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Kabatas GS, Ertas B, Sen A, Sener G, Ercan F, Akakin D. Histological and biochemical effects of an ethanolic extract of Myrtus communis leaf on the pancreases of rats fed high fat diets. Biotech Histochem 2024:1-12. [PMID: 38805000 DOI: 10.1080/10520295.2024.2355212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Abstract
We investigated the effects of an ethanolic extract of Myrtus communis subsp. communis (MC) leaves on the pancreases of rats fed with a high fat diet (HFD). Wistar albino rats were fed either with standard lab chow (Control group) or with a 45% fat diet (HFD and HFD+MC groups) for 4 months, with the MC extract (100 mg/kg) being administered by orogastric gavage to rats in the HFD+MC group during the last month. Blood and pancreas samples were collected from all experimental groups at the end of the study. Insulin and leptin levels, and the lipid profile, were analyzed in the blood serum. Pancreatic injury was assessed histologically. Insulin, nuclear factor kappa beta (NF-κB), and alpha-smooth muscle actin (α-SMA) were assessed using immunohistochemistry. Apoptosis was assessed using terminal deoxynucleotidyl transferase dUTP nick end-labeling (TUNEL) immunohistochemistry. In addition, oxidant/antioxidant activity was analyzed by biochemical methods. Increased body weight, serum insulin and leptin levels, blood glucose level and pancreatic tissue malondialdehyde (MDA), 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels, myeloperoxidase (MPO) activity and decreased tissue glutathione (GSH) level were observed in the HFD group compared to the Control group, in addition to dyslipidemia. An increased histopathological damage score, pancreatic islet area, insulin, TUNEL, NF-κB and α-SMA immunoreactivity were seen in animals from the HFD group compared to the Control group. However, such pathological changes were reduced in the HFD+MC group. Our data indicate further investigation of MC extract as a therapeutic adjuvant for HFD-induced pancreatic injury, acting via anti-inflammatory and antioxidant mechanisms, is worth carrying out.
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Affiliation(s)
- Gul Sinemcan Kabatas
- Department of Histology and Embryology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Busra Ertas
- Department of Pharmacology, School of Pharmacy, Marmara University, Istanbul, Turkey
| | - Ali Sen
- Department of Pharmacognosy, School of Pharmacy, Marmara University, Istanbul, Turkey
| | - Goksel Sener
- Department of Pharmacology, School of Pharmacy, Fenerbahce University, Turkey
| | - Feriha Ercan
- Department of Histology and Embryology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Dilek Akakin
- Department of Histology and Embryology, School of Medicine, Marmara University, Istanbul, Turkey
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Rajizadeh MA, Khaksari M, Bejeshk MA, Amirkhosravi L, Jafari E, Jamalpoor Z, Nezhadi A. The Role of Inhaled Estradiol and Myrtenol, Alone and in Combination, in Modulating Behavioral and Functional Outcomes Following Traumatic Experimental Brain Injury: Hemodynamic, Molecular, Histological and Behavioral Study. Neurocrit Care 2023; 39:478-498. [PMID: 37100976 DOI: 10.1007/s12028-023-01720-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 03/24/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND Traumatic brain injury (TBI) is an important and growing cause of disability worldwide, and its cognitive consequences may be particularly significant. This study assessed the neuroprotective impacts of estradiol (E2), myrtenol (Myr), and the combination of the two on the neurological outcome, hemodynamic parameters, learning and memory, brain-derived neurotrophic factor (BDNF) level, phosphoinositide 3-kinases (PI3K/AKT) signaling, and inflammatory and oxidative factors in the hippocampus after TBI. METHODS Eighty-four adult male Wistar rats were randomly divided into 12 groups with seven rats in each (six groups to measure intracranial pressure, cerebral perfusion pressure, brain water content, and veterinary coma scale, and six groups for behavioral and molecular studies): sham, TBI, TBI/vehicle, TBI/Myr, TBI/E2, and TBI/Myr + E2 (Myr 50 mg/kg and E2 33.3 μg/kg via inhalation for 30 min after TBI induction). Brain injury was induced by using Marmarou's method. Briefly, a 300-g weight was dropped down from a 2-m height through a free-falling tube onto the head of the anesthetized animals. RESULTS Veterinary coma scale, learning and memory, brain water content, intracranial pressure, and cerebral perfusion pressure were impaired following TBI, and inflammation and oxidative stress were raised in the hippocampus after TBI. The BDNF level and PI3K/AKT signaling were impaired due to TBI. Inhalation of Myr and E2 had protective effects against all negative consequences of TBI by decreasing brain edema and the hippocampal content of inflammatory and oxidant factors and also by improving BDNF and PI3K/AKT in the hippocampus. Based on these data, there were no differences between alone and combination administrations. CONCLUSIONS Our results propose that Myr and E2 have neuroprotective effects on cognition impairments due to TBI.
