Recent Advances in the Treatment of Neurodegenerative Disorders E-Book
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- Herausgeber: Bentham Science Publishers
- Kategorie: Wissenschaft und neue Technologien
- Sprache: Englisch
Researchers have tried various effective treatments that prevent the progressive neurodegeneration of neurons within the brain. Parkinson’s disease (PD), Alzheimer’s disease (AD), and Multiple sclerosis (MS) are some of the most common neurodegenerative diseases (NDDs). Recent Advances in the Treatment of Neurodegenerative Disorders provides interesting updates on treatments of these neurological disorders. Ten chapters have been contributed by experts in pharmacology and give a unique perspective to reader on special topics in this area, including the treatment of neurodegenerative treatment of neurodegenerative disease through ayurveda and phytochemicals, the therapeutic role of vitamins in Parkinson’s disease, mushrooms in NDD treatment, MS treatment, ALS treatment and the use of nanoparticles and nano formulations in NDD treatment. This is an informative reference for pharmacologists, medicinal chemists and healthcare professionals (general practitioners and neurologists) seeking updates in the treatment of some common neurodegenerative disorders.
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Veröffentlichungsjahr: 2021
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FOREWORD
A limited boom in neurodegenerative diseases (NDDs) and their treatments attract scientists all around the world. However, the conventional medications of NDDS are not sufficient to provide a better cure for patients. Surgical alternatives also have minimal efficacy with different kinds of side effects. Likewise, advancement in alternative treatment for different NDDs is essential nowadays. Chemically mediated therapy also have a minimal impact, which is associated with significant side-effects. The blood-brain barrier is the biggest culprit to minimize the response of different drugs. Nanoparticles and nanoformulation-based treatment can overcome the BBB problem and improve the efficacy of treatments. Therefore, eating habit also has a significant impact on the management of NDDs. The herbs and plant extracts serve as a better alternative with minimal side-effects. However, edible mushrooms can treat various kinds of NDDs, like Parkinson’s disease (PD) and Alzheimer’s (AD).The gut biome modulates the therapeutic efficacy in most common NDDs like PD and AD. Polyphenols also show the maximum impact on the treatment of NDDs. Moreover, animal models play a vital role in the standardization of drugs for the treatment of NDDs. Different yoga postures and techniques have a beneficial impact on the management of different neuronal diseases. As mentioned earlier, these options are the most advanced alternatives for treating diverse kinds of brain disorders. In this book, the editor has included all the above-mentioned recent advancements for the medication of neurological disorders. This book attracts the interest of researchers and scientists to explore the current treatment option in their researches. It draws both basic and clinical kinds of research to utilize a different alternative option that will be very efficient in treating NDDs. The literature in this book will be significantly crucial for the academicians, molecular biologists, graduates, and undergraduate students engaged in basic and clinical research. The mentioned distinct tools and techniques in this book can unravel the problem of different NDDs. However, we believed that the information that will be gainedby reading the chapters includedin this book, edited by Dr. Sachchida Nand Rai. The later exchange on every topic serves as an essential and valuable tool to understand the different and more advanced alternative treatment options for different Neurological disorders.
PREFACE
The central nervous system (CNS) is the most vital component of our body, regulating various kinds of daily activities that are essential for our life processes. Keeping the balance between body and brain and maintaining the homeostasis of CNS is one of the main focuses of researchers nowadays.
Neurodegenerative diseases (NDDs) arise as a result of progressive degeneration of neurons in the CNS. Researchers have tried various effective treatments that prevent this progressive neurodegeneration of neurons within the CNS. Parkinson’s disease (PD), Alzheimer’s disease (AD), Multiple sclerosis (MS), etc.,are some of the most common NDDs. Conventional treatment has limited success in the treatment of NDDs. The primary aim of this book is to provide an audience worldwide with recent advancements in treating various kinds of Neurological disorders.
This book comprises a new efficient treatment strategy for different kinds of neuronal disorders. It will help in the advancement of alternative treatment scheme for NDDs. In addition, recent nanoparticle-mediated protection for NDDs has also been included in this book. Therefore, the section contains various knowledge that focused on the role of enzyme and polyphenols for PD and AD, respectively.
