Kabasura kudineer choornam, a medicinal polyherbal formulation, modulates human macrophage polarization and phagocytic function

BACKGROUND/AIM: Kabasura kudineer choornam (KKC) is a polyherbal formulation of 15 ingredients. It has antiinflammatory and antimicrobial properties and are effective in managing the symptoms of H1N1 swine flu and COVID-19. However, its mechanism of action is not fully understood. In this study, we examined the effect of KKC on the polarization and function of primary human macrophages. MATERIALS AND METHODS: Human monocyte-derived macrophages (M0 macrophages) pretreated with KKC extract were polarized into M1, M2a, or M2c subtypes. The expression of the M1/M2 polarization markers was analyzed using qPCR, flow cytometry, and ELISA, and the phagocytosis capacity of macrophages was analyzed using flow cytometry. RESULTS: Our data show that the KKC treatment increased the expression of the M1 markers IDO1, IL-1β, IL-12a (p35), and TNF in both polarized and unpolarized macrophages at mRNA level. However, it decreased the secretion of IL-12 (p70) in M1 macrophages and increased the secretion of TNF in M0, M2a, and M2c macrophages. IL-10 secretion was increased in M0 and M2a macrophages, while it was decreased in M1 macrophages after the KKC treatment. Interestingly, all KKC-treated macrophage phenotypes displayed a downregulation in the expression of the M1/M2 surface markers CD64, CD206, CD209, and CD163, which also play a role in phagocytosis. In accordance with this result, the phagocytic capacity of both polarized and unpolarized macrophages was decreased after the KKC treatment. CONCLUSION: KKC extract modulates macrophage inflammatory response and could be a potential supplement for the treatment of infectious and inflammatory diseases.