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Peruvian Medicinal Plants and Cosmopolitan Plants with Potential use in the Treatment of Respiratory Diseases and COVID-19

Article Information

Guillermo E. Delgado-Paredes1,2*, Paulo R. Delgado-Rojas3, Consuelo Rojas-Idrogo1,2

1Laboratory of Plant Tissue Culture and Genetic Resources - Faculty of Biological Sciences, Pedro Ruiz Gallo National University, Lambayeque (Peru)

2General Laboratory of Biotechnology - Vice-Rector's Office for Research (UNPRG)

3Faculty of Medicine, San Martín de Porres University, North Branch (Chiclayo), Peru

*Corresponding Author: Guillermo E. Delgado-Paredes. General Laboratory of Biotechnology, Vice President for Research (UNPRG), Atahualpa 423, Lambayeque, Peru

Received: 11 May 2021; Accepted: 19 May 2021; Published: 24 May 2021

Citation: Guillermo E. Delgado-Paredes, Paulo R. Delgado-Rojas, Consuelo Rojas-Idrogo. Peruvian Medicinal Plants and Cosmopolitan Plants with Potential use in the Treatment of Respiratory Diseases and COVID-19. International Journal of Plant, Animal and Environmental Sciences 11 (2021): 295-321.

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Abstract

The SARS-CoV-2 pandemic, responsible for COVID-19, has caused more than 157 million infections and more than 3.2 million deaths. A short-term solution is the production of vaccines that confer temporary or permanent immunity. However, the genetic variants of the virus, with greater contagion and lethality capacity, the economic limitations of many countries in the world to acquire vaccines, the limited and controversial effectiveness of the drugs tested, the logistical problems of conservation and distribution of vaccines, among others, lead to proposing and developing other alternatives. One of these alternatives is the use of medicinal plants, especially those plants traditionally used in the treatment of respiratory tract diseases, both in Peru and the world, without risks or collateral problems for the human being and validated with phytochemical and ethnopharmacological studies. The flora of Peru is particularly rich in these species and even more so in endemic species, potentially useful against SARS-CoV-2. The aim of this review is to highlight some Peruvian medicinal plants and species introduced and commercialized in Peru (Cosmopolitan species) potentially useful in the treatment of respiratory diseases and COVID-19.

Keywords

Antiviral activity; Cosmopolitan plants; COVID-19; natural products; Peruvian medicinal plants; respiratory diseases

Antiviral activity articles; Cosmopolitan plants articles; COVID-19 articles; natural products articles; Peruvian medicinal plants articles; respiratory diseases articles

Article Details

1. Introduction

The SARS-CoV-2 pandemic, the coronavirus that causes COVID-19, which originated in 2019 in Wuhan (China), has caused more than 157 million infections to date (May 7, 2021) and more than 3.2 million deaths [1]. The efforts made by various academic institutions and private laboratories around the world in the search for an efficient vaccine to combat the disease have been commendable [2,3]. Several of these vaccines have shown an immune efficiency greater than 90%, which has been quite significant [4-6]. However, the appearance of new genetic variants of the virus such as the British (14 December 2020), South African (18 December 2020), Japanese (09 January 2021), and Brazilian (12 January 2021) variants [7], which are attributed a greater infectious capacity and possibly greater lethality, have generated uncertainty in the international scientific community about the efficacy of such vaccines and the time of immunological protection that they can confer. The entire genome of SARS-CoV-2 viral strains circulating worldwide has been suggested to involve high heterogeneity [8,9].

Despite the large number of ultimate generation drugs tested in the treatment of SARS-CoV-2 such as remdesivir, favipiravir (= favilavir), lopinavir, ritonavir, among others [10], none of these have shown absolute efficacy to the point that it can be applied to a standardized treatment. In addition, many people have been conducted to use some drugs indiscriminately, even without a prescription, which may cause more harm than good to health [11,12]. Drugs like ivermectin, hydroxychloroquine, azithromycin, dexamethasone, and paracetamol have been widely published. Is possible that this disorderly form of medication, the diverse geographic environments where the virus is spreading and other factors yet to be investigated, are determining the apperance of more genetic variants of the virus.

It exits enormous asymmetry about the distribution of vaccines in the world to the detriment of countries with very poor, underdeveloped or developing economies to the point that, until February 2021, only ten countries considered first world have monopolized 90% of world vaccine production (Israel, United Kingdom, United States, Spain, Italy, Germany, Belgium, France, Canada and Netherlands) [13]. On the other hand, some vaccines need the protection of a cold chain of up to -50 oC, which implies having sophisticated refrigeration equipment; in addition, the vast majority of vaccines require up to two application doses in a three-week interval, making it difficult to apply a second dose in itinerant populations. The presence of many populations far from the main populated centers such as high-Andean and jungle populations of Peru and other countries of the world with similar geography, the mass vaccination process would be very complicated to apply massive vaccination.

Numerous ethnobotanicals and ethnopharmacological studies have demonstrated the potential of plant species in the treatment and cure of numerous diseases that afflict humans since their origins and currently against COVID-19 [14,15]. However, in most of these studies plants of Asian and European origin have been used and in no case South American plants [15]. A notable example is traditional Chinese medicine [16-18] and traditional Indian medicine [19] in the treatment of respiratory tract diseases. In these compositions, the curative potential of most of these plants was validated with numerous phytochemical and pharmacological studies [15]. The discovery of numerous secondary metabolites with potent antiviral activity against SARS-CoV-2 [20-22] have opened a new horizon of hope in the treatment of this disease.

Given this, the use of medicinal plants, mainly used in traditional Peruvian medicine of the ancestral peoples of the coast, mountains and jungle of Peru, in the treatment of respiratory diseases, would be an important alternative, if we consider that the flora of Peru registers more of 22,000 species and many of these endemic [23, 24]. In addition to this, the great diversity of secondary metabolites of medicinal plants would make it very difficult for SARS-CoV-2 (COVID-19) to generate resistance and consequently genetic variations, and the use of hetergeneous plant extracts to induce a synergistic effect over some specific organism [25]. Likewise, the appearance of other viral forms of the coronavirus family should be considered, as has already happened with the Severe acute respiratory sindrome (SARS), in february, 2003 [26] and Middle east respiratory syndrome coronavirus (MERS-CoV), in june, 2012 [27].

Because of the afore mentioned reasons, the objective of this review is to emphasize the importance of Peruvian medicinal plants and numerous cosmopolitan species in the treatment of SARS-CoV-2, based in the use of some plant compositions, with high content of secondary metabolites, which may be ingested as decoction, especially by rural and native populations, without risk to health, thus contributing to the solution of a serious health problem that involves all of humanity.

2. Methods

The method used was the review of relevant literature on the plant species used in traditional Peruvian medicine and species of cosmopolitan distribution and use. Likewise, it is worth highlighting the plant species studied phytochemically and pharma-cologically, due to the presence of secondary metabolites with antiviral effect, especially against respiratory tract diseases and SARS-CoV-2. In most cases the Scopus database was use with articles published between 2010 to 2020, and articles published between 1993 to 2010 on the flora of Peru and medicinal plants. In this way, the authors prepared a list of plant species that can be used to prepare decoction for the initial and preventive treatment of SARS-CoV-2 and eventually to strengthen the immune system of rural and native populations.

3. Results

A list of introduced and naturalized, commercialized, and native plants, which contain secondary metabolites with potential use in the treatment of respiratory tract diseases and against SARS-CoV-2 (COVID-19), is show in table 1.

Plant species/Family

Biological activities/

[Traditional use]

Secondary metabolites

References

Alnus spp./Betulaceae

(as A. japonica)

Several biological activities

Hirsutenone

[28, 29]

Alnus acuminata ssp. arguta

[Anti-inflammatory]

Triterpenoids and diarylheptanoids

[30]

A. acuminata (Aliso blanco and aliso colorado, aliso andino)

[Cold]

Bark, fresh

[31, 32]

Allium cepa/Alliaceae

(Onion)

Plant lectin: Allium cepa agglutinin (ACA)

[33]

Allium sativum/Alliaceae

(Garlic)

Quercetin

[34]

A. sativum/Alliaceae

Allyl disulfide and allyl trisulfide

[35]

Baccharis latifolia/Asteraceae

(chilca)

[Soothe cough and bronchitis]

Limonene, b-hellandrene, sabinene, β-pinene and α-pinene

[36-38]

Bursera graveolens/Burseraceae

Burseranin,

picropolygamain,

lupeol and epi-lupeol

[39]

B. graveolens (Palo santo)

[Cough, flu, bronchitis, Cold]

Stems, bark and Wood, dried

[31, 32]

B. graveolens (Palo santo)

Antimicrobial activities

α-Terpinene and others (essential oil)

[40]

Capparicordis crotonoides

(= Capparis crotonoides)/Capparaceae

(satuyo, yunto)

[Bronchites, cold, colds]

flowers, fresh

[31]

Cinchona officinalis; C. pubescens/Rubiaceae

(cascarilla, quinuagiro)

[Colds, cough]

flowers and leaves, dried; bark

[31, 32, 41]

C. officinalis

Chloroquine and hydroxychloroquine

[42]

Citrus x aurantifolia

(= C. aurantifolia)/Rutaceae

(Lemon tree, limón criollo or limón sutil)

Antimicrobial, anti-infammatory, anti-cancer, anti-asthmatic and antioxidant properties

Alkaloids, coumarins, essential oils, flavonoids and triterpenoids. Citrus oil: Limonene, β-pinene, γ-terpinene, citral, and others

[43]

C. aurantifolia

Klebsiella pneumoniae, Pseudomonas sp., Staphyloccocus aureus, Aspergillus niger, and Mucor spp.

