State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing, 210023, PR China.
State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing, 210023, PR China.
J Ethnopharmacol. 2020 Jul 15;257:112830. doi: 10.1016/j.jep.2020.112830. Epub 2020 Apr 4.
Cognitive symptom is a "core" symptom of major depressive disorder (MDD) patients with clear deficit in memory, social and occupational function, and may persist during the remitting phase. Therefore, the remission of cognitive symptom has been considered as one of the main objectives in the treatment of MDD. Herbal antidepressants have been used to treat MDD, and there has been great advances in the understanding of the ability of these herbs to improve cognitive deficit linked to brain injury and various diseases including depression, Alzheimer disease, diabetes and age-related disorders. This systematic review summarizes the evidence from preclinical studies and clinical trials of herbal antidepressants with positive effects on cognitive deficit. The potential mechanisms by which herbal antidepressants prevent cognitive deficit are also reviewed. This review will facilitate further research and applications.
We conducted an open-ended, English restricted search of MEDLINE (PubMed), Web of Science and Scopus for all available articles published or online before 31 December 2019, using terms pertaining to medical herb/phytomedicine/phytochemical/Chinese medicine and depression/major depressive disorder/antidepressant and/or cognitive impairment/cognitive deficit/cognitive dysfunction.
7 prescriptions, more than 30 individual herbs and 50 phytochemicals from China, Japan, Korea and India with positive effects on the depressive state and cognitive deficit are reviewed herein. The evidence from preclinical studies and clinical trials proves that these herbal antidepressants exhibit positive effects on one or more aspects of cognitive defect including spatial, episodic, aversive, and short- and long-term memory. The action mode of the improvement of cognitive deficit by these herbal antidepressants is mediated mainly through two pathways. One pathway is to promote hippocampal neurogenesis through activating brain derived neurotrophic factor-tropomyosin-related kinase B signaling. The other pathway is to prevent neuronal apoptosis through the inhibition of neuro-inflammation and neuro-oxidation.
These herbal antidepressants, having potential therapy for cognitive deficit, may prevent pathological processes of neurodegenerative diseases. Furthermore, these herbal medicines should provide a treasure trove, which will accelerate the development of new antidepressants that can effectively improve cognitive symptom in MDD. Studies on their molecular mechanisms may provide more potential targets and therapeutic approaches for new drug discovery.
认知症状是重度抑郁症（MDD）患者的“核心”症状，表现为记忆、社交和职业功能明显受损，并且可能在缓解期持续存在。因此，缓解认知症状已被认为是 MDD 治疗的主要目标之一。草药抗抑郁药已被用于治疗 MDD，并且人们对这些草药改善与脑损伤以及包括抑郁症、阿尔茨海默病、糖尿病和与年龄相关的疾病在内的各种疾病相关的认知缺陷的能力有了更深入的了解。本系统综述总结了具有改善认知缺陷作用的草药抗抑郁药的临床前研究和临床试验证据。还回顾了草药抗抑郁药预防认知缺陷的潜在机制。本综述将有助于进一步的研究和应用。
我们对 MEDLINE（PubMed）、Web of Science 和 Scopus 进行了开放式、英文限制搜索，使用与药用植物/植物药/植物化学/中药和抑郁/重度抑郁症/抗抑郁药和/或认知障碍/认知缺陷/认知功能障碍相关的术语，检索所有截至 2019 年 12 月 31 日之前发表或在线的可用文章。
本文综述了来自中国、日本、韩国和印度的 7 个处方、30 多种单味草药和 50 种植物化学物质，它们对抑郁状态和认知缺陷有积极作用。临床前研究和临床试验的证据证明，这些草药抗抑郁药对认知缺陷的一个或多个方面表现出积极作用，包括空间、情景、厌恶、短期和长期记忆。这些草药抗抑郁药改善认知缺陷的作用模式主要通过两种途径介导。一种途径是通过激活脑源性神经营养因子-原肌球蛋白相关激酶 B 信号通路促进海马神经发生。另一种途径是通过抑制神经炎症和神经氧化来防止神经元凋亡。
这些具有改善认知缺陷潜力的草药抗抑郁药可能预防神经退行性疾病的病理过程。此外，这些草药应该提供一个宝库，这将加速开发新的抗抑郁药，这些药物可以有效地改善 MDD 患者的认知症状。对其分子机制的研究可以为新药发现提供更多的潜在靶点和治疗方法。
