Friday Hope: Radix Astragali/Radix Angelicae sinensis (RA/RAS): A Promising Therapeutic for Long COVID

Radix Astragali/Radix Angelicae sinensis is also effective in treating Idiopathic Pulmonary Fibrosis (IPF) and exhibits strong anti-inflammatory and anti-oxidative stress properties.

Forest plot of comparison: clinical efficacy. (A) Total effective rate of clinical efficacy was statistically significantly higher in experimental group than control group. (B) TCM syndrome effective rate of clinical efficacy was statistically significantly higher in experimental group than control group.

Given the emerging evidence that SARS-CoV-2 and its Spike Protein induce lung fibrosis, I began a search for therapeutics which may be useful in treating the condition. After reviewing the literature, I found the TCM herb Radix Astragali to hold great promise. Not only does this herb treat IPF, it also holds great potential for treating those suffering from Long COVID.

Radix Astragali/Radix Angelicae sinensis is an herbal supplement used in Traditional Chinese Medicine.

A traditional Chinese medicine comprising of Radix Angelicae Sinensis (RAS) and Radix Astragali (RA), with potential anti-inflammatory, immunostimulatory, neuroprotective, anti-hepatotoxic and antineoplastic activities. The main chemical constituents of RAS include ferulic acid, Z-ligustilide, butylidenephthalide and various polysaccharides. RA is the dried root of Astragalus membranaceus with primary constituents such polysaccharides, triterpenoids as well as isoflavones. Though their mechanisms of action remain largely elusive, Radix Angelicae Sinensis/Radix Astragali herbal supplements are commonly used for the treatment of various health conditions affecting women including premenstrual syndrome, dysmenorrhea, pelvic pain, recovery from childbirth and menopausal symptoms. These agents are also used for alleviating constipation, preventing and treating anemia and allergic attacks, and for the management of hypertension, joint pain and ulcers.

Radix Angelicae sinensis/Radix Astragali herbal supplement
https://www.cancer.gov/publications/dictionaries/cancer-drug/def/radix-angelicae-sinensis-radix-astragali-herbal-supplement

In those suffering from Long COVID, Radix Astragali was found to offer great potential in treating the inflammation which leads to fatigue. Please note that it lowers virtually all of the key inflammatory agents exacerbated by SARS-CoV-2 and its Spike Protein.

A medicinal plant named Radix Astragali is renowned in oriental medicine for enhancing immune responses. It serves as the king drug in Bu-Zhong-Yi-Qi decoction. A study highlighted its anti-inflammatory properties in zymosan air-pouch mice by lowering IL-1β, COX-2, iNOS, TNF-α, and IL-6 expression and NO generation76. In another investigation conducted by Xie et al., a comprehensive exploration of Astragali Radix against fatigue was undertaken using network pharmacology77. This analysis identified 16 active AR compounds and pinpointed 7 core targets. Core compounds in Astragali Radix, such as quercetin, kaempferol, formononetin, and isorhamnetin, combat fatigue partly through their anti-inflammatory effects. Formononetin scavenges DPPH radicals and promotes IL-4 release to ease fatigue. Isorhamnetin reduces TNF-α and IL-12 production and boosts heme oxygenase 1, exerting anti-inflammatory effects77. Quercetin has the capability to decrease IL-6 and STAT3 plasma concentrations, thereby inhibiting the inflammatory response linked to fatigue78.

Medicinal Plants for the Management of Post-COVID-19 Fatigue: a Literature Review on the Role and Mechanisms
https://www.sciencedirect.com/science/article/pii/S2225411024000622

What intrigues me the most about Radix Astragali/RAS is that it is also effective in treating those suffering from IPF. As is now well known, IPF is potential sequela of COVID infection/Spike Protein exposure. While there is currently no cure for IPF, the combination was shown to improve quality of life.

Currently, the main study end point of IPF is the absolute value of FVC, and the secondary study end point is quality of life score and 6MWD (Noble et al., 2011; Lee et al., 2013; Ryerson et al., 2019). We analyzed these indicators primarily. In this study, the RCTs of RA and RAS in the treatment of IPF were systematically evaluated and meta-analysis was carried out. The results of meta-analysis show that total effective rate and TCM syndrome effective rate were statistically significantly higher in experimental group than control group, which suggest that RA and RAS can significantly improve the curative effect of IPF; FVC, FVC% pred, TCL% pred, DLCO and DLCO% pred, were statistically significantly higher in experimental group than control group, which suggest that RA and RAS is beneficial to pulmonary function of patients with IPF; 6MWD was statistically significantly higher in experimental group than control group and Borg scale questionnaire score was statistically significantly lower in experimental group than control group, which suggest that RA and RAS can improve exercise tolerance in patients with IPF; there was no significant difference between experimental group and control group compared total SGRQ scores, activity limitation scores and impact scores, but symptoms scores of SGRQ scores was statistically significantly lower in experimental group than control group, which suggest that RA and RAS can improve respiratory symptoms in patients with IPF, and other indexes may have more influencing factors.

We have also conducted a meta-analysis of other indicators. PaO2 were statistically significantly higher in experimental group than control group, which suggest that RA and RAS can improve the oxygenation in patients with IPF and there was no significant difference between experimental group than control group compared SaO2, which may be related to the characteristics of the oxygen dissociation curve (Figure S3). TNF-α was statistically significantly lower in experimental group than control group and there was no significant difference between experimental group than control group compared TGF-β1, which suggest that inhibitory inflammatory factors may play a role of RA and RAS in the treatment of IPF, but more samples are needed to further verify it (Figure S4).

In this systematic evaluation, the TCM syndrome effective rate and syndrome score of TCM were analyzed and made meta-analysis. The results of meta-analysis showed that TCM syndrome effective rate of clinical effect was statistically significantly higher in experimental group than control group; cough, wheezing, short of breath, fatigue, thirst, coated tongue and pulse manifestation syndrome score of TCM were statistically significantly lower in experimental group than control group. These results suggest that RA and RAS is effective in treating IPF, especially could improve the syndrome of cough, wheezing, short of breath and other syndrome which are closely related to the respiratory system.

Radix Astragali and Radix Angelicae Sinensis in the Treatment of Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-analysis
https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2020.00415/full

It is not currently known whether the pulmonary fibrosis induced by SARS-CoV-2 and its Spike Protein is progressive. Regardless, RA/RAS has demonstrated that it, at the very least, may provide some relief for those experiencing pulmonary fibrosis and fatigue post-COVID.

One other aspect of RA, is that is provides significant protection against oxidative stress-related disease. This would then logically lead one to believe that its use is most likely warranted in the acute phase of COVID/Spike Protein exposure.

Specifically, constituents of the dried roots of Astragalus spp. (Radix Astragali) provide significant protection against heart, brain, kidney, intestine, liver and lung injury in various models of oxidative stress-related disease. Different isolated constituents of Astragalus spp., such as astragalosides, flavonoids and polysaccharides also displayed significant prevention of tissue injury via antioxidant mechanisms.

The Antioxidant Effects of Radix Astragali (Astragalus membranaceus and Related Species) in Protecting Tissues from Injury and Disease
https://pubmed.ncbi.nlm.nih.gov/26343107/

As with all of my Friday Hope posts, please remember that they are not medical advice. They are works of medical research meant to be shared with your Primary Care Provider to determine if any of the therapeutics may be beneficial. RA/RAS is capable of inducing some nasty side effects in some individuals. Please consult your Primary Care Provider before using any medicine or supplement.

Thank you, again and always, for your continued support, readership and dialog. As I have always maintained, and recently stated, I couldn’t do this without your support.