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Ren Y, Qu S. Constituent isoflavones of Puerariae radix as a potential neuroprotector in cognitive impairment: Evidence from preclinical studies. Ageing Res Rev 2023; 90:102040. [PMID: 37619620 DOI: 10.1016/j.arr.2023.102040] [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: 08/03/2023] [Revised: 08/21/2023] [Accepted: 08/21/2023] [Indexed: 08/26/2023]
Abstract
With the increasing aging population worldwide, the incidence of senile cognitive impairment (CI) is increasing, posing a serious threat to the health of elderly persons. Despite developing new drugs aimed at improving CI, progress in this regard has been insufficient. Natural preparations derived from plants have become an unparalleled resource for developing new drugs. Puerariae radix (PR) has a long history as Chinese herbal medicine. PR is rich in various chemical components such as isoflavones, triterpenes, and saponins. The isoflavones (puerarin, daidzein, formononetin, and genistein) exhibit potential therapeutic effects on CI through multiple mechanisms. Relevant literature was organized from major scientific databases such as PubMed, Elsevier, SpringerLink, ScienceDirect, and Web of Science. Using "Puerariae radix," "Pueraria lobata," "isoflavones," "puerarin," "antioxidant," "daidzein," "formononetin," "genistein," "Alzheimer"s disease," and "vascular cognitive impairment" as keywords, the relevant literature was extracted from the databases mentioned above. We found that isoflavones from PR have neuroprotective effects on multiple models of CI via multiple targets and mechanisms. These isoflavones prevent Aβ aggregation, inhibit tau hyperphosphorylation, increase cholinergic neurotransmitter levels, reduce neuroinflammation and oxidative stress, improve synaptic plasticity, promote nerve regeneration, and prevent apoptosis. PR has been used as traditional Chinese herbal medicine for a long time, and its constituent isoflavones exert significant therapeutic effects on CI through various neuroprotective mechanisms. This review will contribute to the future development of isoflavones present in PR as novel drug candidates for the clinical treatment of CI.
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Affiliation(s)
- Yaoyao Ren
- Department of Otolaryngology Head and Neck Surgery, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, 110004 Shenyang, Liaoning, PR China
| | - Shengtao Qu
- Department of Neurosurgery, Shengjing Hospital of China Medical University, No. 36 Sanhao St, Shenyang 110004, PR China.
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López-Morales MA, Escobar I, Saul I, Jackson CW, Ferrier FJ, Fagerli EA, Raval AP, Dave KR, Perez-Pinzon MA. Resveratrol Preconditioning Mitigates Ischemia-Induced Septal Cholinergic Cell Loss and Memory Impairments. Stroke 2023; 54:1099-1109. [PMID: 36912143 DOI: 10.1161/strokeaha.122.040899] [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: 08/08/2022] [Accepted: 01/10/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Cholinergic cells originating from the nuclei of the basal forebrain (BF) are critical for supporting various memory processes, yet BF cholinergic cell viability has not been explored in the context of focal cerebral ischemia. In the present study, we examined cell survival within several BF nuclei in rodents following transient middle cerebral artery occlusion. We tested the hypothesis that a previously established neuroprotective therapy-resveratrol preconditioning-would rescue BF cell loss, deficits in cholinergic-related memory performance, and hippocampal synaptic dysfunction after focal cerebral ischemia. METHODS Adult (2-3-month old) male Sprague-Dawley rats or wild-type C57Bl/6J mice were injected intraperitoneally with a single dose of resveratrol or vehicle and subjected to transient middle cerebral artery occlusion using the intraluminal suture method 2 days later. Histopathological, behavioral, and electrophysiological outcomes were measured 1-week post-reperfusion. Animals with reduction in cerebral blood flow <30% of baseline were excluded. RESULTS Cholinergic cell loss was observed in the medial septal nucleus and diagonal band of Broca following transient middle cerebral artery occlusion. This effect was prevented by resveratrol preconditioning, which also ameliorated transient middle cerebral artery occlusion-induced deficits in cognitive performance and hippocampal long-term potentiation. CONCLUSIONS We demonstrate for the first time that focal cerebral ischemia induces cholinergic cell death within memory-relevant nuclei of the BF. The preservation of cholinergic cell viability may provide a mechanism by which resveratrol preconditioning improves memory performance and preserves functionality of memory-processing brain structures after focal cerebral ischemia.
