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Sawangjit R, Chuenchom C, Sanverm T, Chaiyakunapruk N, Jiranukool J, Nithipaijit R, Sadoyu S, Phianchana C, Jinatongthai P. Efficacy and safety of herbal medicine on dementia and cognitive function: An umbrella review of systematic reviews and meta-analysis. Phytother Res 2023. [PMID: 36728740 DOI: 10.1002/ptr.7759] [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: 08/26/2022] [Revised: 12/09/2022] [Accepted: 01/22/2023] [Indexed: 02/03/2023]
Abstract
This study aims to summarize the effects of herbs on dementia and assess the strength of evidence. Six international and local databases were searched from inception to October 2021 for systematic reviews and meta-analyses of clinical trials investigated the effects of herbal medicine on dementia or cognitive function. Two researchers independently extracted data, assessed the methodological quality, and rated the credibility of evidence according to established criteria. Thirty-seven articles evaluating 13 herbal medicines were included. Of these, 65% were rated critically low using AMSTAR2. Of 90 unique outcomes, 41 (45.6%) were statistically significant based on random effects model (p ≤ .05). Only 3 herbs were supported by suggestive evidence whereas the others were supported by weak evidence. The suggestive evidence supported benefits of Chinese herbal medicine (CHM) plus pharmacotherapy (WMD:1.84; 95% CI: 1.34, 2.35) and Vinpocetine (WMD: -0.94; 95%CI: -1.50, -0.38) on improving cognitive function assessing by Montreal Cognitive Assessment and Syndrom-Kurz-Test, respectively. Moreover, suggestive evidence supported benefit of Huperzia serrata on improving Activities of Daily Living (WMD:-7.18; 95%CI: -9.12, -5.23). No SAE was reported. In conclusion, several herbs were used for improving dementia and cognitive function but recent evidence were limited by the small sample size and poor methodological quality. Therefore, further large and well-designed studies are needed to support the evidence.
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Affiliation(s)
- Ratree Sawangjit
- Department of Clinical Pharmacy, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand.,Clinical Trials and Evidence-Based Syntheses Research Unit (CTEBs RU), Mahasarakham University, Mahasarakham, Thailand
| | - Chorthip Chuenchom
- Department of Clinical Pharmacy, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand
| | - Thanchanok Sanverm
- Department of Clinical Pharmacy, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, Utah, USA
| | - Jariya Jiranukool
- Department of Psychiatry, Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand
| | - Rodchares Nithipaijit
- Department of Clinical Pharmacy, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand.,Clinical Trials and Evidence-Based Syntheses Research Unit (CTEBs RU), Mahasarakham University, Mahasarakham, Thailand
| | | | - Chankiat Phianchana
- Department of Clinical Pharmacy, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand
| | - Peerawat Jinatongthai
- Pharmacy Practice Division, Faculty of Pharmaceutical Sciences, Ubon Ratchathani University, Ubon Ratchathani, Thailand
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Gong W, Wang K, Wang X, Chen Y, Qin X, Lu A, Guan D. Mathematical algorithm–based identification of the functional components and mechanisms in depression treatment: An example of Danggui-Shaoyao-San. Front Cell Dev Biol 2022; 10:937621. [PMID: 36072347 PMCID: PMC9441958 DOI: 10.3389/fcell.2022.937621] [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: 05/06/2022] [Accepted: 07/14/2022] [Indexed: 12/02/2022] Open
Abstract
Depression, a complex epidemiological mental disorder, affects around 350 million people worldwide. Despite the availability of antidepressants based on monoamine hypothesis of depression, most patients suffer side effects from these drugs, including psychomotor impairment and dependence liability. Traditional Chinese medicine (TCM) is receiving more and more attention due to the advantages of high therapeutic performance and few side effects in depression treatment. However, complex multicomponents and multi-targets in TCM hinder our ability to identify the functional components and molecular mechanisms of its efficacy. In this study, we designed a novel strategy to capture the functional components and mechanisms of TCM based on a mathematical algorithm. To establish proof of principle, the TCM formula Danggui-Shaoyao-San (DSS), which possesses remarkable antidepressant effect but its functional components and mechanisms are unclear, is used as an example. According to the network motif detection algorithm, key core function motifs (CIM) of DSS in treating depression were captured, followed by a functional analysis and verification. The results demonstrated that 198 pathways were enriched by the target genes of the CIM, and 179 coincided with the enriched pathways of pathogenic genes, accounting for 90.40% of the gene enrichment pathway of the C-T network. Then the functional components group (FCG) comprising 40 components was traced from CIM based on the target coverage accumulation algorithm, after which the pathways enriched by the target genes of FCG were selected to elucidate the potential mechanisms of DSS in treating depression. Finally, the pivotal components in FCG of DSS and the related pathways were selected for experimental validation in vitro and in vivo. Our results indicated good accuracy of the proposed mathematical algorithm in sifting the FCG from the TCM formula, which provided a methodological reference for discovering functional components and interpreting molecular mechanisms of the TCM formula in treating complex diseases.