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Affiliation(s)
- Mohammad Amin Rajizadeh
- Cognitive and Neuroscience Research Center, AJA University of Medical Sciences, Tehran, Iran
| | - Mohammad Khaksari
- Department of Physiology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Abbas Bejeshk
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Ladan Amirkhosravi
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Elham Jafari
- Pathology and Stem Cell Research Center, Pathology Department, Kerman University of Medical Sciences, Kerman, Iran
| | - Zahra Jamalpoor
- Trauma Research Center, AJA University of Medical Sciences, Tehran, Iran
| | - Akram Nezhadi
- Cognitive and Neuroscience Research Center, AJA University of Medical Sciences, Tehran, Iran.
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Dabbaghi MM, Fadaei MS, Soleimani Roudi H, Baradaran Rahimi V, Askari VR. A review of the biological effects of Myrtus communis. Physiol Rep 2023; 11:e15770. [PMID: 37464095 PMCID: PMC10354007 DOI: 10.14814/phy2.15770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/03/2023] [Accepted: 07/03/2023] [Indexed: 07/20/2023] Open
Abstract
The World Health Organization stated that 1.6 million deaths worldwide were caused by contact with chemicals and toxins in 2019. In the same year, the Centers for Disease Control and Prevention stated that natural toxins caused 3960 deaths. Myrtus communis, also known as common Myrtle, is a flowering plant native to the Mediterranean region. Myrtle has been traditionally used to treat diarrhea, inflammation, bleeding, headache, pulmonary and skin diseases. This review was performed to assess Myrtle's protective and therapeutic efficacy against various chemical, natural, and radiational noxious. Multiple databases such as PubMed, Web of Sciences, and Scopus were investigated without publication time limitation. Recent studies have demonstrated its potential as a protective agent against both natural and chemical toxins. One of Myrtle's most significant protective properties is its high antioxidant content. Studies have shown that the antioxidant properties of Myrtle can protect against harmful substances such as heavy metals, pesticides, and other environmental toxins. Additionally, Myrtle has anti-inflammatory properties that can help reduce the damage caused by long-term exposure to toxins. The anti-inflammatory and antimicrobial properties of Myrtle have also proven effective in alleviating gastrointestinal conditions such as gastric ulcers.
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Affiliation(s)
- Mohammad Mahdi Dabbaghi
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Saleh Fadaei
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hesan Soleimani Roudi
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vafa Baradaran Rahimi
- Department of Cardiovascular Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vahid Reza Askari
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Ertas B, Hazar-Yavuz AN, Topal F, Keles-Kaya R, Karakus Ö, Ozcan GS, Taskin T, Cam ME. Rosa canina L. improves learning and memory-associated cognitive impairment by regulating glucose levels and reducing hippocampal insulin resistance in high-fat diet/streptozotocin-induced diabetic rats. JOURNAL OF ETHNOPHARMACOLOGY 2023; 313:116541. [PMID: 37088237 DOI: 10.1016/j.jep.2023.116541] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/09/2023] [Accepted: 04/20/2023] [Indexed: 05/03/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Recent studies claim that Type-2 diabetes mellitus (T2DM) and Alzheimer's disease (AD) overlap in several common pathological pathways which from neuronal damage to impaired memory performance. It is known that the use of Rosa canina L. (R. canina) as medicine in folk medicine dates back to ancient times and is used in the treatment of nervous diseases in Persian medicine. However, the effect of R. canina on diabetes-related cognitive decline and memory impairment has not yet been studied. AIM OF THE STUDY We evaluated the impact of T2DM on AD-like alterations and examined the molecular mechanism of a possible effect of R. canina on cognitive alterations in diabetic rats. MATERIALS&METHODS R. canina ethanol extract was obtained by maceration method. This study was performed with male Spraque-Dawley rats fed with a high-fat diet (HFD) for 8 weeks, low-dose streptozotocin (STZ; 35 mg/kg IP) injection for 4 weeks, and R. canina (250 mg/kg; per oral) and metformin (400 mg/kg; per oral) administration for 4 weeks. The weight and blood glucose of rats were measured weekly. To evaluate glucose tolerance area under the curve (AUC) was calculated by performing an oral glucose tolerance