Leaf extract

[44]

C. sinensis

SARS-CoV-2: Against protein S and viral replication

Hesperidin

[45]

C. aurantifolia

SARS-CoV-2: ACE2 inhibitor

Essential oils: Limonene

[46]

C. aurantifolia

Immunomodulatory, anti-inflammatory, and antiviral properties

Essential oils: Limonene

[47]

Coffea arabica/Rubiaceae (cafeto)

Inhibitors of SARS-CoV-2

Khainaoside C, 6-O-Caffeoylarbutin, khainaoside B, khainaoside C and vitexfolin A

[48]

C. arabica

Caffeine, theobromine and trigonelline

[49]

Cordia alliodora/Boraginaceae (Laurel)

[Bronchitis]

Bark and stems, dried

[31]

C. alliodora/Boraginaceae (Laurel)

Antimicrobial

[Tonic to treat pulmonary disorders]

Several hydroquinones as alliodorin and alliodorol, and triterpenoids

[50-53]

Erythroxylon coca/Erythroxylaceae (coca)

[Cold, cough, inflammation of the throat]

Leaves, dried

[31]

E. coca

Cocaine, and other tropanes

[54]

Eucalyptus globulus/Myrtaceae (eucalipto)

[Asthma, bronchitis, cold, cough, respiration, sinusitis]

Leaves, dried

[31, 41]

E. globulus

Anti-inflammatory, anti-bacterial, anti-viral activities

[55]

E. globulus

[Bronchitis, cold, cough, catarrh of the upper respiratory tract]

1,8-cineole, α-pinene and camphor

[56]

Juglands neotropica

 (= J. nigra)/Juglandaceae (Nogal)

[Asthma, bronchitis, cough]

Leaves, fresh

[31, 32, 41]

J. neotropica

In vitro antioxidant capacity, and in vitro/in vivo hypoglycemic activity

Pyran compounds, and phenols

[57]

Lablad niger

(=Dolichos lablad) /Fabaceae

(chileno, zarandaja, yunya)

[Protects the lungs]

Fruits, fresh

[31]

Medicago sativa/Fabaceae

(alfalfa)

[Bronchitis]

flowers and leaves, extracts

[31]

Melilotus alba/Fabaceae

(alfalfilla)

[Colds, respiratory infections, tuberculosis]

Seeds extracts

[31]

Nicotiana tabacum/Solanaceae (tabaco)

Plant lectin: Nictaba

[58]

Piper aduncum/Piperaceae

(Matico, hierba del soldado, nudillo, cordoncillo)

[Bronchitis, chills, cold, cough, tuberculosis, pharyngitis, pneumonia]

Leaves, fresh or dried

[31, 32, 41]

P. aduncum/Piperaceae

Monoterpenoids, sesquiterpenoids, phenylpropanoids, and others

[59-62]

Pelargonium graveolens/Geraniaceae

(Geranium or geranio)

SARS-CoV-2: ACE2 inhibitor

Essential oils: Citronellol, geraniol and neryl acetate

[46]

Pelargonium spp.

[Used in traditional medicine in various countries]

Monoterpenes, sesquiterpenes, coumarins, tannins, phenolics acids, cinnamic acids, flavones, flavonoids and flavonols derivatives

[63]

Plantago linearis/Plantaginaceae (Llantén serrano)

[Bronchitis, cough]

Roots, fresh

[31, 41]

Plantago major/Plantaginaceae (Llantén)

[Bronchitis, cough]

Seeds, fresh or dried

[31, 32, 41]

P. major

[Tonic, diuretic and coughs mixture]

[64]

P. major

Anti-

herpes and anti-adeno virus activities

Caffeic acid and chlorogenic acid

[65]

P. major

Wound

healer, antiulcerative, antidiabetic, anti-inflammatory, anti-

bacterial, and antiviral agent

flavonoids, alkaloids, terpenoids, and others

[66]

Prosopis pallida

(= P. limensis)/Fabaceae

(algarrobo)

[Bronchitis, cough]

Seeds, dried

[31, 41]

Prosopis limensis

[Bronchitis, cough, expectorant, flu]

[67]

Psittacanthus linearis/Loranthaceae (suelda con suelda)

[In the treatment of respiratory diseases]

Kaempferol,

quercetin

[68]

Sambucus nigra/Adoxaceae

(sauco)

[Inhibit infectious bronchitis virus]

[69]

Salix chilensis

(= S. humboltiana)/Salicaceae

(sauce)

[Colds]

Leaves, fresh

[31, 32, 41]

Schinus molle/Anacardiaceae (molle)

[Bronchitis, chills, cold cough]

Used topically (cream or ointment)

flowers, leaves and stems, fresh

[31, 32]

Urtica dioica/(Urticaceae)

(ortiga)

Plant lectin: Urtica dioica agglutinin (UDA)

[70, 71]

U. dioica

[In the treatment of asthma,

expectorant,

respiratory problems, and others]

flavonoids: kaempferol, isorhamnetin, quercetin,

isoquercitrin, astragalin, and rutin

Phenolics: phenylpropanes, caffeic acid, chlorogenic

acid and scopoletin)

[72]

Viscum album/Viscaceae

(mistletoe)

Plant lectin: ML III inhibitor of SARS-CoV

[70]

Zingiber officinale/Zingiberaceae (Ginger or kión)

SARS-CoV-2

[73]

Z. officinale

Diallyl-disulfide

[74]

Z. officinale

Citral

[75]

Z. officinale

Antiviral activity against human respiratory syncytial virus

[76]

Table 1: Secondary metabolites and plant extracts from Peruvian medicinal plants and cosmopolitan plants with potential use in the treatment of respiratory diseases and COVID-19.

3.1 Peruvian, native, and endemic plant species

Hirsutenone, an active diarylheptanoid isolated from Alnus japonica (Thunb.) Steud., A. hirsuta, A. pendula, A. nepalensis, A. glutinosa, A. firma, A. formosana and A. acuminata, showed remarkable inhibitory effect to papain-like protease of SARS-CoV-2, and catechol and α, β-unsaturated carbonyl moiety may be responsible for the inhibitory activity [28]. In A. acuminata ssp. arguta Spach, seven triterpenoids and five diarylheptanoids were isolated and characterized. The authors indicated that stem bark infusions of this species is used in the treatment of acute inflammations in traditional Mexican medicine [30]. Alnus acuminata (aliso andino) is a species of forest importance widely distributed in the Andes from South America to Mexico. In traditional Peruvian medicine, it is used as an anti-inflammatory and colds [31, 32].

 Baccharis latifolia (R.&P.) Pers. (chilca, chilco), is an Asteraceae native to South America, widely distributed in the Andean region. The decoction of leaves and flowers is used in traditional medicine in the treatment of soothe coughs and bronchitis [36] The main compounds identified in the aerial part of B. latifolia are limonene, b-hellandrene, sabinene, β-pinene and α-pinene [37]. A brief review on phytochemical and therapeutic use of B. latifolia has been published by Sequeda-Castañeda et al. [38]. Other Baccharis species such as B. genistelloides (Lam.) Pers. (carqueja), B. latifolia and B. vacciniifolia Cuatrec. (asmachilca) are used in traditional Peruvian medicine in the treatment of bronchial asthma, cough, flu and colds, as a bronchodilator and expectorant [32, 41].

Burseranin, a new aryltetralin lignan, and picropolygamain were isolated in stem extracts (resin and oils) from Bursera graveolens (Kunth) Triana & Planch., together with the already characterized triterpenes, lupeol and epi-lupeol [39]. A comprehensive review on ethnopharmacological, phytochemical and pharmacological aspects of lignans from Mexican Bursera spp. was carried out by Marcotullio et al. [77]. In another study using the essential oils extracted from fallen branches of B. graveolens, moderate to high biological activities against Staphilococcus aureus, Bacillus cereus, Listeria monocytogenes, Clostridium perfringens, Escherichia coli, Salmonella choleraesuis and Candida albicans [40]. The most abundant compound in the essential oil was α-Terpinene and isocaryophillene. In traditional Peruvian medicine B. graveolens is used for respiratory tract diseases such as asthma, cough, flu, bronchitis and cold [31, 32].

One of the most successful studies in the treatment of diseases using plants has been the case of malaria with the alkaloid quinine, obtained from the bark of Cinchona officinalis L., and that currently the structural analogues of quinine, Chloroquine (Cq) and hydroxychloroquine (Hcq), in combination with azytromycin, have been reported to be more effective against SARS-CoV-2 by reducing viral load [42]. In traditional Peruvian medicine C. officinalis is used in the treatment of coughs and colds [31, 41] and C. pubescens Vahl is used in the treatment of chronic cold and flu [32].

Decoction prepared from Cordia alliodora (R.&P.) Oken leaves is being used traditionally in Tropical America (from Mexico to Argentina) as tonic to treat pulmonary disorders [78]. Several hydroquinones were isolated from heartwood [50] and terpenoids from leaves [51]. Likewise, the ethanol extract of stem bark showed antimicorbial activity against Enterococcus faecalis, Pseudomonas aeruginosa, Candida albicans, and other microorganisms [52]. In traditional Peruvian medicine C. alliodora is used in bronchitis treatment [31].

