1. INTRODUCTION:

The outbreak of the new corona virus (SARS-CoV-2) infection is spreading to every continent; Hailing from a large family of viruses, Corona viruses can cause respiratory illnesses. As per the statistics, geriatric peoples are more susceptible for the COVID-19 infection because of their low immunity against pathogens & various underlying diseases. [1]

Covid19 is newly identified infectious disease. In 2019, December the new Coronavirus was found in Wuhan, China with a number of cases of pneumonia patients. Corona Viruses are big group classified in Nidovirales order; by use of a nested set of mRNAs virus get replicated ("nido-" for "nest") [1].

There are four genera of Coronavirus sub family: alpha, beta, gamma, and delta corona viruses. Two genera of the human corona viruses (HCoVs): alpha corona viruses (HCoV-229E and HCoV-NL63) and beta corona viruses (HCoV-HKU1, HCoV-OC43, Middle East respiratory syndrome corona virus [MERS-CoV], and the severe acute respiratory syndrome corona virus [SARS-CoV). [1]

2. COVID-19 AND IMMUNITY:

2.1 Transmission of COVID-19 (SARS-COV-2):

This virus is transferred from one individual to another by airborne droplets to the nasal mucosa. In cells of the ciliated epithelium virus get replicate and then inflammation, cell damage is caused. [3]

2.2 Spread of COVID-19:

In 2019, the Centers for Disease Control and Prevention (CDC) started monitoring outbreak of the new corona virus (SARS-CoV-2) infection is spreading to every continent [4]

2.3 Structure COVID-19:

Corona viruses are medium-sized, spherical or pleomorphic enveloped, non-segmented (single stranded) positive sense RNA Viruses associated with a nucleoprotein within a capsid comprised of matrix protein in Nidovirales Order. The envelope bears spikes like projection on surface which is made up of glycoprotein which gives the virus a characteristic crown-like appearance. [3]

3. ROLE OF IMMUNITY IN COVID-19:

A report in Lancet shows that acute respiratory distress syndrome (ARDS), a common immunopathological event for SARS-CoV-2, SARS-CoV and MERS-CoV infections is the main death cause of COVID-19, and one of the main mechanisms for ARDS is the cytokine storm. The occurrence and development of SARS-CoV-2 depend on the interaction between the virus and the individual’s immune system. Viral factors include virus type, mutation, viral load, viral titre, and viability of the virus in vitro.

Fig: 1. COVID-19 infection: the perspectives on immune responses in Cell

The individual’s immune system factors include genetics (such as HLA genes), age, gender, nutritional status, neuro endocrine-immune regulation, and physical status. These factors all contribute to whether an individual is infected with the virus, the duration and severity of the disease, and the reinfection. In the early stages of the epidemic, accurate diagnosis helps control the spread of the disease. [5]

3.1 Treatment:

As yet, effective treatment is unavailable, social distancing &boosting the body’s immune system may prevent the disease from spreading.

3.2 Immune System:

Our immune system consists of a complex collection of cells, processes, and chemicals that constantly defends our body against invading pathogens, including viruses, toxins, and bacteria. [6][7]

After an incubation period, the invading COVID-19 virus causes non-severe symptoms and elicits protective immune responses. The successful elimination of the infection relies on the health status and the HLA haplotype of the infected individual. In this period, strategies to boost immune response can be applied. If the general health status and the HLA haplotype of the infected individual do not eliminate the virus, the patient then enters the severe stage, when strong damaging inflammatory response occurs, especially in the lungs. [8]

It seems that when the body is unable to produce an adequate adaptive response against the virus, the persistent innate-induced inflammation can then lead to a cytokine storm, ARDS, and diffuse organ involvement. With aging, the population of naïve T-cells shrinks while antigen experienced, memory T-cells comprises an important portion of T-cells population. [9]

4. WHO INFECTED MORE?

The National Institutes of Health (NIH) suggest that several groups of people have the highest risk of developing complications due to COVID-19. These groups include Young children, According to WHO People aged 65 years or older get infected more because of weak immunity & According to CDC due to physiologic and immunologic changes Pregnant Women are more susceptible to viral respiratory infections, including Covid19. [10] The people more infected by Covid19 are who suffers with diseases like Chronic Respiratory disease, diabetes, Cancer, Cardiac problem. [11]

Population is generally susceptible to SARS-CoV-2, the median age was 47.0 years (IQR, 35.0 to 58.0), 87% case patients were 30 to 79 years of age, and 3% were age 80 years or older, and the number of female patients was 41.9%. Most cases were diagnosed in Hubei Province, China (75%). 81% cases were classified as mild, 14% cases were severe, and 5% were critical. The overall case-fatality rate (CFR) was 2.3%, but cases in those aged 70 to 79 years had an 8.0% CFR and cases in those aged 80 years and older had a 14.8%. [12]