test. Then the rats were subjected to behavioural tests, and their hippocampus and cortex tissues were obtained for biochemical and morphological analyses. RESULTS R. canina could manage glucose responsiveness by reducing post-prandial blood glucose levels, preventing weight loss, and raising serum insulin levels in T2DM-induced rats. Behavioural tests showed that R. canina significantly improves diabetes-related cognitive decline in recall and long-term memory. Treatment with R. canina significantly reversed HFD/STZ-induced increases in insulin, amyloid-β, amyloid precursor protein levels, and acetylcholinesterase activity in the prefrontal cortex and hippocampus. Furthermore, histological analyzes revealed the protection of R. canina against neuronal disruption in the cortical and hippocampal CA3 region caused by chronic hyperglycemia. CONCLUSION Analyzed collectively, these results suggest that R. canina can correct T2DM-related cognitive decline may be attributed to insulin pathway modulation, prevention of amyloid deposition, and increased cholinergic transmission.
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Affiliation(s)
- Busra Ertas
- Department of Pharmacology, Faculty of Pharmacy, Marmara University, Istanbul, 34854, Turkey; Genetic and Metabolic Diseases Research and Investigation Center, Marmara University, 34722, Istanbul, Turkey
| | - Ayse Nur Hazar-Yavuz
- Department of Pharmacology, Faculty of Pharmacy, Marmara University, Istanbul, 34854, Turkey
| | - Fadime Topal
- Department of Pharmacology, Faculty of Pharmacy, Marmara University, Istanbul, 34854, Turkey
| | - Rumeysa Keles-Kaya
- Department of Pharmacology, Faculty of Pharmacy, University of Health Sciences, Istanbul, 34854, Turkey
| | - Özge Karakus
- Department of Pharmacology, Faculty of Pharmacy, Marmara University, Istanbul, 34854, Turkey
| | - Gul Sinemcan Ozcan
- Stem Cell and Gene Therapies Research and Applied Center, Medical Faculty, Kocaeli University, Kocaeli, 41380, Turkey
| | - Turgut Taskin
- Department of Pharmacognosy, Faculty of Pharmacy, Marmara University, Istanbul, 34854, Turkey
| | - Muhammet Emin Cam
- Department of Pharmacology, Faculty of Pharmacy, Marmara University, Istanbul, 34854, Turkey; Genetic and Metabolic Diseases Research and Investigation Center, Marmara University, 34722, Istanbul, Turkey; UCL Division of Surgery and Interventional Science, Royal Free Hospital Campus, University College London, Rowland Hill Street, NW3 2PF, UK; Biomedical Engineering Department, University of Aveiro, 3810-193, Aveiro, Portugal; Center for Nanotechnology and Biomaterials Application and Research, Marmara University, Istanbul, 34722, Turkey.
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Gokce S, Herkiloglu D, Cevik O, Turan V. Evaluation of Intrafollicular Syndecan 1, Glypican 3, and Spermidine Levels in Women with Diminished Ovarian Reserve. Reprod Sci 2023; 30:569-575. [PMID: 36131221 DOI: 10.1007/s43032-022-01085-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/08/2022] [Indexed: 10/14/2022]
Abstract
We aimed to evaluate the levels of Spermidine, Syndecan 1, and Glypican 3 (GPC3) in the follicle fluid of women with diminished ovarian reserve (DOR) and to examine the relationship of these markers with the number of embryos and clinical pregnancy. A total of 27 women with DOR and 34 women with normal ovarian reserve who underwent in vitro fertilization procedure were included in this prospectively designed study. Spermidine, Syndecan 1, and GPC3 levels were studied in the follicle fluid samples taken from the women at the time of oocyte retrieval by ELISA method, and their relations with the cycle outcomes were examined. The mean age was found as 38.1 ± 7.4 years in the DOR group and 35.1 ± 5.2 years in the control group (p = 0.027). When adjusted for age and body mass index, while the median Spermidine level was significantly higher (p < 0.001), both Syndecan 1 (p < 0.001) and GPC3 (p = 0.006) were significantly lower in the DOR group compared with control group. The cut-off value of Spermidine for clinical pregnancy prediction was found as 74.08 ng/mL with 78.9% sensitivity and 57.1% specificity [OR: 5 (95% CI: 1.4-17.6); AUC: 0.621; p = 0.138], while it was 0.96 ng/mL with 84.2% sensitivity and 59.5% specificity [OR: 7.8 (95% CI: 2-31.1); AUC: 0.701; p = 0.004] for GP3 and 1.15 ng/mL with 78.9 sensitivity and 57.1% specificity [OR: 5 (95% CI: 1.4-17.6); AUC: 0.680; p = 0.009] for Syndecan 1. Intrafollicular spermidine, Syndecan 1, and GPC3 levels may have a role in ovarian aging. Further randomized controlled studies in a larger population are needed for the relationship of these markers with cycle and pregnancy outcomes.