This book also demonstrates some yoga techniques in the management of NDDs. Moreover, this book explores the natural compound and nanoformulation-based treatment of different NDDs, which are the most advanced treatment options. This book also covers the MS medication strategy by demonstrating the vital effect on animal models. Gut-brain axis based therapy of AD and PD is a hottopic, which is also included in the book chapters. However, Ayurvedic medicine for different NDDs has also been mentioned. Mushrooms mediated treatment of PD and AD is also included for better exploratory knowledge. Thus, we can say that this edition shows distinct advanced treatment alternatives that inevitably attract the interest of scientists and researchers working on NDDs. They can utilize various alternative treatment options for treating neurological disorders. Besides, researchers and scientists all across the world can also use different approaches to the treatment of brain-related ailments disorders. Furthermore, they can also learn separate tools and techniques that have been mentioned in the chapters of the book for NDDs analysis. Thus, it will be a complete package for researchers and scientists working in various fields of NDDs.
ACKNOWLEDGEMENTS
Daneysa L. Kalschne,Marinês Paula Corso,Cristiane CananWords are sometimes hard to find when one tries to say thanks for something, as priceless as loving criticism, considerate helpfulness, and valuable guidance. Though facts must be evidently acknowledged, and honest thankfulness must be unequivocally stated. This is what I have humbly attempted to do here.
Above all, I would like to thank the Almighty for making a way and helping me with every step of my life and in the successful completion of this book.
I cannot forget the affection, innumerable blessings, and strength that were bestowed on me by my family. I thank God for giving me wonderful parents Dr. Ravindra Rai and Mrs. Asha Rai, who sincerely raised me with their care and gentle love and have immense faith in me, which brought this work to completion. I would also like to appreciate the support and assistance provided by my uncle and aunty for their consistent love, blessings, and encouragement. I have no words to express my gratitude to my wife Payal Singh, my sister Reena Rai and my brother Ashwini Kumar Rai for their constant support and help during the preparation of this book.
The editor would like to acknowledge UGC Dr. D.S. Kothari Postdoctoral scheme for awarding the fellowship to Dr. Sachchida Nand Rai (Ref. No-F.4-2/2006 (BSR)/BL/19-20/0032).
List of Contributors
An Introduction to Neurodegenerative Diseases and its Treatment
Payal Singh1,Sachchida Nand Rai2,*Abstract
In the 21st century, a lot of progress has been made in the treatment against different kinds of Neurodegenerative disorders (NDs). Antioxidant therapy is one of the most common types of therapy for NDs. Among Antioxidant therapy, reduced GSH delivery systems are widely utilized. Gut-microbiome based treatment is also widely accepted. The blood-brain barrier (BBB) is one of the major hurdles that reduce the efficacy of several neuroprotective drugs. That is why nanoformulation based drug is currently trending to potentially treat the neurodegenerative disease. 3D organoid model is employed to mimic the in vivo condition for the development of drugs for NDs. Target specific surgical interventions are also utilized to improve the symptoms of neurological diseases. Chemical compound mediated protection only provides symptomatic relief. In long term usage, this chemical compound causes several side effects. Herbal plant-mediated therapy is a better alternative for the same. Diet is a basic part of our life. By manipulating our diet in such a way that include several beans may be very helpful in the treatment of several NDs. Accordingly, this chapter explores some important recent advancement in the treatment of different NDs.
INTRODUCTION
In recent years, several targets for different neurodegenerative diseases (NDs) have been identified and tested for therapeutic implications. Different areas of the brain have been explored to find a connection between neuroanatomy and disease progression. Sporadic and genetic level factors have been taken into consideration for therapeutic response against these diseases. Ayurveda provides a very efficient way to prevent progressive degeneration in NDs [1]. The gut-brain axis was explored by several researchers to establish a link between the gut and brain [2]. The following are some advancements made in the treatment of NDs.
