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Frontiers in Clinical Drug Research - Anti-Allergy Agents is a book series comprising of a selection of updated review articles relevant to the recent development of pharmacological agents used for the treatment of allergies. The scope of the reviews includes clinical trials of anti-inflammatory and anti-allergic drugs, drug delivery strategies used to treat specific allergies (such as inflammation, asthma and dermatological allergies), lifestyle dependent modes of therapies and the immunological or metabolic mechanisms that are of interest to researchers as targets for new drugs.
The fourth volume of this series brings 5 reviews which cover the following topics:
Anti-inflammatory and Immunomodulatory properties of medicinal plant products
Helminth therapy: a new tool for treatment of allergic diseases
An overview of anti-allergic medications in paediatric population
In-silico approaches in drug discovery and design of anti-allergic agents
Microbiota and allergy: possible Interventions
Frontiers in Clinical Drug Research - Anti-Allergy Agents will be of interest to immunologists and drug discovery researchers interested in anti-allergic drug therapy as the series provides relevant cutting edge reviews written by experts in this rapidly expanding field.
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Seitenzahl: 293
Veröffentlichungsjahr: 2020
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Frontiers in Clinical Drug Research - Anti Allergy Agents (Volume 4) comprises five comprehensive chapters on various treatment strategies for allergic conditions. In chapter 1, Bouyahya and Bakri focus on the anti-inflammatory and immunomodulatory properties of medicinal plant products. Research on these plants has allowed the discovery of bioactive molecules that have found a major role in the treatment of several diseases. In the second chapter, Dalia S. Ashour discusses helminth therapy (HT) as a new tool for the treatment of allergic diseases. This chapter also highlights the interaction between helminth infections and allergic diseases, the current status of HT, its challenges, and future prospects.
Dias and Dias present an overview of anti-allergic medications in the pediatric population in the next chapter of the book. Allergies in children are due to the interaction between environmental and genetic factors with the immune system. With the discovery of gene involvement and pathogenesis in allergic responses, the introduction of novel medications inhibiting allergic tissue responses should lead to improved treatments.
Roy et al., in chapter 4 discuss researches on different targets for anti-allergic agents. They present a brief overview on in silico methods as well as computational studies carried out on the targets. This can be helpful in accelerating the drug discovery for novel and more potent anti-allergic agents that can be useful for controlling diseases such as bronchial asthma, allergic rhinoconjunctivitis and atopic dermatitis.
In the last chapter Banerjee et al. discuss the role of the microbiota in the immune system and its subsequent effects on allergic reactions. They also discuss the various possible interventions, including the use of probiotics, prebiotics, and synbiotics as potential anti-allergic agents.
I hope that this volume will be of great interest to the scientific community and it will contribute to the development of more effective therapeutic agents to combat various allergies and pulmonary ailments.
I would like to thank all the authors for their excellent contributions. I am also grateful to the excellent team of Bentham Science Publishers, particularly Mr. Mahmood Alam (Director Publications), Mr. Obaid Sadiq (Incharge Books Department), and Ms. Asma Ahmed (Senior Manager Publications) for their support and hard work.
Medicinal plants are rich in bioactive compounds derived from the secondary metabolism that characterizes these plants. These secondary metabolites showed several in vitro and in vivo pharmacological properties such as antimicrobial, antioxidant and anticancer effects. Several studies have focused on anti-inflammatory and immunomodulatory properties of medicinal plants and their bioactive compounds. These substances have enormous immunomodulatory anti-inflammatory effects; they can suppress inflammatory factors, potentiate the immune response and regulate the differentiation of immune cells. The mechanistic insights of these molecules are very diverse and include the targeting of immune system receptors, the interference with signaling pathways and deregulation of genes expression. Secondary metabolites activate the expression of several cytokines such as IL-2 and IL-12 to modulate immune response, and decrease the expression of some transcriptional factors such as Nf-KB to suppress inflammatory process.
The therapeutic use of plants is very old and has evolved with the history of humanity. Research on these plants has allowed the discovery of bioactive molecules that have a major role in the treatment of several diseases.
Indeed, medicinal plants are rich in secondary metabolites such as flavonoids [1], polyphenols [2], polysaccharides [3], alkaloids [4], and terpenes [1]. These metabolites have various pharmacological properties such as anti-inflammatory [5], antioxidant [6], antibacterial [7], anticancer [6] and, antidiabetic activities [8].
