INTRODUCTION
On the 31st December, 2019, the WHO China Country Office was informed of
44 cases of pneumonia of unknown microbial aetiology associated with
Wuhan City,Hubei Province, China. (Overview of 2019 novel coronavirus
(2019-nCoV).WHO recommends that the interim name of the disease causing
the current outbreak should be
“2019-nCoV acute respiratory
disease” (where ‘n’ is for novel and ‘CoV’ is for coronavirus) (Novel
Coronavirus(2019-nCoV) Situation Report – 10). Seasonal outbreaks of
the virus affect nearly 10% of the world population and may lead up to
a million deaths annually (Layne, Monto, & Taubenberger, 2009).
There is a folk song that highlights the importance of the elderberry,
“Skin, leaf, flower and fruit, each piece is a
treasure”2. (Compendium of Materia Medica). The
medicinal plant is used to relieve stress, various stomach ailments,
high cholesterol, congestion, and to fight all strains of the flu.
Elderberries additionally promote a healthy complexion and strengthen
the body’s immune system. The main elderberry species is
Sambucus nigra , which is native and common in Europe and
the UK. It is found wild along hedgerows, edges of woodlands and on
waste ground. Sambucus canadensis, the American
elderberry, originates from northern America, and is similar toSambucus nigra. Sambucus caerule, the blue
elderberry and Sambucus mexicana , are similar species’,
with the latter originating from warmer climates. The fruit may be blue,
bright-blue, or red.
Elderberry, or elder, has been applied to the skin and used for
centuries to treat wounds. Additionally, elder is taken orally to treat
respiratory illnesses such the cold and flu in countries such as
Germany. Evidence (Compendium of Materia Medica )suggests that
chemicals in elder flower and the berries may reduce swelling in mucous
membranes such as the sinuses, and help relieve nasal congestion. Elder
may have anti-inflammatory, antiviral, and anticancer
properties(Compendium of Materia Medica ). The action of elderberry
(Sambucus nigra ) is both direct – suppressing viral entry,
affecting the post-infection phase, and viral transmission from cell to
cell, and indirect – by modulating the release of cytokines such as
IL-6, IL-8, and TNF. ( Golnoosh Torabian et al. 2019)
Since the launch of Sambucol in the US in 1995, and achievement of the
Vity Awards in 1997, 1998, 1999, numerous products have appeared and the
beneficial properties of elderberry are now known worldwide. Sambucus
nigra L. product –Sambucol was shown to be effective in vitro against
10 strains of influenza virus. In a double-blind, placebo-controlled,
randomized study, Sambucol reduced the duration of flu symptoms to 3-4
days. (Barak, V., et al. 2001). A standardized elderberry extract,
(Sambucus nigra), reduced hemagglutination and inhibited replication of
human influenza viruses type A/Shandong 9/93 (H3N2), A/Beijing32/92
(H3N2), A /Texas3 6/91 (H1, N1) A, /Singapore6
/85(H1N1)(Zakay-Rones Z et al.
1995). On influenza A and B viruses, elderberry extract offers an
efficient, safe and cost-effective supplement to the present
armamentarium of medications for the prophylaxis and treatment of
influenza. (Zakay-Rones Z et al. 200). The elderberry extract
inhibited Human Influenza A (H1N1) infection in vitro with an IC50 value
of 252 ± 34 lg/mL. The Direct Binding Assay established that flavonoids
from the elderberry extract bind to H1N1 virions and, when bound, block
the ability of the viruses to infect host cells. These flavonoids are
the major contributors to the anti-influenza activity of the elderberry
extract. The molecular mode-of-action of these flavonoids was determined
by demonstrating their direct binding to H1N1 virus particles resulting
in the inability of the H1N1 viruses to enter host cells, effectively
preventing H1N1 infection in vitro (Roschek B Jr. et al.2009).
Elderberry contains flavonoids, which have antioxidant properties and
may help to prevent damage to the body’s cells. However, very few
studies have been done in humans, so researchers have no exact data
about the effectiveness of elderberry. Of the several species of elder,Sambucus nigra , the European or black elder, is used the most
commonly for medicinal purposes. The dwarf elder (Sambucus
ebulus ) is to be avoided as it is toxic. Recommendations suggest using
a trusted preparation of elder, raw or unripe fruit –as well as the
leaves, seeds, and rind –contain a chemical related to cyanide, which
is poisonous.
Elderberry (Sambucus nigra L. subsp. nigra) is a
European species with an oceanic, sub-oceanic, cool-temperate and
west-Mediterranean range. This species is common in western and central
Europe as well as North Africa, Scandinavia and Great Britain. Its
distribution range reaches 63°N latitude in western Norway (with
scattered naturalized shrubs up to at least 68°N) and approximately 55°N
in Lithuania (Laivinš, 2002; Atkinson and Atkinson, 2002).