Page 113 - วารสารการแพทย์แผนไทย ปีที่ 21 ฉบับที่ 2

J Thai Trad Alt Med Vol. 21 No. 2 May-Aug 2023 329

Introduction and Objectives acts with ACE2 that directly affects the fitness
[3]
Since the Coronavirus disease 2019 and transmissibility of the virus. Therefore,
(COVID-19) outbreak in Wuhan, China in inhibition of ACE2 or TMPRSS2 and other
December 2019, more than 460 million people host-target molecules could limit the transmis-
[1]
have been infected and 6 million have died. sion in the early phase of infection. ACE2 and
The disease is caused by severe acute respira- TMPRSS2 have been studied and identified to
tory syndrome coronavirus 2 (SARS-CoV-2), a be the main targets of SARS-CoV-2 inhibitors.
[4-7]
coronavirus with a spike protein. The receptor- ACE2 and TMPRSS2 are mostly expressed not
binding domain of the spike protein on the only in lung tissue but also in kidney, oesopha-
[8-9]
viral envelope of SARS-CoV-2 can directly and gus, colon, heart, brain and other organs.
specifically bind to angiotensin-converting Patients infected with the virus might have
enzyme 2 (ACE2), a membrane-associated symptoms such as fever, cough, shortness and

enzyme. The SARS-CoV-2 spike protein can difficulty in breathing and some complications
be cleaved and activated by transmembrane of pneumonia, kidney failure or even death. [10]
proteases, including serine 2 (TMPRSS2) be- In Thailand, some people have turned

fore being endocytosed into host cells. Once to using medicinal plants or alternative
the virus enters the cell, the virus also needs medicines to alleviate symptoms caused by
the PIKfyve enzyme to form an endosome and the infection with most showing antipyretic

transport virus particles in the cytoplasm. properties or the inhibition of virus-caused
This process also needs cathepsin L protease, disease. Traditional drug formulations in the
which is responsible for endosome maturity. National List of Essential Medicine including

The Inhibition of PIKfyve and cathepsin L pro- Ya Prasa Pro Yai, Ya Ha Rak and Ya Chanthalila
tease has been shown to be effective against formulations have been widely used for alle-

SARS-CoV-2, Ebola virus (EBOV) and African viating fever during the pandemic and have
swine fever in the early and mid-stages of the been prepared in several forms (capsules, dried
[2]
infection. Presently, the virus continues to powder and tablets). Formulations of these
mutate producing different strains including traditional drug have been published on the
alpha (B.1.1.7), beta (B.1.351), gamma (P.1), website of Thai Food and Drug Administration

delta (B.1.617.2) and omicron (B.1.1.529). (Thai FDA). Ya Prasa Pro Yai is specifically
[11]
Each mutation has an altered sequence at the used to treat flu, stomach pain, flatulence and
receptor-binding domain (RBD), which inter- anorexia in children. The formulation con-