key: cord-0951605-y2i5pdmb authors: Wiwanitkit, Viroj title: Chinese Medicine in the Management of New and Emerging Infectious Diseases date: 2018-03-31 journal: Digital Chinese Medicine DOI: 10.1016/s2589-3777(19)30004-7 sha: fbee33a93bda173e8b7f94c1c4a077234983489b doc_id: 951605 cord_uid: y2i5pdmb ABSTRACT Emerging infectious diseases are an important problem in medicine, and many continue to pose a global threat. However, the management of new and emerging infections is usually difficult due to a lack of knowledge and tools to address the problem. The use of Chinese medicine to manage new and emerging infectious diseases, however, has attracted significant attention. This brief article summarizes and discusses the use of Chinese medicine in the management of new and emerging infectious diseases. Infection is an important problem in contemporary medicine. There are many pathogens, including parasites, bacteria, viruses and fungi, which can cause disease in humans. Sometimes, new infections caused by previously non-pathogenic organisms occur and become new problems in medicine. A single case report can signal the outbreak of a new and emerging infection, and often serves as a warning to anticipate future outbreaks [1] , which is an important problem in [2] ; even more time is usually required for the development of diagnostic and therapeutic tools [2] . Searching for new therapies against new emerging infections is a critical step in management strategies. The use of Chinese medicine in this regard has become an interesting avenue of investigation. In this brief article, the use of Chinese medicine in the management of new emerging infectious diseases is summarized and discussed. Chinese medicine is actually a valuable derivative of Asian wisdom. Given its long history, Chinese medicine has been successfully used in the management of several diseases, including infections, for many thousands of years. There is little doubt that Chinese medicine is a source of "hidden gems" for the management of several diseases. In modern medicine, a representative example of applied Chinese medicine in the management of emerging infection is the case of classical drug-resistant malaria. Malaria is a prevalent tropical mosquito-borne infection that is common in several tropical countries around the world. The use of classical quinine antimalarial drug has been recommended for decades. Nevertheless, due to poorly controlled drug use in many developing tropical countries, the emergence of drug-resistant malaria has occurred [3] . The problem was initially encountered in Southeast Asia [3] , and the search for a new drug became an important issue. Finally, the success in finding a new drug against classical antimalarial drug-resistant malaria was based on the reappraisal of a Chinese medicine regimen. "Artemisinin (Qing Hao Su, 青蒿素)" is a traditional Chinese herb with proven antimalarial activity [4] , and is effective against classical antimalarial drug-resistant malaria. In fact, the new antimalarial drug, artemisinin, was successfully developed from Artemisinin (Qing Hao Su, 青蒿素) [5] . Presently, artemisinin is the drug of choice for management of classical drug-resistant malaria in tropical medicine [6] . The As mentioned, an increased role for Chinese medicine in the management of new and emerging infectious diseases can be anticipated, and some reports describing its use have already been published. There are many new emerging cross-species influenza infections. In the past few years, the typical emerging influenzas are usually a serious zoonotic influenza that repeatedly occurs, with bird flu being a well-known example. As an avian-related disease, control of poultry farming is the current standard of practice against bird flu due to the lack of effective antiviral therapy, which makes the management of emerging bird flu problematic. Applications for Chinese medicine have, however, been found in this context. Chang et al. [7] noted that "Traditional Chinese Medicine de novo derivatives may be suitable candidates of dual-targeting drugs for influenza". The authors also noted the use of standard modern Chinese medicine databases as a basic tool for new Chinese medicine-based drug discovery against new and emerging influenzas [8] . Of several Chinese medicine regimens, the use of the edible bird's nest (EBN) has been widely proposed for its possible effectiveness against new and emerging influenzas, and its utility has been extensively studied. Haghani et al. studied the "in vitro and in vivo mechanism of immunomodulatory and antiviral activity of EBN against influenza A virus infection [9] . Immunomodulation via cytokine induction due to EBN has been reported [10] . Haghani et al. [11] commented on "the potential of EBNs as supplementary medication or alternative to antiviral agents to inhibit influenza infections". In addition to EBN, the efficacy of ginseng against emerging influenza has also been intensively studied. In an experimental animal study, Dong et al. [12] found that "treatment of mice with ginsenosides (Ren Shen Zao Dai, 人参皂甙) protected the animals from lethal 2009 pandemic H 1 N 1 infection and lowered viral titers in animal lungs", and concluded that "the interference in the viral attachment process subsequently minimizes viral entry into the cells and decreases the severity of the viral infection" [12] . Interestingly, the use of Chinese medicine for the management of influenza is currently a common practice. At present, Lian Hua Qing Wen capsule (LQC) is a common Chinese medical preparation containing flavonoids, phenylpropanoids, anthraquinones, triterpenoids and iridoids, and is widely used to treat viral influenza [13, 14] . LQC has also been used to treat and manage an outbreak of SARS [13] . According to the SARS crisis, Leung analyzed the role of Chinese medicine and reported that "the results revealed positive but inconclusive indications about the efficacy of the combined treatments using Chinese medicine as an adjuvant" [16] . The author also reported that "positive effects using adjuvant herbal therapy included better control of fever, quicker clearance of chest infection, lesser consumption of steroids and other symptoms relief" [16] . [17] . The emerging infections [18] . The usefulness of case reports in managing emerging infectious disease Reporting on emerging infectious diseases Epidemiology of drug-resistant malaria Qinghaosu and its derivatives Malaria: An Update Poultry workers, avian flu and prevention Two birds with one stone? Possible dual-targeting H1N1 inhibitors from traditional Chinese medicine In vitro and in vivo mechanism of immunomodulatory and antiviral activity of Edible Bird's Nest (EBN) against influenza A virus (IAV) infection Edible bird's nest modulate intracellular molecular pathways of influenza A virus infected cells Protective effect of Korean red ginseng extract on the infections by H1N1 and H3N2 influenza viruses in mice Inhibition of influenza A virus infection by ginsenosides Qualitative and quantitative analysis of the major constituents in Chinese medical preparation Lianhua-Qingwen capsule by UPLC-DAD-QTOF-MS Complementary and alternative medicine is expected to make greater contribution in controlling the prevalence of influenza Traditional Chinese medicine herbal extracts of Cibotium barometz, Gentiana scabra, Dioscorea batatas, Cassia tora, and Taxillus chinensis inhibit SARS-CoV replication The efficacy of Chinese medicine for SARS: a review of Chinese publications after the crisis Experience of integrated traditional Chinese and Western medicine in first case of imported Zika virus disease in China The need of Asian pharmaceutical researchers' cooperation The author declares no conflict of interest.