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).