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Affiliation(s)
- Wenxia Gong
- Modern Research Center for Traditional Chinese Medicine of Shanxi University, Taiyuan, Shanxi, China
- Key Laboratory of Chemical Biology and Molecular Engineering of Ministry of Education, Taiyuan, Shanxi, China
- Key Laboratory of Effective Substances Research and Utilization in TCM of Shanxi Province, Taiyuan, Shanxi, China
| | - Kexin Wang
- National Key Clinical Specialty/Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Neurosurgery Institute, Guangzhou, China
- Institute of Integrated Bioinformedicine and Translational Science, Hong Kong Baptist University, Hong Kong, China
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Xueyuan Wang
- Modern Research Center for Traditional Chinese Medicine of Shanxi University, Taiyuan, Shanxi, China
| | - Yupeng Chen
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Xuemei Qin
- Modern Research Center for Traditional Chinese Medicine of Shanxi University, Taiyuan, Shanxi, China
- Key Laboratory of Chemical Biology and Molecular Engineering of Ministry of Education, Taiyuan, Shanxi, China
- Key Laboratory of Effective Substances Research and Utilization in TCM of Shanxi Province, Taiyuan, Shanxi, China
- *Correspondence: Xuemei Qin, ; Aiping Lu, ; Daogang Guan,
| | - Aiping Lu
- Institute of Integrated Bioinformedicine and Translational Science, Hong Kong Baptist University, Hong Kong, China
- *Correspondence: Xuemei Qin, ; Aiping Lu, ; Daogang Guan,
| | - Daogang Guan
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
- Guangdong Key Laboratory of Single Cell Technology and Application, Southern Medical University, Guangzhou, China
- *Correspondence: Xuemei Qin, ; Aiping Lu, ; Daogang Guan,
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Walczak-Nowicka ŁJ, Herbet M. Acetylcholinesterase Inhibitors in the Treatment of Neurodegenerative Diseases and the Role of Acetylcholinesterase in their Pathogenesis. Int J Mol Sci 2021; 22:9290. [PMID: 34502198 PMCID: PMC8430571 DOI: 10.3390/ijms22179290] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 12/21/2022] Open
Abstract
Acetylcholinesterase (AChE) plays an important role in the pathogenesis of neurodegenerative diseases by influencing the inflammatory response, apoptosis, oxidative stress and aggregation of pathological proteins. There is a search for new compounds that can prevent the occurrence of neurodegenerative diseases and slow down their course. The aim of this review is to present the role of AChE in the pathomechanism of neurodegenerative diseases. In addition, this review aims to reveal the benefits of using AChE inhibitors to treat these diseases. The selected new AChE inhibitors were also assessed in terms of their potential use in the described disease entities. Designing and searching for new drugs targeting AChE may in the future allow the discovery of therapies that will be effective in the treatment of neurodegenerative diseases.
