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Xia Q, Pingcuo R, Yang C, Xiong W, Peng X, Xia J, Wang W, Hai M. A Review on the Chemical Properties, Plant Sources, Anti-shock Effects, Pharmacokinetics, Toxicity, and Clinical Applications of Anisodamine. Chem Biodivers 2024; 21:e202301477. [PMID: 38415906 DOI: 10.1002/cbdv.202301477] [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] [Received: 09/21/2023] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 02/29/2024]
Abstract
Alkaloids are natural products that occur widely in many herbal plants. Anisodamine, widely present in the Solanaceae family, is an alkaloid extracted from the roots of the Anisodus tanguticus Maxim. It is an antagonist to M-choline receptors and exhibits diverse pharmacological effects, such as cholinolytic effect, calcium antagonist effect, anti-oxygenation effect. Anisodamine, a prominent constituent of the tropine alkaloid family, exhibits a range of pharmacological effects akin to those of atropine and scopolamine. owing to its low toxicity and moderate efficacy in clinical to wide applications, especially for varieties of shock treatment. However, there remains a dearth of research regarding the in vivo pharmacokinetics, mechanism of action, and toxicity of anisodamine. Consequently, this paper provides a comprehensive review of the anti-shock effects, toxicity, and pharmacokinetic characteristics of anisodamine to increase the understanding of its medicinal value, and provide reference and inspiration for the clinical application and further in-depth research of anisodamine.
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Affiliation(s)
- Qiurui Xia
- College of Agronomy and Biotechnology, Yunnan Agricultural University, Kunming, 650201, China
| | - Raoji Pingcuo
- Limei Tibetan Medicine Hospital, Liwuqi, 855600, China
| | - Ce Yang
- School of Pharmacy, Chongqing Three Gorges Medical Colleges, Chongqing, 404120, China
- Chongqing Key Laboratory of Development and Utilization of Genuine Medicinal Materials in Three Gorges Reservoir Area, Chongqing, 404120, China
| | - Wei Xiong
- Chongqing Key Laboratory of Development and Utilization of Genuine Medicinal Materials in Three Gorges Reservoir Area, Chongqing, 404120, China
| | - Xiaoyuan Peng
- School of Pharmacy, Chongqing Three Gorges Medical Colleges, Chongqing, 404120, China
- Chongqing Key Laboratory of Development and Utilization of Genuine Medicinal Materials in Three Gorges Reservoir Area, Chongqing, 404120, China
| | - Jing Xia
- Chongqing Key Laboratory of Development and Utilization of Genuine Medicinal Materials in Three Gorges Reservoir Area, Chongqing, 404120, China
| | - Wenxiang Wang
- School of Pharmacy, Chongqing Three Gorges Medical Colleges, Chongqing, 404120, China
- Chongqing Key Laboratory of Development and Utilization of Genuine Medicinal Materials in Three Gorges Reservoir Area, Chongqing, 404120, China
| | - Meirong Hai
- College of Agronomy and Biotechnology, Yunnan Agricultural University, Kunming, 650201, China
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Zhang Y, Zou J, Wan F, Peng F, Peng C. Update on the sources, pharmacokinetics, pharmacological action, and clinical application of anisodamine. Biomed Pharmacother 2023; 161:114522. [PMID: 37002581 DOI: 10.1016/j.biopha.2023.114522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 03/10/2023] [Accepted: 03/10/2023] [Indexed: 03/16/2023] Open
Abstract
Anisodamine is an anticholinergic drug extracted and isolated from the Anisodus tanguticus (Maxim.) Pascher of the Solanaceae family which is also a muscarinic receptor antagonist. Owing to the lack of natural sources of anisodamine, synthetic products are now used. Using ornithine and arginine as precursor compounds, putrescine is catalyzed by different enzymes and then undergoes a series of reactions to produce anisodamine. It has been used clinically to protect cardiac function and treat septic shock, acute pancreatitis, calculous renal colic, bronchial asthma, blood circulation disturbances, jaundice, analgesia, vertigo, acute poisoning, and other conditions.This review describes the relevant pharmacokinetic parameters. Anisodamine is poorly absorbed in the gastrointestinal tract, and it is not as effective as intravenous administration. For clinical medication, intravenous infusion should be used rather than rapid intravenous injection. With the advancement of research in recent years, the application scope of anisodamine has expanded, with significant developments and application values surging.This review systematically describes the sources, pharmacokinetics, pharmacological effects and clinical application of anisodamine, in order to provide a basis for clinical use.
