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Wen J, Zhang X, Rush E, Panickan VA, Li X, Cai T, Zhou D, Ho YL, Costa L, Begoli E, Hong C, Gaziano JM, Cho K, Lu J, Liao KP, Zitnik M, Cai T. Multimodal representation learning for predicting molecule-disease relations. Bioinformatics 2023; 39:7034101. [PMID: 36805623 PMCID: PMC9940625 DOI: 10.1093/bioinformatics/btad085] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/23/2022] [Accepted: 02/08/2023] [Indexed: 02/22/2023] Open
Abstract
MOTIVATION Predicting molecule-disease indications and side effects is important for drug development and pharmacovigilance. Comprehensively mining molecule-molecule, molecule-disease and disease-disease semantic dependencies can potentially improve prediction performance. METHODS We introduce a Multi-Modal REpresentation Mapping Approach to Predicting molecular-disease relations (M2REMAP) by incorporating clinical semantics learned from electronic health records (EHR) of 12.6 million patients. Specifically, M2REMAP first learns a multimodal molecule representation that synthesizes chemical property and clinical semantic information by mapping molecule chemicals via a deep neural network onto the clinical semantic embedding space shared by drugs, diseases and other common clinical concepts. To infer molecule-disease relations, M2REMAP combines multimodal molecule representation and disease semantic embedding to jointly infer indications and side effects. RESULTS We extensively evaluate M2REMAP on molecule indications, side effects and interactions. Results show that incorporating EHR embeddings improves performance significantly, for example, attaining an improvement over the baseline models by 23.6% in PRC-AUC on indications and 23.9% on side effects. Further, M2REMAP overcomes the limitation of existing methods and effectively predicts drugs for novel diseases and emerging pathogens. AVAILABILITY AND IMPLEMENTATION The code is available at https://github.com/celehs/M2REMAP, and prediction results are provided at https://shiny.parse-health.org/drugs-diseases-dev/. SUPPLEMENTARY INFORMATION Supplementary data are available at Bioinformatics online.
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Affiliation(s)
- Jun Wen
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA 02115, USA.,VA Boston Healthcare System, Boston, MA 02130, USA
| | - Xiang Zhang
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA 02115, USA
| | - Everett Rush
- Department of Energy, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
| | - Vidul A Panickan
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA 02115, USA.,VA Boston Healthcare System, Boston, MA 02130, USA
| | - Xingyu Li
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA 02115, USA
| | - Tianrun Cai
- VA Boston Healthcare System, Boston, MA 02130, USA.,Mass General Brigham, Boston, MA 02130, USA
| | - Doudou Zhou
- Department of Statistics, University of California, Davis, CA 95616, USA
| | - Yuk-Lam Ho
- VA Boston Healthcare System, Boston, MA 02130, USA
| | - Lauren Costa
- VA Boston Healthcare System, Boston, MA 02130, USA
| | - Edmon Begoli
- Department of Energy, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
| | - Chuan Hong
- VA Boston Healthcare System, Boston, MA 02130, USA.,Department of Biostatistics and Bioinformatics, Duke University, Durham, NC 27708, USA
| | - J Michael Gaziano
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA 02115, USA.,VA Boston Healthcare System, Boston, MA 02130, USA.,Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Kelly Cho
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA 02115, USA.,VA Boston Healthcare System, Boston, MA 02130, USA.,Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Junwei Lu
- VA Boston Healthcare System, Boston, MA 02130, USA.,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Katherine P Liao
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA 02115, USA.,VA Boston Healthcare System, Boston, MA 02130, USA.,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Marinka Zitnik
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA 02115, USA.,Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.,Harvard Data Science Initiative, Cambridge, MA 02138, USA
| | - Tianxi Cai
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA 02115, USA.,VA Boston Healthcare System, Boston, MA 02130, USA.,Mass General Brigham, Boston, MA 02130, USA
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Malík M, Tlustoš P. Nootropics as Cognitive Enhancers: Types, Dosage and Side Effects of Smart Drugs. Nutrients 2022; 14:nu14163367. [PMID: 36014874 PMCID: PMC9415189 DOI: 10.3390/nu14163367] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/14/2022] [Accepted: 08/15/2022] [Indexed: 12/22/2022] Open
Abstract
Nootropics, also known as “smart drugs” are a diverse group of medicinal substances whose action improves human thinking, learning, and memory, especially in cases where these functions are impaired. This review provides an up-to-date overview of the potential effectiveness and importance of nootropics. Based on their nature and their effects, this heterogeneous group of drugs has been divided into four subgroups: classical nootropic compounds, substances increasing brain metabolism, cholinergic, and plants and their extracts with nootropic effects. Each subgroup of nootropics contains several main representatives, and for each one, its uses, indications, experimental treatments, dosage, and possible side effects and contraindications are discussed. For the nootropic plant extracts, there is also a brief description of each plant representative, its occurrence, history, and chemical composition of the medicinal part. Lastly, specific recommendations regarding the use of nootropics by both ill and healthy individuals are summarized.