AYURVEDA in NEURODEGENERATIVE DISEASES (NDs)
Ayurveda plays a very important role in the prevention of different NDs. The progression of several NDs as Parkinson’s disease (PD), Alzheimer’s disease (AD), Huntington’s disease (HD), and Amyotrophic lateral sclerosis (ALS), has been slow down by different Ayurvedic and herbal plant [3]. The bioactive components present in these Ayurvedic and herbal plants are mainly responsible for the underlying therapeutic responses [4]. In PD, Mucuna pruriens (Mp) protected the death of dopaminergic neurons in substantia nigra pars compacta (SNpc) and in the striatum (ST) through NF-κB and pAkt1 pathways [5]. The seed extract of Mp contains a significant amount of levodopa (L-DOPA) that provides the major symptomatic response in PD [5, 6]. Ursolic acid (UA) is the major bioactive components in the seed extract of Mp that also shows potent Anti-Parkinsonian activity in the toxin-induced PD mouse model [7, 8]. Similar to Mp, Withania somnifera (Ws) also exhibits strong antioxidative activity in the toxin-induced PD mouse model by targeting the apoptotic pathway [9, 10]. Similar to UA, chlorogenic acid (CA) is also found in several herbal plants that exhibit potent anti-oxidative and anti-inflammatory activity in the PD model by modulating the mitochondrial pathways [11, 12]. Tinospora cordifolia (Tc) prevented the progressive neurodegeneration in PD by its antioxidative and anti-inflammatory activity in the toxin model of PD [13]. Inflammation is the common characteristics in almost all NDs. Mp inhibits the inflammation in LPS induced in vitro cells and might play an important role in the treatment of all NDs [14]. Mp also exhibits its therapeutic activity in the stroke (ischemia) model of rats [15]. The bioactive components of Ws also show therapeutic activity in AD. Withanamides is vital bioactive constituents of Ws that protect from beta-amyloid-induced toxicity in PC12 model of AD [16]. In silico analysis along with integrated system pharmacology shows the potent therapeutic activity of Ws in AD [17]. Ws also shows its therapeutic potential by inhibiting the production of amyloid beta through neuroinflammatory and epigenetic pathways in the AD in vitro model [18]. Withanolide is also an important bioactive component in Ws that exhibits neuroprotective activity via the intranasal route in the ischemia model of mice [19]. Gastrodiaelata (GE) is also an important herbal plant that controls the morphology of mitochondria by attenuating protein aggregations induced by mutant huntingtin [20]. In the 3-nitropropionic acid-induced HD model, seed extracts of Psoralea corylifolia Linn. show a neuroprotective effect by improving mitochondrial dysfunction [21]. In the spinocerebellar ataxia 3 cell model, an aqueous extract of Glycyrrhiza inflata inhibits aggregation by upregulating PPARGC1A and NFE2L2-ARE pathways [22]. GE also inhibits the aggregation of huntingtin proteins through the activation of the ubiquitin proteasomal system and adenosine A2A receptor [23].
In this way, we can say that Ayurvedic plants and their bioactive components show promising therapeutic activity in different NDs. Further study will be needed to explore the additional Ayurvedic plants and their bioactive components against NDs.
VITAMINS in NEURODEGENERATIVE DISEASES (NDs)
In this COVID-19 pandemic, vitamins show a very promising response against the viral load [24]. Clinical trials on COVID-19 patients prove that vitamins fight strongly against coronavirus by enhancing host immunity [25, 26]. The neurological symptoms in COVID-19 patients were well managed by vitamin supplementation [27]. Both water-soluble vitamins and lipid-soluble vitamins exhibit immune-enhancing activity and have been tested against different ND, as shown by several types of research. Vitamin D (VitD) improves the cognitive functions in PD, and its low level may be a potential biomarker of mild cognitive impairment [28]. Similarly, ascorbate also improves the cognitive function in PD and decreasesthe urate concentration [29]. Supplementation of Vitamin B9-B12 improves the cognitive functions by neurogenesis in aged rat models who are subjected to gestational and perinatal deficiency of the same vitamins [30]. Vitamins also modulate the progression of AD through multiple pathways [31]. A deficient level of VitD enhances the AD-like pathologies by reducing the antioxidative potential [32]. Vitamin A (VitA) and retinoic acid also improve the cognitive function in cognitive disease [33]. The receptor of retinoic acid is a very important component in all NDs and might be targeted for vitamin supplementation-based therapy [34].
Thus, vitamin supplementation is very vital to improve our immune function and also to manage the neurological symptoms found in different NDs.
GUT-BRAIN AXIS and ASSOCIATED PRO AND PRE-BIOTICS THERAPY for NDs
The dysfunctional gut-brain axis is found in NDs, and it could be an early sign of the disease condition as like in PD, AD, and HD [35-37]. Repeated infection of few pathogens like Citrobacter rodentium is responsible for the PD pathology in Pink1-/- mice compared to wild type. Characterization of the gut shows the disturbance in the level of short-chain fatty acids and butyric acid in the PD model versus control. Thus, gut-brain homeostasis plays a very important role in PD progression [38]. Probiotics and prebiotics treatment prove to beimproved the homeostasis of different NDs by balancing the activity of the gut-brain axis [39]. The gut microbiome modulates various signaling pathways as it balances the epigenetic pathways in NDs [40]. In diet-induced obese mice, cognitive impairment was significantly alleviated by beta-glucan [41]. Gut dysbiosis is strongly associated with the pathophysiology of HD, and associated pro and pre-biotics therapy considerably improve the disease symptoms [42]. The modulation of various microbiota prevents the progression of AD and offers a significant therapeutic approach to treat this disease [43]. Neuroinflammation was effectively modulated by gut microbiota and prevent progressive neurodegeneration in AD [44]. Neuropathic Pain was influenced by the gut-brain axis by modulating the level of proinflammatory and anti-inflammatory cytokines T cells [45]. Manganese exposure induced neuroinflammation was ameliorated by the gut-microbiota by inhibiting cerebral NLRP3 inflammasome [46]. Progression of MPTP-induced neurodegeneration in the PD model was significantly alleviated by Lactobacillus Plantarum PS128 that restored the normal function of the gut-brain axis [47]. Plant polysaccharides show the ability to modulates the gut-brain axis in different NDs [48]. Lactic acid bacteria improve the deformity in the eye and improves the gut-brain axis in the AD Drosophila model [49]. In salsolinol-induced SH-SY5Y cells, Butyrate protects the progressive neurodegeneration in PD by modulating the gut-brain axis [50].