Coca leaves, obtaine from Erythroxylum coca Lam., contain the highest amounts of cocaine alkaloid and other tropanes [78], and in traditional medicine is utilized for a wide variety of conditions as digestive maladies, altitude sickness, and sexual impotence [79]. An interdisciplinary review of the Erythroxylum genus has recently been published [54]. In traditional Peruvian medicine E. coca is used in cold, cough, and throat inflammation [31].

In the “nogal peruano” or “Peruvian walnut” (Juglands neotropica Diels) it was determined that the lyophilized extract of dried leaves does not show any toxicit, it has good in vitro antioxidant capacity and in vitro/in vivo hypoglycemic activity [57]. A comprehensive review on the chemical constituents and functional uses of walnut (Juglands spp.), especially Juglands regia L. (Persian or English walnut), the most important member of the Juglands genus, has recently been published [80]. In traditional Peruvian medicine J. neotropica is used in the treatment of lung diseases such as asthma, cough and bronchitis [31, 32, 41].

Other American species such as Nicotiana tabacum L. (tobacco), in addition to numerous secondary metabolites, present a group of proteins that show homology to the N. tabacum agglutinin or Nictaba, referred to as “inducible” lectins, and that are expressed after exposure of the plant to different stress and changing environmental conditions [81]. This tobacco lectin, that is the prototype of the familiy of Nictaba-related proteins, is expressed in leaves of N. tabacum induced by the plant hormone jasmonic acid methyl ester (JAME), being absent from untreated plants [58]. Nictaba is markedly active against the SARS-CoV with a selectively index of >59 [71]. Even though in traditional Peruvian medicine it is not used in the treatment of respiratory diseases, due to the presence of lectins it has a potential use against COVID-19.

In Neotropical species of Piper, nine different chemotypes of P. aduncum L. have been characterized, with significant differences in the content of dillapiole (31.5% to 97.3%) [60, 61] and the terpenoid compounds such as (E) -nerolidol and linalool [59]. In P. aduncum leaves, high variability has been observed in essential oils, depending on the collection sites (Ecuador, Cuba, Panama, Bolivia, and other countries), especially in the content of monoterpenoids, sesquiterpenoids or phenylpropanoids [61]. Furthermore, the Yaneshas tribe in the Peruvian Amazon used teas and steam baths from the P. aduncum leaves for general infections and fever [82]. A comprehensive review on their phytochemistry, biological activities and applications on Piper species has recently been published by Salehi et al. [62]. In traditional Peruvian medicine P. aduncum is used in the treatment of cold, cough, bronchitis, chills, pharyngitis, pneumonia, and tuberculosis [31, 32, 41].

Fruits and seeds of Prosopis limensis (Humb. & Bonpl. ex Willd.) Kunth (=P. pallida), algarrobo or carob tree, have been used in traditional medicine in the treatment of cough and bronchitis [31]. In the traditional medicine of Mórrope (Lambayeque), one of the most ancient indigenous peoples of northern Peru, the algarrobo bark is used as an infusion in the treatment of coughs and bronchitis. The Prosopis species are highly effective in asthma, expectorant, fever, flu, and other diseases as diabetes, malaria, rheumatism and stomachache, mainly due to their content of C-glycosyl flavones such as schaftoside, isoschaftoside, vicenin II, vitexin and isovitexin [67]. They also contain the flavonoids: apigenin, luteolin, quercetin and kaempherol, and the phenolic acids: gallic, hydroxybenzoic, chlorogenic, ferulic, caffeic and coumaric acids [67].

In the traditional medicine of the indigenous communities of the Lambayeque region (Peru) “suelda con suelda” [Psittacanthus linearis (Killip) J.K. Macbride], a hemi-parasitic species of the Loranthaceae family, is used as an anti-inflammatory in the treatment of respiratory tract diseases. The main isolated and characterized chemical compounds are kaempferol and quercetin [68]. Other Loranthaceae species such as Loranthus acaciae Zucc., native to Saudi Arabia, have shown anti-diabetic, anti-inflammatory and antioxidant activity [83].

The literature does not record studies on phytopharmacological aspects and medicinal properties of Salix chilensis Molina. However, a study carried out in S. aegyptiaca L. has been shown to have antioxidant, anxiolytic activity and hypocholestroline effect, due to the high amounts of phenols and flavonoids such as gallic acid, caffeic acid, myricetin, catechin, quercetin as well as salicin, reported from the leaves [84]. Caffeic acid derivatives (CAFDs) have recently been reported as inhibitors of SARS-CoV-2 [48]. In traditional Peruvian medicine S. chilensis (= S. humboltiana Will.) is used in the treatment of cold, fever and flu [31, 32, 41].

Likewise, the literature does not record studies on phytopharmacological aspects and medicinal properties of Schinus molle L. However, several studies have demonstrated various biological effects of the Schinus areira L. as analgesic, anti-inflammatory, anti-rheumatic, antimicrobial, antispasmodic, and anti-depressive [85]. This species was considered a variety of S. mole but is currently considered a different species. In traditional Peruvian medicine S. molle is used in the treatment of bronchitis, cough, cold and chills, but only as a rub (topical use) [31, 32], as well as in throat inflammation (gargle) [41].

In a docking study of flavonoids derivatives (quercetin, catechin, naringenin, luteolin, hispidulin, vitexin, chrysin and kaempherol) as potent inhibitors of influenza H1N1 virus neuraminadase (NA), the results indicated that these compounds may effectively block the NA active site [86]. In this regard, it has been indicated that the species Salvia sagittata Ruiz & Pav, Alcea rosea L, Cinchona officinalis, Allium cepa L, Sambucus peruvianus Kunth, flaveria bidentis (L.) Kuntze Juglands nigra L, Tessaria integrifolia L, Ocimum basilicum L, Crescentia cujete L, Begonia fischeri Schrank and Cantua buxifolia Juss. ex Lam, which contain quercetin and/or kaempherol [41], can be used in the treatment of influenza and potentially in the treatment of COVID-19.

Among all these species, we highlight F. bidentis (matagusano), an Asteraceae traditionally used in Peruvian medicine as antiparasitic and bronchial diseases and cough, mainly in children [31, 41], detecting tannins, flavonoids, leucoanthocyanidins, steroids and triterpenoids in inflorescences, stems, leaves and roots [87]. T. integrifolia (pájaro bobo), is another Asteraceae used in traditional Peruvian medicine for the treatment of respiratory diseases such as asthma and cough, acting as a febrifuge, anti-inflammatory, antimicrobial and expectorant [32, 41]. Likewise, showed a stronger antioxidative activity, due to the effect of phenolic compounds, flavonoids, lignans and caffeoly quinic acid [88]. C. cujete (calabash, huingo, tecomate or tutumo) is an American Bignoniaceae traditionally used in the treatment of colds, bronchitis, cough, and asthma, observed in the fruit’s compounds similar to saponins, flavonoids, cardenolides, tannins and phenol [89]. Alcea rosea (syn. Althaea rosea) (malva real or malvarrosa), is a Malvaceae of unknown origin, widely distributed in America, Europe, Asia and Australia, whose flavonoids (dihydrokaempherol, apigenin, kaempherol-3-O-β-d-glucopyranoside, and others) have shown immune stimulant, antioxidant, and cytotoxic activities on hepatocellular carcinoma HepG-2 cell line [90]. In Peruvian traditional medicine A. rosea is used in the treatment of cough [31,41], and in traditional medicine of other countries, fruits and leaves are used in the treatment of cough, asthma, bronchitis, and fever, presenting as main compounds cyclohexanol, limonene, phellandrene and β-sitosterol [91]. Likewise, C. buxifolia (kantuta) is a shrub of the Polemoniaceae family and is the national flower of Peru. The flowers are used as an infusion in the treatment of throat inflammation due to its quercetin content [41].