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Preobrazhenskaya IS. COVID-associated cognitive impairments: A review. CONSILIUM MEDICUM 2022. [DOI: 10.26442/20751753.2022.2.201512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The COVID-19 pandemic, caused by the SARS-CoV-2 virus, began in March 2020 and continues to the present. The virus most often affects the respiratory system; to date, there is evidence of possible damage to the heart, skin, kidneys, central nervous system in this disease. In this regard, it is of great interest to study the neurological features of COVID-19, in particular, the development of cognitive disorders or the increase in the severity of already existing cognitive impairments. This review provides the latest data on the relationship of COVID-19 and cognitive impairment, the proposed etiology, pathogenesis and main clinical manifestations of cognitive disorders, and also discusses possible strategies for the treatment of cognitive impairment after suffering COVID-19.
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Klamkam P, Pagcharoenpol R, Treesaranuwattana T, Silpsrikul P, Jaruchinda P, Wasuwat P, Suwannahitatorn P. A clinical trial of nicergoline to prevent temporary threshold shift. Laryngoscope Investig Otolaryngol 2022; 7:515-522. [PMID: 35434325 PMCID: PMC9008157 DOI: 10.1002/lio2.746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 11/25/2021] [Accepted: 01/11/2022] [Indexed: 01/10/2023] Open
Abstract
Objective To evaluate the effectiveness of nicergoline to prevent temporary threshold shift (TTS) in military personnel. Study Design A randomized control trial. Methods Two hundred and twenty‐four participants were enrolled. Nicergoline 30 mg twice daily intake was prescribed to the study group (n = 119) for 3 weeks. The placebo was prescribed to the control group (n = 105) for 3 weeks, as well. Audiometric thresholds were measured at baseline and within 24 h after the participants attended a 1‐day weapons firing practice. During the firing practice, all participants had to wear foam earplugs. The TTS was assessed by using a variety of published significant threshold shift (STS) definitions. Additionally, the effects of the treatment group on the magnitude of pre‐ to postexposure threshold shifts were estimated. Tinnitus and other adverse effects of the medication were recorded. Results The incidence of STS was 65.4% from the study group and 75% from the control group. The negative STS (thresholds improved) was 68.6% from the study group and 44.7% from the control group. The positive STS (thresholds worsened) from the study group and the control group was 31.4% and 55.3%, respectively. The effect of treatment in participants receiving nicergoline demonstrated significant coefficients (change in dB) in both ears (p = .001). The mean different threshold of participants receiving nicergoline showed negative STS in all tested frequencies without statistical significance. However, the mean different threshold of participants receiving a placebo showed positive STS with statistical significance. Additionally, there were 16 ears detecting a warning sign of permanent hearing loss. These participants from the control group presented a longer duration of tinnitus (p = .042). Moreover, the serious adverse effects of nicergoline were considerably low. Conclusion The study results suggest that nicergoline may attenuate noise‐related TTS and tinnitus, and justify further investigation on the effectiveness of this drug as an otoprotectant. Level of Evidence 2
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Affiliation(s)
- Pana Klamkam
- Department of Otolaryngology Phramongkutklao Hospital, Royal Thai Amy Bangkok Thailand
| | - Rongrat Pagcharoenpol
- Department of Otolaryngology Phramongkutklao Hospital, Royal Thai Amy Bangkok Thailand
| | | | - Pichayen Silpsrikul
- Medical Battalion, Support Regiment, Marines Division Royal Thai Navy Sattahip Chonburi Thailand
| | - Pariyanan Jaruchinda
- Department of Otolaryngology Phramongkutklao Hospital, Royal Thai Amy Bangkok Thailand
| | - Piyalarp Wasuwat
- Department of Otolaryngology Phramongkutklao Hospital, Royal Thai Amy Bangkok Thailand
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Ekusheva EV. [Efficacy of Sermion in the treatment of tinnitus noise in patients with chronic cerebrovascular pathology]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:60-66. [PMID: 34874656 DOI: 10.17116/jnevro202112110160] [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: 11/17/2022]