To fight against several external or internal pathogenic agents, the human body possesses the immune system. It consists of several organs and cells, connected by cytokines and chemokines to assure the protection of physiological functions. However, in certain pathological situations, the response pathways of the immune system become weak or misdirected. Excessive inflammatory reactions, may lead to chronic diseases [9]. Moreover, during an immune response, the deregulation of certain pathogenic pathways involves an inefficiency of the immune responses. This is the case, for example, aberrant expression of cytokines, chemokines, and cell differentiation factors [10].
Cellular inflammation can be the driving factor in many diseases, leading to either untimely cell death, causing organ-specific damage, or cell stimulation, initiating the formation of various tumors. Chronic inflammation is seen to be integral to the development of various diseases including diabetes, heart disease, cancer, digestive disorders, autoimmune diseases, or neurodegenerative disorders [1, 2]. Because inflammation is the result of the immune system’s protective response, to invading pathogens or endogenous signals like damaged cells, it has long been associated with the symptomatology of infectious diseases.
On the other hand, our immune response is traditionally classified into innate and adaptive immunity covering different and specific roles in the immune defense responses. The innate and adaptive systems are not strictly separated but work closely together like a fine-tuning machine. The imbalance of immune responses can be responsible for a plethora of disorders, such as allergy and autoimmune diseases [11, 12]. Nowadays, epidemiological data provides evidence of an increase in immunological diseases. This still-growing issue has led to the development of a particular class of molecules, overall called immunomodulators, able to enhance or suppress the immune response in immune system mediated diseases [11, 12].
Several studies showed the need to target immune systems for the treatment of various pathologies [11-14]. Indeed, the stimulation of the immune system is an approach supported by several researchers as a strategy that could be effective in the fight against several pathologies including inflammatory diseases.
In this context, several studies began today to study the anti-inflammatory and immunomodulatory activity of medicinal plants and their bioactive compounds. The aim of this review is to carry out a synthetic study on the immunomodulatory and anti-inflammatory activities of medicinal plant products.
Medicinal plants synthesize numerous bioactive compounds as secondary metabolites. These components belong to various chemical families such as polyphenols, flavonoids, terpenoids, alkaloids, and polysaccharides. Several recent studies showed that secondary metabolites of medicinal plants possess several biological properties such as antimicrobial, antioxidant, antiparasitic, anticancer, anti-inflammatory, and immunomodulatory activities [15].
Terpenes are very volatile molecules that are common in nature, especially in plants where they are the main constituents of essential oils. Terpenes are derived from the coupling of at least 2 isoprenic 5-carbon subunits [16]. Depending on the number of isoprene units, terpenes are classified as 10-carbon monoterpenes, 15-carbon sesquiterpenes, and 20-carbon diterpenes [16].
The best-known products are the monoterpenes, which correspond to the crude formula of (C10H16), the sesquiterpenes (C15H24) and the diterpenes (C20H32) (Fig. 1). Monoterpenes and sesquiterpenes are almost always found in essential oils in acyclic, monocyclic or bicyclic form with the existence of numerous functionalized molecules (alcohols, aldehyde, ketones, esters, ethers, peroxides) [17].
Essential oils showed numerous biological properties such as antimicrobial, antioxidant, anticancer and other biological activities [16, 17]. Furthermore, some studies have investigated anti-inflammatory and immunomodulatory properties of these volatiles compounds [10, 18].
Polyphenols are families of chemical substances widely distributed in plants. They are not directly involved in any metabolic process and are therefore considered secondary metabolites [19]. Chemically, these are phenolic organic compounds with a high molecular weight, characterized by the presence of a benzene ring carrying one or more hydroxyl groups. They are classified as natural antioxidants because they reduce the formation of free radicals. Polyphenols are classified into several subfamilies such as tannins, flavonoids, and phenolic acids. They have shown interesting biological effects, particularly in antioxidant and anti-inflammatory properties [20, 21].
Flavonoids are compounds having a basic skeleton of fifteen carbon atoms, consisting of two aromatic rings and a pyran-type central heterocycle, forming a C6-C3-C6 structure [22]. These are the most abundant compounds among all phenolic compounds. They are involved in the pigmentation of flowers and in the defense processes against UV radiation, herbivores and microbial attacks [23]. Flavonoids are present in a wide variety of foods (fruits and vegetables, cereals, fruit juice, tea and wine ...). Flavonoids are subdivided into several chemical families and contain various bioactive compounds (Fig. 2). As polyphenolic compounds, flavonoids possess remarkable antioxidant, anti-inflammatory and immunomodulatory activities [24-26].
