You're using an outdated browser. Please upgrade to a modern browser for the best experience.
Please note this is a comparison between Version 1 by Giselle Amanda Borges E Soares and Version 2 by Bruce Ren.
The strategies involved in the development of therapeutics for neurodegenerative disorders are very complex and challenging due to the existence of the blood-brain barrier (BBB), a closely spaced network of blood vessels and endothelial cells that functions to prevent the entry of unwanted substances in the brain. The emergence and advancement of nanotechnology shows favourable prospects to overcome this phenomenon. Engineered nanoparticles conjugated with drug moieties and imaging agents that have dimensions between 1 and 100 nm could potentially be used to ensure enhanced efficacy, cellular uptake, specific transport, and delivery of specific molecules to the brain, owing to their modified physico-chemical features. The conjugates of nanoparticles and medicinal plants, or their components known as nano phytomedicine, have been gaining significance lately in the development of novel neuro-therapeutics owing to their natural abundance, promising targeted delivery to the brain, and lesser potential to show adverse effects.
- nanomedicine
- nanoparticles
- phytomedicine
- bioinformatics
- neurodegenerative diseases
1. Introduction
Nanotechnological advancements in neurological science are projected to have a significant effect on the development of novel therapeutical strategies. The capability to produce nanoparticles in the same size domain as proteins has led to a wide range of applications in the biomedical field, as they can invigorate, respond to, and affect target cells and tissues to ensure the desired physiological reactions while diminishing undesirable results. In addition, nanotechnology can permit a more exact and ideal control of complex natural frameworks than customary pharmacological methodologies can, for example, the blood-mind obstruction (BBB). “Neurodegenerative diseases” (NDs) refers to a gathering of discontinuous or potentially familial conditions portrayed by the deficiency of neuronal subtypes over a long period. Alzheimer’s disease (AD) and Parkinson’s disease (PD) are amongst the most decimating illnesses of the twenty-first century [1][2][3][4][5][6][1,2,3,4,5,6].
Around 24 million individuals overall experience the ill-effects of dementia, with Alzheimer’s sickness representing 60% of cases [7]. Learning and memory issues occur in Alzheimer’s patients. Net cerebral decay, which demonstrates the deficiency of neurons and the presence of various neuronal extracellular plaques and intracellular neurofibrillary tangles, has been found in post-mortem examinations of human brain tissue, fundamentally in the front-facing and transient flaps, including the hippocampus [8]. Notwithstanding, although the pathophysiology of AD is known, the reason for which it occurs, and its trigger, is unknown. As a result, AD treatment is only based on symptomatic treatment of the disease. The degeneration of nigrostriatal dopaminergic neurons in the midbrain causes extreme side effects including hypokinesia, bradykinesia, unbending nature, and a resting quake [9].
Although Parkinson’s disease (PD) is the second most prevalent chronic and progressive non-degenerative illness (ND), it has an enormous social and economic effect on the great majority of people affected by it [10]. The ventral tegmental region and the substantia nigra of the brain produce less dopamine (DA) when dopamine neurons degenerate over time. Patients with Parkinson’s disease (PD) may have a wide range of symptoms including stiffness, tremor, and slowness of movement. In certain cases, it may be difficult to tell the difference between Parkinson’s disease and other conditions that have many of the same symptoms. As a result, the word “Parkinsonism” has come to describe a wide range of neurological conditions. Symptoms of Parkinsonism fall into two categories: primary and secondary. Idiopathic Parkinsonism, the most common kind of primary Parkinsonism, has no recognised aetiology. A variety of conditions may lead to secondary Parkinsonism, including progressive supranuclear palsy, multiple system atrophy, and others, the most frequent of which is drug-induced Parkinsonism following cerebrovascular illness. Vascular Parkinsonism is a distinct clinical entity that falls under the umbrella of Parkinsonism, although it has a variable natural history and a wide range of clinical manifestations. In addition, there is strong evidence for inclusion of clock genes in PD [10].