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Alozi M, Rawas-Qalaji M. Treating organophosphates poisoning: management challenges and potential solutions. Crit Rev Toxicol 2020; 50:764-779. [DOI: 10.1080/10408444.2020.1837069] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Maria Alozi
- College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Mutasem Rawas-Qalaji
- College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
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Yu SY, Gao YX, Walline J, Lu X, Zhao LN, Huang YX, Tao J, Yu AY, Ta N, Xiao RJ, Li Y. Role of penehyclidine in acute organophosphorus pesticide poisoning. World J Emerg Med 2020; 11:37-47. [PMID: 31893002 DOI: 10.5847/wjem.j.1920-8642.2020.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Penehyclidine is a newly developed anticholinergic agent. We aimed to investigate the role of penehyclidine in acute organophosphorus pesticide poisoning (OP) patients. METHODS We searched the Pubmed, Cochrane library, EMBASE, Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical literature (CBM) and Wanfang databases. Randomized controlled trials (RCTs) recruiting acute OP patients were identified for meta-analysis. Main outcomes included cure rate, mortality rate, time to atropinization, time to 60% normal acetylcholinesterase (AchE) level, rate of intermediate syndrome (IMS) and rate of adverse drug reactions (ADR). RESULTS Sixteen RCTs involving 1,334 patients were identified. Compared with the atropine- or penehyclidine-alone groups, atropine combined with penehyclidine significantly increased the cure rate (penehyclidine+atropine vs. atropine, 0.97 vs. 0.86, RR 1.13, 95% CI [1.07-1.19]; penehyclidine+atropine vs. penehyclidine, 0.93 vs. 0.80, RR 1.08, 95% CI [1.01-1.15]) and reduced the mortality rate (penehyclidine+atropine vs. atropine, 0.015 vs. 0.11, RR 0.17, 95% CI [0.06-0.49]; penehyclidine+atropine vs. penehyclidine, 0.13 vs. 0.08, RR 0.23, 95% CI [0.04-1.28]). Atropine combined with penehyclidine in OP patients also helped reduce the time to atropinization and AchE recovery, the rate of IMS and the rate of ADR. Compared with a single dose of atropine, a single dose of penehyclidine also significantly elevated the cure rate, reduced times to atropinization, AchE recovery, and rate of IMS. CONCLUSION Atropine combined with penehyclidine benefits OP patients by enhancing the cure rate, mortality rate, time to atropinization, AchE recovery, IMS rate, total ADR and duration of hospitalization. Penehyclidine combined with atropine is likely a better initial therapy for OP patients than atropine alone.
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Affiliation(s)
- Shi-Yuan Yu
- Department of Emergency Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yan-Xia Gao
- Department of Emergency Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Joseph Walline
- Accident and Emergency Medicine Academic Unit, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China
| | - Xin Lu
- Department of Emergency Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Li-Na Zhao
- Department of Emergency Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yuan-Xu Huang
- Department of Emergency Medicine, the Fourth Affiliated Hospital of Jishou University, Huaihua, China
| | - Jiang Tao
- Department of Emergency Medicine, the Fourth Affiliated Hospital of Jishou University, Huaihua, China
| | - An-Yong Yu
- Department of Emergency Medicine, the First Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Na Ta
- Department of Emergency Medicine, Chifeng Municipal Hospital, Chifeng, China
| | - Ren-Ju Xiao
- Department of Emergency Medicine, Xingyi People's Hospital, Xingyi, China
| | - Yi Li
- Department of Emergency Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
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Eisenkraft A, Falk A. Possible role for anisodamine in organophosphate poisoning. Br J Pharmacol 2016; 173:1719-27. [PMID: 27010563 DOI: 10.1111/bph.13486] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 03/02/2016] [Accepted: 03/17/2016] [Indexed: 12/16/2022] Open
Abstract
In cases of organophosphate poisoning, patients are treated with a combination of antidotes. In addition to these poison-directed antidotes, patients may require extra oxygen and artificial ventilation; other modalities may also be needed due to the wide range of toxic effects. Anisodamine is a belladonna alkaloid, and like other drugs from this family is non subtype-selective muscarinic, and a nicotinic cholinoceptor antagonist, which has been employed in traditional Chinese medicine. As a muscarinic antagonist, it displays similar pharmacological effects to atropine and scopolamine. However, anisodamine is not only less potent than atropine and scopolamine but also less toxic. Current in vitro and animal model studies have demonstrated that anisodamine has protective effects in a variety of diseases. Organophosphate poisoning involves not only the central and peripheral nervous systems, but also the cardiac and respiratory systems, as well as activation of inflammatory processes and oxidative stress. Therefore, the anticholinergic and additional activities of anisodamine appear to be relevant and justify its consideration as an addition to the existing remedies. However, more research is needed, as at present data on the role of anisodamine in the management of organophosphate poisoning are limited. Here, we review the beneficial effects of anisodamine on processes relevant to organophosphate poisoning.