Anti-tumor necrosis factor (TNF) antibodies have been identified in disease tissues of patients with COVID-19. Also there is sufficient evidence to support clinical trials of anti-TNF therapy in patients with COVID-19. [13]

Except in children and adolescents this virus infects the age group evenly and it is reported in a survey of 1000 patients in Wuhan, china. Near 15% cases progress to severe phase and 65% have big chance to progress to severe phase. [14]

5. IMMUNITY WORK:

Immunity solitary break the chain of transmission by starved pathogen of host infect, breaking chain of transmission help to protect health of humans. [15]

The division of two-phase is playing an important role: the first immune defense-based protective phase and the second inflammation-driven damaging phase. Doctors should try to increase immune responses throughout the first phase and put down it in the second phase. [14] To conclude, in populations at risk (elderly, associated co morbidities, immunosuppressed), when activation of the innate immune system fails to produce an adequate adaptive response (i.e., virus-specific CD8+ T-cells), it seems that persistent self-induced inflammation can then cause mortality. Thus, mounting an early adaptive immune response may save lives. [9]

6. CURCUMIN AND IMMUNITY:

6.1 Turmeric:

Curcumin is the main active compound in turmeric. It has powerful anti-inflammatory properties, and animal studies indicate that it may help improve immune function. [16]

6.2 Chemistry:

6.3 Curcumin as Immunity Boosters

Hot milk is given with turmeric because it helps respiratory system to stay healthy. [17]

Curcumin has positive effects on numerous disease conditions in patients and in animal systems.

The terminal stage of viral diseases is often the onset of a cytokine storm, the massive overproduction of cytokines by the body’s immune system. The suppression of cytokine release by Curcumin correlates with clinical improvement in experimental models of disease conditions where a cytokine storm plays a significant role in mortality. [18]

Curcumin regulates inflammatory cytokines such as IL-1 beta, IL-6, IL-12, TNF-alpha and IFN gamma and associated JAK-STAT, AP-1, and NF-kappa signaling pathways in immune cells. [19]

As Curcumin (diferuloylmethane), a component of turmeric (Curcuma longa) can block TNF-α action and production in in-vitro models, in animal models and in humans. [20]

Curcumin was shown inhibitory properties for SARS-CoV in the range of 3–10µM. [21]

A study shown significant decreases in all markers of inflammation (soluble CD40 ligand (sCD40L), interleukin 1 beta (IL-1β), interleukin 6 (IL-6), soluble vascular cell adhesion molecule 1 (sVCAM-1), and erythrocyte sedimentation rate (ESR) comparing baseline to follow-up, while the control group did not. [22]

A molecular docking study with the aim to examine several medicinal plant-derived compounds that may be used to inhibit the COVID-19 infection pathway found the Curcumin molecule have good affinity, and low binding energy with low inhibition constant, this study also conclude that demethoxycurcumin, curcumin’s related compound, have stronger affinity than the Curcumin molecule. [23]

Therefore, we suggested that demethoxycurcumin and Curcumin are few of the most recommended compounds found in medicinal plants that may act as potential inhibitors of COVID-19. [23]

7. DOSE OF CURCUMIN:

Dose study of Curcumin shows that Curcumin not show any toxic affect if consume 12g/day over 3 months. [24] According to other studies dose of 1,200–2100 mg of Curcumin per day for 2-6 weeks there is no toxic or adverse effect occurs. [25][26]

8. CONCLUSION:

Whole world is in a great trouble nowadays due to the pandemic of COVID-19, which is a highly contagious viral infection causing severe respiratory discomfort & even death in some cases. Significantly high blood plasma levels of inflammatory cytokines such as IL-1 beta, IL-6, IL-12, TNF-alpha etc were found in patients with COVID-19 infection. The severity of this corona virus infection was found to be too high in peoples of old age and/or of immune-compromised once. In this review, we suggest that the boosting of immune system may found helpful in the prevention of COVID-19 infection. We also present Curcumin, a turmeric phyto-chemical, as a potent immune-booster as well as an anti-inflammatory agent, which also proved its affinity in a molecular docking study.

9. REFERENCES:

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Received on 13.05.2020 Modified on 21.05.2020

Res. J. Pharmacognosy and Phytochem. 2020; 12(3):174-177.

DOI: 10.5958/0975-4385.2020.00029.1