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 Table of Contents  
REVIEW ARTICLE
Year : 2020  |  Volume : 3  |  Issue : 3  |  Page : 3-7

Review on constituents and activity of Siddha Herbal Formulation Ammaiyar Koondhal Kudineer (AKK) against SARS CoV-2


1 Siddha Clinical Research Unit (CCRS, Ministry of AYUSH, Govt. of India), Tirupati, Andhra Pradesh - 517 507, India
2 National Institute of Siddha, Govt. of India, Chennai - 600 047, India

Date of Web Publication27-Sep-2021

Correspondence Address:
K Arunachalam
Siddha Clinical Research Unit (CCRS, Ministry of AYUSH, Govt. of India), Tirupati, Andhra Pradesh - 517 507
India
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Source of Support: None, Conflict of Interest: None


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  Abstract 


Introduction: COVID-19 is the current most affecting pandemic disease more than 200 countries. The rapid transmission of corona viral disease is a challenging and invention of an effective drug for its management is the need of the hour. Antiviral drugs, anti-pyretic drugs and immunomodulators are commonly used for the management of SARS CoV-2 infection in Complementary and Alternative Medicines (CAM). Siddha system of medicine which was indicated since ancient times to treat respiratory illnesses like cough, cold, dyspnoea may possibly have a significant effectiveness on prophylactic and symptomatic management. Ammaiyar Koondhal Kudineer (AKK) is a classical Siddha formulation, which was formulated by sage Therar for the management of vishakaichal (fever). This drug was taken into consideration to explore its antiviral effects. So, an attempt was made to explore the antiviral nature of AKK. The herbals formulated in this Siddha drug such as Cuscuta reflexa, Hemidesmus indicus, Evolvulus alsinoides etc., have pharmacologically proven antiviral properties. Conclusion: This review on its antiviral therapeutic value of AKK helped to bring a new insight to the management of COVID-19. Further preclinical and clinical evaluation will be helpful in ensuring more therapeutic benefits of AKK.

Keywords: Anti-Viral Siddha Formulation, COVID-19, SARS CoV-2, Vishakaichal.


How to cite this article:
Arunachalam K, Rajamaheswari K, Samraj K. Review on constituents and activity of Siddha Herbal Formulation Ammaiyar Koondhal Kudineer (AKK) against SARS CoV-2. J Res Siddha Med 2020;3, Suppl S1:3-7

How to cite this URL:
Arunachalam K, Rajamaheswari K, Samraj K. Review on constituents and activity of Siddha Herbal Formulation Ammaiyar Koondhal Kudineer (AKK) against SARS CoV-2. J Res Siddha Med [serial online] 2020 [cited 2021 Dec 3];3, Suppl S1:3-7. Available from: http://www.jrsm.com/text.asp?2020/3/3/3/326809




  Introduction Top


COVID-19 was emerged as an infectious disease in China later it spreads to other countries such as Italy, South Korea, United states of America, India etc. In January 2020 Global emergency was declared by WHO by considering the rapid spread and severity of this disease. WHO dashboard for COVD-19[1] show as of 3rd November 2020, there were 46403652 confirmed COVID-19 cases, 1198569 confirmed deaths due to this outbreak in nearly around 219 countries, areas or territories. COVID-19 outbreak is caused by SARS CoV2 infection. It was identified that the disease-causing pathogen belongs to the genus of beta corona virus and it affects the humans via binding with the ACE2 receptor pathway by its spike protein molecule[2],[3].

2019-nCoV is a unique virus which severely affects the respiratory pathway through infective aerosols. The Developing infectious diseases, such as severe acute respiratory syndrome and coronavirus disease, present foremost threat to community health[4],[5]. Coronavirus disease (SARS-CoV-2) is a contagious disease caused by a newly discovered coronavirus[6]. The incubation period is from 1-14 days and the median is considered as 5.2 days according to WHO report. The symptoms seen are mostly upper respiratory such as rhinorrhoea, sneezing, sore throat and common symptoms such as fever, cough, dyspnoea. Hypertension, diabetes mellitus are the risk factors for COVID-19. Sometimes fever will not be observed in aged or immunodeficient persons. RTPCR is used to diagnose and confirm the positivity of COVID-19 in humans. Drugs used in the management of COVID-19 such as lopinavir, ritonavir and hydroxychloroquine were found beneficial in some cases[7]. Still there are no approved drugs with proven efficacy against corona viruses.