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Affiliation(s)
- Sefik Gokce
- Department of Obstetrics and Gynecology, Gaziosmanpasa Hospital of Yeni Yuzyil University, Istanbul, Turkey.
| | - Dilsad Herkiloglu
- Department of Obstetrics and Gynecology, Gaziosmanpasa Hospital of Yeni Yuzyil University, Istanbul, Turkey
| | - Ozge Cevik
- Department of Biochemistry, Aydin Adnan Menderes University, Aydin, Turkey
| | - Volkan Turan
- Istanbul Health and Technology University School of Medicine, İstanbul, Turkey
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Şener G, Karakadıoglu G, Ozbeyli D, Ede S, Yanardag R, Sacan O, Aykac A. Petroselinum crispum extract ameliorates scopolamine-induced cognitive dysfunction: role on apoptosis, inflammation and oxidative stress. FOOD SCIENCE AND HUMAN WELLNESS 2022. [DOI: 10.1016/j.fshw.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gayathri S, Chandrashekar H R, Fayaz S M. Phytotherapeutics Against Alzheimer's Disease: Mechanism, Molecular Targets and Challenges for Drug Development. CNS & NEUROLOGICAL DISORDERS-DRUG TARGETS 2021; 21:409-426. [PMID: 34544351 DOI: 10.2174/1871527320666210920120612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 06/24/2021] [Accepted: 08/30/2021] [Indexed: 11/22/2022]
Abstract
Alzheimer's disease is inflating worldwide and is combatted by only a few approved drugs. At best, these drugs treat symptomatic conditions by targeting cholinesterase and N-methyl-D-aspartate receptors. Most of the clinical trials in progress are focused to develop disease-modifying agents that aim single targets. The 'one drug-one target' approach is failing in the case of Alzheimer's disease due to its labyrinth etiopathogenesis. Traditional medicinal systems like ayurveda uses a holistic approach encompassing legion of medicinal plants exhibiting multimodal activity. Recent advances in high-throughput technologies have catapulted the research in the arena of ayurveda, specifically in identifying plants with potent anti-Alzheimer's disease properties and their phytochemical characterization. Nonetheless, clinical trials of very few herbal medicines are in progress. This review is a compendium of Indian plants and ayurvedic medicines against Alzheimer's disease and their paraphernalia. A record of 230 plants that are found in India with anti-Alzheimer's disease potential and about 500 phytochemicals from medicinal plants has been solicited with the hope of exploring the unexplored. Further, the molecular targets of phytochemicals isolated from commonly used medicinal plants such as Acorus calamus, Bacopa monnieri, Convolvulus pluricaulis, Tinospora cordifolia and Withania somnifera have been reviewed with respect to their multidimensional property such as antioxidant, anti-inflammation, anti-aggregation, synaptic plasticity modulation, cognition and memory enhancing activity. In addition, the strengths, and challenges in ayurvedic medicine that limit its use as mainstream therapy is discussed and a framework for the development of herbal medicine has been proposed.