Dopamine agonists, such as levodopa, are currently utilized as first-line treatment for PD. However, as the disease advances, patients become less receptive to levodopa and disease progression continues. Profound mind incitement and foetal dopamine neuron transplantation have been examined as options in contrast to pharmacological consideration [11][12][11,12]. These medicines are currently suggestive, and do not appear to have the option to stop or counteract the progressing consumption of dopaminergic neurons [13][14][15][13,14,15]. Medication conveyance to the cerebrum remains a significant test in the treatment of AD and PD. The rise of new, useful treatment modalities for the treatment of NDs is an intriguing issue of examination at the present time [16]. Considering the various defensive hindrances that encompass the CNS, the development of effective therapeutics to treat patients with NDs is of crucial significance.
There are microvascular endothelial cells that line the cerebral capillaries of most mammals and other species with a well-developed CNS, which the BBB is composed of. Based on an average microvessel surface area of 150–200 cm2 per g of tissue, it is anticipated that a normal adult has a total surface area of 12–18 m2 [4]. The BBB serves as a barrier between the bloodstream and the central nervous system, protecting the brain’s parenchyma from exposure to potentially harmful substances carried by the bloodstream. Specialized ion channels and transporters combine in the BBB to keep the ionic composition optimal for neuronal and synaptic signalling processes. Potassium concentrations in the CSF and ISF, for example, are 2.5–2.9 mM. The plasma potassium concentration is 4.5 mM, regardless of whether the fluctuations are induced by illness or imposed artificially. Calcium, magnesium, and pH are all controlled by the BBB [17]. Neuronal excitability and macrophage movement across the BBB are regulated by calcium and potassium homeostasis [18].
The BBB’s limitation and the medication discharge energy that trigger fringe results are two significant realities about neurotherapeutics. Despite the prevalent attitude, it is presently realized that NDs can be multisystemic in nature, which represents different difficulties for future consideration. A course of a few harmful atomic and cell occasions, instead of a solitary pathogenic factor, causes the demise of specific kinds of neurons in NDs. Accordingly, nanotechnology can offer an expected answer for a significant number of these difficulties in the treatment of AD and PD by considering specific medication conveyance and improving the bioavailability as well as the viability of different medications and other bioactive specialists utilized in NDs [19].
2. Role of Nanotechnology in Neurodegenerative Disorders
Neurodegenerative disorders are a collection of neurological illnesses that damage the brain or spinal cord’s neuronal structure and function. Because of the ageing population and the increasing prevalence of CNS disorders including Alzheimer’s, Parkinson’s, and strokes, the healthcare industry is faced with a tremendous issue. Early identification and treatment of CNS illnesses are still difficult despite advancements in the ouresearchers knowledge of their pathophysiology, and current medications are focused mostly on treating their symptoms. Due to unsatisfactory pharmacokinetics and unspecific targeting of new medications (such as proteins and peptides) that have been developed, many of these new treatments may not succeed because they may raise the risk of side effects. Biological barriers, such as the blood-brain barrier (BBB), are at the root of these difficulties. As a barrier between the CNS and peripheral circulation, it blocks the transfer of most chemicals from the blood to the brain [20][23]. In order to prevent chemicals, ions, and cells from crossing from the bloodstream into the central nervous system, BBB is made up of endothelial cells, astrocyte end-feet, and pericytes. The five primary ways by which chemicals traverse the BBB are diffusive transcellular lipoid bilayer membrane transport; transport carriers; specific receptor-mediated endocytosis and transcytosis; adsorptive transcytosis; and paracellular-tight junction transport. Toxins, infections, and inflammation are all prevented, and the CNS’s homeostasis is maintained, due to the presence of BBB [21][24]. Drug transport to the central nervous system (CNS) was further hindered by the BBB’s restrictive character. Furthermore, BBB malfunction has been reported in the majority of CNS illnesses, including Alzheimer’s, Parkinson’s, and strokes. Although it is unclear whether BBB failure is the primary cause of illness development, alterations in the transport system and enzymes are a significant contributor and exacerbator [21][24]. In CNS illnesses, the BBB impairment has major consequences for therapy. CNS illness patients may benefit from having an intact blood-brain barrier (BBB). In light of the fact that BBB malfunction plays a critical role in developing illness, this will undoubtedly be a divisive approach.
Nanotechnology, on the other hand, has advanced quickly in recent years and may offer significant benefits for the detection and treatment of CNS illnesses. Control or manipulation of nanometre-scale (one billionth of a metre) designed materials or devices is what is meant by the term “nanotechnology” [22][25]. Due to changes in the arrangement and spacing of surface atoms and molecules, nanomaterials exhibit markedly different characteristics than their macroscale counterparts [23][26].