Therefore, gut-brain axis and associated pro and pre-biotics therapy show strong efficiency in the treatment of different NDs.
NANOPARTICLES AND NANOFORMULATION BASED THERAPY FOR DIFFERENT NDS
The efficacy of different drugs for the NDs shows limited response because of the blood-brain-barrier (BBB) [51]. BBB prevents the delivery of desired drug into the central nervous system (CNS). Strategies like improving the BBB permeability might be dangerous as it allows the delivery of certain undesired molecules also [52]. Nanoparticles and nanoformulation offer an efficient alternative for the hurdle induced by BBB [53]. The size of the nanoparticles is very small, and it easily crosses the BBB. Therefore, the drug is very effective at a very minimum dose as a result of nanoformulation [54-56]. Nanotechnology offers a promising response in the treatment of different NDs by providing novel and effective therapeutic approaches for the drug delivery system [57]. In the paraquat (PQ) induced model of drosophila, piperine-coated gold nanoparticles improve the motor response in a significant way [58]. Exosome mediated drug delivery also shows promising advantages over conventional treatment for PD [59]. Intranasal delivery of nanoparticles is more advantageous in different NDs as compared to other routes [60]. Nanoformulation based on herbal drugs also shows potent therapeutic activity in minimum dose in NDs [61]. Curcumin and its nanoformulation exhibit strong therapeutic responses in several neurological disorders [62]. Lipid-based nanoformulation also shows a similar therapeutic activity [63]. In the rotenone-induced PD model, deferoxamine and curcumin loaded nanocarriers prevent the progression of the disease [64]. Anti-amyloid and antioxidant activity were significantly shown by modified magnetic core-shell mesoporous silica nano-formulations with encapsulated quercetin in the AD model [65]. Similarly, in the streptozotocin-induced AD mouse model, the rosiglitazone embedded nanocarrier system offers significant neuroprotection [66]. Likewise, pomegranate and its nano-formulations show a strong therapeutic response in the AD rat model [67].
CONCLUSION
In conclusion, we can say that Ayurveda, herbal plant, and bioactive components show strong therapeutic efficacy with minimal side effects in the treatment of different NDs. Vitamins are very crucial to maintain the normal homeostasis in our body and also enhances the immunity of our body. Both water-soluble and lipid-soluble vitamins are in the hot spot for the treatment of different NDs. The Gut-brain axis and associated pro and pre-biotics therapy also show strong efficiency in the treatment of different NDs. Finally, nanoparticles and nanoformulation based drug delivery show a strong response in the minimum dose that removes the hurdles associated with BBB. These areas are currently hot topics for several researchers working worldwide and offer novel therapeutic targets in the treatment of different NDs. Further studies will be needed to identify other novel approaches and perspectives for the treatment of NDs.
CONSENT FOR PUBLICATION
Not applicable.
CONFLICT OF INTEREST
The authors declare no conflict of interest, financial or otherwise.
ACKNOWLEDGEMENTS
Authors would like to acknowledge UGC Dr. D.S. Kothari Postdoctoral scheme for awarding the fellowship to Dr. Sachchida Nand Rai (Ref. No-F.4-2/2006 (BSR)/BL/19-20/0032).
