key: cord-0978039-c9n8cro3
authors: Soni, Vivek Kumar; Mehta, Arundhati; Shukla, Dhananjay; Kumar, Sujeet; Vishvakarma, Naveen Kumar
title: Fight COVID-19 depression with immunity booster: Curcumin for psychoneuroimmunomodulation
date: 2020-09-01
journal: Asian J Psychiatr
DOI: 10.1016/j.ajp.2020.102378
sha: 72509b3faf1caac48ee691889103f013295e6860
doc_id: 978039
cord_uid: c9n8cro3

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Beyond infection, the COVID-19 pandemic has affected individuals through associated anxiety and stress and caused a collateral damage (Tandon, 2020) . Real and perceived fear of infection and distorted daily activities invites psychiatric illness including depression (Banerjee and Viswanath, 2020; Kumar and Somani; , Tandon, 2020 . Void for specific therapeutic measures also contributed to this psychotic illness. A 'tsunami of psychiatric illness' will follow as predicted by various organizations and imminent experts (Tandon, 2020) . Therefore, attention towards this mental health crisis approaching worldwide is necessary (Tandon, 2020) . Along with preventive measures, incorporating 'immunity boosters', including established food ingredients/herbs, are advised. Recently, uncovering the potential of Ayurveda was exigencies to combat COVID-19 outbreaks through modulation of pyschoneuroimmune (PNI) response . Curcumin is the bioactive component of turmeric, one of the key ingredients of prescribed ayurvedic interventions and spices used in meal preparation in South-East Asia Vishvakarma, 2014) . Therefore, critical evaluation of the psychopharmacological potential of turmeric in COVID-19-pandemic-associated psychosomatic disorders is warranted.

The inter-dependent nature of immunity and psychological state is established and decides the outcome of disorders. An immune response can be largely affected by mental well-being, and depression can negatively affect its outcome Zalachoras et al., 2020) .

Targeting either one of depression or immunity may face insufficiency; dual-acting drug hold promise to improve health amid COVID-19 pandemic. Known for immunoboosting aptitude, curcumin can alleviate the COVID-19 associated ill-effects including cytokine storm (Liu and J o u r n a l P r e -p r o o f Ying, 2020) . Alleviating psychological stress by curcumin will also adjunct its immunoboosting potential.

Curcumin can avert the anxiety and the stress-driven manifestation of depression through modulation of the monoaminergic troupe (dopamine, glutamate, serotonin, and noradrenaline) by curcumin . Depression-disorders in COVID-19 prevention measuresdriven social distort are possibly brought by oxidative stress . Curcumin, through Nuclear factor erythroid-2-related factor 2 (Nrf2), can prevent such stress and improve antioxidant Glutathione (GSH) production . GSH prevents the physiological damage to brain cells during stress. Nrf2 also balances the tone of the immune response (Lopresti and Drummond, 2017; Zalachoras et al., 2020) . Major depression disorders (MDD) associate with disturbances in the hypothalamus-pituitary-adrenal (HPA) axis. Curcumin can correct the HPA disturbances and avert elevated glucocorticoids, their receptor as well as inducers (cortisone and adrenocorticotropic hormone) (Lopresti and Drummond, 2017) .

Along with evident immunomodulator, turmeric component, especially curcumin exhibit antidepressant activity, and improve cognitive/mood function (Lopresti and Drummond, 2017) .

The potential of curcumin containing nutraceutical in COVID-19 has been predicted both through PNI modulation and 'meaning response' . Moreover, curcumin can alleviate the overt inflammatory consequences (Vishvakarma, 2014; Soni et al., 2020) , even those associated with COVID-19 (Liu and Ying, 2020) , and thus will improve physical wellbeing. Ayurvedic utilization of turmeric as a concoction, spices and/or golden milk (turmeric in warm milk) provide PNI benefits through alleviated anxiety/depression along with modulation of neurotransmission (through monoamine and gamma-aminobutyric acid) . Reports indicate the onset of post-traumatic stress disorder J o u r n a l P r e -p r o o f

Chronic stress elevates proinflammatory cytokines (IL-1, IL-6, TNF-α) which triggers the production of catabolites of tryptophan (TRYCATs) through stimulation of indolamine-2,3-dioxygenase

2020); thus may improve MDD through PNI modulation. High proinflammatory cytokines in MDD individuals wreck the hematopoiesis and weaken the immunity

Curcumin can improve the hematopoietic differentiation of immune cells (Vishvakarma

and thus can mitigate ill effects even through reinstating immune cells number. Moreover, curcumin improves neurogenesis and hippocampus functioning

2020), antidepressant effect, and neurogenesis (Zalachoras et al., 2020, Lopresti and Drummond, 2017) may also improve the mood function and ward off anxiety

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