In general, in addition to the afore mentioned plants, traditional Peruvian medicine used numerous plant species, both native and introduced, in the treatment of various diseases of the respiratory tract: fever, cough, sore throat, flu, cold, pneumonia, whooping cough, and pulmonary diseases. These species are as follows: Abelmoschus moschatus (L.) Medik. (mishumurillo), Achyrocline alata (Kunth) DC. (ishpingo), Adiantum digitatum Hook. (culantrillo de pozo), Adiantum poiretti Wikström (culantrillo de pozo), Aloe vera (L.) Burm. (sábila), Aloysia citriodora Paláu (cedrón), Alternanthera porrigens (Jacq.) Kuntze (lancetilla), Ambrosia peruviana Willd. (altamisa), Aniba roseadera Ducke (palo de rosa), Apium graveolens L. (apio), Argemone subfusiformis Owbn. (cardo santo), Baccharis genistelloides (Lam.) Pers. (carqueja), Baccharis vacciniifolia Cuatrec. (asmachilca), Bidens pilosa L. (amor seco), Bixa orellana L. (achiote), Borago officinalis L. (borraja), Buddleja polycephala Kunth. (flor blanca), Caesalpinia spinosa (Molina) Kuntze (tara), Calceolaria linearis Ruiz & Pav. (globito), Celtis iguanae (Jacq.) Sarg. (palo blanco), Centrum hediondinum Dun. (yerba santa), Cestrum auriculatum L’Hér. (yerba santa), Chenopodium ambrosioides L. (paico), Chuquiraga jussieui J.F. Gmel. (amaro – huamanpinta), Cocos nucifera L. (coco), Copaifera paupera (Herzog) Dwyer (copaiba), Costus erythrocoryne Jacq. (caña agria), Crescentia cujete (huingo), Croton lechleri Müll.-Arg. (sangre de grado), Cymbopogon citratus (DC.) Stapf (hierba luisa), Cyphomandra betaceae (Cav.) Sendtn (berenjena), Desmodium molliculum (Kunth) DC. (pie de perro), Dodonaea viscosa Jacq. (chamana), Ephedra americana Humb. & Bonpl.) ex Willd. (diego lópez), Eryngium foetidium L. (sachaculantro), Equisetum giganteum L. (cola de caballo), Fuchsia ayavacensis Kunth (concha lay), Galvesia fruticosa J.F. Gmel. (curil), Gentianella thyrsoidea (Hook.) Fabris (hercampuri), Gynerium sagittatum (Aubl.) P. Beauv. (caña brava), Isetia krausei Standl. (azarcito), Krameria lappacea (Dombey) Burdet & B.B. Simpson (rataña), Laccopetalum giganteum (Wedd.) Ulbr. (pacra pacra), Lantana glutinosa Poepp. (maestranza), Lantana scabiosaefolia Kunth. (mastrando), Lavandula angustifolia Mill. (alucema), Lepechinia meyenii (Walp.) Epling (salvia de jalca), Linum prostratum Domb. ex Lam. (canchalagua), Lippia alba (Mill) N. E. Br. ex Britton & P. Wilson (mastrante), Lobelia decurrens Cav. (contoya), Malachra alceifolia Jacq. (malva), Maytenus macrocarpa (Ruiz & Pav.) Briq. (chuchuhuasi), Mentha piperita L. (menta), Momordica charantia L. (balsamina), Muehlenbeckia tammifolia Meisn. (mullaca), Musa spp. (plátano), Myrcianthes discolor (Kunth) McVaugh (lanche), Nicandra physaloides (L.) Gaertn. (capulí cimarrón), Niphidium crassifolium (L.) Lellinger (lengua de ciervo), Ocimum basilicum L. (albahaca), Opuntia ficus-indica (L.) Mill. (tuna), Passiflora tripartita (Juss.) Poir. (poro poro), Peperomia hartwegiana Miq. (congona), Perezia multiflora (Bonpl.) Less. (escorzonera), Persea americana Mill. (palto), Phyllanthus niruri L. (chanca piedra), Physalis angulata L. (bolsa mullaca), Physalis peruviana L. (capulí), Picrosia longifolia D. Don (chicoria), Piper nigrum L. (pimienta negra), Pluchea chingoyo (Khunt) DC. (toñuz, párrano), Plumbago scandens L. (pega pega), Polypodium decumanum Willd. (cotochupa), Portulaca oleracea L. (verdolaga), Prunus serotina Ehrh. (capulí), Rorippa nasturtium-aquaticum Rorippa nasturtium-aquaticum L. (berro blanco), Rubus robusta C. Presl. (zarzamora), Ruta graveolens L. (ruda), Salvia sagittata Ruiz & Pav. (salvia real), Satureja sericea (C. Presl. ex Benth.) Briq. (macho romero), Senecio canescens (Bonpl.) Cuatrec. (vira – vira), Senecio tephrosioides Turcz. (huamanripa), Solanum tuberosum L. (papa), Sonchus oleraceus L. (cerraja), Stachis arvensis (L.) L. (supequehua), Tagetes elliptica Sm. (culantrillo serrano), Tagetes erecta L. (flor de muerto), Tagetes filifolia Lag. (anisquehua), Theobroma cacao L. (cacao), Thymus vulgaris L. (tomillo), Trifolium repens L. (trébol blanco), Tropaeolum majus L. (mastuerzo), Uncaria guianensis (Aubl.) J.F. Gmel (uña de gato), Uncaria tomentosa (Willd. ex Schult.) DC. (uña de gato), Verbena littoralis Kunth (verbena), Verbena officinalis L. (verbena negra), Zea mays L. (maíz), and others [92,31,32,93,41].

3.2 Plant species introduced, naturalized, and commercialized in Peru (Cosmopolitan species)

Citrus x aurantifolia or Citrus aurantifolia (Christm.) Swingle. (lemon tree, limón criollo or limón sutil) is a species widely cultivated on the north coast of Peru and widely used in the preparation of “ceviche” (typical Peruvian food with marine fish and lemon). Its medicinal importance is due to a large number of secondary metabolites such as alkaloids, coumarins, essential oils, flavonoids and triterpenoids. Likewise, for its numerous antimicrobials, anti-infammatory, anti-cancer, anti-asthmatic, and antioxidant medicinal properties [43]. In other studies, the in vitro antimicrobial activity of C. aurantifolia leaf extracts have been demonstrated in Klebsiella pneumoniae, Pseudomonas sp., Staphyloccocus aureus, Aspergillus niger, and Mucor spp. [44]. A recent study carried out in orange fruits (C. sinensis) has shown that among the flavonoids it contains, hesperidin binds to the key proteins of the SARS-CoV-2, and both protein S and with the main protease that transforms the early proteins of the virus, pp1a and pp1b, into the complex responsible for viral replication [45]. In addition, it has been confirmed by immunoblotting and qPCR analysis that lemon (C. aurantifolia) oils possess potent ACE2 (angiotensin-converting enzyme 2) inhibitory effects, highlighting the presence of limonene [46]. On the other hand, in-silico studies have shown that limonene, a dietary terpene of natural origin, has activity on viral proteins, which is why it has been suggested to be better studied in research on COVID-19, due to its immunomodulatory, anti-inflammatory, and antiviral properties [47].

A library of 27 caffeic-acid derivatives (CAFDs) was screened against 5 proteins of SARS-Co-2 (COVID-19 MPro, Nsp15, SARS-CoV-2 spike S2 subunit, spike open state and closed state structure) observing Khainaoside C, 6-O-Caffeoylarbutin, khainaoside B, khainaoside C and vitexfolin A as potent modulators of COVID-19. Also, Calceolarioside B, a pan inhibitor, showing strong although specific molecular interactions [48]. In addition, Coffea arabica L. plants contain two different kinds of alkaloids: The purine alkaloids caffeine (1,3,7-N-trimethylxanthine) and theobromine (3,7-N-dimethylxanthine), and the pyridine alkaloid, trigonelline (1-N-methylnicotinic acid) [49].

The pharmacological and clinical activity of Eucaliptus globulus Labill. include anti-inflammatory, anti-bacterial and anti-viral activities with direct activity on the respiratory tract, the coughing reflex, and the airflow in the nasal tract [55]. Likewise, Eucalyptus oils (0.5-3.5%), obtained from the fresh leaves or the fresh terminal branchlets of various species of Eucalyptus as E. globulus have as main component 1,8-cineole (> 70%), α-pinene and camphor, and the primary use of eucalyptus oil includes the treatment of bronchitis, cold, cough, and other respiratory tract diseases [56]. E. globulus is widely used as a medicinal plant in Peru in the treatment of bronchitis, respiration, cold, cough, flu, sinusitis and asthma [31, 41].

Medicago sativa L., commonly known as the "father of all foods" (alfalfa), is a perennial herbaceous Fabaceae originating in Asia. This species has been widely used in traditional Chinese medicine, traditional Indian medicine (Ayurvedic) and other countries in the treatment of coughs and as antidiabetic, antioxidant, anti-asthmatic, antimicrobial, and in central nervous system disorders [94]. Among the great variety of phytochemicals reported there are the following flavonoids: quercetin, myricetin, luteolin, apigenin, medicarpin, vestitol, sativan and others [95, 96]. Likewise, the phenolic compounds: p-hydroxybenzoic acid, p-coumaric acid, salycilic acid, caffeic acid, chlorogenic acid, and others [97]. Melilotus alba Medik. (= M. albus) has been studied sido as source of phenolic compounds and antimicrobial and antioxidant potential [98]. M. sativa and M. alba are used in Peru in the treatment of bronchitis, colds, respiratory infections, and tuberculosis [31].

Plantago major L. (llantén) is a perennial medicinal plant with several chemical constituents such as flavonoids, alkaloids, terpenoids and others, effective as a wound healer, as well as antiulcerative, antidiabetic, antioxidant, anti-bacterial and antiviral agent [66]. The antiviral activity of P. major on herpes virus (HSV-1, HSV-2) and adenoviruses (ADV-3, ADV-8, and ADV-11) was also studied, observing that chlorogenic acid was active against all the indicated viruses, whereas caffeic acid was active against HSV-1, HSV-2 and ADV-3, and both acids with greater antiviral effect than ferulic acid and p-coumaric acid [65]. However, ethnobotanical study of the medicinal plants from Tlanchinol, Hidalgo, México, classified Plantago australis for the gastrointestinal category [99]. Plantago major and P. linearis Kunth are used in Peru in the treatment of bronchitis, cold, cough, dry cough, fever, and throat inflamation [31, 41].

