Traditional Chinese Medicine for Viral Pneumonia Therapy: Pharmacological Basis and Mechanistic Insights

Abstract

Different respiratory viruses might cause similar symptoms, ranging from mild upper respiratory tract involvement to severe respiratory distress, which can rapidly progress to septic shock, coagulation disorders, and multiorgan failure, ultimately leading to death. The COVID-19 pandemic has shown that predicting clinical outcomes can be challenging because of the complex interactions between the virus and the host. Traditional Chinese medicine (TCM) has distinct benefits in the treatment of respiratory viral illnesses due to its adherence to the principles of "different treatments for the same disease" and "same treatment for different diseases". This paper examines the effectiveness and underlying mechanisms of key TCM treatments for viral pneumonia in recent years. The aim of this study was to discover and confirm the active substances of TCM with potential therapeutic effects on viral pneumonia and their integrative effects and synergistic mechanisms and to provide a scientific basis for elucidating the effectiveness of TCM treatment and drug discovery. Furthermore, a thorough analysis of previous research is necessary to evaluate the effectiveness of TCM in treating viral pneumonia.

Keywords: adenovirus; influenza virus; respiratory syncytial virus; severe acute respiratory syndrome-coronavirus 2; traditional Chinese medicine; viral pneumonia.

Figure 1

Distribution of syndrome elements associated with viral pneumonia. The syndromes distributed of (A) IAV, (B) IBV, (C) RSV, (D) AdV, (E) SARS-CoV-2. (F) Distribution percentage of TCM syndrome of multiple viral pneumonia.

Figure 2

Viral and antiviral action of TCMs. TCMs inhibit viral pneumonia through multiple mechanisms, including binding viruses, blocking viral invasion, transcription and replication, and preventing exocytosis and release. The green boxes list the representative TCMs associated with each mechanism. The illustration was produced using BioRender, a website specializing in scientific graphics.

Figure 3

Lung immune cells activated by TCMs. The activation of lung immune cells during viral infection includes both innate and adaptive immunity. Neutrophils and DCs, as part of the innate immune system, trigger adaptive immune responses by secreting IFN, producing antibodies, and killing infected cells. The green boxes list the representative TCMs associated with each mechanism. The illustration was produced using BioRender, a website specializing in scientific graphics.

Figure 4

Protection of organs by TCMs. Viruses must breach the epithelial or mucosal barrier to gain entry into the body. They spreads through lymphatic vessels or through the bloodstream (freely or within inflamed cells). This in turn leads to organ damage in the host. The associated damage caused by respiratory viruses in each organ is listed in the red box. The green boxes list the representative TCMs associated with each mechanism. The illustration was produced using BioRender, a website specializing in scientific graphics.

Figure 5

Regulation of metabolism by TCMs. Metabolic pathways are influenced by viral infections and particularly affect the metabolism of glucose, glutamine, and fatty acids in the host. The green boxes list the representative TCMs associated with each mechanism. The illustration was produced using BioRender, a website specializing in scientific graphics.

Figure 6

Synergistic multitarget mechanism of TCMs. Cellular pathways in the host that become active during viral lung infection. The green boxes list the representative TCMs associated with each mechanism. The illustration was produced using BioRender, a website specializing in scientific graphics.