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Mohamed Yusof NIS, Mohd Fauzi F. Nature's Toolbox for Alzheimer's Disease: A Review on the Potential of Natural Products as Alzheimer's Disease Drugs. Neurochem Int 2024; 176:105738. [PMID: 38616012 DOI: 10.1016/j.neuint.2024.105738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 03/18/2024] [Accepted: 04/06/2024] [Indexed: 04/16/2024]
Abstract
Numerous clinical trials involving natural products have been conducted to observe cognitive performances and biomarkers in Alzheimer's Disease (AD) patients. However, to date, no natural-based drugs have been approved by the FDA as treatments for AD. In this review, natural product-based compounds that were tested in clinical trials from 2011 to 2023, registered at www.clinicaltrials.gov were reviewed. Thirteen compounds, encompassing 7 different mechanisms of action were covered. Several observations were deduced, which are: i) several compounds showed cognitive improvement, but these improvements may not extend to AD, ii) compounds that are endogenous to the human body showed better outcomes, and iii) Docosahexaenoic acid (DHA) and cerebrolysin had the most potential as AD drugs among the 13 compounds. Based on the current findings, natural products may be more suitable as a supplement than AD drugs in most cases. However, the studies covered here were conducted in a relatively short amount of time, where compounds acting on AD pathways may take time to show any effect. Given the diverse pathways that these natural products are involved in, they may potentially produce synergistic effects that would be beneficial in treating AD. Additionally, natural products benefit from both physicochemical properties being in more favorable ranges and active transport playing a more significant role than it does for synthetic compounds.
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Affiliation(s)
| | - Fazlin Mohd Fauzi
- Faculty of Pharmacy, Universiti Teknologi MARA Selangor, Puncak Alam Campus, 42 300 Bandar Puncak Alam, Selangor, Malaysia; Center for Drug Discovery Research, Faculty of Pharmacy, Universiti Teknologi MARA Selangor, Puncak Alam Campus, 42 300 Bandar Puncak Alam, Selangor, Malaysia.
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Peng Y, Chen Q, Xue YH, Jin H, Liu S, Du MQ, Yao SY. Ginkgo biloba and Its Chemical Components in the Management of Alzheimer's Disease. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2024; 52:625-666. [PMID: 38654507 DOI: 10.1142/s0192415x24500277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
The pathogenesis of Alzheimer's disease (AD), a degenerative disease of the central nervous system, remains unclear. The main manifestations of AD include cognitive and behavioral disorders, neuropsychiatric symptoms, neuroinflammation, amyloid plaques, and neurofibrillary tangles. However, current drugs for AD once the dementia stage has been reached only treat symptoms and do not delay progression, and the research and development of targeted drugs for AD have reached a bottleneck. Thus, other treatment options are needed. Bioactive ingredients derived from plants are promising therapeutic agents. Specifically, Ginkgo biloba (Gb) extracts exert anti-oxidant, anticancer, neuroplastic, neurotransmitter-modulating, blood fluidity, and anti-inflammatory effects, offering alternative options in the treatment of cardiovascular, metabolic, and neurodegenerative diseases. The main chemical components of Gb include flavonoids, terpene lactones, proanthocyanidins, organic acids, polysaccharides, and amino acids. Gb and its extracts have shown remarkable therapeutic effects on various neurodegenerative diseases, including AD, with few adverse reactions. Thus, high-quality Gb extracts are a well-established treatment option for AD. In this review, we summarize the insights derived from traditional Chinese medicine, experimental models, and emerging clinical trials on the role of Gb and its chemical components in the treatment of the main clinical manifestations of AD.
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Affiliation(s)
- Yong Peng
- Department of Neurology, Affiliated First Hospital of Hunan Traditional, Chinese Medical College, Zhuzhou, Hunan, P. R. China
- Department of Neurology, Affiliated Provincial Hospital of Hunan University of Chinese Medicine, Zhuzhou, Hunan, P. R. China
| | - Quan Chen
- Department of Neurology, Affiliated First Hospital of Hunan Traditional, Chinese Medical College, Zhuzhou, Hunan, P. R. China
- Department of Neurology, Affiliated Provincial Hospital of Hunan University of Chinese Medicine, Zhuzhou, Hunan, P. R. China
| | - Ya-Hui Xue
- Department of Neurology, Affiliated First Hospital of Hunan Traditional, Chinese Medical College, Zhuzhou, Hunan, P. R. China
- Department of Neurology, Affiliated Provincial Hospital of Hunan University of Chinese Medicine, Zhuzhou, Hunan, P. R. China
| | - Hong Jin
- Department of Neurology, Affiliated First Hospital of Hunan Traditional, Chinese Medical College, Zhuzhou, Hunan, P. R. China
- Department of Neurology, Affiliated Provincial Hospital of Hunan University of Chinese Medicine, Zhuzhou, Hunan, P. R. China
| | - Shu Liu
- Department of Neurology, Affiliated First Hospital of Hunan Traditional, Chinese Medical College, Zhuzhou, Hunan, P. R. China
- Department of Neurology, Affiliated Provincial Hospital of Hunan University of Chinese Medicine, Zhuzhou, Hunan, P. R. China
| | - Miao-Qiao Du
- Department of Neurology, Affiliated First Hospital of Hunan Traditional, Chinese Medical College, Zhuzhou, Hunan, P. R. China
- Department of Neurology, Affiliated Provincial Hospital of Hunan University of Chinese Medicine, Zhuzhou, Hunan, P. R. China
| | - Shun-Yu Yao
- Department of Neurology, Affiliated First Hospital of Hunan Traditional, Chinese Medical College, Zhuzhou, Hunan, P. R. China
- Department of Neurology, Affiliated Provincial Hospital of Hunan University of Chinese Medicine, Zhuzhou, Hunan, P. R. China
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He MT, Kim JH, Cho EJ. Co-treatment with the seed of Carthamus tinctorius L. and the aerial part of Taraxacum coreanum synergistically suppresses Aβ 25-35-induced neurotoxicity by altering APP processing. Food Sci Nutr 2024; 12:1573-1580. [PMID: 38455162 PMCID: PMC10916591 DOI: 10.1002/fsn3.3768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/18/2023] [Accepted: 09/27/2023] [Indexed: 03/09/2024] Open
Abstract
Accumulation of β-amyloid peptide (Aβ) induces neurotoxicity, which is the primary risk factor in the pathogenesis of Alzheimer's disease (AD). The cleavage of amyloid precursor protein (APP) by the β- (BACE) and γ- (PS1, PS2) secretases is a critical step in the amyloidogenic pathway. The induction of neuronal apoptosis by Aβ involves increased expression of B-cell lymphoma protein 2 (Bcl-2)-associated X (Bax) and decreased Bcl-2 expression. The seed of Carthamus tinctorius L. (CTS) and the aerial part of Taraxacum coreanum (TC) are traditional herbs used to treat several neurodegenerative diseases. In this study, the neuroprotective effects of co-treatment with CTS and TC on Aβ-induced neurotoxicity in SH-SY5Y neuroblastoma cells and the underlying mechanisms were investigated. CTS, TC, and the co-treatment (CTS + TC) were added to Aβ25-35-treated SH-SY5Y cells. CTS + TC synergistically increased cell viability and inhibited reactive oxygen species production. CTS + TC resulted in significant downregulation of BACE, PS1, PS2, and APP, as well as the 99-aa C-terminal domain of APP, compared with either CTS or TC alone. Compared with the single herbs, co-treatment with CTS and TC markedly decreased the expression of Bax and increased the expression of Bcl-2, consistent with its anti-apoptotic effects. These findings suggest that co-treatment with CTS and TC may be useful for AD prevention.
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Affiliation(s)
- Mei Tong He
- College of Korean MedicineGachon UniversitySeongnamKorea
| | - Ji Hyun Kim
- Department of Food Science and NutritionGyeongsang National UniversityJinjuKorea
| | - Eun Ju Cho
- Department of Food Science and Nutrition & Kimchi Research InstitutePusan National UniversityBusanKorea
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Zhi J, Yin L, Zhang Z, Lv Y, Wu F, Yang Y, Zhang E, Li H, Lu N, Zhou M, Hu Q. Network pharmacology-based analysis of Jin-Si-Wei on the treatment of Alzheimer's disease. JOURNAL OF ETHNOPHARMACOLOGY 2024; 319:117291. [PMID: 37925002 DOI: 10.1016/j.jep.2023.117291] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/28/2023] [Accepted: 10/06/2023] [Indexed: 11/06/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Jin-Si-Wei (JSW), a traditional Chinese medicine (TCM) formula, have cognitive enhancing effect and delay the memory decline in an animal model of AD, which has been reported. However, the therapeutic mechanism of JSW in the treatment of AD remains unclear. AIM OF THE STUDY This study aimed to verify the pharmacodynamics of JSW in the treatment of AD, and to explore its potential mechanism based on network pharmacology, molecular docking and experimental validation both in vitro and in vivo. MATERIALS AND METHODS In this study, the underlying mechanism of JSW against AD was investigated by the integration of network pharmacology. Then, the core pathways and biological process of JSW were verified by experiment, including behavioral test and pathological and biochemical assays with 6-month-old APPswe/PS1ΔE9 transgenic (APP/PS1) mice in vivo and verified with Aβ1-42-stimulated SH-SY5Y cells in vitro. At last, molecular docking was used to show the binding activity of each active ingredient to the core genes of JSW treatment in AD. RESULTS A Drug-Ingredient-Target network was established, which included 363 ingredients and 116 targets related to the JSW treatment of AD. The main metabolic pathway of JSW treatment for AD is neuroactive ligand-receptor interaction pathway, and biological processes are mainly involved in Aβ metabolic process. In vivo experiments, compared with APP/PS1 mice, the cognitive and memory ability of mice was significantly improved after JSW administration. In brain tissue of APP/PS1 mice, JSW could increase the contents of low-density lipoprotein receptor-related protein 1 (LRP-1), enkephalinase (NEP) and Acetyl choline (ACh), and decrease the contents of Aβ1-42, amyloid precursor protein (APP) and receptor for advanced glycation end products (RAGE), decrease the vitality of cholinesterase (AChE) and choline acetyltransferase (ChAT). Besides, JSW could increase α-secretase expression and decrease β/γ-secretase expression, and improve the number and morphology of synapses in CA1 region of the hippocampus of APP/PS1 mice. In vitro experiments, Drug-Containing Serum (JSW-serum) has a neuroprotective effect by reducing the apoptosis on Aβ1-42-stimulated SH-SY5Y cells. Molecular docking results showed that 2-Isopropyl-8-methylphenanthrene-3,4-dione had strong binding activity with PTGS2, which maybe a potential ingredient for the treatment of AD. CONCLUSIONS JSW improves AD in APP/PS1 mice, and this therapeutic effect may be achieved in part by altering the neuroactive ligand-receptor interaction pathway.
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Affiliation(s)
- Jiayi Zhi
- Department of Pharmacology, School of Pharmacy, China Pharmaceutical University, Nanjing, 211198, PR China
| | - Li Yin
- Department of Pharmacology, School of Pharmacy, China Pharmaceutical University, Nanjing, 211198, PR China
| | - Zhoudong Zhang
- College of Pharmaceutical Sciences, Soochow University, Suzhou, 215006, PR China
| | - Yaozhong Lv
- Nanjing Central Hospital, Nanjing, 210018, PR China
| | - Fan Wu
- Department of Pharmacology, School of Pharmacy, China Pharmaceutical University, Nanjing, 211198, PR China
| | - Yang Yang
- Department of Pharmacology, School of Pharmacy, China Pharmaceutical University, Nanjing, 211198, PR China
| | - Enming Zhang
- Department of Pharmacology, School of Pharmacy, China Pharmaceutical University, Nanjing, 211198, PR China
| | - Huanqiu Li
- College of Pharmaceutical Sciences, Soochow University, Suzhou, 215006, PR China.
| | - Ning Lu
- Nanjing Central Hospital, Nanjing, 210018, PR China.
| | - Mengze Zhou
- Department of Pharmacology, School of Pharmacy, China Pharmaceutical University, Nanjing, 211198, PR China.
| | - Qinghua Hu
- Department of Pharmacology, School of Pharmacy, China Pharmaceutical University, Nanjing, 211198, PR China
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Zhang J, Yang Z, Fan H. Knowledge structure and future research trends of body-mind exercise for mild cognitive impairment: a bibliometric analysis. Front Neurol 2024; 15:1351741. [PMID: 38322586 PMCID: PMC10844579 DOI: 10.3389/fneur.2024.1351741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/09/2024] [Indexed: 02/08/2024] Open
Abstract
Background Mild cognitive impairment (MCI) is a common neurodegenerative disorder that poses a risk of progression to dementia. There is growing research interest in body-mind exercise (BME) for patients with MCI. While we have observed a rapid growth in interest in BME for MCI over the past 10 years, no bibliometric analysis has investigated the knowledge structure and research trends in this field. Consequently, the objective of this research is to conduct a bibliometric analysis of global publications of BME for MCI from 2013 to 2022. Methods A total of 242 publications in the field of BME for MCI were retrieved from the Web of Science Core Collection. Bibliometric analysis, including performance analysis, science mapping, and visualization, was performed using CiteSpace, VOSviewer, and Microsoft Excel. Results Publications and citations in the field of BME for MCI have shown a rapidly increasing trend over the last decade. Geriatrics & Gerontology, and Neurosciences were the most frequently involved research categories. China (78 documents) and the USA (75 documents) contributed to the largest number of publications and had the strongest international collaborative networks. Fujian University of Traditional Chinese Medicine contributed to the largest number of publications (12 documents), and Chen, L of this institution was the most prolific author (12 documents). Frontiers in Aging Neuroscience (16 documents), and JOURNAL OF ALZHEIMER'S DISEASE (12 documents) were the most prolific journals. Tai Chi and Baduanjin, as specific types of BME, were the hotspots of research in this field, while evidence synthesis and guidelines might be future research trends. Conclusion In the last decade, there has been a rapid growth in scientific activities in the field of BME for MCI. The results of this study provide researchers and other stakeholders with knowledge structure, hotspots, and future research trends in this field.
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Affiliation(s)
- Jing Zhang
- Faculty of Physical Education, Shanghai International Studies University, Shanghai, China
| | - Zhen Yang
- Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- Lothian Birth Cohort, Department of Psychology, The University of Edinburgh, Edinburgh, United Kingdom
| | - Huiying Fan
- School of Physical Education, Shanghai Normal University, Shanghai, China
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Adam CE, Fitzpatrick AL, Leary CS, Ilango SD, Phelan EA, Semmens EO. The impact of falls on activities of daily living in older adults: A retrospective cohort analysis. PLoS One 2024; 19:e0294017. [PMID: 38170712 PMCID: PMC10763967 DOI: 10.1371/journal.pone.0294017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/25/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Falls contribute to impairments in activities of daily living (ADLs), resulting in significant declines in the quality of life, safety, and functioning of older adults. Understanding the magnitude and duration of the effect of falls on ADLs, as well as identifying the characteristics of older adults more likely to have post-fall ADL impairment is critical to inform fall prevention and post-fall intervention. The purpose of this study is to 1) Quantify the association between falls and post-fall ADL impairment and 2) Model trajectories of ADL impairment pre- and post-fall to estimate the long-term impact of falls and identify characteristics of older adults most likely to have impairment. METHOD Study participants were from the Ginkgo Evaluation of Memory Study, a randomized controlled trial in older adults (age 75+) in the United States. Self-reported incident falls and ADL scores were ascertained every 6 months over a 7-year study period. We used Cox proportional hazards analyses (n = 2091) to quantify the association between falls and ADL impairment and latent class trajectory modeling (n = 748) to visualize trajectories of ADL impairment pre-and post-fall. RESULTS Falls reported in the previous 6 months were associated with impairment in ADLs (HR: 1.42; 95% CI 1.32, 1.52) in fully adjusted models. Based on trajectory modeling (n = 748), 19% (n = 139) of participants had increased, persistent ADL impairment after falling. Participants who were female, lived in a neighborhood with higher deprivation, or experienced polypharmacy were more likely to have ADL impairment post-fall. CONCLUSIONS Falls are associated with increased ADL impairment, and this impairment can persist over time. It is crucial that all older adults, and particularly those at higher risk of post-fall ADL impairment have access to comprehensive fall risk assessment and evidence-based fall prevention interventions, to help mitigate the negative impacts on ADL function.