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Affiliation(s)
| | - Mariola Herbet
- Chair and Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Jaczewskiego 8bStreet, 20-090 Lublin, Poland;
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Yan Q, Wang W, Weng J, Zhang Z, Yin L, Yang Q, Guo F, Wang X, Chen F, Yang G. Dissolving microneedles for transdermal delivery of huperzine A for the treatment of Alzheimer's disease. Drug Deliv 2021; 27:1147-1155. [PMID: 32729341 PMCID: PMC7470133 DOI: 10.1080/10717544.2020.1797240] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Increasingly attention has been paid to the transdermal drug delivery systems with microneedles owing to their excellent compliance, high efficiency, and controllable drug release, therefore, become promising alternative with tremendous advantages for delivering specific drugs such as huperzine A (Hup A) for treatment of Alzheimer’s disease (AD) yet with low oral bioavailability. The purpose of the present study is to design, prepare, and evaluate a dissolving microneedle patch (DMNP) as a transdermal delivery system for the Hup A, investigating its in vitro drug release profiles and in vivo pharmacokinetics as well as pharmacodynamics treating of AD. Skin penetration experiments and intradermal dissolution tests showed that the blank DMNP could successfully penetrate the skin with an adequate depth and could be quickly dissolved within 5 min. In vitro transdermal release tests exhibited that more than 80% of the Hup A was accumulatively permeated from DMNP through the skin within three days, indicating a sustained release profile. In vivo pharmacokinetic analysis demonstrated that the DMNP group resulted in longer Tmax (twofold), longer t1/2 (fivefold), lower Cmax (3:4), and larger AUC(0–∞) (twofold), compared with the oral group at the same dose of Hup A. Pharmacodynamic research showed a significant improvement in cognitive function in AD rats treated with DMNP-Hup A and Oral-Hup A, as compared to the model group without treatment. Those results demonstrated that this predesigned DMNP is a promising alternative to deliver Hup A transdermally for the treatment of AD.
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Affiliation(s)
- Qinying Yan
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, China.,Research Institute of Pharmaceutical Particle Technology, Zhejiang University of Technology, Hangzhou, China
| | - Weiwei Wang
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, China
| | - Jiaqi Weng
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, China
| | - Zhenghan Zhang
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, China
| | - Lina Yin
- Zhejiang Academy of Medical Sciences, Institute of Materia Medica, Hangzhou, China
| | - Qingliang Yang
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, China.,Research Institute of Pharmaceutical Particle Technology, Zhejiang University of Technology, Hangzhou, China
| | - Fangyuan Guo
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, China
| | - Xingang Wang
- Department of Burns, School of Medicine, Second Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Fan Chen
- Hubei Collaborative Innovation Center for Green Transformation of Bio-Resources, Life Sciences School of Hubei University, Wuhan, China
| | - Gensheng Yang
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, China.,Research Institute of Pharmaceutical Particle Technology, Zhejiang University of Technology, Hangzhou, China
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Li C, Huang J, Cheng YC, Zhang YW. Traditional Chinese Medicine in Depression Treatment: From Molecules to Systems. Front Pharmacol 2020; 11:586. [PMID: 32457610 PMCID: PMC7221138 DOI: 10.3389/fphar.2020.00586] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 04/16/2020] [Indexed: 12/26/2022] Open
Abstract
Depression is a multigenetic or multifactorial syndrome. The central neuron system (CNS)-orientated, single target, and conventional antidepressants are insufficient and far from ideal. Traditional Chinese Medicine (TCM) has historically been used to treat depression up till today, particularly in Asia. Its holistic, multidrug, multitarget nature fits well with the therapeutic idea of systems medicine in depression treatment. Over the past two decades, although efforts have been made to understand TCM herbal antidepressants at the molecular level, many fundamental questions regarding their mechanisms of action remain to be addressed at the systems level in order to better understand the complicated herbal formulations in depression treatment. In this Mini Review, we review and discuss the mechanisms of action of herbal antidepressants and their acting targets in the pathological systems in the brain, such as monoamine neurotransmissions, hypothalamic–pituitary–adrenal (HPA) axis, neurotropic factor brain-derived neurotrophic factor (BDNF) cascade, and glutamate transmission. Some herbal molecules, constituents, and formulas are highlighted as examples to discuss their mechanisms of action and future directions for comprehensive researches at the systems level. Furthermore, we discuss pharmacological approaches to integrate the mechanism of action from the molecular level into the systems level for understanding of systems pharmacology of TCM formulations. Integration of the studies at the molecular level into the systems level not only represents a trend in TCM study but also promotes our understanding of the system-wide mechanism of action of herbal antidepressant formulations.
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Affiliation(s)
- Chan Li
- School of Life Sciences, Guangzhou University, Guangzhou, China.,Department of Pharmacology, School of Medicine Yale University, New Haven, CT, United States
| | - Junying Huang
- School of Life Sciences, Guangzhou University, Guangzhou, China
| | - Yung-Chi Cheng
- Department of Pharmacology, School of Medicine Yale University, New Haven, CT, United States
| | - Yuan-Wei Zhang
- School of Life Sciences, Guangzhou University, Guangzhou, China.,Department of Pharmacology, School of Medicine Yale University, New Haven, CT, United States
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