Pelargonium hortorum L.H. Bailey or Pelargonium x hortorum (common geranium) is a hybrid species originated by crossing P. inquinans and P. zonale, widely used in gardening as a decorative plant in Peru. Roots from P. sidoides are used in Europe in the preparation of EPs 7630 in the treatment of acute bronchitis in adults and children, due to their high content of polymeric polyphenolic compounds [100, 101]. Likewise, it has been confirmed by immunoblotting and qPCR analysis that geranium oils (P. graveolens L’Hér.) possess potent ACE2 inhibitory effects, highlighting the presence of citronellol, geraniol and neryl acetate [46]. An extensive study on the phytopharmacological importance of Pelargonium spp. was published by Saraswathi et al. [63].

Studies carried out in Infectious bronchitis virus (IBV), a pathogenic chicken coronavirus, showed that the Sambucus nigra L. extract inhibited IBV at an early point of virus replication [69]. S. nigra has been also indicated, together with Althaea officinalis L., Commiphora molmol (Engl.) Engl., Glycyrrhiza glabra L. and Hedera helix L., in five cases of positive treatment in patients with COVID-19 [102]. The literature does not record studies on Sambucus peruviana Kunth; however, there are several phytochemical studies and potential health effects in other Sambucus species, such as S. williamsii Hance. [103] and S. ebulus L. [104], showing as main components lignans, terpenoids, phenolic acids and flavonoids with antifungal, antioxidant, anti-inflammatory, and anti-cancer properties, and in the treatment of sore throat. In traditional Peruvian medicine, S. peruviana is used in the treatment of bronchitis, fever, cough and cold [31, 41].

Urtica dioica L. (Stinging Nettle) has been show antibacterial, antiviral, anti-inflammatory, and analgesic activities with a wide variety of secondary metabolites such as flavonoids, tannins, scopoletin, isolectins and sterols [105, 72]. The N-acetyl glucosamine-specific lectin isolated from Urtica dioica (UDA) was markedly active against the SARS-CoV with a selectivity index of > 77 [71]. This UDA prevented HIV entry and eventually select for viruses in which conserved N-glycosilation sites in GP120 envelope were deleted [106]. In the flora of Peru is U. urens, a species very similar morphologically to U. dioica, and even though in traditional Peruvian medicine it is not used in the treatment of respiratory diseases, the important content of lectins makes it potentially useful against COVID- 19.

Another plant lectin, the mistletoe lectins (ML), specifically ML II and ML III, isolated from Viscum album L. (mistletoe) were tested against SARS-CoV, showing only ML III antiviral activity with a selectively index of > 12.6 [70]. Numerous hemi-parasitic species of the Loranthaceae, Santalaceae, and Viscaceae families with the Dendrophthora and Phoradendron genera have been reported in the Peruvian flora [23].

Ginger or kion (Zingiber officinale Rosc.) has recently been incorporated by the Ministry of AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy) - India, which recommended a formulation composed of 15 plants, among these, Z. officinale, Syzygium aromaticum (L.) Merr. & L.M. Perry and Cyperus rotundus L., with synergistic antiviral effects against SARS-CoV-2 [73], three species commercialized or present in the flora of Peru. On the other hand, it has been reported that numerous plants such as Z. officinale, Allium sativum L., Ocimum tenuiflorum L., among others, stimulate the human immune system, although the biomolecules and how they interact with the immune system to improve resistance to diseases have not been identified [107]. Diallyl-disulfide, an organosulphur compound of garlic [74], and the terpenoid citral [75] have been used in therapeutic applications in the treatment of SARS-CoV-2. Likewise, a trial on the benefits-risks of medicinal plants in the treatment of COVID-19 indicated a positive effect in some cases and a promising effect in other cases, and among these species, Z. officinale was tested. [102].

That is why table 2 shows a list of plants, mostly present in the flora of Peru, both in the coast, Andean and jungle, and numerous cosmopolitan species, used in the treatment of respiratory diseases and with potential use in the treatment of SARS-CoV-2. Table 3 provides a list of plants that can be prepared in decoction, recommending not to exceed 8 species per liter of decocotion. The information is contained in various studies [31, 32, 41, 93, 94], as well as direct consultations with traditional healers (“curanderos tradicionales”) and personal experience. With certainty, it is a very great activity to test all the possible combinations of the mentioned species, without ruling out that other plant species may join this relationship.

Coast region

Andean region

Jungle region

Species native, introduced or commercialized in Peru

(Spanish name)

Species native, introduced or commercialized in Peru

(Spanish name)

Species native, introduced or commercialized in Peru

(Spanish name)

Allium cepa (cebolla)

A. cepa

A. cepa

Allium sativum (ajo)

A. sativum

A. sativum

Zingiber officinale (kión)

Z. officinale

Z. officinale

Citrus aurantifolia (limón)

C. aurantifolia

C. aurantifolia

Piper aduncum (matico)

Alnus acuminata (aliso)

Erytroxylon coca (coca)

Bursera graveolens (palo santo)

Cordia alliodora (laurel)

Uncaria tomentosa (uña de gato)

Psittacanthus linearis

(suelda con suelda)

Sambucus peruviana (sauco)

C. arabica

Prosopis limensis (algarrobo)

Eucalyptus globulus (eucalipto)

Theobroma cacao (cacao)

Ambrosia peruviana (marco)

Cinchona officinalis (cascarilla)

Genipa americana L. (huito)

Nicotiana tabacum (tabaco)

Cantua buxifolia (kantuta)

Eryngium foetidum (sachaculantro)

Plantago major (llantén)

Juglands neotropica (nogal)

Malachra ruderalis L. (malva)

Coffea arabica (cafeto)

Plantago linearis (llantén serrano)

Maytenus macrocarpa (chuchuhuasi)

Pelargonium hortorum

(geranio criollo)

C. arabica

Verbena littoralis (verbena negra)

Tessaria integrifolia (pájaro bobo)

Urtica urens (ortiga)

Polypodium ducumanum (cotochupa)

Capparicordis crotonoides

(Kunth) Iltis & Cornejo (satuyo)

M. sativa

Tabebuia serratifolia [= Handroanthus serratifolius (Vahl) (SO Grose](tahuari)

Medicago sativa (alfalfa)

Baccharis genistelloides (carqueja)

Cestrum hediondinum (yerba santa)

Cymbopogon citratus (hierba luisa)

Baccharis vacciniifolia (asmachilca)

Abelmochus moschatus (mishumurillo)

Galvesia fruticosa (curil)

Caesalpinia spinosa (tara)

Musa spp. (plátano)

Cestrum auriculatum (hierba santa)

Calceolaria linearis (globito)

Costus erythrocoryne (caña agria)

Lantana glutinosa (maestranza)

Borrago officinalis (borraja)

Crescentia cujete (huingo)

Aphelandra cirsioides (espina de hoja)

Trema micrantha (atadijo)

Scoparia dulcis (escobilla, piqui pichana)

Tynanthus panurensis (clavo huasca)

Physalis angulata (mullaca, capulí cimarrón)

Canna indica (achira)

Table 2: Composition of proposed medicinal plants, introduced and native, that can be used in the geographic regions of the Peruvian coast, Andean, and jungle, in the treatment of respiratory diseases and COVID-19 [31, 32, 41, 92, 93].