Fig. (1)) Isoprene unit and some synthesized terpenes compounds.Alkaloids are organic substances of natural origin containing one or more nitrogen atoms with a basic character. There are five major classes of alkaloids, each divided into several sub-families: heterocyclic alkaloids, alkaloids carrying an exocyclic nitrogen atom, putrescine-type alkaloids, spermidine and spermine, peptide alkaloids and terpene and steroidal alkaloids. The vast majority of alkaloids are in the class of heterocyclic alkaloids [27]. These molecules have shown enormous pharmacological effects, in particularly the anticancer activity thanks to its ability to interpose with the DNA molecule [28]. Nowadays, researchers have begun to realize that alkaloids have both immunomodulatory and anti-inflammatory properties [20, 29, 30].
Fig. (2)) General structure of flavonoids (1) and some derivative compounds; (2) naringin, (3) naringenin-hexoside, (4) apigenin 7-O-neohesperidoside, and (5) pigenin 7-O-glucoside.Inflammation is a physiological process involving the intervention of the immune system. The key role of this process is to fight against microbial infections and in some cases physiological destruction such as autoimmune diseases. However, the inflammatory process can become harmful in some cases, thus leading to serious pathological situations. Indeed, continuous overexpression of inflammatory factors in a way alters the physiological processes via the different signaling pathways (Fig. 3), in particular, by the central pathway mediated by the transcriptional factor Nf-KB [31].
The suppression of inflammation is an interesting therapeutic strategy for fighting inflammatory diseases. Targeting mediators involved in the inflammatory response can achieve this. Recently, some studies have begun to screen bioactive substances with anti-inflammatory effects [32-34]. Natural substances extracted from medicinal plants have shown an ability to inhibit molecular pathways involved in inflammation processes (Fig. 4) such as cytokines, chemokines and pro and neo-inflammatory mediators [9, 35, 36].
Table 1 summarizes the anti-inflammatory property of medicinal plant products (Table 1). As indicated, several medicinal plants have revealed anti-inflammatory activities. The diagram illustrates medicinal plants are belonging to different botanical families such as Melastomataceae, Berberidaceae, Aizoaceae, Araliaceae, Phyllanthaceae, Apocynaceae, Lauraceae, and Euphorbiaceae.
Fig. (3)) Molecular pathways inducing an inflammatory response. The first pathway involves TLR (Toll-Like Receptor) activation. After the intervention of protein MYD88, the IRAK1 protein kinase can self phosphorylates after the intervention of protein MYD88. IRAK1 phosphorylates TAK1 kinase, which induces the phosphorylation of other signaling molecules such as TAB1, TAB2, and IKK. Phosphorylated IKK can then phosphorylates IkB, and leads it to the proteasome. The transcription factor NFkB family is released and its nuclear localization sequence is unmasked to perform its function and produce pro-inflammatory molecules such as IL-6, TNF-α, and COX-2. The second inflammatory pathway is mediated by the activation of ILR (Interleukins receptors), in particularly IL-R1. The activation phosphorylates JAK (Janus Kinase) protein, which induces the phosphorylation of STAT (Signal Transducers and Activators of Transcription). After this phosphorylation, STATs migrate to the nucleus where they recognize promoters of target genes (NF-kB) and activate their transcription.The methanolic extract of Echinacea pallida has been studied for its anti-inflammatory property in mice [35]. Indeed, using the immunoblotting technique, the authors showed that this extract importantly markedly inhibited the production of NO in mouse macrophages. Another study carried out on Artenisia asiatica showed that the ethanolic extract of this plant induces an inhibition of macrophage activation, this showed that the activity is dependent on studied [24]. However, the study of ethanolic extract from Artemisia ludoviciana rich terpenes (a plant belonging to the same genus) demonstrated an anti-inflammatory effect through the inhibition of NF-kB expression in epithelial cells [18].
On the other hand, alkaloids showed also anti-inflammatory effects. Indeed, the ethanolic extract of Alstonia scholaris (family Apocynaceae) which is rich in alkaloids inhibited inflammatory processes [33]. The mechanism is related to the ability of this extract to inhibit the expression of pro-inflammatory mediators [33].