Abstract
Noise in the ears or tinnitus is one of the earliest and most frequent non-cognitive manifestations of chronic cerebral ischemia (CCI) and is the most difficult clinical phenomenon for therapeutic intervention. OBJECTIVE Of an open observational noncomparative clinical study was to study in patients with CCI and tinnitus and/or head the efficacy and tolerability of Sermion in a daily dose of 30 mg for 6 months. MATERIAL AND METHODS 56 patients (51.1±8.7 years) were clinically and neurologically examined using standard questionnaires to analyze the severity of tinnitus and its impact on daily life and the level of patient distress associated with noise, and to study the quality of life using the SF-36 questionnaire. All patients independently assessed the therapy satisfaction index. RESULTS AND CONCLUSION The safety, good tolerance and obvious clinical effect were shown when using the drug Sermion. The best results were obtained with the use of Sermion for 6 months in relation to the severity of tinnitus, the degree of its influence on daily activity, the level of distress and an increase in the quality of life of patients, as well as a significant improvement in well-being and cognitive functions in almost all subjects. It has been shown that after an adequate course of therapy and after 3 months, the therapeutic efficacy of Sermion is preserved, and the patients themselves were more satisfied with this remedy after 6 months of treatment. The data obtained suggest a wider use of Sermion in patients with cerebrovascular diseases and tinnitus and/or head, the use of which allows a safe, effective and pathogenetically reasonable effect on the existing disorders in these patients.
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Affiliation(s)
- E V Ekusheva
- Academy of Postgraduate Education of the Federal Research and Clinical Center for Specialized Types of Medical Care and Medical Technologies, Moscow, Russia.,Belgorod State National Research University, Belgorod, Russia
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Sanders O, Rajagopal L. Phosphodiesterase Inhibitors for Alzheimer's Disease: A Systematic Review of Clinical Trials and Epidemiology with a Mechanistic Rationale. J Alzheimers Dis Rep 2020; 4:185-215. [PMID: 32715279 PMCID: PMC7369141 DOI: 10.3233/adr-200191] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Preclinical studies, clinical trials, and reviews suggest increasing 3',5'-cyclic adenosine monophosphate (cAMP) and 3',5'-cyclic guanosine monophosphate (cGMP) with phosphodiesterase inhibitors is disease-modifying in Alzheimer's disease (AD). cAMP/protein kinase A (PKA) and cGMP/protein kinase G (PKG) signaling are disrupted in AD. cAMP/PKA and cGMP/PKG activate cAMP response element binding protein (CREB). CREB binds mitochondrial and nuclear DNA, inducing synaptogenesis, memory, and neuronal survival gene (e.g., brain-derived neurotrophic factor) and peroxisome proliferator-activated receptor-γ coactivator-1α (PGC1α). cAMP/PKA and cGMP/PKG activate Sirtuin-1, which activates PGC1α. PGC1α induces mitochondrial biogenesis and antioxidant genes (e.g.,Nrf2) and represses BACE1. cAMP and cGMP inhibit BACE1-inducing NFκB and tau-phosphorylating GSK3β. OBJECTIVE AND METHODS We review efficacy-testing clinical trials, epidemiology, and meta-analyses to critically investigate whether phosphodiesteraseinhibitors prevent or treat AD. RESULTS Caffeine and cilostazol may lower AD risk. Denbufylline and sildenafil clinical trials are promising but preliminary and inconclusive. PF-04447943 and BI 409,306 are ineffective. Vinpocetine, cilostazol, and nicergoline trials are mixed. Deprenyl/selegiline trials show only short-term benefits. Broad-spectrum phosphodiesterase inhibitor propentofylline has been shown in five phase III trials to improve cognition, dementia severity, activities of daily living, and global assessment in mild-to-moderate AD patients on multiple scales, including the ADAS-Cogand the CIBIC-Plus in an 18-month phase III clinical trial. However, two books claimed based on a MedScape article an 18-month phase III trial failed, so propentofylline was discontinued. Now, propentofylline is used to treat canine cognitive dysfunction, which, like AD, involves age-associated wild-type Aβ deposition. CONCLUSION Phosphodiesterase inhibitors may prevent and treat AD.