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Affiliation(s)
- Claire E. Adam
- School of Public and Community Health Sciences, University of Montana, Missoula, Montana, United States of America
- Center for Population Health Research, University of Montana, Missoula, Montana, United States of America
| | - Annette L. Fitzpatrick
- Department of Family Medicine, University of Washington, Seattle, Washington, United States of America
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, United States of America
| | - Cindy S. Leary
- School of Public and Community Health Sciences, University of Montana, Missoula, Montana, United States of America
- Center for Population Health Research, University of Montana, Missoula, Montana, United States of America
| | - Sindana D. Ilango
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, United States of America
| | - Elizabeth A. Phelan
- Division of Gerontology and Geriatric Medicine, School of Medicine, University of Washington, Seattle, Washington, United States of America
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington, United States of America
| | - Erin O. Semmens
- School of Public and Community Health Sciences, University of Montana, Missoula, Montana, United States of America
- Center for Population Health Research, University of Montana, Missoula, Montana, United States of America
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de Veij Mestdagh CF, Smit AB, Henning RH, van Kesteren RE. Mitochondrial Targeting against Alzheimer's Disease: Lessons from Hibernation. Cells 2023; 13:12. [PMID: 38201215 PMCID: PMC10778235 DOI: 10.3390/cells13010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
Alzheimer's disease (AD) is the most common cause of dementia worldwide and yet remains without effective therapy. Amongst the many proposed causes of AD, the mitochondrial cascade hypothesis is gaining attention. Accumulating evidence shows that mitochondrial dysfunction is a driving force behind synaptic dysfunction and cognitive decline in AD patients. However, therapies targeting the mitochondria in AD have proven unsuccessful so far, and out-of-the-box options, such as hibernation-derived mitochondrial mechanisms, may provide valuable new insights. Hibernators uniquely and rapidly alternate between suppression and re-activation of the mitochondria while maintaining a sufficient energy supply and without acquiring ROS damage. Here, we briefly give an overview of mitochondrial dysfunction in AD, how it affects synaptic function, and why mitochondrial targeting in AD has remained unsuccessful so far. We then discuss mitochondria in hibernation and daily torpor in mice, covering current advancements in hibernation-derived mitochondrial targeting strategies. We conclude with new ideas on how hibernation-derived dual mitochondrial targeting of both the ATP and ROS pathways may boost mitochondrial health and induce local synaptic protein translation to increase synaptic function and plasticity. Further exploration of these mechanisms may provide more effective treatment options for AD in the future.
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Affiliation(s)
- Christina F. de Veij Mestdagh
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands; (A.B.S.); (R.E.v.K.)
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands;
- Alzheimer Center Amsterdam, Amsterdam UMC Location VUmc, 1081 HV Amsterdam, The Netherlands
| | - August B. Smit
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands; (A.B.S.); (R.E.v.K.)
| | - Robert H. Henning
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands;
| | - Ronald E. van Kesteren
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands; (A.B.S.); (R.E.v.K.)
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Wang Q, Sun J, Chen T, Song S, Hou Y, Feng L, Fan C, Li M. Ferroptosis, Pyroptosis, and Cuproptosis in Alzheimer's Disease. ACS Chem Neurosci 2023; 14:3564-3587. [PMID: 37703318 DOI: 10.1021/acschemneuro.3c00343] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023] Open
Abstract
Alzheimer's disease (AD), the most common type of dementia, is a neurodegenerative disorder characterized by progressive cognitive dysfunction. Epidemiological investigation has demonstrated that, after cardiovascular and cerebrovascular diseases, tumors, and other causes, AD has become a major health issue affecting elderly individuals, with its mortality rate acutely increasing each year. Regulatory cell death is the active and orderly death of genetically determined cells, which is ubiquitous in the development of living organisms and is crucial to the regulation of life homeostasis. With extensive research on regulatory cell death in AD, increasing evidence has revealed that ferroptosis, pyroptosis, and cuproptosis are closely related to the occurrence, development, and prognosis of AD. This paper will review the molecular mechanisms of ferroptosis, pyroptosis, and cuproptosis and their regulatory roles in AD to explore potential therapeutic targets for the treatment of AD.
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Affiliation(s)
- Qi Wang
- College of Integrated Chinese and Western Medicine, Changchun University of Chinese Medicine, Changchun 130117, Jilin, China
| | - Jingyi Sun
- Department of Neurology, The Second Affiliated Hospital of Shandong First Medical University, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian 271000, Shandong, China
| | - Tian Chen
- Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efficacy, Jilin Provincial Key Laboratory of Bio-Macromolecules of Chinese Medicine, Ministry of Education, Northeast Asia Research Institute of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun 130117, Jilin, China
| | - Siyu Song
- Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efficacy, Jilin Provincial Key Laboratory of Bio-Macromolecules of Chinese Medicine, Ministry of Education, Northeast Asia Research Institute of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun 130117, Jilin, China
| | - Yajun Hou
- Department of Neurology, The Second Affiliated Hospital of Shandong First Medical University, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian 271000, Shandong, China
| | - Lina Feng
- Department of Neurology, The Second Affiliated Hospital of Shandong First Medical University, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian 271000, Shandong, China
| | - Cundong Fan
- Department of Neurology, The Second Affiliated Hospital of Shandong First Medical University, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian 271000, Shandong, China
| | - Mingquan Li
- College of Integrated Chinese and Western Medicine, Changchun University of Chinese Medicine, Changchun 130117, Jilin, China
- Department of Neurology, The Third Affiliated Clinical Hospital of the Changchun University of Chinese Medicine, Changchun 130117, Jilin, China
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Aslam MM, Fan KH, Lawrence E, Bedison MA, Snitz BE, DeKosky ST, Lopez OL, Feingold E, Kamboh MI. Genome-wide analysis identifies novel loci influencing plasma apolipoprotein E concentration and Alzheimer's disease risk. Mol Psychiatry 2023; 28:4451-4462. [PMID: 37666928 PMCID: PMC10827653 DOI: 10.1038/s41380-023-02170-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 06/16/2023] [Accepted: 06/27/2023] [Indexed: 09/06/2023]
Abstract
The APOE 2/3/4 polymorphism is the greatest genetic risk factor for Alzheimer's disease (AD). This polymorphism is also associated with variation in plasma ApoE level; while APOE*4 lowers, APOE*2 increases ApoE level. Lower plasma ApoE level has also been suggested to be a risk factor for incident dementia. To our knowledge, no large genome-wide association study (GWAS) has been reported on plasma ApoE level. This study aimed to identify new genetic variants affecting plasma ApoE level as well as to test if baseline ApoE level is associated with cognitive function and incident dementia in a longitudinally followed cohort of the Ginkgo Evaluation of Memory (GEM) study. Baseline plasma ApoE concentration was measured in 3031 participants (95.4% European Americans (EAs)). GWAS analysis was performed on 2580 self-identified EAs where both genotype and plasma ApoE data were available. Lower ApoE concentration was associated with worse cognitive function, but not with incident dementia. As expected, the risk for AD increased from E2/2 through to E4/4 genotypes (P for trend = 4.8E-75). In addition to confirming the expected and opposite associations of APOE*2 (P = 4.73E-79) and APOE*4 (P = 8.73E-12) with ApoE level, GWAS analysis revealed nine additional independent signals in the APOE region, and together they explained about 22% of the variance in plasma ApoE level. We also identified seven new loci on chromosomes 1, 4, 5, 7, 11, 12 and 20 (P range = 5.49E-08 to 5.36E-10) that explained about 9% of the variance in ApoE level. Plasma ApoE level-associated independent variants, especially in the APOE region, were also associated with AD risk and amyloid deposition in the brain, indicating that genetically determined ApoE level variation may be a risk factor for developing AD. These results improve our understanding of the genetic determinants of plasma ApoE level and their potential value in affecting AD risk.
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Affiliation(s)
- M Muaaz Aslam
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kang-Hsien Fan
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Elizabeth Lawrence
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Margaret Anne Bedison
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Beth E Snitz
- Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Steven T DeKosky
- McKnight Brain Institute and Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Oscar L Lopez
- Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Eleanor Feingold
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - M Ilyas Kamboh
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
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10
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Hersant H, He S, Maliha P, Grossberg G. Over the Counter Supplements for Memory: A Review of Available Evidence. CNS Drugs 2023; 37:797-817. [PMID: 37603263 DOI: 10.1007/s40263-023-01031-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/22/2023]
Abstract
In 2021, the Global Brain Health Supplement Industry Market size was valued at US$7.6 billion. It is predicted to increase to US$15.59 billion by 2030. Memory and its enhancement are a segment of the market that comprised the highest global revenue share in 2021. In the USA alone, dietary supplement sales reached US$18 billion in 2018. The US Food and Drug Administration (FDA) does not have the authority to approve dietary supplements' safety, effectiveness, or labeling before products go on the market. The FDA often does not even review supplements before they go to market. Supplement manufacturers are thus responsible for ensuring their products are safe and that their claims are truthful. An extensive review of current supplements on the market was performed by surveying memory products for sale at local and national pharmacies and grocery stores. A list of 103 supplements was compiled and the ingredients in these memory supplements were reviewed. The 18 most common ingredients in these supplements were identified. Each of the supplements included at least one of the 18 most common ingredients. Scientific data relative to these ingredients and their effect on memory was searched using PubMed and Cochrane library databases. Currently, there is no compelling evidence for use of apoaequorin, coenzyme Q10, coffee extracts, L-theanine, omega-3 fatty acids, vitamin B6, vitamin B9, or vitamin B12 supplementation for memory. On the other hand, there is some current evidence for memory benefit from supplementation with ashwagandha, choline, curcumin, ginger, Lion's Mane, polyphenols, phosphatidylserine, and turmeric. There are current studies with mixed results regarding the benefit of carnitine, gingko biloba, Huperzine A, vitamin D, and vitamin E supplementation for memory. Dietary supplements geared toward improving cognition are a billion-dollar industry that continues to grow despite lacking a solid scientific foundation for their marketing claims. More rigorous studies are needed relative to the long-term use of these supplements in homogenous populations with standardized measurements of cognition. Health care providers need to be aware of any and all supplements their older adult patients may be consuming and be educated about their side effects and interactions with prescription medications. Lastly, the FDA needs to take an active position relative to monitoring marketed supplements regarding safety, purity and claims of efficacy.
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Affiliation(s)
- Haley Hersant
- Department of Psychiatry & Behavioral Neuroscience, Saint Louis University School of Medicine, 1438 South Grand Boulevard, Saint Louis, MO, 63104, USA.
| | - Sean He
- Department of Psychiatry & Behavioral Neuroscience, Saint Louis University School of Medicine, 1438 South Grand Boulevard, Saint Louis, MO, 63104, USA
| | - Peter Maliha
- Department of Psychiatry & Behavioral Neuroscience, Saint Louis University School of Medicine, 1438 South Grand Boulevard, Saint Louis, MO, 63104, USA
| | - George Grossberg
- Department of Psychiatry & Behavioral Neuroscience, Saint Louis University School of Medicine, 1438 South Grand Boulevard, Saint Louis, MO, 63104, USA
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11
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Plascencia-Villa G, Perry G. Roles of Oxidative Stress in Synaptic Dysfunction and Neuronal Cell Death in Alzheimer's Disease. Antioxidants (Basel) 2023; 12:1628. [PMID: 37627623 PMCID: PMC10451948 DOI: 10.3390/antiox12081628] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/11/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Alzheimer's disease (AD) is a brain disorder that progressively undermines memory and thinking skills by affecting the hippocampus and entorhinal cortex. The main histopathological hallmarks of AD are the presence of abnormal protein aggregates (Aβ and tau), synaptic dysfunction, aberrant proteostasis, cytoskeletal abnormalities, altered energy homeostasis, DNA and RNA defects, inflammation, and neuronal cell death. However, oxidative stress or oxidative damage is also evident and commonly overlooked or considered a consequence of the advancement of dementia symptoms. The control or onset of oxidative stress is linked to the activity of the amyloid-β peptide, which may serve as both antioxidant and pro-oxidant molecules. Furthermore, oxidative stress is correlated with oxidative damage to proteins, nucleic acids, and lipids in vulnerable cell populations, which ultimately lead to neuronal death through different molecular mechanisms. By recognizing oxidative stress as an integral feature of AD, alternative therapeutic or preventive interventions are developed and tested as potential or complementary therapies for this devastating neurodegenerative disease.
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Affiliation(s)
- Germán Plascencia-Villa
- Department of Neuroscience, Developmental and Regenerative Biology, The University of Texas at San Antonio (UTSA), San Antonio, TX 78249, USA;
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12
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Moreira J, Machado M, Dias-Teixeira M, Ferraz R, Delerue-Matos C, Grosso C. The neuroprotective effect of traditional Chinese medicinal plants-A critical review. Acta Pharm Sin B 2023; 13:3208-3237. [PMID: 37655317 PMCID: PMC10465969 DOI: 10.1016/j.apsb.2023.06.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/23/2023] [Accepted: 04/03/2023] [Indexed: 09/02/2023] Open
Abstract
Neurodegenerative and neuropsychiatric diseases are increasingly affecting individuals' quality of life, thus increasing their cost to social and health systems. These diseases have overlapping mechanisms, such as oxidative stress, protein aggregation, neuroinflammation, neurotransmission impairment, mitochondrial dysfunction, and excitotoxicity. Currently, there is no cure for neurodegenerative diseases, and the available therapies have adverse effects and low efficacy. For neuropsychiatric disorders, such as depression, the current therapies are not adequate to one-third of the patients, the so-called treatment-resistant patients. So, searching for new treatments is fundamental. Medicinal plants appear as a strong alternative and complement towards new treatment protocols, as they have been used for health purposes for thousands of years. Thus, the main goal of this review is to revisit the neuroprotective potential of some of the most predominant medicinal plants (and one fungus) used in traditional Chinese medicine (TCM), focusing on their proven mechanisms of action and their chemical compositions, to give clues on how they can be useful against neurodegeneration progression.
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Affiliation(s)
- João Moreira
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Porto 4249-015, Portugal
| | - Mariana Machado
- Ciências Químicas e das Biomoléculas/CISA, Escola Superior de Saúde—Instituto Politécnico do Porto, Porto 4200-072, Portugal
| | - Mónica Dias-Teixeira
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Porto 4249-015, Portugal
- NICiTeS—Núcleo de Investigação em Ciências e Tecnologias da Saúde, Escola Superior de Saúde Ribeiro Sanches, Lisboa 1950-396, Portugal
| | - Ricardo Ferraz
- Ciências Químicas e das Biomoléculas/CISA, Escola Superior de Saúde—Instituto Politécnico do Porto, Porto 4200-072, Portugal
- REQUIMTE/LAQV, Departamento de Química e Bioquímica Faculdade de Ciências, Universidade do Porto, Porto 4169-007, Portugal
| | - Cristina Delerue-Matos
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Porto 4249-015, Portugal
| | - Clara Grosso
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Porto 4249-015, Portugal
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13
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Akanchise T, Angelova A. Ginkgo Biloba and Long COVID: In Vivo and In Vitro Models for the Evaluation of Nanotherapeutic Efficacy. Pharmaceutics 2023; 15:pharmaceutics15051562. [PMID: 37242804 DOI: 10.3390/pharmaceutics15051562] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 05/17/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023] Open
Abstract
Coronavirus infections are neuroinvasive and can provoke injury to the central nervous system (CNS) and long-term illness consequences. They may be associated with inflammatory processes due to cellular oxidative stress and an imbalanced antioxidant system. The ability of phytochemicals with antioxidant and anti-inflammatory activities, such as Ginkgo biloba, to alleviate neurological complications and brain tissue damage has attracted strong ongoing interest in the neurotherapeutic management of long COVID. Ginkgo biloba leaf extract (EGb) contains several bioactive ingredients, e.g., bilobalide, quercetin, ginkgolides A-C, kaempferol, isorhamnetin, and luteolin. They have various pharmacological and medicinal effects, including memory and cognitive improvement. Ginkgo biloba, through its anti-apoptotic, antioxidant, and anti-inflammatory activities, impacts cognitive function and other illness conditions like those in long COVID. While preclinical research on the antioxidant therapies for neuroprotection has shown promising results, clinical translation remains slow due to several challenges (e.g., low drug bioavailability, limited half-life, instability, restricted delivery to target tissues, and poor antioxidant capacity). This review emphasizes the advantages of nanotherapies using nanoparticle drug delivery approaches to overcome these challenges. Various experimental techniques shed light on the molecular mechanisms underlying the oxidative stress response in the nervous system and help comprehend the pathophysiology of the neurological sequelae of SARS-CoV-2 infection. To develop novel therapeutic agents and drug delivery systems, several methods for mimicking oxidative stress conditions have been used (e.g., lipid peroxidation products, mitochondrial respiratory chain inhibitors, and models of ischemic brain damage). We hypothesize the beneficial effects of EGb in the neurotherapeutic management of long-term COVID-19 symptoms, evaluated using either in vitro cellular or in vivo animal models of oxidative stress.