In Siddha various medicines like Ammaiyar Koondhal Kudineer (AKK) are used for anti-viral therapies.


  Method Top


The Siddha Medicine AKK drug was quoted in Theran Kudineer 100 and identified through Gunapadam (Mooligai vaguppu) written by Murugesa Mudhaliyar[8]. All the ingredients are assessed by its pharmacological activities and the biological properties of their chemical constituents.


  Discussion Top


Some of the major chemical compounds present in the ingredients of Siddha drug AKK having Anti-viral, Anti-inflammatory, Anti-pyretic, Anti-asthmatic pharmacological activities [Table 1]. These references explore the AKK having potentials in management on COVID-19 Symptoms.
Table 1: The ingredients of Ammaiyar Koondhal Kudineer and their major compounds with biological properties

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The flavanones isolated from Cuscuta reflexa showed some ability in neutralizing virus, inhibit CD4/gp120 interaction and the virus enzymes reverse transcriptase and protease[9]. Hemidesmus indicus extracts showed potent anti-viral activity against HSV 1 and HSV 2 by inhibiting viral binding to the cellular receptor level[29]. Allicin the compound of Allium cepa exhibits anti-viral effect. It inhibited the viral infection by the way of altering of transcription and translational of viral genome of the host cell. This compound has the ability to pass through the phospholipid membrane of the cell and thus inhibited the viral multiplication[12]. The biomolecules of Acorus calamus exhibits anti-viral property towards Huh7it-1 cell lines (Dengue cell line). It was found that it showed inhibition of DENV-2 at a dose of 20 μg/mL to 96.5%[30]. Embilica officinalis exhibits strong reverse transcriptase inhibitory activity in Human Immuno deficiency Virus 1 on PBMC cells[31]. The natural tannin chebulagic acid present in Terminalia chebula has anti-viral activity by inhibiting the entry through Glycosaminoglycans[32]. Some studies reveal that chebulagic acid and chebulinic acid shows influenza viral neuraminidase inhibiting effect[33].

The essential oil of Citrus limon has been identified as anti-viral against hepatitis A virus (HAV) infection[34]. Recent pharmacological studies on leaves and whole plant of Evolvulus alsinoides have shown immunomodulatory properties[35]. The ethanolic extract of Phyllanthus niruri has anti-viral potential against Hepatitis C Virus mediated via 4GAG, the presence of chemical constituent phyllantin and hypophyllantin was reported as entities behind this activity[36]. These studies reveal the anti-viral activities through inhibiting the viral multiplications, inhibiting viral binding to the cellular receptor level on HIV, HSV and Influenza virus. In silico analysis of AAK explored 16 active compounds has a high biding affinity with COVID-19 protease, it may suggest a possibility to protease inhibitory mechanism[37].

Diospyrin from Diospyros montana has been reported to have anti-inflammatory property via inhibition in mouse macrophage cell lines[38]. Asystasia gangetica extracts showed anti-inflammatory activity in mice model[39]. Potential anti-coronavirus therapies can be divided into two categories depending on the target, one acting on the human immune system or human cells and the other on coronavirus itself. AAK can deals with both immunomodulation and anti-viral therapies against SARS Cov-2 infection.

The drug AKK is possibly potent in treating SARS CoV-2 because of its antiviral properties of the plants Cuscuta reflexa, Hemidesmus indicus, Allium cepa, Citrus limon and Lageneria siceraria by the way of inhibiting viral replication. Therefore, can justify that the classical Siddha formulation may be effective in the treatment of SARS CoV-2 infection.


  Conclusion Top


The present review on AAK showed that the ingredients present in the medicine had anti-viral, antioxidant, anti-diabetic, anti-asthmatic, anti-hypertensive, anti-inflammatory and anti-viral activity against HIV. Hence this medicine might be effective even in COVID-19 patients with comorbid conditions. Further clinical studies are warranted to prove the efficacy of the drug AAK in COVID-19 symptomatic patients.



 
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