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BULBOACA AE, NICULA 3, C, BULBOACA A, BLIDARU M, BOARESCU PM, FESTILA D, DOGARU G, STANESCU I. Oxidative stress/antioxidant balance implication in reducing of intra-ocular pressure in patients with stroke, nicergoline therapy and open-angle glaucoma. BALNEO RESEARCH JOURNAL 2019. [DOI: 10.12680/balneo.2019.266] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: The continue efforts for long term reducing of intraocular pressure (IOP) in patients with open angle glaucoma, focused the attention on those patients who received different therapies, other that topical drugs for IOP reduction, that can influence this parameter.. The aim of this study was to evaluate the IOP, total oxidative stress and anti-oxidant capacity of plasma before and after nicergoline therapy in patients with ischemic stroke and associated open angle glaucoma.
Material and method: a group of 35 patients with ischemic stroke and chronic open angle glaucoma (under topical beta-blockers therapy) was studied regarding the values of IOP, total oxidative stress (TOS) and total antioxidant capacity (TAC) before (T1) and after 6 month (T2) of nicergoline therapy.
Results: IOP values for both eyes were significantly reduced when the values of T1 examination were compared with those of T2 assessment. The total oxidative stress parameter was also significantly reduced after nicergoline therapy together with increasing of total antioxidant capacity of plasma.
Conclusions: besides its positive effects on neuronal metabolism for ischemic stroke patients, nicergoline is able to influence the IOP in patients with open angle glaucoma and to improve the plasmatic oxidative stress/antioxidant balance. By this mechanism nicergoiline can contribute to a neuroprotection and better visual function preservation for these patients, improving their chances to neuro-motor rehabilitation and their quality of life.
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Affiliation(s)
- Adriana Elena BULBOACA
- Department of Pathophysiology, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania 2Clinical Rehabilitation Hospital, Cluj-Napoca, Romania
| | - Cristina NICULA 3,
- Department of Ophthalmology, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Angelo BULBOACA
- Clinical Rehabilitation Hospital, Cluj-Napoca, Romania, Department of Neurology, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Mihai BLIDARU
- Department of Pathophysiology, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Paul Mihai BOARESCU
- Department of Pathophysiology, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Dana FESTILA
- Department of Orthodontics, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Gabriela DOGARU
- Clinical Rehabilitation Hospital, Cluj-Napoca, Romania, Department of Medical Rehabilitation, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Ioana STANESCU
- Clinical Rehabilitation Hospital, Cluj-Napoca, Romania, Department of Neurology, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
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Efficacy of nicergoline treatment in Parkinson's disease associated with dementia. J Clin Neurosci 2019; 70:136-139. [PMID: 31431403 DOI: 10.1016/j.jocn.2019.08.048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 08/06/2019] [Indexed: 11/24/2022]
Abstract
Parkinson's disease (PD) has a variable spectrum of cognitive impairment. However, there are no clear evident-based management guidelines for PD with dementia (PDD). Alternative treatments for PDD are therefore required. We conducted this longitudinal study to evaluate the efficacy of nicergoline in treating PDD by analyzing changes in regional cerebral blood flow (rCBF) and neuropsychological tests before and after nicergoline administration. A total of nine PDD patients who received nicergoline therapy (PDD + N) and 14 PD patients who did not receive nicergoline therapy (PDD - N) underwent single photon emission computed tomography (SPECT) and clinical assessments at baseline and 12-month follow-up visits. The PDD + N received nicergoline at 30 mg twice per day. Changes in rCBF were compared between the groups, and correlation analysis was performed to determine possible relationship between rCBF and clinical characteristics. There were no significant differences in rCBF between the two groups at baseline. Although changes in cognitive test scores and the motor severity scale were not significantly different between baseline and the 12-month follow-up within groups, rCBF was lower in both the temporal and inferior frontal restricted areas in the PDD - N group than the PDD + N at the 12-month follow-up visit. In conclusions, nicergoline appears to delay the speed of deterioration of cognitive function in patients with PDD based on our observation of decreased rCBF in the temporal regions and inferior frontal regions of PDD - N patients compared to PDD + N patients after 12-month of nicergoline therapy. Therefore, we cautiously suggest that nicergoline administration in PDD patients may slow progression of cognitive impairment in affected brain regions.