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Affiliation(s)
- Thelma Akanchise
- Université Paris-Saclay, CNRS, Institut Galien Paris-Saclay, 91400 Orsay, France
| | - Angelina Angelova
- Université Paris-Saclay, CNRS, Institut Galien Paris-Saclay, 91400 Orsay, France
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14
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Semmens EO, Leary CS, Fitzpatrick AL, Ilango SD, Park C, Adam CE, DeKosky ST, Lopez O, Hajat A, Kaufman JD. Air pollution and dementia in older adults in the Ginkgo Evaluation of Memory Study. Alzheimers Dement 2023; 19:549-559. [PMID: 35436383 PMCID: PMC9576823 DOI: 10.1002/alz.12654] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 02/13/2022] [Accepted: 02/17/2022] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Growing evidence implicates air pollution as a risk factor for dementia, but prior work is limited by challenges in diagnostic accuracy and assessing exposures in the decades prior to disease development. We evaluated the impact of long-term fine particulate matter (PM2.5 ) exposures on incident dementia (all-cause, Alzheimer's disease [AD], and vascular dementia [VaD]) in older adults. METHODS A panel of neurologists adjudicated dementia cases based on extensive neuropsychological testing and magnetic resonance imaging. We applied validated fine-scale air pollutant models to reconstructed residential histories to assess exposures. RESULTS An interquartile range increase in 20-year PM2.5 was associated with a 20% higher risk of dementia (95% confidence interval [CI]: 5%, 37%) and an increased risk of mixed VaD/AD but not AD alone. DISCUSSION Our findings suggest that air pollutant exposures over decades contribute to dementia and that effects of current exposures may be experienced years into the future.
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Affiliation(s)
- Erin O. Semmens
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA
| | - Cindy S. Leary
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA
| | - Annette L. Fitzpatrick
- Departments of Family Medicine and Global Health, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Sindana D. Ilango
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Christina Park
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Claire E. Adam
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA
| | - Steven T. DeKosky
- Department of Neurology and McKnight Brain Institute, University of Florida, Gainesville, Florida, USA
| | - Oscar Lopez
- Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Anjum Hajat
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Joel D. Kaufman
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
- Departments of Environmental and Occupational Health Sciences and Medicine, School of Public Health, University of Washington, Seattle, Washington, USA
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15
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Shieh SF, Lu FJ, Gill DL, Yu CH, Tseng SP, Savardelavar M. Influence of mental energy on volleyball competition performance: a field test. PeerJ 2023; 11:e15109. [PMID: 36992946 PMCID: PMC10042163 DOI: 10.7717/peerj.15109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/01/2023] [Indexed: 03/31/2023] Open
Abstract
Athletic mental energy is a newly emerging research topic in sport science. However, whether it can predict objective performance in competition remains unexplored. Thus, the purpose of this study was to examine the predictability of mental energy on volleyball competition performance. We recruited 81 male volleyball players (Mage = 21.11 years ± SD = 1.81) who participated in the last 16 remaining teams in a college volleyball tournament. We assessed participants' mental energy the night before the competition and collected their competition performance over the next 3 days. We used six indices of the Volleyball Information System (VIS) developed by the International Volleyball Federation (FIVB) to examine its associations with mental energy. All six factors of mental energy -motivation, tirelessness, calm, vigor, confidence, and concentration correlated with volleyball competition performance. Further, a hierarchical regression found mental energy predicted volleyball receivers' performance (R2 = .23). The findings advance our knowledge of mental energy and objective performance in competition. We suggest that future studies may examine the effects of mental energy on different sports with different performance indices.
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Affiliation(s)
- Shiow-Fang Shieh
- Graduate School of Leisure and Exercise, National Yunlin University of Science and Technology, Yunlin, Taiwan
| | - Frank J.H. Lu
- Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei, Taiwan
| | - Diane L. Gill
- Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, United States of America
| | - Chih-Hsuan Yu
- Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei, Taiwan
| | - Shu-Ping Tseng
- Tainan University of Technology, Tainan University of Technology, Tainan, Taiwan
| | - Meisam Savardelavar
- Department of Sport Sciences, Zand Institute of Higher Education, Shiraz, Iran
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Obrenovich M, Singh SK, Li Y, Perry G, Siddiqui B, Haq W, Reddy VP. Natural Product Co-Metabolism and the Microbiota-Gut-Brain Axis in Age-Related Diseases. LIFE (BASEL, SWITZERLAND) 2022; 13:life13010041. [PMID: 36675988 PMCID: PMC9865576 DOI: 10.3390/life13010041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 12/28/2022]
Abstract
Complementary alternative medicine approaches are growing treatments of diseases to standard medicine practice. Many of these concepts are being adopted into standard practice and orthomolecular medicine. Age-related diseases, in particular neurodegenerative disorders, are particularly difficult to treat and a cure is likely a distant expectation for many of them. Shifting attention from pharmaceuticals to phytoceuticals and "bugs as drugs" represents a paradigm shift and novel approaches to intervention and management of age-related diseases and downstream effects of aging. Although they have their own unique pathologies, a growing body of evidence suggests Alzheimer's disease (AD) and vascular dementia (VaD) share common pathology and features. Moreover, normal metabolic processes contribute to detrimental aging and age-related diseases such as AD. Recognizing the role that the cerebral and cardiovascular pathways play in AD and age-related diseases represents a common denominator in their pathobiology. Understanding how prosaic foods and medications are co-metabolized with the gut microbiota (GMB) would advance personalized medicine and represents a paradigm shift in our view of human physiology and biochemistry. Extending that advance to include a new physiology for the advanced age-related diseases would provide new treatment targets for mild cognitive impairment, dementia, and neurodegeneration and may speed up medical advancements for these particularly devastating and debilitating diseases. Here, we explore selected foods and their derivatives and suggest new dementia treatment approaches for age-related diseases that focus on reexamining the role of the GMB.
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Affiliation(s)
- Mark Obrenovich
- Research Service, Department of Veteran’s Affairs Medical Center, Cleveland, OH 44106, USA
- Department of Chemistry, Case Western Reserve University, Cleveland, OH 44106, USA
- The Gilgamesh Foundation for Medical Science and Research, Cleveland, OH 44116, USA
- Department of Medicinal and Biological Chemistry, College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, OH 43614, USA
- Departments of Chemistry and Biological and Environmental Sciences, Cleveland State University, Cleveland, OH 44115, USA
- Correspondence:
| | - Sandeep Kumar Singh
- Indian Scientific Education and Technology (ISET) Foundation, Lucknow 226002, India
| | - Yi Li
- Department of Nutrition and Dietetics, Saint Louis University, Saint Louis, MO 63103, USA
| | - George Perry
- Department of Neuroscience Developmental and Regenerative Biology, University of Texas, San Antonio, TX 78249, USA
| | - Bushra Siddiqui
- School of Medicine, Northeast Ohio College of Medicine, Rootstown, OH 44272, USA
| | - Waqas Haq
- School of Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - V. Prakash Reddy
- Department of Chemistry, Missouri University of Science and Technology, Rolla, MO 65409, USA
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17
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Cardelo MP, Corina A, Leon-Acuña A, Quintana-Navarro GM, Alcala-Diaz JF, Rangel-Zuñiga OA, Camargo A, Conde-Gavilan C, Carmona-Medialdea C, Vallejo-Casas JA, Carmona-Asenjo E, Ochoa-Sepulveda JJ, Aguera-Morales E, Delgado-Lista J, Katsiki N, Lopez-Miranda J, Perez-Jimenez F, Yubero-Serrano EM, Perez-Martínez P. Effect of the Mediterranean diet and probiotic supplementation in the management of mild cognitive impairment: Rationale, methods, and baseline characteristics. Front Nutr 2022; 9:1037842. [PMID: 36570150 PMCID: PMC9773830 DOI: 10.3389/fnut.2022.1037842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/22/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction Mild cognitive impairment (MCI) can progress to Alzheimer's disease (AD). When MCI is not properly controlled, the speed of deterioration can dramatically increase. Reduction of oxidative stress/inflammation and the modulation of the gut-brain axis could be new potential therapeutic targets for the prevention and treatment of AD. Consumption of specific nutrients, diets and probiotic supplementation have been evaluated for neurodegenerative disorders. We focus on a detailed description of the study methods and baseline characteristics of a clinical trial aiming to evaluate the efficacy of a combined nutritional intervention, i.e., a Mediterranean diet with probiotics, on cognitive capacity in a population with MCI. Methods In this randomized, latin-square crossover, double-blind, and controlled dietary intervention trial (clinicaltrials.gov NCT05029765), 47 MCI patients were randomized to consume three dietary interventions for 24-weeks each: (1) A Mediterranean diet supplemented with probiotics (109 colony-forming units of Lactobacillus rhamnosus and Bifidobacterium longum); (2) A Mediterranean diet + placebo; and (3) A Healthy diet according to the World Health Organization (WHO) recommendations. Participants will be evaluated before and after each of the three intervention periods (each 24-weeks, with a total of 72-weeks) for adherence to the assigned diet, blood tests, cognitive performance, gut microbiota analysis and functional neuroimaging studies. Results Fifty patients, ≥60 years-old and diagnosed with MCI, underwent randomization. A total of 47 patients completed follow-up dietary interventions (57.4% males), with a good glycemic control (HbA1c 5.8 ± 0.1%, fasting glucose and insulin 99.7 ± 3.3 mg/dL and 10.4 ± 0.9 mU/L, respectively), elevated systolic blood pressure (136.9 ± 2.1 mmHg) and increased degree of inflammation (high-sensitivity C-reactive protein, 8.8 ± 0.9 mg/dL). Baseline adherence to the Mediterranean diet was medium (7.5 ± 0.3 points on the score that ranged from 0 to 14 points). Conclusion The results of this clinical study would provide more evidence on the need for dietary therapeutic strategies, for clinical and individual practice, in the management of MCI patients to reduce the risk of AD development. Targeting lifestyle modifications in high-risk populations could prevent substantial cases of cognitive decline. Clinical trial registration [ClinicalTrials.gov], identifier [NCT05029765].
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Affiliation(s)
- Magdalena P. Cardelo
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Andreea Corina
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Ana Leon-Acuña
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Gracia M. Quintana-Navarro
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Juan F. Alcala-Diaz
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Oriol Alberto Rangel-Zuñiga
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Antonio Camargo
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Cristina Conde-Gavilan
- Neurology Service, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, Córdoba, Spain
| | - Claudia Carmona-Medialdea
- Neurology Service, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, Córdoba, Spain
| | - Juan A. Vallejo-Casas
- Unidad de Gestión Clinica de Medicina Nuclear, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, Córdoba, Spain
| | - Elvira Carmona-Asenjo
- Unidad de Gestión Clinica de Medicina Nuclear, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, Córdoba, Spain
| | - Juan J. Ochoa-Sepulveda
- Neurology Service, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, Córdoba, Spain
| | - Eduardo Aguera-Morales
- Neurology Service, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, Córdoba, Spain
| | - Javier Delgado-Lista
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Niki Katsiki
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece,School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - José Lopez-Miranda
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Francisco Perez-Jimenez
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Elena M. Yubero-Serrano
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Pablo Perez-Martínez
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain,*Correspondence: Pablo Perez-Martínez,
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Pérez Palmer N, Trejo Ortega B, Joshi P. Cognitive Impairment in Older Adults: Epidemiology, Diagnosis, and Treatment. Psychiatr Clin North Am 2022; 45:639-661. [PMID: 36396270 DOI: 10.1016/j.psc.2022.07.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Cognitive impairment and dementia affect dozens of millions of people worldwide and cause significant distress to patients and caregivers and a financial burden to families and health care systems. Careful history-taking, cognitive and physical examination, and supplemental neuroimaging and fluid-based biomarkers can accurately diagnose neurocognitive disorders. Management includes non-pharmacological and pharmacological treatments tailored to the etiology and to the individual.
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Affiliation(s)
- Nicolás Pérez Palmer
- Department of Psychiatry, Yale School of Medicine, 300 George Street, Suite 901, New Haven, CT 06511, USA.
| | - Barbara Trejo Ortega
- Department of Psychiatry, Yale School of Medicine, 300 George Street, Suite 901, New Haven, CT 06511, USA
| | - Pallavi Joshi
- Banner Alzheimer's Institute, 901 East Willeta Street, Phoenix, AZ 85006, USA; Department of Psychiatry, University of Arizona College of Medicine-Phoenix, 475 North 5th, Phoenix, AZ 85004, USA
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Kim J, Kim MY, Kim JA, Lee Y. Factors affecting preventive behaviors of Alzheimer's disease in family members of patients with Alzheimer's disease. Medicine (Baltimore) 2022; 101:e31136. [PMID: 36281127 PMCID: PMC9592491 DOI: 10.1097/md.0000000000031136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
As genetic factors increase the risk of Alzheimer's disease (AD), the families of dementia patients are at risk of AD. We aimed to evaluate the factors affecting preventive behaviors of AD in family members of AD patients. Using constructed questionnaire based on the Health Belief Model (HBM) theoretical framework, this cross-sectional study investigated factors influencing preventive behaviors of AD such the intention to take AD-preventive medicines, prior experience of taking cognitive function supplements, and AD-preventive lifestyle. 147 family members of AD patients were recruited through the Korea Alzheimer's Caregiver Association. Out of 147 participants, 94.6% had intention to take AD-preventive medicines and 46.3% had experience of taking cognitive function supplements. The intention to take AD-preventive medicines were significantly influenced by self-efficacy (odds ratio [OR] 1.39, 95% confidence interval [CI] 1.03, 1.87) and dementia knowledge (OR 3.42, 95% CI 1.13, 10.39), whereas prior experience of cognitive function supplements was significantly associated with cue to action (OR 1.22, 95% CI 1.07, 1.40). AD-preventive lifestyle was significantly influenced by socio-demographics such as age, sex, and marital status, and the HBM factors such as perceived susceptibility, self-efficacy, and cue to action. Self-efficacy, cue to action, dementia knowledge, and perceived susceptibility were significantly associated with preventive behaviors of AD. Also, family members of dementia patients, who are at risk of dementia due to genetic factors, lifestyles, and environment factors, had high level of AD-preventive lifestyle and strong intention to take AD-preventive medicines. Further research could be suggested to understand AD-preventive behavior and intention to take AD-preventive medicines in general population.
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Affiliation(s)
- JiEun Kim
- Medical, Eisai Korea Inc, Gangnam-gu, Seoul, Republic of Korea
- *Correspondence: JiEun Kim, Department of Medical, Eisai Korea Inc, 6 Bongeunsa-ro 86-gil, Gangnam-gu, Seoul, Republic of Korea (e-mail: )
| | - Min Young Kim
- Medical, Eisai Korea Inc, Gangnam-gu, Seoul, Republic of Korea
| | - Jung-Ae Kim
- Real World Solutions, IQVIA Korea, Jung-gu, Seoul, Republic of Korea
| | - Youngeun Lee
- Real World Solutions, IQVIA Korea, Jung-gu, Seoul, Republic of Korea
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20
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Crotty GF, Keavney JL, Alcalay RN, Marek K, Marshall GA, Rosas HD, Schwarzschild MA. Planning for Prevention of Parkinson Disease: Now Is the Time. Neurology 2022; 99:1-9. [PMID: 36219787 PMCID: PMC10519135 DOI: 10.1212/wnl.0000000000200789] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 04/11/2022] [Indexed: 11/15/2022] Open
Abstract
Parkinson disease (PD) is a chronic progressive neurodegenerative disease with increasing worldwide prevalence. Despite many trials of neuroprotective therapies in manifest PD, no disease-modifying therapy has been established. Over the past several decades, a series of breakthroughs have identified discrete populations at substantially increased risk of developing PD. Based on this knowledge, now is the time to design and implement PD prevention trials. This endeavor builds on experience gained from early prevention trials in Alzheimer disease and Huntington disease. This article first reviews prevention trial precedents in these other neurodegenerative diseases before focusing on the critical design elements for PD prevention trials, including whom to enroll for these trials, what therapeutics to test, and how to measure outcomes in prevention trials. Our perspective reflects progress and remaining challenges that motivated a 2021 conference, "Planning for Prevention of Parkinson: A Trial Design Symposium and Workshop."