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Affiliation(s)
- Mikahela A López-Morales
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratories (M.A.L.-M., I.E., I.S., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
- Department of Neurology (M.A.L.-M., I.E., I.S., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
| | - Iris Escobar
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratories (M.A.L.-M., I.E., I.S., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
- Department of Neurology (M.A.L.-M., I.E., I.S., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
- Neuroscience Program (I.E., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
| | - Isabel Saul
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratories (M.A.L.-M., I.E., I.S., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
- Department of Neurology (M.A.L.-M., I.E., I.S., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
| | - Charles W Jackson
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratories (M.A.L.-M., I.E., I.S., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
- Department of Neurology (M.A.L.-M., I.E., I.S., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
- Neuroscience Program (I.E., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
| | - Fernando J Ferrier
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratories (M.A.L.-M., I.E., I.S., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
- Department of Neurology (M.A.L.-M., I.E., I.S., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
- Neuroscience Program (I.E., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
| | - Eric A Fagerli
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratories (M.A.L.-M., I.E., I.S., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
- Department of Neurology (M.A.L.-M., I.E., I.S., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
- Neuroscience Program (I.E., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
| | - Ami P Raval
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratories (M.A.L.-M., I.E., I.S., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
- Department of Neurology (M.A.L.-M., I.E., I.S., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
- Neuroscience Program (I.E., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
| | - Kunjan R Dave
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratories (M.A.L.-M., I.E., I.S., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
- Department of Neurology (M.A.L.-M., I.E., I.S., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
- Neuroscience Program (I.E., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
| | - Miguel A Perez-Pinzon
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratories (M.A.L.-M., I.E., I.S., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
- Department of Neurology (M.A.L.-M., I.E., I.S., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
- Neuroscience Program (I.E., C.W.J., F.J.F., E.A.F., A.P.R., K.R.D., M.A.P.-P.), University of Miami Leonard M. Miller School of Medicine, FL
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Goraltchouk A, Mankovskaya S, Kuznetsova T, Hladkova Z, Hollander JM, Luppino F, Seregin A. Comparative evaluation of rhFGF18 and rhGDF11 treatment in a transient ischemia stroke model. Restor Neurol Neurosci 2023; 41:257-270. [PMID: 38363623 DOI: 10.3233/rnn-231347] [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] [Indexed: 02/17/2024]
Abstract
Background Pharmacological treatments for ischemic stroke remain limited to thrombolysis, which is associated with increased risk of potentially fatal hemorrhage. Treatments with Recombinant Human Fibroblast Growth Factor 18 (rhFGF18) and Growth and Differentiation Factor 11 (rhGDF11) appear promising based on different preclinical models. The goal of this study was to compare the effects of rhFGF18 and rhGDF11 directly on survival, behavioral deficits, and histological fingerprint of cerebral ischemia in the Wistar rat middle cerebral artery occlusion (MCAO) model of stroke. Methods Ischemia-reperfusion injury was induced using a 2-hour transient MCAO. Animals were administered rhFGF18 (infusion), rhGDF11 (multi-injection), or Phosphate Buffered Saline (PBS) vehicle control and followed for 42 days. Motor-Cognitive deficits were evaluated using the Morris Water Maze at Days 0 (pre-MCAO), 7, 21, and 42. Histopathological assessments were performed on Days 21 and 42. Results Day 7 post-ischemia water maze performance times increased 38.3%, 2.1%, and 23.1% for PBS, rhFGF18, and rhGDF11-treated groups, respectively. Fraction of neurons with abnormal morphology (chromatolysis, pyknotic nuclei, somal degeneration) decreased in all groups toward Day 42 and was lowest for rhFGF18. AChE-positive fiber density and activity increased over time in the rhFGF18 group, remained unchanged in the rhGDF11 treatment arm, and declined in the PBS control. Metabolic increases were greatest in rhGDF11 treated animals, with both rhFGF18 and rhGDF11 achieving improvements over PBS, as evidenced by increased succinate dehydrogenase and lactate dehydrogenase activity. Finally, rhFGF18 treatment exhibited a trend for reduced mortality relative to PBS (5.6%, 95% CI [27.3%, 0.1% ] vs. 22.2%, 95% CI [47.6%, 6.4% ]). Conclusions rhFGF18 treatment appears promising in improving survival and promoting motor-cognitive recovery following cerebral ischemia-reperfusion injury.
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Affiliation(s)
| | | | | | - Zhanna Hladkova
- Institute of Physiology, National Academy of Sciences, Minsk, Belarus
| | - Judith M Hollander
- Remedium Bio, Inc., Needham, MA, USA
- Department of Immunology, Tufts University School of Medicine, Boston, MA, USA
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Ball EL, Shah M, Ross E, Sutherland R, Squires C, Mead GE, Wardlaw JM, Quinn TJ, Religa D, Lundström E, Cheyne J, Shenkin SD. Predictors of post-stroke cognitive impairment using acute structural MRI neuroimaging: A systematic review and meta-analysis. Int J Stroke 2022; 18:543-554. [PMID: 35924821 DOI: 10.1177/17474930221120349] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Stroke survivors are at an increased risk of developing post-stroke cognitive impairment and post-stroke dementia; those at risk could be identified by brain imaging routinely performed at stroke onset. AIM This systematic review aimed to identify features which are associated with post-stroke cognitive impairment (including dementia) on magnetic resonance imaging (MRI) performed at stroke diagnosis. SUMMARY OF REVIEW We searched the literature from inception to January 2022 and identified 10,284 records. We included studies that performed MRI at the time of stroke (0-30 days after a stroke) and assessed cognitive outcome at least 3 months after stroke. We synthesized findings from 26 papers, comprising 27 stroke-populations (N = 13,114, average age range = 40-80 years, 19-62% female). When data were available, we pooled unadjusted (ORu) and adjusted (ORa) odds ratios.We found associations between cognitive outcomes and presence of cerebral atrophy (three studies, N = 453, ORu = 2.48, 95% CI = 1.15-4.62), presence of microbleeds (two studies, N = 9151, ORa = 1.36, 95% CI = 1.08-1.70), and increasing severity of white matter hyperintensities (three studies, N = 704, ORa = 1.26, 95% CI = 1.06-1.49). Increasing cerebral small vessel disease score was associated with cognitive outcome following unadjusted analysis only (two studies, N = 499, ORu = 1.34, 95%CI = 1.12-1.61; three studies, N = 950, ORa = 1.23, 95% CI = 0.96-1.57). Associations remained after controlling for pre-stroke cognitive impairment. We did not find associations between other stroke features and cognitive outcome, or there were insufficient data. CONCLUSION Acute stroke MRI features may enable healthcare professionals to identify patients at risk of post-stroke cognitive problems. However, there is still substantial uncertainty about the prognostic utility of acute MRI for this.
