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Using Complementary and Alternative Medicines to Target the Host Response during Severe Influenza
Evidence-based Complementary and Alternative Medicine , 10/05/09

Alleva LM et al. – The example given here of an ancient Chinese medicine formula used to treat influenza containing nine (out of 11) herbs with anti–inflammatory properties provides compelling evidence that the way forward for the treatment of influenza in a pandemic should be immunomodulation. The host response is targeted, rather than the virus itself. The authors' observation that treatment of influenza virus–infected mice with a pharmaceutical used in humans, the lipid–lowering and immunomodulatory PPAR alpha agonist gemfibrozil, resulted in significantly decreased influenza–induced mortality, further shows that targeting the host response is a valid possibility. The natural immunomodulatory agent biochanin A from Red Clover, which is both a PPAR alpha and PPAR gamma agonist, could have similar effects to gemfibrozil on the course of influenza disease in vivo. Chinese herbs such as A. sinensis and S. miltiorrhiza which independently reduce secretion of the novel inflammatory cytokine HMGB1, and glycyrrhizin from liquorice root, which binds to HMGB1 and inactivates its activity, provide another avenue for investigation, as does the establishment of the role of HMGB1 in severe influenza.

Exclusive Author Commentary
Lisa Alleva, 10/05/09

Immunomodulatory treatments could be harnessed to treat severe influenza. We propose that complementary and alternative medicine, as well as conventional medicine, should be explored for therapies, and that special attention should be payed to those therapies that specifically tone-down the pro-inflammatory response.