S.No

Plant speciesb

Preparation

Spanish

English

1

Allium cepa1,2,3

Una cebolla de tamaño medio

One medium-sized onion

2

Allium sativum1,2,3

1-2 dientes de ajo

1-2 garlic cloves

3

Zingiber officinale1,2,3

Un rizoma de 5 cm de largo, trozado

A 5 cm long rhizome, chopped up

4

Citrus aurantifolia1,2,3

Un limón en rodajas

A sliced lemon

5

Piper aduncum1

5-10 hojas, frescas o secas

5-10 leaves, fresh or dried

6

Bursera graveolens1

5-10 g corteza y tallos pequeños, secos

5-10 g bark and small stems, dried

7

Psittacanthus linearis1

3-5 g hojas y tallos, frescas o secas

3-5 g leaves and stems, fresh or dried

8

Prosopis limensis1

3 cortezas de tallo de 10 cm de largo

Three 10 cm long stem barks

9

Ambrosia peruviana1

5 g hojas y tallos, frescos

5 g leaves and stems, fresh

10

Nicotiana tabacum1

10 g hojas, frescas o secas

10 g leaves, fresh or dried

11

Plantago major1

10 g semillas, frescas o secas

10 g seeds, fresh or dried

12

Coffea arabica1,2,3

1-5 semillas tostadas

1-5 roasted seeds

13

Pelargonium hortorum1

5 g hojas, frescas

5 g leaves, fresh

14

Tessaria integrifolia1

15 g hojas, frescas o secas

15 g leaves, fresh or dried

15

Capparicordis crotonoides1

10 flores, fresca

10 flowers, fresh

16

Medicago sativa1,2

5-10 g hojas y flores, frescas

5-10 g leaves and flowers, fresh

17

Cymbopogon citratus1

5 g raíces, hojas y tallos, frescos o secos

5 g roots, leaves and stems, fresh or dried

18

Galvesia fruticosa1

10 g hojas, tallos y flores, frescos o secos

10 g leaves, stems and flowers, fresh or dried

19

Cestrum auriculatum1

5 g hojas, frescas o secas

5 g leaves, fresh or dried

20

Lantana glutinosa1

10 g ramas terminales con hojas y flores, frescas o secas

10 g terminal branches with leaves and flowers, fresh or dried

21

Alnus acuminata2

10 g corteza, fresca

10 g bark, fresh

22

Cordia alliodora2

10 g de corteza y tallos, secos

10 g bark and stems, dried

23

Sambucus peruviana2

5-20 g tallos, hojas y flores, frescas

5-20 g stems, leaves and flowers, fresh

24

Eucalyptus globulus2

10 g hojas, secas

10 g leaves, dried

25

Cinchona officinalis2

10 g hojas y flores, secas (1 cucharada) o 50 g corteza

10 g leaves and flowers, dried (1 tablespoon) or 50 g bark

26

Cantua buxifolia2

5-10 flores, frescas o secas

5-10 flowers, fresh or dried

27

Juglands neotropica2

10 g hojas, frescas

10 g leaves, fresh

28

Plantago linearis2

2 raíces, frescas

2 roots, fresh

30

Urtica urens2

20 g hojas, frescas o secas

20 g leaves, fresh or dried

32

Baccharis genistelloides2

15 g tallos, frescos o secos

10 g stems, fresh or dried

33

Baccharis vacciniifolia2

10 g ramas terminales, frescas o secas

10 g terminal branches, fresh or dried

34

Caesalpinia spinosa2

10 g frutos, secos

10 g fruits, dried

35

Calceolaria linearis2

5 g hojas y tallos, secos

5 g leaves and stems, dried

36

Borrago officinalis2

10 g toda la planta fresca o seca

10 g whole plant, fresh or dried

37

Erytroxylon coca3

5 g hojas, secas

5 g leaves, dried

38

Uncaria tomentosa3

10 g hojas y tallos, frescos o secos

10 g leaves and stems, fresh or dried

40

Theobroma cacao3

10 g cascarilla de las semillas

10 g seed husks

41

Genipa americana3

1-2 fresh or boiled fruits

1-2 fresh or boiled fruit

42

Eryngium foetidum3

10 g hojas, frescas

10 g leaves, fresh

43

Malachra ruderalis3

5 g raíces, fresca o secas

5 g roots, fresh or dried

44

Maytenus macrocarpa3

100 g corteza, fresca o seca

100 g bark, fresh or dried

45

Verbena littoralis3

30 g planta completa, fresca o seca

30 g whole plant, fresh or dried

46

Polypodium ducumanum3

50-100 g rizoma, fresco o seco

50-100 g rhizome, fresh or dried

47

Tabebuia serratifolia3

3-5 flores, frescas o secas

3-5 flowers, fresh or dried

48

Cestrum hediondinum3

10 g hojas, frescas o secas

10 g leaves, fresh or dried

49

Abelmochus moschatus3

1-3 g semillas trituradas

1-3 g crushed seeds

50

Musa spp.3

3 cucharadas de savia en ayunas

3 tablespoons of sap on an empty stomach

51

Costus erythrocoryne3

5 g tallos, secos

5 g stems, dried

52

Crescentia cujete3

Pulpa de un fruto. Directamente una cucharada tres veces al día

Pulp of a fruit. Directly one tablespoon three times/day

53

Canna indica3

1-2 tallos, frescos. Una cucharadita

1-2 stems, fresh. A teaspoon

54

Trema micrantha3

7 hojas, secas

7 leaves, dried

55

Tagetes erecta3

5 g hojas, secas

5 g leaves, dried

56

Physalis angulata3

5-10 hojas, frescas o secas

5-10 leaves, fresh or dried

57

Tynanthus panurensis3

2 g corteza

2 g stem bark

58

Malachra ruderalis3

5 g raíz

5 g root

59

Scoparia dulcis3

10 g hojas y tallos

10 g leaves and stems

60

Aphelandra cirsioides2

5-10 g planta entera

5-10 g whole plant

Table 3: Preparation of medicinal plants, native and introduced, that can be used in the geographic regions of the Peruvian coast, Andean, and jungle, in the treatment of respiratory diseases and COVID-19a 19 [92, 93, 31, 32, 41, 93, 93; consultations with traditional healers and personal experiences].

aIn all cases, a liter of boiled water is used in the preparation, then the vegetable samples are added, and it is left to boil for 15 minutes. Administration is oral, one glass three times a day for a week. All the species indicated for each geographical region of Peru or those that can be obtained in the medicinal plant market can be used. bPeruvian geographic regions: coast (1), Andean (2) and jungle (3). It is recommended to use between 5 to 8 species of plants in the decoction preparation.

5. Conclusion

Numerous studies have demonstrated the phytochemical and pharmacological potential of hundreds of plants in the treatment of COVID-19. However, it is important to search for other plant species, such as those that exist in the flora of Peru, used since ancient times in the treatment of respiratory diseases, therefore with potential use in the treatment of COVID-19 and the strengthening of the immune system. A synergistic action between the Peruvian species traditionally used in the treatment of respiratory diseases and the species introduced, naturalized, or commercialized in Peru, would be an excellent alternative against COVID-19.

Sources of funding

None

Conflict of interest

The authors declare no competing finnacial interest.

Acknowledgment

The authors are grateful to Professor Alain Monsalve-Mera for English improvements. This research was funded by the General Biotechnology Laboratory-VRINV (UNPRG).