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Mridula Chaturvedi,Abhishek Kumar Chaturvedi*Abstract
Neurodegenerative diseases (NDDs) are not the only diseases but a key term for a range of conditions that mainly affect the neurons in the human brain resulting in progressive degeneration or death of the nerve cells, which is a deadly and debilitating state. It affects millions of people worldwide. The most common NDDs worldwide are Parkinson’s disease (PD) and Alzheimer's disease (AD). According to De Lau & Breteler et al., the incidence of PD is about 10 million globally (i.e., approximately 0.3% of the world population) and 1% of those above 60 years. Management of NDDs has become a big challenge in the modern system of medicine & public health at present because of demographic changes worldwide. There is no specific therapy for the conventional management of NDDs in the modern system of medicine. The absence of specific and complete therapy for NDDs in the present era makes Ayurveda more important to consider some alternative and complementary system of medicine for the treatment. Ayurveda is an Indian system of medicine that comes under AYUSH and treats the NDDs since its inception, which is mainly described under the VataVyadhi (neurological disorder) context. In this chapter, the recent advancement in Ayurvedic medicinal plants, RasaAusadhies (herbo-mineral drugs) & combined drugs, Panchkarma therapies (bio-purification procedures), and Yoga & Asanas (bodily postures) that successfully treat the various common NDDs worldwide will be described.
INTRODUCTION
The building blocks of the nervous system (brain and spinal cord) are neurons that generally do not replace or reproduce if they become dead or damaged, result in
problems in the movement known as ataxias or mental function known as dementias [1]. Due to this, they are responsible for the greatest trouble of neurodegenerative disorders in which Parkinson’s disease (PD) and Alzheimer's disease (AD) contributes approximately 60-70% of cases worldwide [2]. At cellular, molecular as well as subcellular level, most of the neurodegenerative diseases (NDDs) exhibit the common features [3]. In common NDDs, various intracellular and extracellular changes can be observed, especially in Alzheimer’s, Parkinson’s, Huntington’s, and other NDDs [4]. In the living organism, the cytoplasm and reticulum are mainly conscientious for the fabrication of structural and functional protein molecules for which the mechanism of translational and post-translation synthesis is extremely multifaceted and complicated [5]. The main characteristics of NDDs are amassing of anomalous protein aggregation that leads to inflammation as well as oxidative stress (OS) in the central nervous system (CNS) [6]. These NDDs (PD & AD) are caused by environmental and genetic influences [7].
Scientists recognize that the amalgamation of a person’s genes and environment contributes to the threat of developing NDDs. That is, a person may have a gene that makes him more vulnerable to certain NDDs. But how severely the person is exaggerated depends on environmental exposures throughout life [8]. NDDs are exemplified by aggregation of proteins, inflammation, and OS in the CNS, degradation of neurotransmitters in the synaptic cleft due to the elevated activity of enzymes, mitochondrial dysfunction, and excitotoxicity of neurons [9]. Deficiency or inadequate synthesis of neurohormones and transmitters, anomalous ubiquitination, and stress are directly related to NDDs and also some other induced origin including the drugs which are used for the treatment of autism, and other chronic illnesses are not without side effects and injure the blood-brain barrier which leads to various nervous system related disorders [10].
OVERVIEW of NEURODEGENERATIVE DISEASES (NDDs)
The progressive loss of function as well as the structure of neurons due to known cause or unknown cause, including the death of neuronal cells, are called NDDs. Many NNDs are discovered, which are the result of these degenerative process in which PD, AD, and Huntington's disease (HD) are most common [11]. Such diseases are fatal, not curable, and permanent in nature, resulting in a debilitating situation for the patient. As research works progress, many similarities come into view that linkthese diseases to one another on a sub-cellular level [12].
The Preamble of Common Neurodegenerative Diseases
Several NDDs are discovered since the beginning, but the most common accounts of 70% of cases worldwide are preamble and are discussed below:
Alzheimer's Disease (AD)
The main features of this disease are neuronal inflammation, cognitive decline, neuronal loss, and neuronal death, which are also known as apoptosis. The main etiology of AD is an aggregation of β-amyloid (Aβ). The formation of microtubule associated protein i.e. hyper-phosphorylated Tau in the neurons is directly related to the AD [13].
Parkinson's Disease (PD)
This is an example of movement disorder and is characterized mainly by the abnormal accumulation of α-synuclein protein in the neurons [14].
Huntington’s Disease (HD)
This disease is a typical NDDs of the CNS and mainly occurs due to the aggregation of abnormal long polyglutamine [15].
NDDs can be generally classified by their scientific presentations, with extrapyramidal and pyramidal movement disorders and cognitive or behavioral disorders being the most frequent. Few patients have pure syndromes, with most having dissimilar clinical features. Although NDDs are classically defined by specific protein accumulations and anatomic susceptibility, they share many elementary processes associated with progressive neuronal dysfunction and fatality, such as proteotoxic stress and its attendant abnormalities in ubiquitin–proteasomal and autophagosomal/lysosomal systems, OS, programmed cell death, and neuroinflammation (Table 1) [16].
