Qualitative analysis of chemical components in Lianhua Qingwen capsule by HPLC-Q Exactive-Orbitrap-MS coupled with GC-MS

The Lianhua Qingwen(LHQW) capsule is a popular traditional Chinese medicine for the treatment of viral respiratory diseases.In particular,it has been recently prescribed to treat infections caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).However,due to its complex composition,little attention has been directed toward the analysis of chemical constituents present in the LHQW capsule.This study presents a reliable and comprehensive approach to characterizing the chemical constituents present in LHQW by high-performance liquid chromatography-Q Exactive-Orbitrap mass spectrometry(HPLC-Q Exactive-Orbitrap-MS) coupled with gas chromatography-mass spectrometry(GC-MS).An automated library alignment method with a high mass accuracy(within 5 ppm) was used for the rapid identification of compounds.A total of 104 compounds,consisting of alkaloids,flavonoids,phenols,phenolic acids,phenylpropanoids,quinones,terpenoids,and other phytochemicals,were successfully characterized.In addition,the fragmentation pathways and characteristic fragments of some representative compounds were elucidated.GC-MS analysis was conducted to characterize the volatile compounds present in LHQW.In total,17 compounds were putatively characterized by comparing the acquired data with that from the NIST library.The major constituent was menthol,and all the other compounds were terpenoids.This is the first comprehensive report on the identification of the major chemical constituents present in the LHQW capsule by HPLC-Q Exactive-Orbitrap-MS,coupled with GCMS,and the results of this study can be used for the quality control and standardization of LHQW capsules.

Retrospective analysis of the efficacy of traditional Chinese medicine Lianhua Qingwen Capsule for the treatment of novel coronavirus-infected pneumonia

Objective:The aim of this study was to evaluate the clinical efficacy of traditional Chinese medicine Lianhua Qingwen Capsule(LQC)for the treatment of novel coronavirus-infected pneumonia by a retrospective analysis of confirmed COVID-19 cases,thereby providing a reference for clinical treatment.Methods:We retrospectively analyzed the clinical data of patients with confirmed NCIP treated at the Hanchuan Hospital of People’s Hospital of Wuhan University of China between January 21 and January 30,2020.A total of 32 patients were included in the treatment group,who received routine treatment plus LQC(1 packet,tid),and 32 patients were included in the control group,who received routine treatment alone.The data about response rate of respiratory symptoms were compared and analyzed between the two groups.Results:No significant between-group difference was observed in baseline data.The response rates for fever were 84.4%in the treatment group and 56.3%in the control group;for cough,the response rates were 47.8%and 7.4%in the treatment group and the control group,respectively(P<0.05).The response rates for expectoration were 71.4%in the treatment group and 11.8%in the control group;for shortness of breath,the response rates were 78.6%and 0%in the treatment group and the control group,respectively(P<0.05).The average duration of symptoms like fever,cough,fatigue and expectoration in the treatment group were shorter than that in the control group(P<0.05).There was no significant difference in the incidence rate between LQC and control group.Conclusion:Traditional Chinese medicine LQC significantly improved fever,cough,expectoration,and shortness of breath in patients with confirmed COVID-19,thereby providing preliminary evidence for clinical treatment.

Network pharmacological approach to explore the mechanisms of Lianhua Qingwen capsule in coronavirus disease 2019

Background:This study aimed to explore the molecular mechanisms of the active compounds of Lianhua Qingwen capsule in the treatment of coronavirus disease 2019 by using systemic pharmacology approach.Methods:In this study,network pharmacology methodology was applied,including active chemical component screening,target gene prediction,herbal-compound and compound-target gene network construction,gene enrichment analysis,pathway enrichment analysis and network analysis.Results:Network analysis showed that 3 bioactive ingredients(quercetin,kaempferol,AC1LIUG4)were screened as pivotal ingredients.30 target genes were identified as the anti-coronavirus disease 2019 of Lianhua Qingwen capsule.Among the targets,tumor necrosis factor,JUN(transcription factor AP-1),interleukin 6,vascular endothelial growth factor A,interleukin 1B,interleukin 2,mitogen-activated protein kinases 1 were regulated by various compounds and screened as the core genes of protein-protein interaction network.Nineteen signaling pathways screened by Kyoto Encyclopedia of Genes and Genomes pathway enrichment(P<0.05)were enriched on various inflammatory signaling pathways such as interleukin 17 signaling pathway,NF-κB signaling pathway,tumor necrosis factor signaling pathway and C-type lectin receptor signaling pathway.Conclusion:The bioactive compounds in Lianhua Qingwen capsule may have a therapeutic effect on coronavirus disease 2019 by inhibiting cytokine storms by regulating multiple inflammatory signaling pathways.