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Drugs to Alter Extracellular Concentration of Glutamate: Modulators of Glutamate Uptake Systems. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/978-1-4939-7228-9_7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Fontana ACK. Current approaches to enhance glutamate transporter function and expression. J Neurochem 2015; 134:982-1007. [DOI: 10.1111/jnc.13200] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Revised: 05/19/2015] [Accepted: 05/20/2015] [Indexed: 12/12/2022]
Affiliation(s)
- Andréia C. K. Fontana
- Department of Pharmacology and Physiology; Drexel University College of Medicine; Philadelphia Pennsylvania USA
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Zajdel P, Bednarski M, Sapa J, Nowak G. Ergotamine and nicergoline - facts and myths. Pharmacol Rep 2014; 67:360-3. [PMID: 25712664 DOI: 10.1016/j.pharep.2014.10.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 10/14/2014] [Accepted: 10/15/2014] [Indexed: 11/28/2022]
Abstract
Ergotamine, being a representative of naturally occurring ergoline alkaloids, derived from d-lysergic acid, and nicergoline, a d-lumilysergic acid derivative belonging to semi-synthetic ergot-derived alkaloids, display diversified affinity for adrenergic, serotoninergic, and dopamine receptors. Although introduction of triptans marginalized use of ergotamine, nicergoline is used in cerebral metabolic-vascular disorders, and dementia. Additionally, nicergoline exhibits a safety profile comparable to that of placebo, and none of the reviewed studies reported any incidence of fibrosis or ergotism with nicergoline treatment. In line with the recent data, activation of 5-HT2B receptor by ergot derivatives i.e. ergotamine, methysergide, pergolide, and carbegoline is involved in pathogenesis of drug-induced valvulopathy. In contrary structurally related drugs - lisuride and terguride do not increase the risk of valvular heart disease. It seems, that more detailed mechanistic studies on nicergoline and ergotamine might be beneficial for determining structural requirements related to activation of G-protein as well as alternative signal transduction pathways e.g. β-arrestins or different kinases, and responsible for drug liabilities.
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Affiliation(s)
- Paweł Zajdel
- Department of Medicinal Chemistry, Jagiellonian University Medical College, Kraków, Poland.
| | - Marek Bednarski
- Department of Pharmacological Screening, Jagiellonian University Medical College, Kraków, Poland
| | - Jacek Sapa
- Department of Pharmacological Screening, Jagiellonian University Medical College, Kraków, Poland
| | - Gabriel Nowak
- Department of Pharmacobiology, Jagiellonian University Medical College, Kraków, Poland; Department of Neurobiology, Institute of Pharmacology, Polish Academy of Sciences, Kraków, Poland
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Safety of nicergoline as an agent for management of cognitive function disorders. BIOMED RESEARCH INTERNATIONAL 2014; 2014:610103. [PMID: 25243157 PMCID: PMC4163411 DOI: 10.1155/2014/610103] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 08/04/2014] [Accepted: 08/12/2014] [Indexed: 11/17/2022]
Abstract
Nicergoline is a semisynthetic ergot derivative and has a selective alpha-1A adrenergic receptor blocking property and also other additional mechanisms of actions, both in the brain and in the periphery. It is in clinical use for over three decades in over fifty countries for conditions such as cerebral infarction, acute and chronic peripheral circulation disorders, vascular dementia, and Alzheimer's disease and has been found to be beneficial in a variety of other conditions. However, concerns about its safety have been raised, especially after the European medicines agency's (EMEA's) restriction in the use of all ergot derivatives including nicergoline. But, most of the available literature and data suggest that the adverse events with nicergoline are mild and transient. Further, none of the available treatment options for cognitive disorders afford definitive resolution of symptoms. In this backdrop, we discuss the pharmacology of nicergoline with special emphasis on the safety of this compound, especially when used in patients suffering from cognitive function disorders.
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