiedene Aspekte zu präklinischen Ergebnissen waren bereits in Heft 2 / 2020 dieser Zeitschrift vorgestellt worden [1]. Wir schließen mit einem Ausblick auf die Möglichkeiten und Schwierigkeiten prospektiver klinischer Forschung mit Phytopharmaka.

Abstract

For doctors and pharmacists involved in phytotherapy, two questions will stay for an indefinite time especially in individual counselling. 1. Is there a possibility of primary prevention especially for people at high risk for infection, e.g. through herbal immunostimulants and adaptogens? 2. Can the course of an infection favourably be influenced by herbal agents with known beneficial effects on the respiratory system or even intrinsic antiviral properties? The objective of this article is to provide preliminary recommendations for the use of phytotherapy. The authors are aware of the limitations of these recommendations. At this time, they can only be based on analogy models in both preclinical and clinical evaluation. Several aspects of preclinical results were already presented in issue 2-2020 of this journal [1]. This article here concludes with a perspective on chances and limitations of prospective clinical research with phytodrugs.

Schlüsselwörter

Phytotherapie - Covid-19 - SARS-CoV-2, Prävention - Virusinfekte - Atemwegsinfekte - Grüntee - Kapland-Pelargonie - Süßholz - Sonnenhut - Zistrose

Key words

Phytotherapy, Covid-19 - SARS-CoV-2 - virus infections - respiratory tract diseases - green tea - African geranium - liquorice - Echinacea - Cistus