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Affiliation(s)
- Gayathri S
- Department of Biotechnology, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka - 576104. India
| | - Raghu Chandrashekar H
- Department of Pharmaceutical Biotechnology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka - 576104. India
| | - Fayaz S M
- Department of Biotechnology, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka - 576104. India
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Fakchich J, Elachouri M. An overview on ethnobotanico-pharmacological studies carried out in Morocco, from 1991 to 2015: Systematic review (part 1). JOURNAL OF ETHNOPHARMACOLOGY 2021; 267:113200. [PMID: 32750461 DOI: 10.1016/j.jep.2020.113200] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 07/08/2020] [Accepted: 07/16/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The full bibliometric records of data retrieved from ethnobotanical field studies carried out in Morocco (1991-2015) was quali-quantitatively analysed. Despite the importance of traditional medicinal uses in Morocco, any comments about the methodologies and approaches adopted by reviewed studies have been undertaken. Include more data about the importance of traditional medicinal uses in Morocco. AIM OF THE STUDY Three key points were targeted in this review: (i) to contribute to original compilation of medicinal plants traditionally used by people at whole Morocco, by gathering and documenting the current status of these ancestral medical practices, (ii) to provide a novel insight into the relationship between local and biomedical disease concepts in Moroccan society, taking into account health-related beliefs, and their influences on medicinal plant uses, (iii) to figurout the weaknesses and the strengths of the conceptual approches and methods adopted by researchers in ethnobotanical field works. MATERIALS AND METHODS With the help of a computerized database querying, we conducted an extensive literature search respecting our integration criteria. We performed this bibliographic research by using the following search engines available over the Web: Google Scholar, PUBMED, Sciencedirect, Current Content Connect, SCOPUS, SPRINGER LINK, GLOBAL PLANTS, Cochrane Library and SCIRUS. The scientific names listed in the present paper have been validated according to the "The Plant List" and the African Plants Database in order to standardize ethnobotanical data on an international level. For the analysis of data gathered, quali-quantitative analyses have been performed. RESULTS A total of 905 medicinal plant species belonging to 116 families and 726 genera have been selected from 63 published articles. The dominant families were ASTERACEAE (111 species) followed by the FABACEAE (77 species), LAMIACEAE (75 species) and APIACEAE (46 species). The plant species listed are used to cure several public ailments. The digestive ailments represented the most important category (494 species) followed by dermatological diseases (407 species), diabetes (315 species) and urinary diseases (277 species). We assigned the importance of the plant species by several measures (including Frequency Cited (FC), Number of Uses (NU), Number of Respondents (NR) and Index of Performance (IP). The ICF (Informant Consensus Factor) calculated was important in all categories of diseases averaging 47%. CONCLUSION The results obtained, which cover the whole country, delineate the profile of rich wealth of indigenous knowledge on traditional uses of medicinal plants heald by Moroccan society. The total number of 905 plant species listed in this paper, are currently being utilized as medicines and the number is expected to grow as infrastructure allows greater access to unexplored parts of the country. Furthermore, the know how, regarding the plants used, is consistent because the ICF has recorded important values for most diseases treated. Furthermore, in the present paper, we suggested, for authors, some useful recommendations for ethnobotanical field works such as the respect of ethnobotanical standards including checklist of plants with international data base, the deposited voucher specimens, sampling and collection methods.
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Affiliation(s)
- Jamila Fakchich
- Laboratory of Physiology, Genetics, and Ethnopharmacology, Mohammed First University, Oujda, Morocco.
| | - Mostafa Elachouri
- Laboratory of Physiology, Genetics, and Ethnopharmacology, Mohammed First University, Oujda, Morocco.
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Khazaei H, Pesce M, Patruno A, Aneva IY, Farzaei MH. Medicinal plants for diabetes associated neurodegenerative diseases: A systematic review of preclinical studies. Phytother Res 2020; 35:1697-1718. [DOI: 10.1002/ptr.6903] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/24/2020] [Accepted: 09/20/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Hosna Khazaei
- Pharmaceutical Sciences Research Center Health Institute, Kermanshah University of Medical Sciences Kermanshah Iran
| | - Mirko Pesce
- Department of Medicine and Aging Sciences University G. d'Annunzio Chieti Italy
| | - Antonia Patruno
- Department of Medicine and Aging Sciences University G. d'Annunzio Chieti Italy
| | - Ina Y. Aneva
- Institute of Biodiversity and Ecosystem Research Bulgarian Academy of Sciences Sofia Bulgaria
| | - Mohammad H. Farzaei
- Pharmaceutical Sciences Research Center Health Institute, Kermanshah University of Medical Sciences Kermanshah Iran
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