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Affiliation(s)
- Grace F Crotty
- From the Department of Neurology (G.F.C., M.A.S.), Massachusetts General Hospital, Boston, MA; Parkinson's Foundation Research Advocates Program (J.L.K.), Parkinson's Foundation, Miami, FL/New York, NY; Department of Neurology (R.N.A.), Columbia University Irving Medical Center, New York, NY; Institute for Neurodegenerative Disorders (K.M.), New Haven, CT; Center for Alzheimer Research and Treatment (G.A.M.) and Center for Neuroimaging of Aging and Neurodegenerative Diseases (H.D.R.), Department of Neurology, Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
| | - Jessi L Keavney
- From the Department of Neurology (G.F.C., M.A.S.), Massachusetts General Hospital, Boston, MA; Parkinson's Foundation Research Advocates Program (J.L.K.), Parkinson's Foundation, Miami, FL/New York, NY; Department of Neurology (R.N.A.), Columbia University Irving Medical Center, New York, NY; Institute for Neurodegenerative Disorders (K.M.), New Haven, CT; Center for Alzheimer Research and Treatment (G.A.M.) and Center for Neuroimaging of Aging and Neurodegenerative Diseases (H.D.R.), Department of Neurology, Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Roy N Alcalay
- From the Department of Neurology (G.F.C., M.A.S.), Massachusetts General Hospital, Boston, MA; Parkinson's Foundation Research Advocates Program (J.L.K.), Parkinson's Foundation, Miami, FL/New York, NY; Department of Neurology (R.N.A.), Columbia University Irving Medical Center, New York, NY; Institute for Neurodegenerative Disorders (K.M.), New Haven, CT; Center for Alzheimer Research and Treatment (G.A.M.) and Center for Neuroimaging of Aging and Neurodegenerative Diseases (H.D.R.), Department of Neurology, Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Kenneth Marek
- From the Department of Neurology (G.F.C., M.A.S.), Massachusetts General Hospital, Boston, MA; Parkinson's Foundation Research Advocates Program (J.L.K.), Parkinson's Foundation, Miami, FL/New York, NY; Department of Neurology (R.N.A.), Columbia University Irving Medical Center, New York, NY; Institute for Neurodegenerative Disorders (K.M.), New Haven, CT; Center for Alzheimer Research and Treatment (G.A.M.) and Center for Neuroimaging of Aging and Neurodegenerative Diseases (H.D.R.), Department of Neurology, Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Gad A Marshall
- From the Department of Neurology (G.F.C., M.A.S.), Massachusetts General Hospital, Boston, MA; Parkinson's Foundation Research Advocates Program (J.L.K.), Parkinson's Foundation, Miami, FL/New York, NY; Department of Neurology (R.N.A.), Columbia University Irving Medical Center, New York, NY; Institute for Neurodegenerative Disorders (K.M.), New Haven, CT; Center for Alzheimer Research and Treatment (G.A.M.) and Center for Neuroimaging of Aging and Neurodegenerative Diseases (H.D.R.), Department of Neurology, Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - H Diana Rosas
- From the Department of Neurology (G.F.C., M.A.S.), Massachusetts General Hospital, Boston, MA; Parkinson's Foundation Research Advocates Program (J.L.K.), Parkinson's Foundation, Miami, FL/New York, NY; Department of Neurology (R.N.A.), Columbia University Irving Medical Center, New York, NY; Institute for Neurodegenerative Disorders (K.M.), New Haven, CT; Center for Alzheimer Research and Treatment (G.A.M.) and Center for Neuroimaging of Aging and Neurodegenerative Diseases (H.D.R.), Department of Neurology, Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Michael A Schwarzschild
- From the Department of Neurology (G.F.C., M.A.S.), Massachusetts General Hospital, Boston, MA; Parkinson's Foundation Research Advocates Program (J.L.K.), Parkinson's Foundation, Miami, FL/New York, NY; Department of Neurology (R.N.A.), Columbia University Irving Medical Center, New York, NY; Institute for Neurodegenerative Disorders (K.M.), New Haven, CT; Center for Alzheimer Research and Treatment (G.A.M.) and Center for Neuroimaging of Aging and Neurodegenerative Diseases (H.D.R.), Department of Neurology, Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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21
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Kang M, Lee DB, Kwon S, Lee E, Kim WJ. Effectiveness of Nootropics in Combination with Cholinesterase Inhibitors on Cognitive Function in Mild-to-Moderate Dementia: A Study Using Real-World Data. J Clin Med 2022; 11:jcm11164661. [PMID: 36012898 PMCID: PMC9409895 DOI: 10.3390/jcm11164661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/03/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
The clinical benefits of nootropics in the treatment of cognitive decline has been either limited or controversial. This study aimed to observe the effectiveness of cholinesterase inhibitor (ChEI) and nootropics combination in the treatment of cognitive impairment in dementia. Data were based on electronic medical records in a university health system. Patients with mild-to-moderate dementia and no history of prior cognitive enhancer use were included (n = 583). The subjects were categorized into the ChEI only group and the ChEI and nootropics combination group. The primary outcome measure was the change in cognitive function, as assessed by the mini-mental state examination (MMSE) from baseline to 300–400 days after the first ChEI prescription. Subsequent analyses were conducted in consideration of the dementia type, medical adherence, and type of nootropics. The changes in MMSE scores from baseline to endpoint were not significantly different between the two groups. In Alzheimer’s dementia, the combination group showed significantly less deterioration in MMSE language subscale scores compared to the ChEI only group (F = 6.86, p = 0.009), and the difference was consistent in the highly adherent subjects (F = 10.16, p = 0.002). The choline alfoscerate and the ginkgo biloba extract subgroups in Alzheimer’s dementia showed more significant improvements in the MMSE language subscale scores compared to the other nootropics subgroup (F = 7.04, p = 0.001). The present study showed that the effectiveness of ChEI and nootropics combination on cognition may appear differently according to the dementia type. This emphasizes the need for well-controlled studies to generalize the effectiveness of nootropics across various clinical settings.
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Affiliation(s)
- Minjae Kang
- Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Dan Bee Lee
- Medical Information Team, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, Korea
| | - Sungchan Kwon
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Eun Lee
- Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Woo Jung Kim
- Medical Information Team, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, Korea
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, Korea
- Correspondence:
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22
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Harper JD, Fan KH, Aslam MM, Snitz BE, DeKosky ST, Lopez OL, Feingold E, Kamboh MI. Genome-Wide Association Study of Incident Dementia in a Community-Based Sample of Older Subjects. J Alzheimers Dis 2022; 88:787-798. [PMID: 35694926 PMCID: PMC9359180 DOI: 10.3233/jad-220293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Alzheimer’s disease (AD) is a complex disease influenced by the environment and genetics; however, much of the genetic component remains unaccounted for. Objective: The purpose of this work was to use genome-wide association analyses to detect genetic associations with incident AD in a sample of older adults aged 75 and above. Methods: We performed a genome-wide association study (GWAS) on genome-wide genotyped and imputed data (14,072,053 variants) on the Gingko Evaluation of Memory (GEM) study sample consisting of 424 incident dementia (mean age = 84.46±3.91) and 2,206 non-demented (mean age = 84.55±3.23) subjects. Results: The established association of APOE*4 carriers with AD was confirmed in this community-based sample of older subjects (odds ratio (OR) = 2.22; p = 9.36E-14) and was stronger in females (OR = 2.72; p = 1.74E-10) than in males (OR = 1.88; p = 2.43E-05). We observed a novel genome-wide significant (GWS) locus on chromosome 12 near ncRNA LOC105369711/rs148377161 (OR = 3.31; p = 1.66E-08). In addition, sex-stratified analyses identified two novel associations in males: one near ncRNA LOC729987/rs140076909 on chromosome 1 (OR = 4.51; p = 3.72E-08) and the other approaching GWS near ncRNA LOC105375138/rs117803234 on chromosome 7 (OR = 3.76; p = 6.93E-08). Conclusion: The use of community-based samples of older individuals and incident dementia as a phenotype may be a helpful approach for the identification of novel genes for AD, which may not be detected in standard case-control studies. Replication of these signals and further studies of these regions and genes will help to provide a clearer picture for their role in AD.
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Affiliation(s)
- Jordan D Harper
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kang-Hsien Fan
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - M Muaaz Aslam
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Beth E Snitz
- Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Steven T DeKosky
- Department of Neurology, College of Medicine, University of Florida, FL, USA
| | - Oscar L Lopez
- Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Eleanor Feingold
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - M Ilyas Kamboh
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
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23
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Dutta T, Anand U, Mitra SS, Ghorai M, Jha NK, Shaikh NK, Shekhawat MS, Pandey DK, Proćków J, Dey A. Phytotherapy for Attention Deficit Hyperactivity Disorder (ADHD): A Systematic Review and Meta-analysis. Front Pharmacol 2022; 13:827411. [PMID: 35592415 PMCID: PMC9110892 DOI: 10.3389/fphar.2022.827411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/01/2022] [Indexed: 11/24/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is commonly a neurodevelopmental behavioural disorder in children and adolescents. Mainly characterized by symptoms like lack of attention, hyperactivity, and impulsiveness, it can impact the overall mental development of the one affected. Several factors, both genetic and non-genetic, can be responsible for this disorder. Although several traditional treatment methods involve medication and other counselling techniques, they also come with different side effects. Hence, the choice is now shifting to alternative treatment techniques. Herbal treatments are considered one of the most popular complementary and alternative medicine (CAM) administered. However, issues related to the safety and efficacy of herbal remedies for the treatment of ADHD need to be investigated further. This study aims to find out the recent advancement in evidence-based use of herbal remedies for ADHD by a comprehensive and systematic review that depicts the results of the published works on herbal therapy for the disorder. The electronic databases and the references retrieved from the included studies present related randomized controlled trials (RCTs) and open-label studies. Seven RCTs involving children and adolescents diagnosed with ADHD met the inclusion criteria. There is a fair indication of the efficacy and safety of Melissa officinalis L., Bacopa monnieri (L.) Wettst., Matricaria chamomilla L., and Valeriana officinalis L. from the studies evaluated in this systematic review for the treatment of various symptoms of ADHD. Limited evidence was found for Ginkgo biloba L. and pine bark extract. However, various other preparations from other plants did not show significant efficacy. There is inadequate proof to strongly support and recommend the administration of herbal medicines for ADHD, but more research is needed in the relevant field to popularize the alternative treatment approach.
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Affiliation(s)
- Tusheema Dutta
- Department of Life Sciences, Presidency University, Kolkata, India
| | - Uttpal Anand
- CytoGene Research & Development LLP, Lucknow, Uttar Pradesh, India
| | | | - Mimosa Ghorai
- Department of Life Sciences, Presidency University, Kolkata, India
| | - Niraj Kumar Jha
- Department of Biotechnology, School of Engineering & Technology, Sharda University, Greater Noida, India
| | - Nusratbanu K. Shaikh
- Department of Pharmaceutical Chemistry, Smt N. M. Padalia Pharmacy College, Ahmedabad, India
| | - Mahipal S Shekhawat
- Department of Plant Biology and Biotechnology, Kanchi Mamunivar Government Institute for Postgraduate Studies and Research, Lawspet, India
| | - Devendra Kumar Pandey
- Department of Biotechnology, School of Biosciences, Lovely Professional University, Phagwara, India
| | - Jarosław Proćków
- Department of Plant Biology, Institute of Environmental Biology, Wrocław University of Environmental and Life Sciences, Wrocław, Poland
| | - Abhijit Dey
- Department of Life Sciences, Presidency University, Kolkata, India
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Ashok A, Andrabi SS, Mansoor S, Kuang Y, Kwon BK, Labhasetwar V. Antioxidant Therapy in Oxidative Stress-Induced Neurodegenerative Diseases: Role of Nanoparticle-Based Drug Delivery Systems in Clinical Translation. Antioxidants (Basel) 2022; 11:antiox11020408. [PMID: 35204290 PMCID: PMC8869281 DOI: 10.3390/antiox11020408] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/02/2022] [Accepted: 02/05/2022] [Indexed: 02/04/2023] Open
Abstract
Free radicals are formed as a part of normal metabolic activities but are neutralized by the endogenous antioxidants present in cells/tissue, thus maintaining the redox balance. This redox balance is disrupted in certain neuropathophysiological conditions, causing oxidative stress, which is implicated in several progressive neurodegenerative diseases. Following neuronal injury, secondary injury progression is also caused by excessive production of free radicals. Highly reactive free radicals, mainly the reactive oxygen species (ROS) and reactive nitrogen species (RNS), damage the cell membrane, proteins, and DNA, which triggers a self-propagating inflammatory cascade of degenerative events. Dysfunctional mitochondria under oxidative stress conditions are considered a key mediator in progressive neurodegeneration. Exogenous delivery of antioxidants holds promise to alleviate oxidative stress to regain the redox balance. In this regard, natural and synthetic antioxidants have been evaluated. Despite promising results in preclinical studies, clinical translation of antioxidants as a therapy to treat neurodegenerative diseases remains elusive. The issues could be their low bioavailability, instability, limited transport to the target tissue, and/or poor antioxidant capacity, requiring repeated and high dosing, which cannot be administered to humans because of dose-limiting toxicity. Our laboratory is investigating nanoparticle-mediated delivery of antioxidant enzymes to address some of the above issues. Apart from being endogenous, the main advantage of antioxidant enzymes is their catalytic mechanism of action; hence, they are significantly more effective at lower doses in detoxifying the deleterious effects of free radicals than nonenzymatic antioxidants. This review provides a comprehensive analysis of the potential of antioxidant therapy, challenges in their clinical translation, and the role nanoparticles/drug delivery systems could play in addressing these challenges.
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Affiliation(s)
- Anushruti Ashok
- Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (A.A.); (S.S.A.); (S.M.); (Y.K.)
| | - Syed Suhail Andrabi
- Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (A.A.); (S.S.A.); (S.M.); (Y.K.)
| | - Saffar Mansoor
- Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (A.A.); (S.S.A.); (S.M.); (Y.K.)
| | - Youzhi Kuang
- Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (A.A.); (S.S.A.); (S.M.); (Y.K.)
| | - Brian K. Kwon
- Department of Orthopaedics, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada;
| | - Vinod Labhasetwar
- Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (A.A.); (S.S.A.); (S.M.); (Y.K.)
- Correspondence:
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25
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Can We Use Ginkgo biloba Extract to Treat Alzheimer’s Disease? Lessons from Preclinical and Clinical Studies. Cells 2022; 11:cells11030479. [PMID: 35159288 PMCID: PMC8833923 DOI: 10.3390/cells11030479] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 02/05/2023] Open
Abstract
(1) Background: Ginkgo biloba extract (GBE) has been widely used to treat central nervous system and cardiovascular diseases. Accumulating evidence has revealed the therapeutic potential of GBE against AD; however, no systematic evaluation has been performed; (2) Methods: a total of 17 preclinical studies and 20 clinical trials assessing the therapeutic effects of GBE against AD were identified from electronic databases. The data in the reports were extracted to conduct a meta-analysis of the AD-related pathological features or symptoms; (3) Results: For the preclinical reports, 45 animals treated with GBE, in six studies, were subjected to cognitive function assessments by the Morris water maze. GBE was shown to reduce the escape latencies in several studies, in both rats and mice (I2 > 70%, p < 0.005). For the clinical trials, eight trials, including 2100 individuals, were conducted. The results show that GBE improved the SKT and ADAS-Cog scores in early-stage AD patients after high doses and long-term administration; (4) Conclusions: GBE displayed generally consistent anti-AD effects in animal experiments, and it might improve AD symptoms in early-stage AD patients after high doses and long-term administration. A lack of sample size calculations and the poor quality of the methods are two obvious limitations of the studies. Nevertheless, the preclinical and clinical data suggest that further large-scale clinical trials may be needed in order to examine the effects of long-term GEB administration on early-stage AD.
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26
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de Vries K, Medawar E, Korosi A, Witte AV. The Effect of Polyphenols on Working and Episodic Memory in Non-pathological and Pathological Aging: A Systematic Review and Meta-Analysis. Front Nutr 2022; 8:720756. [PMID: 35155509 PMCID: PMC8826433 DOI: 10.3389/fnut.2021.720756] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
Life expectancy steadily increases, and so do age-associated diseases, leading to a growing population suffering from cognitive decline and dementia. Impairments in working memory (WM) and episodic memory (EM) are associated with an increased risk of developing dementia. While there are no effective pharmacological therapies to preserve or enhance cognition and to slow down the progression from mild memory complaints to dementia so far, plant-based nutrients including polyphenols have been suggested to exert beneficial effects on brain aging. This review studies whether supplementary polyphenols are effective in preserving or enhancing memory in both non-pathological and pathological aging, and whether there are polyphenol efficiency differences between WM and EM. A systematic literature search was conducted and 66 out of 294 randomized clinical trials with 20 participants or more per group, aged 40 years or older were included. These covered a daily intake of 35–1,600 mg polyphenols, e.g., flavonols, flavonoids, isoflovones, anthocyanins, and/or stilbenes, over the course of 2 weeks to 6.5 years duration. In total, around half of the studies reported a significantly improved performance after polyphenol administration compared to control, while three studies reported a worsening of performance, and the remainder did not observe any effects. According to pooled WM and EM meta-analysis of all memory outcomes reported in 49 studies, overall effect size for WM and EM indicated a significant small positive effect on EM and WM with similar estimates (b ~ 0.24, p < 0.001), with large study heterogeneity and significant Funnel asymmetry tests suggesting a positivity bias. These results remained similar when excluding studies reporting extremely large positive effect sizes from the meta-analyses. While Ginkgo biloba and isoflavones did not show benefits in subgroup meta-analyses, those suggested some effects in extracts containing anthocyanins, other flavonoids and resveratrol, again potentially resulting from publication bias. To conclude, a systematic review and meta-analysis indicate that short- to moderate-term polyphenol interventions might improve WM and EM in middle-to older aged adults, however, publication bias in favor of positive results seems likely, rendering definite conclusions difficult. Future studies with larger, more diverse samples and sensitive monitoring of cardiovascular, metabolic and beginning brain pathologies as well as longer follow-up are needed to better understand the impact of age, (beginning) pathologies, gender, and long-term use on polyphenol action.