References

  1. Johns Hopkins University & Medicine. Coronavirus around the world. National Public Health Agency. Coronavirus Resources Center 7 (2021).
  2. Padron-Regalado E. Vaccines for SARS-CoV-2: Lessons from other coronavirus strains. Infectious Diseases and Therapy 9 (2020): 255-274.
  3. Thanh Le T, Andreadakis Z, Kumar A, et al. 2020. The COVID-19 vaccine development landscape. Nature Review 19 (2020): 305-306.
  4. Knoll MD, Wonodi C. Oxford – AstraZeneca COVID-19 vaccine efficacy. The Lancet 397(10269) (2021), P72-74.
  5. Lipsitch M, Dean NE. Understanding COVID-19 vaccine efficacy. Science 370 (2020): pp. 763-765.
  6. Polack FP, Stephen JT, KitchinN, et al. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. The New England Journal of Medicine 383 (2020): 2603-2615.
  7. PAHO (Pan American Health Organization). Epidemiological update: occurrence of variants of SARS-COV-2 in the Americas. 20 (2021). Accesed 08 February 2021.
  8. Islam MR, Hoque MN, Rahman MS, et al. Genome-wide analysis of SARS-CoV-2 virus strains circulating worlwide implicates heterogeneity. Scientific Reports 10 (2020): 14004.
  9. Li Q, Wu J, Nie J, et al. The impact of mutations in SARS-CoV-2 spike on viral infectivity and antigenicity. Cell 182 (2020): 1284-1294.
  10. De Andrade Santos I, Grosche VR, Bergamini FRG, et al. Antivirals against coronaviruses: candidate drugs for SARS-CoV-2 treatment?. Frontiers in Microbiology 11 (2020): 1818.
  11. Plantago major has been used by the Chinese as a traditional me
    Chiang LC, Chiang W, Chang MY, Ng LT, Lin CC. 2002. Antiviral activity of Plantago major extracts and related compounds in vitro. Antiviral Research 55:53-62.
    Da Silva JK, da Trindade R, Alves NS, Figueiredo PL, Maia JGS, Setzer WN. 2017. Essential oils from Neotropical Piper species and their biological activities. Int. J. Mol. Sci. 18:2571. De Almeida RRP, Souto RNP, Bastos CN, da Silva MHL, Maia JGS. 2009. Chemical variation in Piper aduncum and biological properties of its dillapiole-rich essential oil. Chem Biodivers. 6:1427-1434.
    Ghazy RM, Almaghraby A, Shaaban R, et al. 2020. A systematic review and meta-analysis on chloroquine and hydoxychloroquine as monotherapy or combined with azithromycin in COVID-19 treatment. Scientific Reports 10 (2020): 1-18.
  12. Silva HM. Medicines and illusions in the fight against COVID-19 in Brazil. Ethics Medicine and Public Health 16 (2021): 100622.
  13. Our World in Data. Coronavirus (COVID-19) vaccinations. 07 (2021).
  14. Perveen S, Al-Taweel A (eds.). Pharmacognosy – Medicinal Plants. IntechOpen (2019).
  15. Adhikari B, Marasini BP, Rayamajhee B, et al. Potential roles of medicinal plants for the treatments of viral diseases focusing on COVID-19: A review. Phytotherapy Research 9 (2020).
  16. Zhen G, Jing J, Fengsen l. Traditional Chinese medicine classic herbal formula Xiaoqinglong decotion for acute exacerbation of chronic obstructive pulmonary disease. Medicine (Baltimore). 97 (2018): e13761.
  17. Xiong H, Dong Z, Lou G, et al. Analysis of the mechanism of Shufeng Jiedu capsule prevention and treatment for COVID-19 by network pharmacology tools. European Journal of Integrative Medicine 40 (2020): 101241.
  18. Zeng M, Li L, Wu L. Traditional Chinese medicine Lianhua Qingwen treating corona virus disease 2019 (COVID-19): Meta-analysis of randomized controlled trials. PLoS One 15 (2020): e0238828.
  19. Srivastava AK, Chaurasia JP, Khan R, et al. Role of medicinal plants of traditional use in recuperating devastating COVID-19 situation. Medicinal and Aromatic Plants (Los Angeles) 9 (2020): No: 359.
  20. O’Connor SE. Engineering of secondary metabolism. Annual Review of Genetics 49 (2015): 71-94.
  21. Benarba B, Pandiella A. Medicinal plants as sources of active molecules against Covid-19. Frontiers in Pharmacology 11 (2020): Article 1189.
  22. Yonesi M, Rezazadeh A. Plants as a prospective source of natural anti-viral compounds and oral vaccines against COVID-19 coronavirus. Preprint – April (2020).
  23. Brako L, Zarucchi J. Catálogo de las Angiospermas y Gimnospermas del Perú. Monographs in Systematic Botany from the Missouri Botanical Garden Vol 45 (1993). 1286 p.
  24. Ulloa C, Zarucchi JL, León B. Diez años de Adiciones a la flora del Perú: 1993-2003. Arnaldoa (Edic. Esp. Noviembre, 2004) (2004): 1-242.
  25. Leatemia J, Isman B. Toxicity and antifeedant activity of crude seed extracst of Annona squamosa (Annonaceae) against lepidopteran pests and natural enemies. International Journal of Tropical Insect Science 24 (2004): 150-158.
  26. Zhong N, Zheng B, Li YM, et al. Epidemiology and cause of severe acute respiratory syndrome (SARS) in Guangdong, People’s Republic of China, in February, 2003. The Lancet 362 (9393) (2003): 1353-1358.
  27. de Groot RJ, Baker SC, Baric RS, et al. Middle east respiratory syndrome coronavirus (MERS-CoV): announcement of the coronavirus study group. Journal of Virology 87 (2013): 7790-7792.
  28. Park JY, Jeong HJ, Kim JH, et al. Diarylheptanoids from Alnus japonica inhibit papain-like protease of severe acute respiratory síndrome coronavirus. Biological and Pharmaceutical Bulletin 35 (2012): 2036-2042.
  29. Ren X, He T, Chang Y, et al. The genus Alnus, a comprehensive outline of its chemical constituents and biological activities. Molecules 22 (2017): 1383.
  30. Aguilar MI, Rovelo R, Verjan JG, et al. Anti-inflammatory activities, triterpenoids, and diarylheptanoids of Alnus acuminata ssp. arguta. Pharmaceutical Biology 49 (2011): 1052-1057.
  31. Bussmann RW, Glenn A. Medicinal plants used in Peru for the treatment of respiratory disorders. Revista Peruana de Biología 17 (2010): 331-346.
  32. Vásquez L, Escurra J, Aguirre R, et al. Plantas medicinales del norte del Perú. FINCyT, Lambayeque – Perú (2010): 382 p.
  33. Prasanna VK, Venkatesh YP. Characteerization of onion lectin (Allium cepa agglutinn) as an immunomodulatory protein inducing Th1-type immune response in vitro. International Immunopharmacology 26 (2015): 304-313.
  34. Pan Y, Zheng YM, Ho WS. Effect of quercetin glucosides from Allium extracts on HepG2, PC-3 and HT-29 cancer cell lines. Oncology Letters 15 (2018): 4657-4661.
  35. Thuy BTP, My TTA, Hai NTT, et al. Investigation into SARS-CoV-2 resistance of compounds in garlic essential oil. ACS Omega 5 (2020): 8312-8320.
  36. Girault L. Baccharis latifolia. In: Quipus SG (ed.). Kallawaya curanderos itinerantes de los Andes: Investigación sobre prácticas medicinales y mágicas. La Paz, Bolivia (1987): 670 p.
  37. Valarezo E, Rosillo M, Cartiche L. et al. Chemical composition, antifungal and atibacterial activity of the essential oil from Baccharis latifolia (Ruiz & Pav.) Pers. (Astercaeae) from Loja, Ecuador. Journal of Essential Oil Research 25 (2013): 233-238.
  38. Sequeda-Castañeda LG, Célis C, Luengas-Caicedo PE. Phytochemical and therapeutic use of Baccharis latifolia (Ruiz & Pav.) Pers. (Asteraceae). Pharmacologyonline 2 (2015): 14-17.
  39. Nakanishi T, Inatomi Y, Murata H, et al. A new and known cytotoxiv aryltetralin-type lignans from stems of Bursera graveolens. Chemical and Pharmaceutical Bulletin 53 (2005): 229-231.
  40. Sotelo AH, Figueroa CG, Césare MF, et al. Chemical composition, antimicrobial and antioxidant activities of the essential oil of Bursera graveolens (Burseraceae) from Perú. Indian Journal of Pharmaceutical Education 51 (2017) (Special Issue).
  41. Ruíz MP, Mejía FR. Plantas utilizadas en medicina tradicional para afecciones respiratorias virales. Revista de Investigación Científica REBIOL 40 (2020): 109-130.
  42. Gautreta P, Lagiera J-C, Parola P, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinicaltrial. International Journal of Antimicrobial Agents 56 (2020): 105949.
  43. Jain S, Arora P, Popli H. A comprehensive review on Citrus aurantifolia essential oil: Its phytochemistry and pharmacological aspects. Brazilian Journal of National Sciences 3 (2020): 354-364.
  44. Pathan RK, Gali PR, Pathan P, et al. In vitro antimicrobial activity of Citrus aurantifolia and its phytochemical screening. Asian Pacific Journal of Tropical Disease 2 (2012): S328-S331.
  45. Bellavite P, Donzelli A. Hesperidin and SARS-CoV-2: New light on the healthy function of Citrus fruits. Antioxidants 9 (2020): 742.
  46. Senthil Kumar KJ, Gokila M, Wang C-S, et al. Geranium and lemon essential oils and their active compounds downregulate angiotensin-converting enzyme 2 (ACE2), a SARS-CoV-2 spike receptor-binding domain, in epithelial cells. Plants 9 (2020): 770.
  47. Meeran MFN, Seenipandi A, Javed H, et al. Can limonene be a possible candidate for evaluation as an agent adjuvant against infection, immunity, and inflammation in COVID-19? Heliyon 7 (2021): e05703.
  48. Adem S, Eyupoglu V, Sarfraz I, et al. Ceffeic acid derivatives (CAFDs) as inhibitors of SARS-CoV-2: CAFDs-based functional foods as a potential alternative approach to combat COVID-19. Phytomedicine (2020): 153310.
  49. Ashihara H. Metabolism of alkaloids in coffe plants. Brazilian Journal of Plant Physiology 18 (2006): 1-8.
  50. Manners G, Jurd L. Alliodorin, a phenolic terpenoid from Cordia alliodora. Tetrahedron Letters 31 (1973): 2955-2958.
  51. Chen TK, Ales DC, Baenziger NC, et al. Ant-repellent triterpenoids from Cordia alliodora. The Journal of Organic Chemistry 48 (1983): 3525-3531.
  52. Kloucek P, Svobodova B, Polesny Z, et al. Antimicrobial activity of some medicinal barks used in Peruvian Amazon. Journal of Ethnopharmacology 111 (2007): 417-429.
  53. Oza MJ, Kulkarni YA. Traditional uses, phytochemistry and pharmacology of the medicinal species of the genus Cordia (Boraginaceae). Journal of Pharmacy and Pharmacology 69 (2017): 755-789.
  54. Restrepo DA, Sáenz E, Jara-Muñoz OA, et al. Erythroxylum in Focus: an interdisciplinary review of an overlooked genus. Molecules 24 (2019): 3788.
