While the world awaits a man-made coronavirus vaccine, Valley-area researchers are scrambling to uncover a more natural and controversial type of treatment: herbal remedies.
Arizona State University and the Southwest College of Naturopathic Medicine in Tempe are collaborating on a research project focused on finding botanicals — or medicinal, plant-based herbal treatments — for COVID-19, the deadly disease caused by the novel coronavirus. The effort is spearheaded by Jeffrey Langland, a virologist with 33 years of experience.
Langland is an assistant research professor at ASU’s Biodesign Center for Immunotherapy, Vaccines and Virotherapy, and an associate professor of medical microbiology at the Southwest College of Naturopathic Medicine in Tempe.
“There are likely plants out there that could be used to treat this virus,” Langland said.
Now, their focus is finding those plants.
Once they zero in on the most promising, they will share their data with the U.S. Food and Drug Administration and Centers for Disease Control and Prevention, “and it'd be up to them if they want to fast track and [move] toward any sort of clinical trials with it.”
Their starting point is a collection of 30 to 40 botanical compounds, called herbal products, which have shown varying degrees of success treating the novel coronavirus and other viruses like it. Among them are those derived from isatis, Chinese licorice, and houttuynia.
“There's mixed literature out there. During the [2002-2003] SARS outbreak — and even during this recent coronavirus outbreak — China has reported that people used botanical [medicine] and reportedly had success,” Langland said. “Now, that's very anecdotal ... the true science behind that is kind of mixed.”
In China, where both botanical medicine and the coronavirus originated, using herbs as medicine is commonplace and culturally accepted. Here, it is fraught with controversy.
Herbal medicine falls into the much maligned umbrella of “alternative treatments.” The mainstream American medical community’s position on such treatments can be less than friendly.
In a special announcement, the National Institutes of Health (NIH) warned specifically against herbal treatments and teas as treatments for the coronavirus: “There is no scientific evidence that any of these alternative remedies can prevent or cure the illness caused by COVID-19. In fact, some of them may not be safe to consume.”
In March, the FDA and FTC sent warning letters to several companies selling “fraudulent” coronavirus treatment products that “pose significant risks to patient health and violate federal law.” Many of them centered around boneset: a North American herb traditionally used by Native Americans to treat fevers and colds. However, no clinical studies have satisfactorily proven its antiviral capabilities in humans, and this is the type of problem Langland is setting out to solve.
“We’re trying to put evidence-based medicine behind botanicals,” he said. “Some [mainstream] physicians are really open to botanical medicine. Other ones are very resistant to it. And that's why we're trying to put the science behind this.”
Much of Langland’s career has been dedicated to bridging the gap between naturopathic and conventional medicine. “One hundred percent, I believe in both,” he said.
As of April 6, Arizona had 2,456 confirmed COVID-19 cases and 65 deaths. According to Arizona Department of Health Director Dr. Cara Christ, the state’s hospitalizations will peak in May.
For those in the traditionally slow and measured business of researching treatments, COVID-19 presents an unusually fast-paced race against time.
Dr. Joe G.N. "Skip" Garcia, the head of a University of Arizona pulmonary science lab that bears his name, is among those trying to quickly develop man-made drugs for COVID-19 patients who exhibit deadly respiratory complications caused by “massive inflammation.” He said he believes botanicals could prevent cases from turning into serious ones requiring hospitalization, but he would like to see the evidence.
“I would say there is a real potential for these types of medicines to alter the severity of a pandemic-related infection in a given individual, and perhaps across a population challenged with resource shortages,” Garcia said. “This would, however, require a rigorous demonstration of clinical benefit and efficacy.”
Langland said the “million dollar question” now is when his researchers will land on some herbs they feel confident in. “My hope is we start getting some preliminary data in the next month to two months,” he said.
At that point, he and his team will go to the CDC and FDA — with whom they’ve dealt before.
Over five years ago, in response to fears about weaponized smallpox, the team developed an herbal treatment derived from sarracenia purpurea, which the FDA ultimately found to be effective at killing the virus. But the treatment has only just entered the animal-testing phase, a pace far too slow to address the current pandemic.
With little time to spare, Langland said that if and when they find an herbal COVID-19 treatment that shows promise, they will make their findings known immediately — even before it can be rigorously tested. He said they will inform doctors of the promising herbs, stressing that they should always be consulted in taking such medicine.
“We certainly would not want people to go and start administering these sorts of botanicals on their own,” he said. Although most of the herbs the team uses are “generally regarded as safe,” he added, without large-scale, time-consuming trials, their efficacy and safety cannot be guaranteed.
While the ASU team scrambles for more powerful plant-based remedies, Langland encourages people to take herbal supplements already known to boost the immune system: elderberry, astragalus, and echinacea. But even those more established herbal treatments have their doubters.
Naysayers point to several studies that have failed to show echinacea has significant success mitigating the common cold. But those studies, Langland suggested, may not have been using high-quality compounds.
“A lot of that [controversy is] based on the fact that it depends on the time of year the plant is harvested [and] the part of the plant that's used,” he said. In order for botanical medicine to work, it needs to be the right plant processed the right way — and not all herbal products get it right. This is another reason why he stresses the role of an experienced doctor in administering botanical medicine.
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Stefanie Werner, a Chandler-based naturopathic doctor, has been deploying her brand of medicine on the ground level as the pandemic reaches Phoenix. While she soon may be armed with the controversial, preliminary results of Langland’s research, she is currently focused on boosting her patients’ immune systems. One of her go-to treatments is high-dose Vitamin C IVs. Much like herbal treatments, these IVs traditionally have been associated with the world of alternative medicine. But, perhaps inspired by Chinese research suggesting they may be effective against the virus, some hard-hit New York hospitals have started administering these types of IVs to COVID-19 patients.
As for Langland, he will not get incontrovertible, FDA-backed proof for his botanical COVID-19 treatments anytime soon. His mission is to provide satisfying scientific proof for ancient natural treatments, but doing so takes time, likely more than this pandemic will allow.
In lieu of clinical trials, Langland falls back on other arguments. He said in the U.S. about one-third of the population uses botanicals on a regular basis, and about 25 percent of active pharmaceutical drugs have their origins in botanicals.
“This isn't a brand new field of hocus-pocus medicine. Botanical medicine has been around for thousands of years,” Langland said. “We certainly want to put more science behind it, though.”