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Affiliation(s)
- Karin de Vries
- Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Evelyn Medawar
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Faculty of Philosophy, Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Aniko Korosi
- Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - A. Veronica Witte
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University Medical Center Leipzig, Leipzig, Germany
- *Correspondence: A. Veronica Witte
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27
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Lorca C, Mulet M, Arévalo-Caro C, Sanchez MÁ, Perez A, Perrino M, Bach-Faig A, Aguilar-Martínez A, Vilella E, Gallart-Palau X, Serra A. Plant-derived nootropics and human cognition: A systematic review. Crit Rev Food Sci Nutr 2022; 63:5521-5545. [PMID: 34978226 DOI: 10.1080/10408398.2021.2021137] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Substances with modulatory capabilities on certain aspects of human cognition have been revered as nootropics from the dawn of time. The plant kingdom provides most of the currently available nootropics of natural origin. Here, in this systematic review, we aim to provide state-of-the-art information regarding proven and unproven effects of plant-derived nootropics (PDNs) on human cognition in conditions of health and disease. Six independent searches, one for each neurocognitive domain (NCD), were performed in parallel using three independent scientific library databases: PubMed, Cochrane and Scopus. Only scientific studies and systematic reviews with humans published between January 2000 and November 2021 were reviewed, and 256 papers were included. Ginkgo biloba was the most relevant nootropic regarding perceptual and motor functions. Bacopa monnieri improves language, learning and memory. Withania somnifera (Ashwagandha) modulates anxiety and social-related cognitions. Caffeine enhances attention and executive functions. Together, the results from the compiled studies highlight the nootropic effects and the inconsistencies regarding PDNs that require further research.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.2021137.
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Affiliation(s)
- Cristina Lorca
- IMDEA-Food Research Institute, +Pec Proteomics, Campus of International Excellence UAM + CSIC, Old Cantoblanco Hospital, Madrid, Spain
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida) - Neuroscience Area - University Hospital Arnau de Vilanova (HUAV) - School of Medicine, University of Lleida (UdL), Lleida, Spain
- Proteored - Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - María Mulet
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida) - Neuroscience Area - University Hospital Arnau de Vilanova (HUAV) - School of Medicine, University of Lleida (UdL), Lleida, Spain
| | - Catalina Arévalo-Caro
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida) - Neuroscience Area - University Hospital Arnau de Vilanova (HUAV) - School of Medicine, University of Lleida (UdL), Lleida, Spain
| | - M Ángeles Sanchez
- IMDEA-Food Research Institute, +Pec Proteomics, Campus of International Excellence UAM + CSIC, Old Cantoblanco Hospital, Madrid, Spain
| | - Ainhoa Perez
- IMDEA-Food Research Institute, +Pec Proteomics, Campus of International Excellence UAM + CSIC, Old Cantoblanco Hospital, Madrid, Spain
| | - María Perrino
- IMDEA-Food Research Institute, +Pec Proteomics, Campus of International Excellence UAM + CSIC, Old Cantoblanco Hospital, Madrid, Spain
| | - Anna Bach-Faig
- FoodLab Research Group (2017SGR 83), Faculty of Health Sciences, Open University of Catalonia (UOC), Barcelona, Spain
- Food and Nutrition Area, Barcelona Official College of Pharmacists, Barcelona, Spain
| | - Alicia Aguilar-Martínez
- FoodLab Research Group (2017SGR 83), Faculty of Health Sciences, Open University of Catalonia (UOC), Barcelona, Spain
| | - Elisabet Vilella
- Hospital Universitari Institut Pere Mata (HUIPM), Institut Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Universitat Rovira i Virgili (URV), Reus, Spain
- Centro de investigación Biomédica en Salud Mental CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Xavier Gallart-Palau
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida) - Neuroscience Area - University Hospital Arnau de Vilanova (HUAV) - School of Medicine, University of Lleida (UdL), Lleida, Spain
- Proteored - Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Hospital Universitari Institut Pere Mata (HUIPM), Institut Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Centro de investigación Biomédica en Salud Mental CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Aida Serra
- IMDEA-Food Research Institute, +Pec Proteomics, Campus of International Excellence UAM + CSIC, Old Cantoblanco Hospital, Madrid, Spain
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida) - Neuroscience Area - University Hospital Arnau de Vilanova (HUAV) - School of Medicine, University of Lleida (UdL), Lleida, Spain
- Proteored - Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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Nowak A, Kojder K, Zielonka-Brzezicka J, Wróbel J, Bosiacki M, Fabiańska M, Wróbel M, Sołek-Pastuszka J, Klimowicz A. The Use of Ginkgo Biloba L. as a Neuroprotective Agent in the Alzheimer's Disease. Front Pharmacol 2021; 12:775034. [PMID: 34803717 PMCID: PMC8599153 DOI: 10.3389/fphar.2021.775034] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 10/22/2021] [Indexed: 12/19/2022] Open
Abstract
Alzheimer's disease, a neurodegenerative disease, is one of the most common causes of dementia if elderly people worldwide. Alzheimer's disease leads to the alienation of individuals and their exclusion from social and professional life. It is characterized mainly by the degradation of memory and disorientation, which occurs as a result of the loss of neuronal structure and function in different brain areas. In recent years, more and more attention has been paid to use in the treatment of natural bioactive compounds that will be effective in neurodegenerative diseases, including Alzheimer's disease. G. biloba L. and its most frequently used standardized extract (EGb 761), have been used for many years in supportive therapy and in the prevention of cognitive disorders. The paper presents an overview of reports on the pathogenesis of Alzheimer's disease, as well as a summary of the properties of G. biloba extract and its effects on the possible pathogenesis of the disease. By exploring more about the pathogenesis of the disease and the benefits of G. biloba extract for patients with Alzheimer's disease, it will be possible to create an individualized therapeutic protocol to optimize the treatment.
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Affiliation(s)
- Anna Nowak
- Department of Cosmetic and Pharmaceutical Chemistry, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Klaudyna Kojder
- Department of Anesthesiology and Intensive Care, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Joanna Zielonka-Brzezicka
- Department of Cosmetic and Pharmaceutical Chemistry, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Jacek Wróbel
- Department of Bioengineering, West Pomeranian University of Technology in Szczecin, Szczecin, Poland
| | - Mateusz Bosiacki
- Department of Functional Diagnostics and Physical Medicine, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Marta Fabiańska
- Institute of Philosophy and Cognitive Science, University of Szczecin, Szczecin, Poland
| | - Mariola Wróbel
- Department of Landscape Architecture, West Pomeranian University of Technology in Szczecin, Szczecin, Poland
| | - Joanna Sołek-Pastuszka
- Department of Anesthesiology and Intensive Care, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Adam Klimowicz
- Department of Cosmetic and Pharmaceutical Chemistry, Pomeranian Medical University in Szczecin, Szczecin, Poland
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Lewis JE, Poles J, Shaw DP, Karhu E, Khan SA, Lyons AE, Sacco SB, McDaniel HR. The effects of twenty-one nutrients and phytonutrients on cognitive function: A narrative review. J Clin Transl Res 2021; 7:575-620. [PMID: 34541370 PMCID: PMC8445631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 06/17/2021] [Accepted: 07/09/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND AIM Brain health is becoming more important to the average person as the number of people with cognitive impairments, such as Alzheimer's disease (AD), is rising significantly. The current Food and Drug Administration-approved pharmacotherapeutics for dementia neither cure nor halt cognitive decline; they just delay the worsening cognitive impairment. This narrative review summarizes the effects of nutrients and phytonutrients on cognitive function. METHODS A comprehensive literature search of PubMed was performed to find clinical trials in humans that assessed the effects of nutrients and phytonutrients on cognitive function published in English between 2000 and 2021. Six independent reviewers evaluated the articles for inclusion in this review. RESULTS Ninety-six articles were summarized in this narrative review. In total 21 categories of nutrients and phytonutrients were included, i.e., α-lipoic acid, Bacopa monnieri, B vitamins, cholinergic precursors, vitamin D, vitamin E, Ginkgo biloba, ginseng, lion's mane mushroom, N-acetyl cysteine, omega-3 fatty acids, aloe polysaccharides, Rhodiola rosea, rosemary, saffron, tart cherries, turmeric, wild yam, Withania somnifera, xanthines, and zinc. Particular noteworthy effects on cognition included memory, recollection, attention, intelligence, vocabulary, recognition, response inhibition, arousal, performance enhancement, planning, creative thinking, reaction time, vigilance, task switching, orientation to time, place, and person, reading, writing, comprehension, accuracy, learning, information processing speed, executive function, mental flexibility, daily functioning, decrease in mental fatigue, and freedom from distractibility. Some nutrients and phytonutrients also improved mood and contentedness and reduced anxiety and the need for caregiving. These effects are not completely consistent or ubiquitous across all patient populations or health statuses. Adverse effects were minimal or nonexistent. CONCLUSION Due to the growing population of people with cognitive impairment and the lack of effective pharmacotherapeutics, it is prudent for those afflicted or their caregivers to find alternative treatments. Our narrative review shows that many of these nutrients and phytonutrients may be promising for treating some aspects of cognitive impairment, especially for people afflicted with AD. RELEVANCE FOR PATIENTS As demonstrated in a number of clinical trials, healthy adults and patients with various health challenges (e.g., AD, mild cognitive impairment, multiple sclerosis, and Parkinson's disease) exhibiting a wide range of severity in cognitive defects would be best served to consider multiple nutrients and phytonutrients to improve aspects of their cognitive function.
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Affiliation(s)
- John E. Lewis
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jillian Poles
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Delaney P. Shaw
- Institute of Human Nutrition, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Elisa Karhu
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sher Ali Khan
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Annabel E. Lyons
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
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Moored KD, Bandeen-Roche K, Snitz BE, DeKosky ST, Williamson JD, Fitzpatrick AL, Carlson MC. Risk of Dementia Differs across Lifestyle Engagement Subgroups: A Latent Class and Time to Event Analysis in Community-Dwelling Older Adults. J Gerontol B Psychol Sci Soc Sci 2021; 77:872-884. [PMID: 34387336 PMCID: PMC9071387 DOI: 10.1093/geronb/gbab152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Better understanding of the lifestyle activities shared among older adult subgroups may inform further health-behavioral interventions that can be deployed at the group or community level. We applied latent class analysis to characterize qualitatively distinct lifestyle engagement groups, examined their differential risk of incident dementia, and compared their predictive utility to traditional activity frequency and variety scores. METHOD Participants were from the Ginkgo Evaluation of Memory Study (N=3,068, Mean age=78.5). Lifestyle activities were measured at baseline using the Lifestyle Activity Questionnaire. All-cause dementia was screened every six months and cases were clinically adjudicated. Median follow-up was 6 years. Time to dementia was assessed using discrete-time proportional hazards models, adjusted for demographic and health covariates. RESULTS Latent classes provided slightly poorer case discrimination than the frequency scores but identified distinct qualitative subgroups. In the four-class model, the Variety (22%) and Intellectual (18%) lifestyle groups had high engagement in intellectual activities, whereas the Variety and Social groups (32%) had high engagement in formal social activities. Compared to the Least Active group (28%), the Variety (HR=.67, 95% CI:(.48,.93)) and Intellectual (HR=.65, 95% CI:(.45,.93)) groups had significantly lower risk of incident dementia, but only among those without prevalent MCI. DISCUSSION Older adults highly engaged in intellectual activities, but not necessarily social activities, had the lowest risk of incident dementia. Activity frequency scores provided only slightly better case discrimination than activity variety scores and latent classes. Latent classes of older adults differed by their amount and types of activities, which may inform intervention design.
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Affiliation(s)
- Kyle D Moored
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Karen Bandeen-Roche
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Beth E Snitz
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Steven T DeKosky
- Department of Neurology, University of Florida College of Medicine, Gainesville, Florida
| | - Jeff D Williamson
- Department of Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Annette L Fitzpatrick
- Departments of Family Medicine, Epidemiology, and Global Health, University of Washington, Seattle, Washington
| | - Michelle C Carlson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Dorman G, Flores I, Gutiérrez C, Castaño RF, Aldecoa M, Kim L. Medicinal herbs and nutritional supplements for dementia therapy: potential therapeutic targets and clinical evidence. CNS & NEUROLOGICAL DISORDERS-DRUG TARGETS 2021; 21:26-51. [PMID: 34370647 DOI: 10.2174/1871527320666210809121230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 02/20/2021] [Accepted: 03/28/2021] [Indexed: 11/22/2022]
Abstract
Spices and herbs have been used for medicinal purposes for centuries. Also, in the last decades, the use of different nutritional supplements has been implemented to treat all kinds of diseases, including those that present an alteration in cognitive functioning. Dementia is a clinical syndrome in which a person's mental and cognitive capacities gradually decline. As the disease progresses, the person's autonomy diminishes. As there is not an effective treatment to prevent progressive deterioration in many of these pathologies, nutritional interventions have been, and still are, one of the most widely explored therapeutic possibilities. In this review, we have discussed a great number of potentially interesting plants, nutritional derivatives and probiotics for the treatment of dementia around the world. Their action mechanisms generally involve neuroprotective effects via anti-inflammatory, antioxidant, anti-apoptotic, b-amyloid and tau anti-aggregate actions; brain blood flow improvement, and effects on synaptic cholinergic and dopaminergic neurotransmission, which may optimize cognitive performance in patients with cognitive impairment. As for their efficacy in patients with cognitive impairment and/or dementias, evidence is still scarce and/or their outcomes are controversial. We consider that many of these substances have promising therapeutic properties. Therefore, the scientific community has to continue with a more complete research focused on both identifying possible action mechanisms and carrying out clinical trials, preferably randomized double-blind ones, with a greater number of patients, a long-term follow-up, dose standardization and the use of current diagnosis criteria.
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Affiliation(s)
- Guido Dorman
- Division of Neurology, Ramos Mejia Hospital. Argentina
| | - Ignacio Flores
- Neuroscience Institute, Favaloro Foundation Hospital. Argentina
| | | | | | - Mayra Aldecoa
- Division of Neurology, Ramos Mejia Hospital. Argentina
| | - Leandro Kim
- Division of Neurology, Ramos Mejia Hospital. Argentina
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Koch M, Furtado JD, DeKosky ST, Fitzpatrick AL, Lopez OL, Kuller LH, Mukamal KJ, Jensen MK. Case-cohort study of plasma phospholipid fatty acid profiles, cognitive function, and risk of dementia: a secondary analysis in the Ginkgo Evaluation of Memory Study. Am J Clin Nutr 2021; 114:154-162. [PMID: 33880495 PMCID: PMC8277434 DOI: 10.1093/ajcn/nqab087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 03/02/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Phospholipids are biomarkers of dietary fat intake and metabolism, linked to several cardiometabolic disorders. Few prospective studies have assessed plasma phospholipids in relation to dementia risk and cognitive function. OBJECTIVES We aimed to evaluate the association between a decrease in linoleic acid accompanied with an increase in other fatty acids and cognitive function and dementia risk. METHODS We conducted a case-cohort study nested within the Ginkgo Evaluation of Memory Study. We included 1252 participants, 498 of whom who developed dementia during a mean of 5 y of follow-up. We measured 45 individual plasma phospholipids (as a percentage of total plasma phospholipid fatty acids) by GC and related these to Modified Mini-Mental State Examination (3MSE) scores at baseline and neurologist-adjudicated incidence of all-cause dementia and Alzheimer disease (AD), adjusting for sociodemographic and clinical characteristics. RESULTS Substitution of 1% of SFAs for 1% of linoleic acid, the predominant polyunsaturated n-6 (ɷ-6) fatty acid, was associated with higher risk of dementia (HR per 1% of SFAs instead of linoleic acid = 1.03; 95% CI: 1.00, 1.07) and a 0.08 point lower 3MSE score at baseline (95% CI: -0.12, -0.03), signifying worse cognitive function. When compared with linoleic acid, we found no associations of total monounsaturated, n-3 polyunsaturated, or trans fatty acids with risk of dementia or AD. However, the substitution of 1% of the marine n-3 PUFA DHA for linoleic acid was associated with lower risk of dementia (HR = 0.86 per 1% of DHA instead of linoleic acid; 95% CI: 0.76, 0.96). These associations were not modified by apolipoprotein E genotype, mild cognitive impairment at baseline, age, or sex. CONCLUSIONS Specific elements of diet may be associated with late-life dementia, a hypothesis that requires formal testing in randomized controlled trials and that represents a possible preventive intervention.
