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用于预防和治疗阿尔茨海默病的营养保健品及其衍生纳米制剂

Nutraceuticals and their Derived Nano-Formulations for the Prevention and Treatment of Alzheimer's Disease.

作者信息

Iqubal Ashif, Iqubal Mohammad Kashif, Fazal Syed Abul, Pottoo Faheem Hyder, Haque Syed Ehtaishamul

机构信息

Department of Pharmacology.

Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi-110062,India.

出版信息

Curr Mol Pharmacol. 2022;15(1):23-50. doi: 10.2174/1874467214666210309115605.

Abstract

Alzheimer's disease (AD) is one of the common chronic neurological disorders and associated with cognitive dysfunction, depression and progressive dementia. The presence of β-amyloid or senile plaques, hyper-phosphorylated tau proteins, neurofibrillary tangle, oxidative-nitrative stress, mitochondrial dysfunction, endoplasmic reticulum stress, neuroinflammation and derailed neurotransmitter status are the hallmarks of AD. Currently, donepezil, memantine, rivastigmine and galantamine are approved by the FDA for symptomatic management. It is well-known that these approved drugs only exert symptomatic relief and possess poor patient-compliance. Additionally, various published evidence showed the neuroprotective potential of various nutraceuticals via their antioxidant, anti-inflammatory and anti-apoptotic effects in the preclinical and clinical studies. These nutraceuticals possess a significant neuroprotective potential and hence, can be a future pharmacotherapeutic for the management and treatment of AD. However, nutraceuticals suffer from certain major limitations such as poor solubility, low bioavailability, low stability, fast hepatic- metabolism and larger particle size. These pharmacokinetic attributes restrict their entry into the brain via the blood-brain barrier. Therefore, to overcome such issues, various nanoformulations of nutraceuticals have been developed, that allow their effective delivery into the brain owing to reduced particle size, increased lipophilicity, increased bioavailability and avoidance of fast hepatic metabolism. Thus, in this review, we have discussed the etiology of AD, focusing on the pharmacotherapeutics of nutraceuticals with preclinical and clinical evidence, discussed pharmaceutical limitations and regulatory aspects of nutraceuticals to ensure safety and efficacy. We have further explored various nanoformulations of nutraceuticals as a novel approach to overcome the existing pharmaceutical limitations and for effective delivery into the brain.

摘要

阿尔茨海默病(AD)是常见的慢性神经疾病之一,与认知功能障碍、抑郁和进行性痴呆相关。β-淀粉样蛋白或老年斑、过度磷酸化的tau蛋白、神经原纤维缠结、氧化-硝化应激、线粒体功能障碍、内质网应激、神经炎症和神经递质状态紊乱的存在是AD的标志。目前,多奈哌齐、美金刚、卡巴拉汀和加兰他敏已获美国食品药品监督管理局(FDA)批准用于症状管理。众所周知,这些获批药物仅能缓解症状,且患者依从性较差。此外,各种已发表的证据表明,在临床前和临床研究中,各种营养保健品通过其抗氧化、抗炎和抗凋亡作用具有神经保护潜力。这些营养保健品具有显著的神经保护潜力,因此,可能成为未来用于管理和治疗AD的药物疗法。然而,营养保健品存在某些主要局限性,如溶解度差、生物利用度低、稳定性低、肝脏代谢快和粒径大。这些药代动力学特性限制了它们通过血脑屏障进入大脑。因此,为了克服这些问题,人们开发了各种营养保健品的纳米制剂,由于粒径减小、亲脂性增加、生物利用度提高以及避免了快速的肝脏代谢,这些纳米制剂能够有效地将营养保健品递送至大脑。因此,在本综述中,我们讨论了AD的病因,重点关注具有临床前和临床证据的营养保健品的药物治疗,讨论了营养保健品的药物局限性和监管方面,以确保安全性和有效性。我们进一步探索了各种营养保健品的纳米制剂,作为克服现有药物局限性并有效递送至大脑的新方法。

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