Fig. (4)) Mechanisms of anti-inflammatory effects of bioactive compounds from medicinal plants. Anti-inflammatory bioactive compounds of medicinal plants can inhibit several pathways of induced inflammation such TLR and ILR1 receptors, ILRs receptors, EGFR receptors and Mdm2 molecule. These pathways are involved in pro-inflammatory molecules generation via the activation transcriptional factors.The methanolic extract of Cinnamomum camphora has shown anti-inflammatory activity, this activity is due to the inhibition of secretion of IL-1b, IL-6, TNF-α, and PGE2 in macrophages [34]. The ethanol extract showed also the ability to inhibit the secretion of pro-inflammatory cytokines and collagen in mice [37].
Wang et al. [50] conducted a study on ethanolic extracts of several Chinese plants combined. The results showed that this ethanolic extract induced an anti-inflammatory activity via the inhibition of TNF-α, IL-1b/6, COX-2, and PGE2 the secretions in macrophages. In another study, using a different method, Gao et al. [51] revealed that the immunomodulatory activity of the same extract is due to the inhibition of inflammatory cytokines and chemokines.
Recently, several researchers have studied the anti-inflammatory effect of phenolic compounds such as phenolic acids and flavonoids [9, 20, 33]. Gatis-Carrazzoni et al. [20] have tested the anti-inflammatory activity of Miconia minutiflora methanolic extract (rich in ellagic acid and gallotannin) using an inflammatory model induced by carrageenan and acetic acid-induced vascular permeability. They revealed that this extract reduced carrageenan-induced paw edema, vascular permeability and inhibited leukocyte migration toward the air pouch and pleural cavity. Moreover, it decreased the level of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) [20].
The methanol and ethanol extracts of Mahonia aquifolium (Chlorogenic acid) have reduced inflammatory process by the inhibition of cytokines and chemokines mediated inflammation pathways such as NO, TOS, and TNF-α [33]. Moreover, the study carried out by Harikrishnan et al. [9] on the anti-inflammatory effects of Phyllanthus amarus ethanolic extract (rich in phenolic compounds) revealed that this extract suppresses inflammatory processes by several mechanisms. Indeed, it inhibited the pro-inflammatory mediators (TNF-α, IL-1β, PGE2) and COX-2 protein expression in macrophages. It also downregulated the mRNA transcription of pro-inflammatory markers (TNF-α, IL-1β, and COX-2) in respective LPS-induced U937 macrophages. Moreover, this extract induced also a downregulation in the expression of upstream signaling molecules such as TLR4 and MyD88, which play a major role in the activation of NF-κB, MAPK and PI3K-Akt signaling pathways [9].
On the other hand, some plant extracts are able to inhibit allergies suggesting that these plants are powerful inhibitors of hypersensitivity. This is the case, for example, Haussknechtia elymatica methanolic extract, which inhibited the IgE antibody response thus delaying hypersensitivity [41].
The immune system plays a crucial role in the maintenance of body homeostasis. Indeed, our immune system has the capacity to fight against various external agents such as viruses and microbes. When this system becomes weak or dysfunctional, infections can survive this genesis of serious pathologies. One of the strategies for potentiating the immune system is the use of molecules that can modulate the different pathways of immune responses. Indeed, several recent studies have suggested the importance of immuno-modulation as an essential approach to strengthen the action of the immune system [52, 53].
In this context, natural products derived from different sources have now shown several different pharmacological properties including immunomodulatory effects [10, 54-57]. Indeed, extracts and /or bioactive compounds from medicinal plants have shown enormous biological properties, especially immunomodulatory activities, that are beginning to attract new interest today. The immunomodulatory activity is certainly related to the plant studied, the chemical composition of the tested extracts and the used experimental methods.
In Table 2, we presented a series of medicinal plants studied for their immunomodulatory properties. The plants tested belong to several botanical families such as Codiaceae, Rubiaceae, Araceae, Rutaceae, Fumariaceae, Zingiberaceae, Aspiadaceae, Asteraceae, Gentinaceae, Euphorbiaceae, Rutaceae, Polygonaceae, Fabaceae, Apoideae, Malvaceae, Elagnaceae. The extracts tested are often prepared with aerial parts using several organic solvents (Table 2). To measure the immunomodulatory activity, the tests are based essentially on the expression of inflammatory cytokines. Depending on the used method and the extract tested, the results are variable.