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Affiliation(s)
- Manja Koch
- Department of Nutrition, Harvard TH Chan School of Public
Health, Boston, MA, USA
| | - Jeremy D Furtado
- Department of Nutrition, Harvard TH Chan School of Public
Health, Boston, MA, USA
| | - Steven T DeKosky
- Department of Neurology, University of Florida,
Gainesville, FL, USA
| | - Annette L Fitzpatrick
- Departments of Family Medicine, Epidemiology, and Global
Health, University of Washington, Seattle, WA, USA
| | - Oscar L Lopez
- Department of Neurology, School of Medicine, University of
Pittsburgh, Pittsburgh, PA, USA
| | - Lewis H Kuller
- Department of Epidemiology, Graduate School of Public Health,
University of Pittsburgh, Pittsburgh, PA, USA
| | - Kenneth J Mukamal
- Department of Medicine, Beth Israel Deaconess Medical
Center, Boston, MA, USA
| | - Majken K Jensen
- Department of Nutrition, Harvard TH Chan School of Public
Health, Boston, MA, USA
- Department of Public Health, Section of Epidemiology,
University of Copenhagen, Copenhagen, Denmark
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Meunier CC, Smit E, Fitzpatrick AL, Odden MC. Balance and cognitive decline in older adults in the cardiovascular health study. Age Ageing 2021; 50:1342-1348. [PMID: 33693525 DOI: 10.1093/ageing/afab038] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 12/19/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Previous studies have demonstrated an association between gait speed and cognitive function. However, the relationship between balance and cognition remains less well explored. This study examined the cross-sectional and longitudinal relationship of balance and cognitive decline in older adults. METHODS A cohort of 4,811 adults, aged ≥65 years, participating in the Cardiovascular Health Study was followed for 6 years. Modified Mini-Mental State Examination (3MSE) and Digit Symbol Substitution Test (DSST) were used to measure cognition. Tandem balance measures were used to evaluate balance. Regression models were adjusted for demographics, behavioural and disease factors. RESULTS Worse balance was independently associated with worse cognition in cross-sectional analysis. Longitudinally, participants aged ≥76 years with poorer balance had a faster rate of decline after adjustment for co-variates: -0.97 points faster decline in 3MSE per year (95% confidence interval (CI): -1.32, -0.63) compared to the participants with good balance. There was no association of balance and change in 3MSE among adults aged <76 years (P value for balance and age interaction < 0.0001). DSST scores reflected -0.21 (95% CI: -0.37, -0.05) points greater decline when adjusted for co-variates. In Cox proportional hazard models, participants with worse balance had a higher risk of being cognitively impaired over the 6 years of follow-up visits (adjusted HR:1.72, 95% CI: 1.30, 2.29). CONCLUSIONS Future studies should evaluate standing balance as a potential screening technique to identify individuals at risk of cognitive decline. Furthermore, a better understanding of the pathophysiological link between balance and cognition may inform strategies to prevent cognitive decline.
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Affiliation(s)
- Claire C Meunier
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, USA
| | - Ellen Smit
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, USA
| | - Annette L Fitzpatrick
- Departments of Family Medicine, Epidemiology, and Global Health, University of Washington, Seattle, WA, USA
| | - Michelle C Odden
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, USA
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA
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Firdaus Z, Singh TD. An Insight in Pathophysiological Mechanism of Alzheimer's Disease and its Management Using Plant Natural Products. Mini Rev Med Chem 2021; 21:35-57. [PMID: 32744972 DOI: 10.2174/1389557520666200730155928] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 05/20/2020] [Accepted: 06/05/2020] [Indexed: 11/22/2022]
Abstract
Alzheimer's disease (AD) is an age-associated nervous system disorder and a leading cause of dementia worldwide. Clinically, it is described by cognitive impairment and pathophysiologically by deposition of amyloid plaques and neurofibrillary tangles in the brain and neurodegeneration. This article reviews the pathophysiology, course of neuronal degeneration, and the various possible hypothesis of AD progression. These hypotheses include amyloid cascade, tau hyperphosphorylation, cholinergic disruption, metal dysregulation, vascular dysfunction, oxidative stress, and neuroinflammation. There is an exponential increase in the occurrence of AD in the recent few years that indicate an urgent need to develop some effective treatment. Currently, only 2 classes of drugs are available for AD treatment, namely acetylcholinesterase inhibitor and NMDA receptor antagonist. Since AD is a complex neurological disorder and these drugs use a single target approach, alternatives are needed due to limited effectiveness and unpleasant side-effects of these drugs. Currently, plants have been used for drug development research especially because of their multiple sites of action and fewer side effects. Uses of some herbs and phytoconstituents for the management of neuronal disorders like AD have been documented in this article. Phytochemical screening of these plants shows the presence of many beneficial constituents like flavonoids, triterpenes, alkaloids, sterols, polyphenols, and tannins. These compounds show a wide array of pharmacological activities, such as anti-amyloidogenic, anticholinesterase, and antioxidants. This article summarizes the present understanding of AD progression and gathers biochemical evidence from various works on natural products that can be useful in the management of this disease.
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Affiliation(s)
- Zeba Firdaus
- Department of Medicinal Chemistry, Institute of Medical Sciences, Banaras Hindu University, Varanasi - 221005, India
| | - Tryambak Deo Singh
- Department of Medicinal Chemistry, Institute of Medical Sciences, Banaras Hindu University, Varanasi - 221005, India
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Tsolaki M, Lazarou E, Kozori M, Petridou N, Tabakis I, Lazarou I, Karakota M, Saoulidis I, Melliou E, Magiatis P. A Randomized Clinical Trial of Greek High Phenolic Early Harvest Extra Virgin Olive Oil in Mild Cognitive Impairment: The MICOIL Pilot Study. J Alzheimers Dis 2021; 78:801-817. [PMID: 33044178 DOI: 10.3233/jad-200405] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Extra virgin olive oil (EVOO) constitutes a natural compound with high protection over cognitive function. OBJECTIVE To investigate for the first time the effect of Greek High Phenolic Early Harvest Extra Virgin Olive Oil (HP-EH-EVOO) versus Moderate Phenolic (MP-EVOO) and Mediterranean Diet (MeDi) in people with mild cognitive impairment (MCI). METHODS We conducted a randomized prospective study so as to examine the HP-EH-EVOO and MP-EVOO versus MeDi in MCI. Genetic predisposition (APOEɛ4) to Alzheimer's disease (AD) was tested and an extensive neuropsychological battery was administered at baseline and after 12 months. Each participant was randomized and assigned one of three groups: 1) Group 1 received the HP-EH-EVOO (50 mL/day); 2) Group 2 received the MP-EVOO (50 mL/day), and 3) Group 3 received only the MeDi instructions. RESULTS Better follow-up performance was found in Group 1 compared to Group 2 and Group 3 in the almost all cognitive domains. Moreover, Group 2 showed also significant improvement compared to Group 3 in ADAS-cog (p = 0.001) and MMSE (p = 0.05), whereas Group 3 exhibited worse or similar to baseline performance in almost all domains. In particular, Group 1 and Group 2 had better outcomes with regards to ADAS-cog (p = 0.003), Digit Span (p = 0.006), and Letter fluency (p = 0.003). Moreover, there was a significant difference (p = 0.001) in the presence of APOEɛ4 between the Groups 1 and 2 versus Group 3. CONCLUSION Long-term intervention with HP-EH-EVOO or MP-EVOO was associated with significant improvement in cognitive function compared to MeDi, independent of the presence of APOEɛ4.
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Affiliation(s)
- Magda Tsolaki
- Department of Neurology General University Hopsital "AHEPA", Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Makedonia, Greece.,Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Makedonia, Greece
| | - Eftychia Lazarou
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Makedonia, Greece
| | - Mahi Kozori
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Makedonia, Greece
| | - Niki Petridou
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Makedonia, Greece
| | - Irene Tabakis
- Department of Neurology General University Hopsital "AHEPA", Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Makedonia, Greece
| | - Ioulietta Lazarou
- Department of Neurology General University Hopsital "AHEPA", Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Makedonia, Greece
| | - Maria Karakota
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Makedonia, Greece
| | - Iordanis Saoulidis
- Department of Neurology General University Hopsital "AHEPA", Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Makedonia, Greece
| | - Eleni Melliou
- Department of Pharmacognosy and Natural Products Chemistry, Faculty of Pharmacy, National and Kapodistrian University of Athens, Panepistimiopolis Zografou, Athens, Greece
| | - Prokopios Magiatis
- Department of Pharmacognosy and Natural Products Chemistry, Faculty of Pharmacy, National and Kapodistrian University of Athens, Panepistimiopolis Zografou, Athens, Greece
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Iqubal A, Rahman SO, Ahmed M, Bansal P, Haider MR, Iqubal MK, Najmi AK, Pottoo FH, Haque SE. Current Quest in Natural Bioactive Compounds for Alzheimer's Disease: Multi-Targeted-Designed-Ligand Based Approach with Preclinical and Clinical Based Evidence. Curr Drug Targets 2021; 22:685-720. [PMID: 33302832 DOI: 10.2174/1389450121999201209201004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/12/2020] [Accepted: 08/23/2020] [Indexed: 12/06/2022]
Abstract
Alzheimer's disease is a common and most chronic neurological disorder (NDs) associated with cognitive dysfunction. Pathologically, Alzheimer's disease (AD) is characterized by the presence of β-amyloid (Aβ) plaques, hyper-phosphorylated tau proteins, and neurofibrillary tangles, however, persistence oxidative-nitrative stress, endoplasmic reticulum stress, mitochondrial dysfunction, inflammatory cytokines, pro-apoptotic proteins along with altered neurotransmitters level are common etiological attributes in its pathogenesis. Rivastigmine, memantine, galantamine, and donepezil are FDA approved drugs for symptomatic management of AD, whereas tacrine has been withdrawn because of hepatotoxic profile. These approved drugs only exert symptomatic relief and exhibit poor patient compliance. In the current scenario, the number of published evidence shows the neuroprotective potential of naturally occurring bioactive molecules via their antioxidant, anti-inflammatory, antiapoptotic and neurotransmitter modulatory properties. Despite their potent therapeutic implications, concerns have arisen in context to their efficacy and probable clinical outcome. Thus, to overcome these glitches, many heterocyclic and cyclic hydrocarbon compounds inspired by natural sources have been synthesized and showed improved therapeutic activity. Computational studies (molecular docking) have been used to predict the binding affinity of these natural bioactive as well as synthetic compounds derived from natural sources for the acetylcholine esterase, α/β secretase Nuclear Factor kappa- light-chain-enhancer of activated B cells (NF-kB), Nuclear factor erythroid 2-related factor 2(Nrf2) and other neurological targets. Thus, in this review, we have discussed the molecular etiology of AD, focused on the pharmacotherapeutics of natural products, chemical and pharmacological aspects and multi-targeted designed ligands (MTDLs) of synthetic and semisynthetic molecules derived from the natural sources along with some important on-going clinical trials.
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Affiliation(s)
- Ashif Iqubal
- Department of Pharmacology, School of Pharmaceutical Education and Research, JamiaHamdard, New Delhi-110062, India
| | - Syed Obaidur Rahman
- Department of Pharmaceutical Medicine, School of Pharmaceutical Education and Research, JamiaHamdard, New Delhi-110062, India
| | - Musheer Ahmed
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, JamiaHamdard, New Delhi-110062, India
| | - Pratichi Bansal
- Department of Pharmaceutical Chemistry, School of Pharmaceutical Education and Research, JamiaHamdard, New Delhi-110062, India
| | - Md Rafi Haider
- Department of Pharmaceutical Chemistry, School of Pharmaceutical Education and Research, JamiaHamdard, New Delhi-110062, India
| | - Mohammad Kashif Iqubal
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, JamiaHamdard, New Delhi-110062, India
| | - Abul Kalam Najmi
- Department of Pharmacology, School of Pharmaceutical Education and Research, JamiaHamdard, New Delhi-110062, India
| | - Faheem Hyder Pottoo
- Department of Pharmacology, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal, University, P.O.BOX 1982, Damman, 31441, Saudi Arabia
| | - Syed Ehtaishamul Haque
- Department of Pharmacology, School of Pharmaceutical Education and Research, JamiaHamdard, New Delhi-110062, India
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Oxidative Stress, Neuroinflammation, and NADPH Oxidase: Implications in the Pathogenesis and Treatment of Alzheimer's Disease. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:7086512. [PMID: 33953837 PMCID: PMC8068554 DOI: 10.1155/2021/7086512] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 03/17/2021] [Accepted: 04/03/2021] [Indexed: 01/17/2023]
Abstract
NADPH oxidase as an important source of intracellular reactive oxygen species (ROS) has gained enormous importance over the years, and the detailed structures of all the isoenzymes of the NADPH oxidase family and their regulation have been well explored. The enzyme has been implicated in a variety of diseases including neurodegenerative diseases. The present brief review examines the body of evidence that links NADPH oxidase with the genesis and progression of Alzheimer's disease (AD). In short, evidence suggests that microglial activation and inflammatory response in the AD brain is associated with increased production of ROS by microglial NADPH oxidase. Along with other inflammatory mediators, ROS take part in neuronal degeneration and enhance the microglial activation process. The review also evaluates the current state of NADPH oxidase inhibitors as potential disease-modifying agents for AD.
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Adam CE, Fitzpatrick AL, Leary CS, Hajat A, Phelan EA, Park C, Semmens EO. The Association between Gait Speed and Falls in Community Dwelling Older Adults with and without Mild Cognitive Impairment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073712. [PMID: 33918186 PMCID: PMC8038190 DOI: 10.3390/ijerph18073712] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/24/2021] [Accepted: 03/31/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: Falls are common in older adults and result in injuries, loss of independence, and death. Slow gait is associated with falls in older adults, but few studies have assessed the association between gait speed and falls among those with mild cognitive impairment (MCI). (2) Methods: The association between gait speed and falls was assessed in 2705 older adults with and without MCI participating in the Ginkgo Evaluation of Memory Study. Gait speed was measured via a 15-foot walk test and fall history through self-report. We used data collected at the 12-month (2001–2003) and 18-month visits (2002–2004). (3) Results: Participant average age was 78.5 years (sd = 3.2); 45% were female, and 14% had MCI at baseline. The average gait speed was 0.93 m/s (sd = 0.20). Sixteen percent (n = 433) and 18% (n = 498) reported at least one fall at the 12-month and 18-month visits, respectively. Faster gait speed was associated with decreased risk of falling (RR: 0.95, 95% CI: 0.91, 0.99) for every 10 cm/s increase in gait speed adjusted for age, gender, study arm, site, and MCI status. (4) Conclusions: The relationship between gait speed and risk of falling did not vary by MCI status (interaction p-value = 0.78).
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Affiliation(s)
- Claire E. Adam
- School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Skaggs Building Room 177, Missoula, MT 59812, USA; (C.S.L.); (E.O.S.)
- Correspondence:
| | - Annette L. Fitzpatrick
- Department of Family Medicine, University of Washington, Box #356390, Seattle, WA 98195-6390, USA;
- Department of Epidemiology, School of Public Health, University of Washington, UW Box #351619, Seattle, WA 98195, USA; (A.H.); (C.P.)
- Department of Global Health, University of Washington, UW Box #351620, Seattle, WA 98195-7965, USA
| | - Cindy S. Leary
- School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Skaggs Building Room 177, Missoula, MT 59812, USA; (C.S.L.); (E.O.S.)
| | - Anjum Hajat
- Department of Epidemiology, School of Public Health, University of Washington, UW Box #351619, Seattle, WA 98195, USA; (A.H.); (C.P.)
| | - Elizabeth A. Phelan
- Division of Gerontology and Geriatric Medicine, Harborview Medical Center, 325 9th Avenue, Box 359755, Seattle, WA 98104-2499, USA;
| | - Christina Park
- Department of Epidemiology, School of Public Health, University of Washington, UW Box #351619, Seattle, WA 98195, USA; (A.H.); (C.P.)
| | - Erin O. Semmens
- School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Skaggs Building Room 177, Missoula, MT 59812, USA; (C.S.L.); (E.O.S.)
