Molecular Docking Analysis of Adhatoda vasica with Thromboxane A2 Receptor (TXA2R) (6IIU) and Antiviral Molecules for Possible Dengue Complications.

OBJECTIVE: The present study is an in silico model of platelet amplification potential of Adhatoda vasica, which can be used to treat thrombocytopenia in dengue complications. METHODS: Docking studies have proved to be an essential tool that facilitates the structural diversity of natural products to be harnessed in an organized manner. In the present study, vasicine containing natural anti-dengue potential was subjected to docking studies using Schrodinger glides software (ver.11.1). The docking study was carried out to find out the potential molecular targets for selected protein. The docking was carried out on different ligands, like vasicine, ramatroban, chloroquine, celgosivir, and standard eltrombopag downloaded from PubChem and retrieved to glide software and ligands prepared using lig prep wizard. Docking was performed using the ligand docking wizard of Glide-maestro 2018. RESULTS: The docking score of vasicine (-5.27) is nearly identical to the standard eltrombopag (-6.08), and both ligands bind with one hydrogen bond. The validation score of ramatroban is -12.39, binding with five hydrogen bonds, Celgosivir exhibited a docking score of -7.3 with three hydrogen bonds, and chloroquine displayed no hydrogen bond but had a docking score of -4.6. CONCLUSION: Vasicine was found to be the most suitable target of platelet amplification potential from Adhatoda vasica. However, the molecular docking results are preliminary, and it has been indicated that vasicine could be one of the potential ligands to treat the thrombocytopenia of dengue; experimental evaluation will be carried out in the near future.

The Role of Justicia adhatoda as Prophylaxis for COVID-19 - Analysis Based on Docking.

Coronavirus causes severe harm to the health of both humans as well as animals, creating a major global health problem affecting millions of populations. Considering the situational emergency of identifying novel targeted therapy, we have chosen the herbal compound Adhatoda Justicia/ vasica, which is a high potent olden vital compound having a key role in various respiratory conditions with multiple beneficial uses. Adhatoda is promoted and supported by the Ministry of AYUSH for symptomatic management of respiratory ailments in the case of COVID 19. In this study, we focused on the efficacy of Adathoda primary active alkaloid, vasicine against coronavirus infectious symptoms, evaluated by in silico screening studies on virus proteins ACE 2 Receptor, 3CL protease and Spike protein SARS HR1 motif using PyRx tool and AutoDoc 1.5.6. Based on PyRx results, Vasicine with ACE 2 Receptor showed a higher docking affinity score -7.1 K/cal respectively when compared to other virus proteins. AutoDoc 1.5.6 screening study report showed that vasicine promotes good inhibitory constant 486.54 mM on 3CL protease more than others. Results reveal that vasicine could be a potential target for the treatment of COVID 19. This study adds strong evidence to the claim by the advisory released by AYUSH. Based on the results with the available literature, Adhatoda could be a drug helpful in relieving symptoms in non-- COVID cases in those who were quarantined or in lockdown pace, thereby reducing pandemic panic in confirmed asymptomatic or mild cases. For usage in moderate to severe cases, this could be an add-on therapy with existing modern medical therapy.

Are We Jumping the Gun with Itolizumab in India? A Situational Analysis from the Pre-COVID Era.

Itolizumab, an anti-CD6 monoclonal antibody, has been recently approved for the off-label indication of cytokine release syndrome in the background of COVID-19, by the Drug Controller General of India. However, this drug has not been included in the National Clinical Management Protocol for COVID-19 yet. The limited-to-no experience of the Indian health workforce with the drug urged us to conduct a situational analysis in the pre-COVID era to analyse the degree of use of the drug and the indications for which it has been employed.

Role of Dupilumab in Approved Indications of COVID-19 Patient: an Efficacy-Based Nonsystematic Critical Analysis.

With many drugs being tried in the management and treatment of COVID-19, dupilumab is one such monoclonal antibody that has come under the limelight for its possible role as an adjunct therapy in COVID-19 position. There are isolated case reports and series that document a milder course of COVID-19 infection in patients who have already been on dupilumab therapy for treatment of conditions such as atopic dermatitis and chronic rhino-sinusitis with nasal polyp. There is also an ongoing debate regarding the continuation of biologicals in the COVID patient. In this article, a non-systematic critical analysis of dupilumab was performed to delve into this hypothesis further.

COVID-19: Older drugs for a novel disease-Chloroquine, hydroxychloroquine, and possible Pentoxifylline-set to start the second innings?

Currently no drug is approved for the prophylaxis and management of COVID 19. Lots of activities on vaccine and trials with drugs are underway. Some evidence have shown positive results using older established drug in the management of severe cases. We are also of same view and opinion to adopt some emergency measure by pharmacological intervention till a newer drug available in the market.

Can HCQ Be Considered a "Safe Weapon" for COVID-19 in the Indian Population?

With no drugs currently approved for treatment and cure of COVID-19 (coronavirus disease 2019), hydroxychloroquine is one of the many first-line drugs used in the management. However, given the life-threatening adverse effects of HCQ that have been reported, its use as a prophylactic treatment remains debated. HCQ has long been used in India for the treatment of malaria, auto-immune and inflammatory diseases, and even type 2 diabetes mellitus recently. We aimed to review existing literature and relevant Web sites regarding the safety profile of HCQ in the Indian subcontinent. A non-systematic critical analysis of all published literature/studies focused on the Indian population, recording on the use of HCQ for various indications up till April 2020 was done and frequency of occurrence of HCQ related life-threatening and cardiac side effects were noted. Results from PubMed database showed an incidence of 0.6% of cardiac-related side effects and 7.42% of other self-limiting and minor side effects among the Indian population on HCQ. Considering its minimal risk and favorable safety profile, cost-effectiveness, availability, and affordability in India, the use of hydroxychloroquine in the fight against COVID-19 appears rationale. Following the results of our study, we hypothesize that Indians might be less likely to suffer from cardiac-related side effects given their genetic make-up. However, this would need further studies, clinical trials, and a pharmacogenomic understanding of the subject.