  55. Rakover Y, Ben-Arye E, Goldstein LH. The treatment of respiratory ailments with essential oils of some aromatic medicinal plants [Article in Hebrew]. Harefuah 147 (2008): 783-788.
  56. Horváth G, Ács K. Essential oils in the treatment of respiratory tract diseases highlighting their role in bacterial infections and their anti-inflammatory action: a review. flavour and Fragrance Journal 30 (2015): 331-341.
  57. Aranda-Ventura J, Villacrá J, García-de Sotero D, et al. Toxicity, in vitro antioxidant capacity and in vitro/in vivo hypoglicement activity of Juglands neotropica Diels (Peruvian walnut) aqueous extract. Revista Peruana de Medicina Integrativa 1 (2016): 16-24.
  58. Chen Y, Peumans WJ, Hause B, et al. Jasmonic acid methyl ester induces the synthesis of a cytoplasmic/nuclear chito-oligosaccharide binding lectin in tobacco leaves. FASEB Journal 16 (2002): 905-907.
  59. Navickiene HM, Morandim AD, Alécio AC, et al. Composition and antifungal activity of essential oils from Piper aduncum, Piper arboreum and Piper tuberculatum. Química Nova 29 (2006): 467-470.
  60. De Almeida RRP, Souto RNP, Bastos C.N., et al. Chemical variation in Piper aduncum and biological properties of its dillapiole-rich essential oil. Chemistry & Biodiversity 6 (2009): 1427-1434.
  61. da Silva JK, da Trinidade R, Alves NS et al. Essential oils from Neotropical Piper species and their biological activities. International Journal of Moleculas Sciences 18 (2017): 2571
  62. Salehi B, Zakaria ZA, Gyawali R, et al. Piper species: A comprehensive review on their phytochemistry, biological activities and applications. Molecules 24 (2019): 1364.
  63. Saraswathi J, Venkatesh K, Barburao N, et al. Phytopharmacological importance of Pelargonium species. Journal of Medicinal Plants Research 5 (2011): 2587-2598.
  64. Oor H, Juing M, Chee B-J, et al. Medicinal properties of Plantago major: hypoglycaemic & male fertility studies. Pertanika Journal of Tropical Agricultural Science 23 (2000): 29-35.
  65. Chiang LC, Chiang W, Chang MY, et. al. Antiviral activity of Plantago major extracts andrelated compounds in vitro. Antiviral Research 55 (2002): 53-62.
  66. Adom MB, Taher M, Mutalabisin MF, et al. Chemical constituents and medical benefits of Plantago major. Biomedicine & Pharmacotherapy 96 (2017): 348-360.
  67. Sharifi-Rad J, Kobarfard F, Ata A, et al. Prosopis plant chemical composition and pharmacological attributes: targeting clinical studies from preclinical evidence. Biomolecules 9 (2019): 777.
  68. Balladares Ballona JP, Delgado Paredes GE, Wagner ML, et al. In vitro tissue culture, preliminar phytochemical analysis, and antibacterial activity of Psittacanthus linearis (Killip) J.K. Macbride (Loranthaceae). Revista Colombiana de Biotecnología 21 (2019): 22-35.
  69. Chen C, Zuckerman DM, Brantley S, et al. Sambucus nigra extracts inhibit infectious bronchitis virus at an early point during replication. BMC Veterinary Research 10 (2014): 24.
  70. Van Damme E, Peumans W, Pusztai A, et al. Handbook of plant lectins: Properties and biomedical applications. John Wiley & Sons, Chichester, West Sussex, England (1998).
  71. Keyaerts E, Vijgen L, Pannecouque C, et al. Plant lectins are potent inhibitors of coronaviruses by interfering with two targets in the viral replication cycle. Antiviral Research 75 (2007): 179-187.
  72. Joshi BC, Mukhija M, Kalia AN. Pharmacognostical review of Urtica dioica L. International Journal of Green Pharmacy 16 (2014): 210-219.
  73. Prasad A, Muthamilarasan M, Prasad M. Synergistic antiviral effects against SARS-CoV-2 by plant-based molecules. Plant Cell Reports 19 (2020): 1-6.
  74. Shin IS, Hong J, Jeon CM, et al. Diallyl-disulfide, an organosulfur compound of garlic, attenuates airway inflammation via activation of the Nrf-2/HO-1 pathway and NF-kappaB suppression. Food and Chemical Toxicology 62 (2013): 506-513.
  75. Mangprayool T, Kupittayanant S, Chudapongse N. Participation of citral in the bronchodilatory effect of ginger oil and posible mechanism of action. Fitoterapia 89 (2013): 68-73.
  76. Chang JS, Wang KC, Yeh CF, et al. Fresh ginger (Zingiber officinale) has antiviral activity against human respiratory syncytial virus in human respiratory tract cell lines. Journal of Ethnopharmacology 145 (2013): 146-151.
  77. Marcotullio MC, Curini M, Becerra JX. An ethnopharmacological, phytochemical and pharmacological review on lignans from Mexican Bursera spp. Molecules 23 (2018): 1976.
  78. Johnson EL. Alkaloid content in Erythroxylum coca tissue during reproductive development. Phytochemistry 42 (1996): 35-38.
  79. Weil AT. The therapeutic value of coca in contemporary medicine. Journal of Ethnopharmacology 3 (1981): 367-376.
  80. Jahanban-Esfahlan A, Ostadrahimi A, Tabibiazar M, et al. A comprehensive review on the chemical constituents and functional uses of walnut (Juglands spp.) Husk. International Journal of Molecular Sciences 20 (2019): 3920.
  81. Delporte A, Van Holle S, Lannoo N, et al. The tobacco lectin, prototype of the family of Nictaba-related proteins. Current Protein & Peptide Science 16 (2015): 5-16.
  82. Durant-Archibold AA, Santana AI, Gupta MP. Ethnomedicinal uses and pharmacological activities of most prevalent species of genus Piper in Panama: A review. Journal of Ethnopharmacology 217 (2018): 63-82.
  83. Noman OM, Mothana RAA, Al-Rehaily AJ, et al. Phytochemical analysis and anti-diabetic, anti-inflammatory and antioxidant activities of Loranthus acaciae Zucc. grown in Saudi Arabia. Saudi Pharmaceutical Journal 27 (2019): 724-730.
  84. Asgarpanah J. Phytopharmacology and medicinal properties of Salix aegyptiaca L. African Journal of Biotechnology 11 (2012): 7145-7150.
  85. Rebolledo V, Otero C, Delgado M, et al. Phytochemical profile and antioxidant activity of extracts of the peruvian peppertree Schinus areira L. from Chile. Saudi Journal of Biological Sciences 28 (2021): 1052-1062.
  86. Sadati SM, Gheibi N, Ranjbar S, et al. Docking study of flavonoid derivatives as potent inhibitors of influenza H1N1 virus neuraminidase. Biomedical Reports 10 (2019): 33-38.
  87. Pastor A, Zelada B. Estudio fitoquímico de flaveria bidentis (L.) Kuntze (Asteraceae). Revista de la Sociedad Química del Perú 72 (2006): 3-11.
  88. Ono M, Masuoka C, Odake Y, et al. Antioxidative constituents from Tessaria integrifolia. Food Science 6 (2000): 106-114.
  89. Ejelonu BC, Oluwafemi AD, Lasisi AA, et al. The chemical constituents of calabash (Crescentia cujete). African Journal of Biotechnology 10 (2011): 19631-19636.
  90. Abdel-Salam NA, Ghazy NM, Sallam SM, et al. flavonoids of Alcea rosea L. and their immune simulant, antioxidant and cytotoxic activities on hepatocellular carcinome HepG-2 cell line. Natural Product Research 32 (2018): 702-706.
  91. Fahamiya N, Shiffa M, Aslam M. A comprehensive review on Althaea rosea Linn. Indo American Journal of Pharmaceutical Research 6 (2016): 6.
  92. Mejía K, Rengifo E. Plantas medicinales de uso popular en la amazonía peruana. Agencia Española de Cooperación Internacional (AECI) y Instituto de Investigaciones de la Amazonía Peruana (IIAP). Tarea Asociación Gráfica Educativa. Lima, Perú (2000): 286 p.
  93. Bussmann RW, Sharon D. Plantas medicinales de los andes y la amazonía – La flora mágica y medicinal del norte del Perú. GRAFICART SRL, Trujillo, Perú. (2015). 292 p.
  94. Bora KS, Sharma A. Phytochemical and pharmacological potential of Medicago sativa: A review. Pharmaceutical Biology 49 (2011): 211-220.
  95. Kowalska I, Stochmal A, Kapusta I, et al. flavonoids from Barrel Medic (Medicago truncatula) aerial parts. Journal of Agricultural of Food Chemistry 55 (2007): 2645-2652.
  96. Stochmal A, Oleszek W. Seasonal and structural changes of flavone in alfalfa (Medicago sativa) aerial parts. Journal of Food, Agriculture and Environment 5 (2007): 170-174.
  97. Dutu LE, Istudor V, Loloiu T, et al. Research on polyphenolic compounds from Medicago sativa L. Farmacia (Bucharest, Romania) 50 (2002): 44-56.
  98. Stefanovic OD, Tešic JD, Comic LR. Melilotus albus and Dorycnium herbaceum extracts as source of phenolic compounds and their antimicrobial, antibiofilm, and antioxidant potentials. Journal of Food and Drug Analysis 23 (2015): 417-424.
  99. Andrade-Cetto A. Ethnobotanical study of the medicinal plants from Tlanchinol, Hidalgo, México. Journal of Ethnopharmacology 122 (2009): 163-171.
  100. Kolodziej H, Kayser O, Radtke OA. Pharmacological profile of extracts of Pelargonium sidoides and their constituents. Phytomedicine 10 Suppl 4(2003): 18-24.
  101. Matthys H, Kamin W, Funk P, et al. Pelargonium sidoides preparation (EPs 7630) in the treatment of acute bronchitis in adults and children. Phyomedicine 14 (2007): 69-73.
  102. Silveira D, Prieto-Garcia JM, Boylan F, et al. COVID-19: Is there evidence for the use of herbal medicines as adjuvant symptomatic therapy? Frontiers in Pharmacology 11 (2020): 1479.
  103. Xiao H-H, Zhang Y, Cooper R, et al. Phytochemicals and potential health effects of Sambucus williamsii Hance (Jiegumu). Chinese Medicine 11 (2016): 36.
  104. Shokrzadeh M, Saeedi Saravi SS. The chemistry, pharmacology and clinal properties of Sambucus ebulus: A review. Journal of Medicinal Plants Resarch 4 (2010): 95-103.
  105. Asgarpanah J, Mohajerani R. Phytochemistry and pharmacologic properties of Urtica dioica L. Journal of Medicine Plant Research 6 (2012): 5714-5719.
  106. Balzarini J, Van Laethem K, Hatse S, et al. Carbohydrate-binding agents cause deletions of highly conserved glycosilation sites in HIV GP120: a new therapeutic concept to hit the achilles heel of HIV. Journal of Biological Chemistry 280 (2005): 41005-41014.
  107. Sharma N, Muthamilarasan M, Prasad A, et al. Genomics approaches to synthesize plant-based biomolecules for therapeutic applications to combat SARS-CoV-2. Genomics 112 (2020): 4322-4331.

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