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Iqubal A, Iqubal MK, Fazal SA, Pottoo FH, Haque SE. Nutraceuticals and their Derived Nano-formulations for the Prevention and Treatment of Alzheimer's disease. Curr Mol Pharmacol 2021; 15:23-50. [PMID: 33687906 DOI: 10.2174/1874467214666210309115605] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/22/2020] [Accepted: 12/02/2020] [Indexed: 11/22/2022]
Abstract
Alzheimer's disease is one of the common chronic neurological disorders and associated with cognitive dysfunction, depression and progressive dementia. Presence of β-amyloid or senile plaques, hyper-phosphorylated tau proteins, neurofibrillary tangle, oxidative-nitrative stress, mitochondrial dysfunction, endoplasmic reticulum stress, neuroinflammation and derailed neurotransmitter status are the hallmark of AD. Currently, donepezil, memantine, rivastigmine and galantamine are approved by the FDA for symptomatic management. It is well-known that these approved drugs only exert symptomatic relief and possess poor patient-compliance. Additionally, various published evidence shows the neuroprotective potential of various nutraceuticals via their antioxidant, anti-inflammatory and anti-apoptotic effects in the preclinical and clinical studies. These nutraceuticals possess a significant neuroprotective potential and hence, can be a future pharmacotherapeutic for the management and treatment of AD. However, nutraceutical suffers from certain major limitations such as poor solubility, low bioavailability, low stability, fast hepatic-metabolism and larger particle size. These pharmacokinetic attributes restrict their entry into the brain via the blood-brain barrier. Therefore, to over such issues, various nanoformulation of nutraceuticals was developed, that allows their effective delivery into brain owning to reduced particle size, increased lipophilicity increased bioavailability and avoidance of fast hepatic metabolism. Thus, in this review, we have discussed the etiology of AD, focused on the pharmacotherapeutics of nutraceuticals with preclinical and clinical evidence, discussed pharmaceutical limitation and regulatory aspects of nutraceuticals to ensure safety and efficacy. We further explored the latitude of various nanoformulation of nutraceuticals as a novel approach to overcome the existing pharmaceutical limitation and for effective delivery into the brain.
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Affiliation(s)
- Ashif Iqubal
- Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi-110062. India
| | - Mohammad Kashif Iqubal
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi-110062. India
| | - Syed Abul Fazal
- Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi-110062. India
| | - Faheem Hyder Pottoo
- Department of Pharmacology, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal, University, P.O.BOX 1982, Damman, 31441. Saudi Arabia
| | - Syed Ehtaishamul Haque
- Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi-110062. India
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Akter R, Rahman MH, Behl T, Chowdhury MAR, Manirujjaman M, Bulbul IJ, Elshenaw SE, Tit DM, Bungau S. Prospective Role of Polyphenolic Compounds in the Treatment of Neurodegenerative Diseases. CNS & NEUROLOGICAL DISORDERS-DRUG TARGETS 2021; 20:430-450. [DOI: 10.2174/1871527320666210218084444] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 12/07/2020] [Accepted: 12/14/2020] [Indexed: 01/18/2023]
Abstract
:
Aging is an important stage of the human life cycle and the primary risk factor for neurodegenerative diseases (ND). The aging process contributes to modifications in cells, which may lead to a lack of nutrient signaling, disrupted cellular activity, increased oxidative pressure, cell homeostasis depletion, genomic instability, misfolded protein aggregation, impaired cellular protection, and telomere reduction. The neuropathologies found in Alzheimer's disease (AD) and Parkinson's disease (PD) are internally and extrinsically compound environmental stressors which may be partially alleviated by using different phytochemicals. The new therapies for ND are restricted as they are primarily targeted at final disease progression, including behavioral shifts, neurological disorders, proteinopathies, and neuronal failure. This review presents the role of phytochemicals-related polyphenolic compounds as an accompanying therapy model to avoid neuropathologies linked to AD, PD and to simultaneously enhance two stochastic stressors, namely inflammation and oxidative stress, promoting their disease pathologies. Therefore, this approach represents a prophylactic way to target risk factors that rely on their action against ND that does not occur through current pharmacological agents over the life of a person.
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Affiliation(s)
- Rokeya Akter
- Department of Pharmacy, Jagannath University, Sadarghat, Dhaka-1100, Bangladesh
| | - Md. Habibur Rahman
- Department of Pharmacy, Southeast University, Banani, 42130, Dhaka-1213, Bangladesh
| | - Tapan Behl
- Chitkara College of Pharmacy, Chitkara University, 140401 Punjab, India
| | | | - Manirujjaman Manirujjaman
- Institute of Health and Biomedical Innovation (IHBI), School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Kelvin Grove, Australia
| | - Israt Jahan Bulbul
- Department of Pharmacy, Southeast University, Banani, 42130, Dhaka-1213, Bangladesh
| | - Shimaa E. Elshenaw
- Center of stem cell and regenerative medicine, Zewail City for Science, Egypt
| | - Delia Mirela Tit
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 10 1 Decembrie Sq., 410073 Oradea, Romania
| | - Simona Bungau
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 10 1 Decembrie Sq., 410073 Oradea, Romania
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Fote GM, Geller NR, Reyes-Ortiz AM, Thompson LM, Steffan JS, Grill JD. A Scoping Review of Dietary Factors Conferring Risk or Protection for Cognitive Decline in APOE ε4 Carriers. J Nutr Health Aging 2021; 25:1167-1178. [PMID: 34866144 PMCID: PMC8890439 DOI: 10.1007/s12603-021-1705-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Alzheimer's disease (AD) is a progressive and fatal neurodegenerative disease. The strongest genetic risk factor for sporadic AD is carriage of the ε4 allele of the Apolipoprotein E (APOE) gene. Strategies to slow the progression of AD, including dietary interventions, may be modified by the pathogenic effect of this polymorphism. Our objective in this review was to determine the extent and quality of the literature investigating how dietary factors and interventions interact with the APOE ε4 genotype to impact cognitive decline in AD. To that end, we performed a systematic scoping review of published English-language articles involving human subjects. We found evidence suggesting that adherence to a Mediterranean diet may reduce cognitive decline among APOE ε4 carriers, whereas ketogenic agents appear to be ineffective. Diets high in saturated fats may be particularly harmful for APOE ε4 carriers. We identified several topics, including the use of ω-3 fatty acid and antioxidant supplements, for which additional high level evidence is needed.
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Affiliation(s)
- G M Fote
- Gianna M. Fote, PhD, UC Irvine Department of Biological Chemistry, 385 S. Manchester Ave, Unit 2096, Orange CA 92868, USA, (310)924-4415, ; Joshua D. Grill, PhD, UC Irvine Institute for Memory Impairments and Neurological Disorders, Professor of Psychiatry and Human Behavior, Professor of Neurobiology and Behavior, University of California, Irvine, 3024 Biological Sciences III, Irvine, CA 92697, USA,
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Băjenaru O, Prada G, Antochi F, Jianu C, Tudose C, Cuciureanu A, Docu AA, Perrot V, Avram M, Tiu C. Effectiveness and Safety Profile of Ginkgo biloba Standardized Extract (EGb761®) in Patients with Amnestic Mild Cognitive Impairment. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2021; 20:378-384. [PMID: 33557741 DOI: 10.2174/1871527320666210208125524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/30/2020] [Accepted: 10/01/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Ginkgo biloba is a common symptomatic treatment for cognitive impairment, although data on its efficacy are controversial. OBJECTIVE The aim of the current study was to evaluate the effectiveness of standardized Ginkgo biloba extract EGb761® (Tanakan®) for the improvements of cognitive functions over 24 months in a local cohort of patients diagnosed with amnestic mild cognitive impairment (aMCI). METHODS This multicentre non-interventional study included 500 eligible patients with a MCI treated with 120 mg/day standardized Ginkgo biloba extract EGb761® (Tanakan®). Patients were evaluated using several scales for assessment of cognition, memory, activities of daily living, and depression (MMSE, FAQ, CGI, HAM-D) at baseline and every 6 months after that for a 24-month period. The median change in MMSE at the 24-month follow-up was the primary outcome of the study. RESULTS A statistically significant increase of 2 points in the median MMSE score was obtained. In patients with other concomitant cognitive disorders, the improvement in MMSE was less significant. Tanakan® improved memory impairment (using the delayed recall test) and the ability to accomplish activities of daily living (mean FAQ score, 1.7); it also decreased the severity of depression (mean HAM-D score, 2.4) at the end of the study. More than 80% of the patients showed minimal improvement of their condition as assessed by the CGI-Improvement Scale. CONCLUSION The administration of EGb761® (Tanakan®) led to a significant improvement of cognitive decline, memory, activities of daily living, and depression in subjects with aMCI over 24 months.
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Affiliation(s)
- Ovidiu Băjenaru
- Department of Neurology, Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania
| | - Gabriel Prada
- Department of Geriatrics and Gerontology, Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania
| | - Florina Antochi
- Department of Neurology, University Emergency Hospital Bucharest, Bucharest, Romania
| | - Cătălin Jianu
- Department of Neurology, Faculty of Medicine, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania
| | - Cătălina Tudose
- Department of Psychiatry, Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania
| | - Adina Cuciureanu
- Department of Neurology, Individual Medical Office, Iasi, Romania
| | - Any A Docu
- Department of Neurology, Faculty of Medicine, University of Medicine and Pharmacy "Ovidius", Constanta, Romania
| | | | | | - Cristina Tiu
- Department of Neurology, University Emergency Hospital Bucharest, Bucharest, Romania
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Tao LX, Ji SS, Szalóki D, Kovács T, Mándi A, Antus S, Ding X, Kurtán T, Zhang HY. An optically active isochroman-2H-chromene conjugate potently suppresses neuronal oxidative injuries associated with the PI3K/Akt and MAPK signaling pathways. Acta Pharmacol Sin 2021; 42:36-44. [PMID: 32393798 PMCID: PMC7921582 DOI: 10.1038/s41401-020-0391-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 02/23/2020] [Indexed: 12/18/2022] Open
Abstract
Increasing evidence suggests that the use of potent neuroprotective agents featured with novel pharmacological mechanism would offer a promising strategy to delay or prevent the progression of neurodegeneration. Here, we provide the first demonstration that the chiral nonracemic isochroman-2H-chromene conjugate JE-133, a novel synthetic 1,3-disubstituted isochroman derivative, possesses superior neuroprotective effect against oxidative injuries. Pretreatment with JE-133 (1-10 μM) concentration-dependently prevented H2O2-induced cell death in SH-SY5Y neuroblastoma cells and rat primary cortical neurons. Pretreatment with JE-133 significantly alleviated H2O2-induced apoptotic changes. These protective effects could not be simply attributed to the direct free radical scavenging as JE-133 had moderate activity in reducing DPPH free radical. Further study revealed that pretreatment with JE-133 (10 μM) significantly decreased the phosphorylation of MAPK pathway proteins, especially ERK and P38, in the neuronal cells. In addition, blocking PI3K/Akt pathway using LY294002 partially counteracted the cell viability-enhancing effect of JE-133. We conclude that JE-133 exerts neuroprotection associated with dual regulative mechanisms and consequently activating cell survival and inhibiting apoptotic changes, which may provide important clues for the development of effective neuroprotective drug lead/candidate.
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Affiliation(s)
- Ling-Xue Tao
- CAS Key Laboratory of Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
| | - Sha-Sha Ji
- CAS Key Laboratory of Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
| | - Dóra Szalóki
- Department of Organic Chemistry, University of Debrecen, Debrecen, P. O. Box 400, H-4002, Debrecen, Hungary
| | - Tibor Kovács
- Department of Organic Chemistry, University of Debrecen, Debrecen, P. O. Box 400, H-4002, Debrecen, Hungary
| | - Attila Mándi
- Department of Organic Chemistry, University of Debrecen, Debrecen, P. O. Box 400, H-4002, Debrecen, Hungary
| | - Sándor Antus
- Department of Organic Chemistry, University of Debrecen, Debrecen, P. O. Box 400, H-4002, Debrecen, Hungary
| | - Xun Ding
- CAS Key Laboratory of Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
| | - Tibor Kurtán
- Department of Organic Chemistry, University of Debrecen, Debrecen, P. O. Box 400, H-4002, Debrecen, Hungary.
| | - Hai-Yan Zhang
- CAS Key Laboratory of Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China.
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Complementary Medicine and Natural Medications in Psychiatry: A Guide for the Consultation-Liaison Psychiatrist. PSYCHOSOMATICS 2020; 61:508-517. [DOI: 10.1016/j.psym.2020.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 04/10/2020] [Accepted: 04/10/2020] [Indexed: 12/27/2022]
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Snitz BE, Chang Y, Tudorascu DL, Lopez OL, Lopresti BJ, DeKosky ST, Carlson MC, Cohen AD, Kamboh MI, Aizenstein HJ, Klunk WE, Kuller LH. Predicting resistance to amyloid-beta deposition and cognitive resilience in the oldest-old. Neurology 2020; 95:e984-e994. [PMID: 32699143 PMCID: PMC7668550 DOI: 10.1212/wnl.0000000000010239] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 02/20/2020] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To explore long-term predictors of avoiding β-amyloid (Aβ) deposition and maintaining unimpaired cognition as outcomes in the oldest old. METHODS In a longitudinal observational cohort study, 100 former participants of the Ginkgo Evaluation of Memory Study (GEMS; 2000-2008) completed biannual Pittsburgh compound B-PET imaging and annual clinical-cognitive evaluations beginning in 2010. Most recent Aβ status and cognitive status were selected for each participant. Longitudinal outcomes included change in serial Aβ and cognitive tests. Baseline predictors from GEMS included neuropsychological tests, daily functioning, APOE genotype, lifestyle variables, occupational measures, health history, sleep, subjective memory, physical and cognitive activities, depressive symptoms, and physical performance and health indices, among others. RESULTS Mean age at the last cognitive evaluation was 92.0 (range 86-100) years. Mean follow-up time from baseline to last measured Aβ status was 12.3 (SD 1.9) years and to last cognitive evaluation was 14.1 (SD 1.9) years. The APOE*2 allele predicted last Aβ status (n = 34 Aβ negative vs n = 66 Aβ positive). Baseline cognition predicted cognitive status (n = 30 unimpaired vs n = 70 impaired). Predictors of cognitive status among Aβ-positive participants only (n = 14 normal cognition vs n = 52 impaired) were baseline cognitive test scores and smoking history. Baseline pulse pressure predicted longitudinal Aβ increase; paid work engagement and life satisfaction predicted less cognitive decline. CONCLUSIONS The APOE*2 allele and lower pulse pressure predict resistance to Aβ deposition in advanced aging. Cognitive test scores 14 years prior, likely reflecting premorbid abilities, predict cognitive status and maintenance of unimpaired cognition in the presence of Aβ. Several lifestyle factors appear protective.