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Affiliation(s)
- Emily L Ball
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK.,Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Mahnoor Shah
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - Eilidh Ross
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | | | | | - Gillian E Mead
- Ageing and Health Research Group, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Joanna M Wardlaw
- Centre for Clinical Brain Sciences, UK Dementia Research Institute, The University of Edinburgh, Edinburgh, UK
| | - Terence J Quinn
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Dorota Religa
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Erik Lundström
- Neurology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Joshua Cheyne
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - Susan D Shenkin
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Ageing and Health Research Group, Usher Institute, The University of Edinburgh, Edinburgh, UK.,Advanced Care Research Centre, Usher Institute, The University of Edinburgh, Edinburgh, UK
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Shen W, Fan X, Wang L, Zhang Y. Traditional Chinese Medicine for Post-Stroke Cognitive Impairment: A Systematic Review and Meta-Analysis. Front Pharmacol 2022; 13:816333. [PMID: 35237166 PMCID: PMC8883343 DOI: 10.3389/fphar.2022.816333] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/18/2022] [Indexed: 12/29/2022] Open
Abstract
Background: Post-stroke cognitive impairment (PSCI) affects more than one-third of stroke patients, and causes much greater harm to long-term function than the initial brain damage. No conventional Western medications have shown convincing clinical effectiveness for treating PSCI. Research shows that Traditional Chinese medicine (TCM) can improve cognitive function in patients. However, the clinical efficacy and safety remain controversial. The aim of this study was to examine the effectiveness and harmful effects of TCMs in the treatment of PSCI. Method: We searched seven databases and two clinical registration websites for randomized controlled trials (RCTs). The revised Cochrane risk of bias tool (RoB 2.0) was used to evaluate the methodological quality and RevMan 5.4 was used for data analysis. This study has been submitted to PROSPERO with registration number is CRD42020149299. Results: We included 34 studies in this review. The results of this study showed that TCM adjuvant therapy improved scores on the MoCA [MD = 2.55, 95% CI (1.56, 3.53), p < 0.00001; MD = 3.07, 95% CI (1.98, 4.17), p < 0.00001 at treatment duration of <3 and 3 months, respectively], MMSE [MD = 2.55, 95% CI (1.99, 3.10), p < 0.00001; MD = 2.53, 95% CI (1.59, 3.47), p < 0.00001; MD = 2.91, 95% CI (1.26, 4.56), p = 0.0006; MD = 3.11, 95% CI (-0.04, 6.27), p = 0.05 at treatment duration of <3, 3, 4, and 6 months, respectively], and BI [MD = 7.34, 95% CI (3.83, 10.85), p < 0.0001; MD = 8.98, 95% CI (4.76, 13.21), p < 0.0001 at treatment duration of <3 and 3 months, respectively] and reduced scores on the ADL (MD = -8.64, 95% CI (-9.83, -7.45), p < 0.00001; MD = -2.00, 95% CI (-2.94, -1.06), p < 0.0001 at treatment duration of 3 and 4 months, respectively], NIHSS [MD = -2.48, 95% CI (-4.97, 0.00), p = 0.05; MD = -3.81, 95% CI (-6.21, -1.40), p = 0.002 at treatment duration of <3 and 3 months, respectively], and CSS [MD = -2.47, 95% CI (-3.49, -1.45), p < 0.00001 at a treatment duration of 3 months]. No serious adverse reactions were observed. Conclusion: Despite the significant positive results, the present evidence supports, to a limited extent because of the methodological flaws and herbal heterogeneity, that TCM adjuvant therapy can be used for patients with PSCI. While, further rigorous RCTs are warranted to confirm the efficacy and safety of TCM. Systematic Review Registration: https://www.crd.york.ac.uk/prospero, identifier CRD42020149299.
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Affiliation(s)
- Wei Shen
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xueming Fan
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Liuding Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yunling Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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