The potential use of Bear bile in Coronavirus Disease (COVID-19)
The objective of this report is to assess current available evidence on the potential of bear bile in COVID-19 management based on the following:
- Efficacy : Focusing on bear bile’s reported properties of 1 : antiviral effects; 2: modulation of immune response, and 3. role as other supportive theraphy or management of disease related complications; and their respective potential mechanism(s) of actions.
- Safety of bear bile.
Electronic databases were searched using pre-determined terminologies such as ‘bear bile’, ‘antiviral’, ‘immunomodulatory’, ‘immune response’, ‘mechanism of action, and ‘ safety’. All clinical and preclinical studies (both in vitro and invivo) related to safety and efficacy or effective ness of probiotics in treating viral disease were included.
Result and discussion
Based on traditional use and published literature, research on bear bile, UDCA, and TUDCA were mostly focused on hepatobiliary disease such as acute and chronic Hepatitis C. Although hepatoprotective effects have been reported, the specific mechanism of action of bear bile powder are unclear while good quality evidence of direct antiviral effects are limited. There are also preclinical evidence of the potential anti-inflammatory and immunomodulatory properties of bear bile, UDCA, and TUDCA. This corresponds to bear bile’s traditional and current documented use based on Chinese Medicine philosophy, which is for the cure of overabundance of liver fire and redness of eyes due to liver heat. Due to this, currently bear bile appears to have more potential to be of as supportive treatment for complications related or unrelated to respiratory infection such as the COVID-19 pneumonia, rather than a direct treatment and cure. Research on the antiviral effects of bear bile should cover parameters such as evidence of direct viral suppressive effects, or on inflammatory parameters such as white blood cell count, lymphocytes (CD3+ CD4 +CD8 + CD4+CD8), C-reactive protein level, erythrocyte sedimentation rate, and clinical imaging such as CT scan of the chest. There are also concerns on user’s perception that farmed bear bile is lower quality than wild-caught bear bile due to the high rate of extraction and poor nutrition.
In conclusion, current preclinical evidence on viral suppression and anti-inflammatory effects of bear bile shows potential use as supportive treatment though further research is required to determine its definitive role in COVID-19 treatment. Future research should focus on identifying the bioactive compounds and mechanism of bear bile in exerting its medicinal effects, to aid in the discovery and design of feasible and humane substitutes, synthetic or natural.