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Affiliation(s)
- Beth E Snitz
- From the Departments of Neurology (B.E.S., O.L.L., W.E.K.), Neurological Surgery (Y.C.), Medicine (D.L.T.), Radiology (B.J.L.), Psychiatry (A.D.C., H.J.A., W.E.K.), Human Genetics (M.I.K.), and Epidemiology (L.H.K.), University of Pittsburgh, PA; Department of Neurology (S.T.D.), University of Florida, Gainesville; and Department of Mental Health (M.C.C.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
| | - Yuefang Chang
- From the Departments of Neurology (B.E.S., O.L.L., W.E.K.), Neurological Surgery (Y.C.), Medicine (D.L.T.), Radiology (B.J.L.), Psychiatry (A.D.C., H.J.A., W.E.K.), Human Genetics (M.I.K.), and Epidemiology (L.H.K.), University of Pittsburgh, PA; Department of Neurology (S.T.D.), University of Florida, Gainesville; and Department of Mental Health (M.C.C.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Dana L Tudorascu
- From the Departments of Neurology (B.E.S., O.L.L., W.E.K.), Neurological Surgery (Y.C.), Medicine (D.L.T.), Radiology (B.J.L.), Psychiatry (A.D.C., H.J.A., W.E.K.), Human Genetics (M.I.K.), and Epidemiology (L.H.K.), University of Pittsburgh, PA; Department of Neurology (S.T.D.), University of Florida, Gainesville; and Department of Mental Health (M.C.C.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Oscar L Lopez
- From the Departments of Neurology (B.E.S., O.L.L., W.E.K.), Neurological Surgery (Y.C.), Medicine (D.L.T.), Radiology (B.J.L.), Psychiatry (A.D.C., H.J.A., W.E.K.), Human Genetics (M.I.K.), and Epidemiology (L.H.K.), University of Pittsburgh, PA; Department of Neurology (S.T.D.), University of Florida, Gainesville; and Department of Mental Health (M.C.C.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Brian J Lopresti
- From the Departments of Neurology (B.E.S., O.L.L., W.E.K.), Neurological Surgery (Y.C.), Medicine (D.L.T.), Radiology (B.J.L.), Psychiatry (A.D.C., H.J.A., W.E.K.), Human Genetics (M.I.K.), and Epidemiology (L.H.K.), University of Pittsburgh, PA; Department of Neurology (S.T.D.), University of Florida, Gainesville; and Department of Mental Health (M.C.C.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Steven T DeKosky
- From the Departments of Neurology (B.E.S., O.L.L., W.E.K.), Neurological Surgery (Y.C.), Medicine (D.L.T.), Radiology (B.J.L.), Psychiatry (A.D.C., H.J.A., W.E.K.), Human Genetics (M.I.K.), and Epidemiology (L.H.K.), University of Pittsburgh, PA; Department of Neurology (S.T.D.), University of Florida, Gainesville; and Department of Mental Health (M.C.C.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Michelle C Carlson
- From the Departments of Neurology (B.E.S., O.L.L., W.E.K.), Neurological Surgery (Y.C.), Medicine (D.L.T.), Radiology (B.J.L.), Psychiatry (A.D.C., H.J.A., W.E.K.), Human Genetics (M.I.K.), and Epidemiology (L.H.K.), University of Pittsburgh, PA; Department of Neurology (S.T.D.), University of Florida, Gainesville; and Department of Mental Health (M.C.C.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Ann D Cohen
- From the Departments of Neurology (B.E.S., O.L.L., W.E.K.), Neurological Surgery (Y.C.), Medicine (D.L.T.), Radiology (B.J.L.), Psychiatry (A.D.C., H.J.A., W.E.K.), Human Genetics (M.I.K.), and Epidemiology (L.H.K.), University of Pittsburgh, PA; Department of Neurology (S.T.D.), University of Florida, Gainesville; and Department of Mental Health (M.C.C.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - M Ilyas Kamboh
- From the Departments of Neurology (B.E.S., O.L.L., W.E.K.), Neurological Surgery (Y.C.), Medicine (D.L.T.), Radiology (B.J.L.), Psychiatry (A.D.C., H.J.A., W.E.K.), Human Genetics (M.I.K.), and Epidemiology (L.H.K.), University of Pittsburgh, PA; Department of Neurology (S.T.D.), University of Florida, Gainesville; and Department of Mental Health (M.C.C.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Howard J Aizenstein
- From the Departments of Neurology (B.E.S., O.L.L., W.E.K.), Neurological Surgery (Y.C.), Medicine (D.L.T.), Radiology (B.J.L.), Psychiatry (A.D.C., H.J.A., W.E.K.), Human Genetics (M.I.K.), and Epidemiology (L.H.K.), University of Pittsburgh, PA; Department of Neurology (S.T.D.), University of Florida, Gainesville; and Department of Mental Health (M.C.C.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - William E Klunk
- From the Departments of Neurology (B.E.S., O.L.L., W.E.K.), Neurological Surgery (Y.C.), Medicine (D.L.T.), Radiology (B.J.L.), Psychiatry (A.D.C., H.J.A., W.E.K.), Human Genetics (M.I.K.), and Epidemiology (L.H.K.), University of Pittsburgh, PA; Department of Neurology (S.T.D.), University of Florida, Gainesville; and Department of Mental Health (M.C.C.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Lewis H Kuller
- From the Departments of Neurology (B.E.S., O.L.L., W.E.K.), Neurological Surgery (Y.C.), Medicine (D.L.T.), Radiology (B.J.L.), Psychiatry (A.D.C., H.J.A., W.E.K.), Human Genetics (M.I.K.), and Epidemiology (L.H.K.), University of Pittsburgh, PA; Department of Neurology (S.T.D.), University of Florida, Gainesville; and Department of Mental Health (M.C.C.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Dietary Interventions to Prevent or Delay Alzheimer’s Disease: What the Evidence Shows. Curr Nutr Rep 2020; 9:210-225. [DOI: 10.1007/s13668-020-00333-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Wang BQ, Mei J, Liu L, Ju CX, Zhao JN, Zhang P, Xu FQ, Chen KJ. Exploratory study on the safety and effectiveness of Yizhi Qingxin Decoction (capsules) in the treatment of hypertension in the elderly with mild cognitive impairment (deficiency of kidney essence syndrome). Medicine (Baltimore) 2020; 99:e20789. [PMID: 32629662 PMCID: PMC7337543 DOI: 10.1097/md.0000000000020789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/21/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Hypertension in the elderly with cognitive impairment has been one of the global health issues. Mild cognitive impairment (MCI) is the state of transition between the normal aging process and cognitive changes of unformed dementia. Diagnosis and treatment of MCI are the keys to prevent dementia, and hypertension is one of the important influencing factors of MCI. Our preclinical experiment found that Yizhi Qingxin Decoction (YQD) could effectively reduce the blood pressure of spontaneously hypertensive rats (SHR), improve their spatial learning and memory abilities in Morris water maze, and play a neuroprotective role. The objective is to estimate the safety and efficacy of YQD (capsules) in the treatment of hypertension in the elderly with MCI (deficiency of kidney essence syndrome) through this study. METHODS According to the random number generated by the block random method, 100 participants will be randomly and equally divided into the treatment group (YQD) or the control group (Ginkgo biloba extract tablets). The conversion rate of dementia will be used as the main evaluating indicator by the CDR scale. The MoCA scale, MMSE scale, ADCS-MCI-ADL-24 scale, CGIC-KDS scale, and 24-h ambulatory blood pressure will be used as the secondary evaluating indicator. Safety will be evaluated based on specific manifestations of adverse reactions and the incidence of adverse events. OBJECTIVE The objective is to estimate the curative effect of YQD (capsules) on hypertension in the elderly with MCI (deficiency of kidney essence syndrome), and to evaluate the safety of its clinical application. TRIAL REGISTRATION Chinese Clinical Trial Registry (ICTRP member): ChiCTR2000030292.
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Affiliation(s)
- Bi-Qing Wang
- Clinical College, Beijing University of Chinese Medicine
- Xiyuan Hospital, China Academy of Chinese Medical Sciences
| | | | - Lu Liu
- Clinical College, Beijing University of Chinese Medicine
- Xiyuan Hospital, China Academy of Chinese Medical Sciences
| | - Chun-Xiao Ju
- Clinical College, Beijing University of Chinese Medicine
- Xiyuan Hospital, China Academy of Chinese Medical Sciences
| | | | | | | | - Ke-Ji Chen
- Cardiovascular Diseases Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Di Nuovo S, De Beni R, Borella E, Marková H, Laczó J, Vyhnálek M. Cognitive Impairment in Old Age. EUROPEAN PSYCHOLOGIST 2020. [DOI: 10.1027/1016-9040/a000391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. A decline in cognitive functioning is part of physiological aging. Accelerated cognitive decline is frequently linked to pathological changes, mostly due to Alzheimer’s Disease (AD), but is present also in Mild Cognitive Impairment (MCI) which is a predictor of transition to dementia. This review aims to summarize possible preventive biological and psychological treatments in different stages of lifespan to avoid more rapid cognitive decline and prevent pathological aging. Psychophysiological approaches aim to prevent brain damage and inflammation, two factors playing probably a major role in middle and old age. Interventions on working memory and imagery, using “cognitive reserve,” are beneficial for tolerating neuropathological age-related changes. Some controversial results are outlined, suggesting explanations for the inconsistency of findings. Although clear evidence from interventional studies is lacking, it seems that multi-domain interventions should be recommended to avoid or delay cognitive decline.
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Affiliation(s)
| | | | - Erika Borella
- Department of Psychology, University of Padua, Italy
| | - Hana Marková
- Memory Clinic, Department of Neurology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital Brno, Czech Republic
| | - Jan Laczó
- Memory Clinic, Department of Neurology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital Brno, Czech Republic
| | - Martin Vyhnálek
- Memory Clinic, Department of Neurology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital Brno, Czech Republic
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Koch M, DeKosky ST, Goodman M, Sun J, Furtado JD, Fitzpatrick AL, Mackey RH, Cai T, Lopez OL, Kuller LH, Mukamal KJ, Jensen MK. Association of Apolipoprotein E in Lipoprotein Subspecies With Risk of Dementia. JAMA Netw Open 2020; 3:e209250. [PMID: 32648923 PMCID: PMC7352155 DOI: 10.1001/jamanetworkopen.2020.9250] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 04/22/2020] [Indexed: 12/13/2022] Open
Abstract
Importance The ε4 allele of the apolipoprotein E (APOE) gene and lower apolipoprotein E (apoE) protein levels in plasma are risk factors for Alzheimer disease, but the underlying biological mechanisms are not fully understood. Half of plasma apoE circulates on high-density lipoproteins (HDLs). Higher apoE levels in plasma HDL were previously found to be associated with lower coronary heart disease risk, but the coexistence of another apolipoprotein, apoC3, modified this lower risk. Objective To investigate associations between the presence of apoE in different lipoproteins with cognitive function, particularly the risk of dementia. Design, Setting, and Participants This prospective case-cohort study embedded in the Ginkgo Evaluation of Memory Study (2000-2008) analyzed data from 1351 community-dwelling participants 74 years and older. Of this group, 995 participants were free of dementia at baseline (recruited from September 2000 to June 2002) and 521 participants were diagnosed with incident dementia during follow-up until 2008. Data analysis was performed from January 2018 to December 2019. Exposures Enzyme-linked immunosorbent assay-measured concentration of apoE in whole plasma, HDL-depleted plasma (non-HDL), HDL, and HDL subspecies that contain or lack apoC3 or apoJ. Main Outcomes and Measures Adjusted hazard ratios for risk of dementia and Alzheimer disease during follow-up and adjusted differences (β coefficients) in Alzheimer Disease Assessment-Cognitive Subscale (ADAS-cog) and Modified Mini-Mental State Examination scores at baseline. Results Among 1351 participants, the median (interquartile range) age was 78 (76-81) years; 639 (47.3%) were women. The median (interquartile range) follow-up time was 5.9 (3.7-6.5) years. Higher whole plasma apoE levels and higher apoE levels in HDL were associated with better cognitive function assessed by ADAS-cog (whole plasma, β coefficient, -0.15; 95% CI, -0.24 to -0.06; HDL, β coefficient, -0.20; 95% CI, -0.30 to -0.10) but were unassociated with dementia or Alzheimer disease risk. When separated by apoC3, a higher apoE level in HDL that lacks apoC3 was associated with better cognitive function (ADAS-cog per SD: β coefficient, 0.17; 95% CI, -0.27 to -0.07; Modified Mini-Mental State Examination score per SD: β coefficient, 0.25; 95% CI, 0.07 to 0.42) and lower risk of dementia (hazard ratio per SD, 0.86; 95% CI, 0.76 to 0.99). In contrast, apoE levels in HDL that contains apoC3 were unassociated with any of these outcomes. Conclusions and Relevance In a prospective cohort of older adults with rigorous follow-up of dementia, the apoE level in HDL that lacked apoC3 was associated with better cognitive function and lower dementia risk. This finding suggests that the cardioprotective associations of this novel lipoprotein extend to dementia.
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Affiliation(s)
- Manja Koch
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - Matthew Goodman
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jiehuan Sun
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jeremy D. Furtado
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - Rachel H. Mackey
- Department of Family Medicine, University of Washington, Seattle
- Department of Epidemiology, University of Washington, Seattle
- Department of Global Health, University of Washington, Seattle
| | - Tianxi Cai
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Oscar L. Lopez
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Lewis H. Kuller
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Kenneth J. Mukamal
- Beth Israel Deaconess Medical Center, Department of Medicine, Boston, Massachusetts
| | - Majken K. Jensen
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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50
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Yamashita H, Surapureddi S, Kovi RC, Bhusari S, Ton TV, Li JL, Shockley KR, Peddada SD, Gerrish KE, Rider CV, Hoenerhoff MJ, Sills RC, Pandiri AR. Unique microRNA alterations in hepatocellular carcinomas arising either spontaneously or due to chronic exposure to Ginkgo biloba extract (GBE) in B6C3F1/N mice. Arch Toxicol 2020; 94:2523-2541. [PMID: 32306082 DOI: 10.1007/s00204-020-02749-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 04/08/2020] [Indexed: 12/18/2022]
Abstract
Ginkgo biloba extract (GBE) is used in traditional Chinese medicine as a herbal supplement for improving memory. Exposure of B6C3F1/N mice to GBE in a 2-year National Toxicology Program (NTP) bioassay resulted in a dose-dependent increase in hepatocellular carcinomas (HCC). To identify key microRNAs that modulate GBE-induced hepatocarcinogenesis, we compared the global miRNA expression profiles in GBE-exposed HCC (GBE-HCC) and spontaneous HCC (SPNT-HCC) with age-matched vehicle control normal livers (CNTL) from B6C3F1/N mice. The number of differentially altered miRNAs in GBE-HCC and SPNT-HCC was 74 (52 up and 22 down) and 33 (15 up and 18 down), respectively. Among the uniquely differentially altered miRNAs in GBE-HCC, miR-31 and one of its predicted targets, Cdk1 were selected for functional validation. A potential miRNA response element (MRE) in the 3'-untranslated regions (3'-UTR) of Cdk1 mRNA was revealed by in silico analysis and confirmed by luciferase assays. In mouse hepatoma cell line HEPA-1 cells, we demonstrated an inverse correlation between miR-31 and CDK1 protein levels, but no change in Cdk1 mRNA levels, suggesting a post-transcriptional effect. Additionally, a set of miRNAs (miRs-411, 300, 127, 134, 409-3p, and 433-3p) that were altered in the GBE-HCCs were also altered in non-tumor liver samples from the 90-day GBE-exposed group compared to the vehicle control group, suggesting that some of these miRNAs could serve as potential biomarkers for GBE exposure or hepatocellular carcinogenesis. These data increase our understanding of miRNA-mediated epigenetic regulation of GBE-mediated hepatocellular carcinogenesis in B6C3F1/N mice.
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MESH Headings
- 3' Untranslated Regions
- Animals
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- CDC2 Protein Kinase/genetics
- CDC2 Protein Kinase/metabolism
- Carcinoma, Hepatocellular/chemically induced
- Carcinoma, Hepatocellular/genetics
- Carcinoma, Hepatocellular/metabolism
- Cell Line, Tumor
- Cell Transformation, Neoplastic/chemically induced
- Cell Transformation, Neoplastic/genetics
- Cell Transformation, Neoplastic/metabolism
- Epigenesis, Genetic
- Female
- Gene Expression Profiling
- Gene Expression Regulation, Neoplastic
- Ginkgo biloba
- Liver Neoplasms/chemically induced
- Liver Neoplasms/genetics
- Liver Neoplasms/metabolism
- Male
- Mice
- MicroRNAs/genetics
- MicroRNAs/metabolism
- Plant Extracts/toxicity
- Time Factors
- Transcriptome
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Affiliation(s)
- Haruhiro Yamashita
- Cellular and Molecular Pathology Branch, DNTP, NIEHS, Research Triangle Park, NC, 27709, USA
- Frontier Research Center, Taisho Pharmaceutical Co. Ltd, Tokyo, 100-6609, Japan
| | - Sailesh Surapureddi
- Signal Transduction Laboratory, DIR, NIEHS, Research Triangle Park, NC, 27709, USA
- United States Environmental Protection Agency, 1200 Pennsylvania Avenue NW, Washington, DC, 20460, USA
| | - Ramesh C Kovi
- Cellular and Molecular Pathology Branch, DNTP, NIEHS, Research Triangle Park, NC, 27709, USA
- Experimental Pathology Laboratories Inc, Research Triangle Park, NC, 27709, USA
| | - Sachin Bhusari
- Cellular and Molecular Pathology Branch, DNTP, NIEHS, Research Triangle Park, NC, 27709, USA
- Global Scientific and Regulatory Affairs, The Coca-Cola Company, 1 Coca Cola Plaza, NW, Atlanta, GA, USA
| | - Thai Vu Ton
- Cellular and Molecular Pathology Branch, DNTP, NIEHS, Research Triangle Park, NC, 27709, USA
| | - Jian-Liang Li
- Integrative Bioinformatics Support Group, DIR, NIEHS, Research Triangle Park, NC, 27709, USA
| | - Keith R Shockley
- Biostatistics and Computational Biology Branch, DIR, NIEHS, Research Triangle Park, NC, 27709, USA
| | - Shyamal D Peddada
- Biostatistics and Computational Biology Branch, DIR, NIEHS, Research Triangle Park, NC, 27709, USA
- Department of Biostatistics, University of Pittsburgh, 7126 Public Health, 130 DeSoto Street, Pittsburgh, PA, 1526, USA
| | - Kevin E Gerrish
- Molecular Genomics Core Laboratory, DIR, NIEHS, Research Triangle Park, NC, 27709, USA
| | - Cynthia V Rider
- Toxicology Branch, DNTP, NIEHS, Research Triangle Park, NC, 27709, USA
| | - Mark J Hoenerhoff
- Cellular and Molecular Pathology Branch, DNTP, NIEHS, Research Triangle Park, NC, 27709, USA
- In Vivo Animal Core, Unit for Laboratory Animal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Robert C Sills
- Cellular and Molecular Pathology Branch, DNTP, NIEHS, Research Triangle Park, NC, 27709, USA
| | - Arun R Pandiri
- Cellular and Molecular Pathology Branch, DNTP, NIEHS, Research Triangle Park, NC, 27709, USA.
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