Analysis of the Real-world Efficacy of Lianhua Qingwen Capsule(莲花清瘟胶囊)in the Treatment of Upper Respiratory Tract Infection

Objective:To explore the efficacy of Lianhua Qingwen Capsule(莲花清瘟胶囊)on upper respiratory tract infection,to understand the impact of Lianhua Qingwen Capsule(莲花清瘟胶囊)on the treatment outcome of upper respiratory tract infection,and provide reference for rational clinical drug use.Methods:The HIS database based on 18 large third-grade class-A hospitals was selected to match 1:1 for upper respiratory tract infection patients using and without Lianhua Qingwen Capsule(莲花清瘟胶囊)according to certain standards.The recombination of treatment outcome as"recovery"and"improvement"in the database was defined as effective treatment,"ineffectiveness","death"and"other"as ineffectivetreatment populations,and the effectiveness of treatment outcomes in the remerged 2 groups was compared by propensity score method.Results:After matching,454 cases were in both the patients treated by(experimental group)and without(control group)Lianhua Qingwen Capsule(莲花清瘟胶囊).Analysis was performed by three Logistic regression methods,all showing regression coefficients greater than 0 and statistically significant differences(P<0.05).Conclusion:Patients with upper respiratory tract infection treated by Lianhua Qingwen Capsule(莲花清瘟胶囊)are more effective than that without Lianhua Qingwen Capsule(莲花清瘟胶囊),it can improve the clinical efficacy of patients with upper respiratory tract infection。

Deciphering suppressive effects of Lianhua Qingwen Capsule on COVID-19 and synergistic effects of its major botanical drug pairs

The COVID-19 pandemic has resulted in excess deaths worldwide.Conventional antiviral medicines have been used to relieve the symptoms,with limited therapeutic effect.In contrast,Lianhua Qingwen Capsule is reported to exert remarkable anti-COVID-19 effect.The current review aims to:1)uncover the main pharmacological actions of Lianhua Qingwen Capsule for managing COVID-19;2)verify the bioactive ingredients and pharmacological actions of Lianhua Qingwen Capsule by network analysis;3)investigate the compatibility effect of major botanical drug pairs in Lianhua Qingwen Capsule;and 4)clarify the clinical evidence and safety of the combined therapy of Lianhua Qingwen Capsule and conventional drugs.Numerous bioactive ingredients in Lianhu Qingwen,such as quercetin,naringenin,β-sitosterol,luteolin,and stigmasterol,were identified to target host cytokines,and to regulate the immune defence in response to COVID-19.Genes including androgen receptor(AR),myeloperoxidase(MPO),epidermal growth factor receptor(EGFR),insulin(INS),and aryl hydrocarbon receptor(AHR)were found to be significantly involved in the pharmacological actions of Lianhua Qingwen Capsule against COVID-19.Four botanical drug pairs in Lianhua Qingwen Capsule were shown to have synergistic effect for the treatment of COVID-19.Clinical studies demonstrated the medicinal effect of the combined use of Lianhua Qingwen Capsule and conventional drugs against COVID-19.In conclusion,the four main pharmacological mechanisms of Lianhua Qingwen Capsule for managing COVID-19 are revealed.Therapeutic effect has been noted against COVID-19 in Lianhua Qingwen Capsule.

New insights for infection mechanism and potential targets of COVID-19:Three Chinese patent medicines and three Chinese medicine formulas as promising therapeutic approaches

The coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)with high pathogenicity and infectiousness has become a sudden and lethal pandemic worldwide.Currently,there is no accepted specific drug for COVID-19 treatment.Therefore,it is extremely urgent to clarify the pathogenic mechanism and develop effective therapies for patients with COVID-19.According to several reliable reports from China,traditional Chinese medicine(TCM),especially for three Chinese patent medicines and three Chinese medicine formulas,has been demonstrated to effectively alleviate the symptoms of COVID-19 either used alone or in combination with Western medicines.In this review,we systematically summarized and analyzed the pathogenesis of COVID-19,the detailed clinical practice,active ingredients investigation,network pharmacology prediction and underlying mechanism verification of three Chinese patent medicines and three Chinese medicine formulas in the COVID-19 combat.Additionally,we summarized some promising and high-frequency drugs of these prescriptions and discussed their regulatory mechanism,which provides guidance for the development of new drugs against COVID-19.Collectively,by addressing critical challenges,for example,unclear targets and complicated active ingredients of these medicines and formulas,we believe that TCM will represent promising and efficient strategies for curing COVID-19 and related pandemics.