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Affiliation(s)
- Arik Eisenkraft
- Israel Ministry of Defense, HaKirya, Tel Aviv, Israel.,Israel Defense Force Medical Corps, Ramat Gan, Israel.,The Institute for Research in Military Medicine, The Faculty of Medicine, The Hebrew University, Jerusalem, Israel
| | - Avshalom Falk
- Israel Ministry of Defense, HaKirya, Tel Aviv, Israel
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Iyer R, Iken B, Leon A. Developments in alternative treatments for organophosphate poisoning. Toxicol Lett 2015; 233:200-6. [PMID: 25595305 DOI: 10.1016/j.toxlet.2015.01.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 01/10/2015] [Accepted: 01/12/2015] [Indexed: 12/25/2022]
Abstract
Organophosphosphates (OPs) are highly effective acetylcholinesterase (AChE) inhibitors that are used worldwide as cheap, multi-purpose insecticides. OPs are also used as chemical weapons forming the active core of G-series and V-series chemical agents including tabun, sarin, soman, cyclosarin, VX, and their chemical analogs. Human exposure to any of these compounds leads to neurotoxic accumulation of the neurotransmitter acetylcholine, resulting in abnormal nerve function and multiple secondary health complications. Suicide from deliberate exposure to OPs is particularly prevalent in developing countries across the world and constitutes a major global health crisis. The prevalence and accessible nature of OP compounds within modern agricultural spheres and concern over their potential use in biochemical weapon attacks have incentivized both government agencies and medical researchers to enact stricter regulatory policies over their usage and to begin developing more proactive medical treatments in cases of OP poisoning. This review will discuss the research undertaken in recent years that has investigated new supplementary drug options for OP treatment and support therapy, including progress in the development of enzymatic prophylaxis.
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Affiliation(s)
- Rupa Iyer
- Center for Life Sciences Technology, Engineering Technology, University of Houston, 300 Technology Building, Houston, TX 77204, USA.
| | - Brian Iken
- Center for Life Sciences Technology, Engineering Technology, University of Houston, 300 Technology Building, Houston, TX 77204, USA
| | - Alex Leon
- Center for Life Sciences Technology, Engineering Technology, University of Houston, 300 Technology Building, Houston, TX 77204, USA
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Kaur S, Singh S, Chahal KS, Prakash A. Potential pharmacological strategies for the improved treatment of organophosphate-induced neurotoxicity. Can J Physiol Pharmacol 2014; 92:893-911. [DOI: 10.1139/cjpp-2014-0113] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Organophosphates (OP) are highly toxic compounds that cause cholinergic neuronal excitotoxicity and dysfunction by irreversible inhibition of acetylcholinesterase, resulting in delayed brain damage. This delayed secondary neuronal destruction, which arises primarily in the cholinergic areas of the brain that contain dense accumulations of cholinergic neurons and the majority of cholinergic projection, could be largely responsible for persistent profound neuropsychiatric and neurological impairments such as memory, cognitive, mental, emotional, motor, and sensory deficits in the victims of OP poisoning. The therapeutic strategies for reducing neuronal brain damage must adopt a multifunctional approach to the various steps of brain deterioration: (i) standard treatment with atropine and related anticholinergic compounds; (ii) anti-excitotoxic therapies to prevent cerebral edema, blockage of calcium influx, inhibition of apoptosis, and allow for the control of seizure; (iii) neuroprotection by aid of antioxidants and N-methyl-d-aspartate (NMDA) antagonists (multifunctional drug therapy), to inhibit/limit the secondary neuronal damage; and (iv) therapies targeting chronic neuropsychiatric and neurological symptoms. These neuroprotective strategies may prevent secondary neuronal damage in both early and late stages of OP poisoning, and thus may be a beneficial approach to treating the neuropsychological and neuronal impairments resulting from OP toxicity.
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Affiliation(s)
- Shamsherjit Kaur
- Department of Pharmacology, ISF College of Pharmacy, Moga 142001, Punjab, India
- Punjab Technical University, Kapurthala 144601, Punjab, India
| | - Satinderpal Singh
- Department of Pharmacology, ISF College of Pharmacy, Moga 142001, Punjab, India
| | - Karan Singh Chahal
- Department of Pharmacology, ISF College of Pharmacy, Moga 142001, Punjab, India
| | - Atish Prakash
- Department of Pharmacology, ISF College of Pharmacy, Moga 142001, Punjab, India
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