Publication History

Received: 06 July 2020

Accepted: 21 July 2020

Article published online:
01 September 2020

• Literatur

• 1 Hensel A, Spiegler V, Kraft K. Pflanzliche Extrakte gegen virale Infektionen des oberen Rachenraumes. Gibt es rationalisierbare protektive Möglichkeiten? Z Phytother 2020; 41: 52-54 . doi: 10.1055/a-1102-1662
• 2 Ide K, Kawasaki Y, Kawakami K, Yamada H. Anti-influenza virus effects of catechins: a molecular and clinical review. Curr Med Chem 2016; 23: 4773-4783 . doi: 10.2174/0929867324666161123091010
• 3 Raekiansyah M, Buerano CC, Luz MAD, Morita K. Inhibitory effect of the green tea molecule EGCG against dengue virus infection. Arch Virol 2018; 163: 1649-1655 . doi: 10.1007/s00705-018-3769-y
• 4 Furushima D, Ide K, Yamada H. Effect of tea catechins on influenza infection and the common cold with a focus on epidemiological / clinical studies. Molecules 2018; 23 (07) . pii: E1795. DOI: 10.3390/molecules23071795.
• 5 Matsumoto K, Yamada H, Takuma N. et al. Effects of green tea catechins and theanine on preventing influenza infection among healthcare workers: a randomized controlled trial. BMC Complement Altern Med 2011; 11: 15. DOI: 10.1186/1472-6882-11-15.
• 6 Ide K, Yamada H, Kawasaki Y. Effect of gargling with tea and ingredients of tea on the prevention of influenza infection: a meta-analysis. BMC Public Health 2016; 16: 396 . doi: 10.1186/s12889-016-3083-0
• 7 Michaelis M, Doerr HW, Jr Cinatl J. Investigation of the influence of EPs® 7630, a herbal drug preparation from Pelargonium sidoides, on replication of a broad panel of respiratory viruses. Phytomedicine 2011; 18: 384-386 . doi: 10.1016/j.phymed.2010.09.008
• 8 Neugebauer P, Mickenhagen A, Siefer O, Walger M. A new approach to pharmacological effects on ciliary beat frequency in cell cultures – exemplary measurements under Pelargonium sidoides extract (EPs 7630). Phytomedicine 2005; 12: 46-51. doi: 10.1016/j.phymed.2003.11.005
• 9 Timmer A, Günther J, Motschall E. et al. Pelargonium sidoides extract for treating acute respiratory tract infections. Cochrane Database Syst Rev 2013; (10): CD006323. DOI: 10.1002/14651858.CD006323.pub3.
• 10 Schapowal A, Dobos G, Cramer H. et al. Treatment of signs and symptoms of the common cold using EPs 7630 – results of a meta-analysis. Heliyon 2019; 5: e02904. DOI: 10.1016/j.heliyon.2019.e02904.
• 11 Careddu D, Pettenazzo A. Pelargonium sidoides extract EPs 7630: a review of its clinical efficacy and safety for treating acute respiratory tract infections in children. Int J Gen Med 2018; 11: 91-98. doi: 10.2147/IJGM.S154198
• 12 Karsch-Völk M, Barrett B, Kiefer D. et al. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev 2014; 2: CD000530. DOI: 10.1002/14651858.CD000530.pub3.
• 13 Cech NB, Kandhi V, Davis JM. et al. Echinacea and its alkylamides: effects on the influenza A-induced secretion of cytokines, chemokines, and PGE2 from RAW 264.7 macrophage-like cells. Int Immunopharmacol 2010; 10: 1268-1278. DOI: 10.1016/j.intimp.2010.07.009.
• 14 Pleschka S, Stein M, Schoop R, Hudson JB. Anti-viral properties and mode of action of standardized Echinacea purpurea extract against highly pathogenic avian influenza virus (H5N1, H7N7) and swine-origin H1N1 (S-OIV). Virol J 2009; 6: 197. doi: 10.1186/1743-422X-6-197
• 15 Rauš K, Pleschka S, Klein P. et al. Effect of an Echinacea-based hot drink versus oseltamivir in influenza treatment: a randomized, double-blind, double-dummy, multicenter, noninferiority clinical trial. Curr Ther Res Clin Exp 2015; 77: 66-72. DOI: 10.1016/j.curtheres.2015.04.001.
• 16 Utsunomiya T, Kobayashi M, Pollard RB, Suzuki F. Glycyrrhizin, an active component of licorice roots, reduces morbidity and mortality of mice infected with lethal doses of influenza virus. Antimicrob Agents Chemother 1997; 41: 551-556 . doi: 10.1128/AAC.41.3.551
• 17 Wolkerstorfer A, Kurz H, Bachhofner N, Szolar OH. Glycyrrhizin inhibits influenza A virus uptake into the cell. Antiviral Res 2009; 83: 171-178 . doi: 10.1016/j.antiviral.2009.04.012
• 18 Cinatl J, Morgenstern B, Bauer G. et al. Glycyrrhizin, an active component of liquorice roots, and replication of SARS-associated coronavirus. Lancet 2003; 361 (9374): 2045-2046. DOI: 10.1016/s0140-6736(03)13615-x.
• 19 Yoshino T, Arita R, Horiba Y, Watanabe K. The use of maoto (Ma-Huang-Tang), a traditional Japanese Kampo medicine, to alleviate flu symptoms: a systematic review and meta-analysis. BMC Complement Altern Med 2019; 19: 68 . doi: 10.1186/s12906-019-2474-z
• 20 Ehrhardt C, Hrincius ER, Korte V. et al. A polyphenol rich plant extract, CYSTUS052, exerts anti influenza virus activity in cell culture without toxic side effects or the tendency to induce viral resistance. Antiviral Res 2007; 76: 38-47. DOI: 10.1016/j.antiviral.2007.05.002.
• 21 Droebner K, Ehrhardt C, Poetter A. et al. CYSTUS052, a polyphenol-rich plant extract, exerts anti-influenza virus activity in mice. Antiviral Res 2007; 76: 1-10. DOI: 10.1016/j.antiviral.2007.04.001.
• 22 Kalus U, Grigorov A, Kadecki O. et al. Cistus incanus (CYSTUS052) for treating patients with infection of the upper respiratory tract. A prospective, randomised, placebo-controlled clinical study. Antiviral Res 2009; 84: 267-271. DOI: 10.1016/j.antiviral.2009.10.001.
• 23 Akram M, Tahir IM, Shah SMA. et al. Antiviral potential of medicinal plants against HIV, HSV, influenza, hepatitis, and coxsackievirus: A systematic review. Phytother Res 2018; 32: 811-822. DOI: 10.1002/ptr.6024.