There are several applications for biomarker discovery, treatments, and theranostics using nanomaterial-based technologies. To begin with, nanomaterials that have been changed may be utilised to identify and treat damaged cells and tissues at the molecular level. When a surface that has been modified with unique molecules, nanoengineered materials may also maintain medication release, boost bioavailability, distribute numerous agents, and preserve substances from degradation. Surface functionalization of nanomaterials may be used to target and infiltrate the BBB while also lengthening the nanomaterial’s blood half-life. For CNS illness diagnosis and treatment, nanomaterials are at the top of the list because of their unique features.
There are many promising advantages to be gained from using nanoparticles in the medical field, such as a high drug-loading capacity, which reduces the risk of chemical interactions or toxicity; a high surface area-to-volume ratio, which makes it easier to administer parenterally; the ability to use active and passive drug-targeting strategies; and sustained and continuous dosing options. Nanoparticle size, targeting properties, lipid, or water solubility and their respective hydrophobicity or hydrophilicity, chemical and physical stability, surface charge, and permeability, biodegradability, biocompatibility, cytotoxicity, drug release profile and antigenicity of the final product all play a role in the selection of the nanoparticle manufacturing materials.
NPs may be used for brain medication delivery because of their multifunctional and adaptable architectures. However, several factors must be considered before they may be used, including surface chemistry, hydrophobicity, shape, size, and charge, to name a few. Biocompatibility, decreased toxicity, and the capacity to bind and transport medications or therapies are all desirable features of an ideal NP. As long as it does not degrade quickly in vivo, it can pass across the BBB and regulate the release of medicines for extended periods of time. All of these characteristics result in NPs that are very effective at penetrating the BBB [24][27]. An investigation into site-specific drug delivery has resulted in a non-invasive distribution of the given dosage to specified areas, allowing for a precise and concentrated administration of the therapeutic dose at the site of the pharmacological activity. There are now non-invasive approaches, such as intranasal administration using drug modification to increase BBB permeability [25][28] as well as invasive ones, such as intraventricular or intracerebral injection or implantation, and infusion [26][29]. Disruption may also be effective in certain cases to cross the BBB [27][30]. The rupture of the BBB is often employed to improve the efficiency of medication transport to the brain. Mannitol, for example, is used to open the BBB to treat some CNS malignancies, and ultrasound is used to create temporary holes in the BBB [28][31]. Small therapeutic compounds (less than 1000 Da) have recently been shown to be able to pass across the BBB in Alzheimer’s disease (AD) and multiple sclerosis (MS) [29][32]. Physical and chemical features of NPs determine their path across the BBB and the methods by which they may cross it [30][33]. It is possible for NPs to penetrate the BBB and distribute medications in the sick brain when they are functionalized with a suitable ligand [31][32][34,35]. Endothelial cells may be crossed via transcytosis, allowing medications or drug-conjugated NPs to enter the central nervous system [33][36]; endothelial cells can be entered by endocytosis, allowing pharmaceuticals to cross the blood-brain barrier [34][37]. Researchers in neuropharmaceuticals are working to understand the processes of receptor-mediated and adsorptive transcytosis, as well as all the inherent physicochemical features of neuropharmeuticals. As a result, this might lead to new therapies that are more effective in crossing the blood-brain barrier (BBB) [35][38].
2.1. Techniques for Preparation of Nanoparticles and Nanocapsules
2.1.1. Nanoprecipitation
Colloidal drug delivery devices may be integrated with active substances using the nanoprecipitation technique pioneered by Fessi et al. [36][39]. Some of the benefits of the generated nanoparticles include controlled release, targeted distribution, and better stability in biological fluids. As a result, you may expect minimal toxicity and moderate side effects. Preparing nanoparticles by nanoprecipitation requires a good solvent (usually an organic solvent such as ethanol, isopropanol, or acetone), whereas the particle is created using a non-solvent (such as water). Nanoprecipitation relies on both an organic and non-solvent phase, often referred to as aqueous phase, to guarantee that all initial components are completely soluble. The organic phase might include a low HLB surfactant and active compounds dissolved in an organic solvent or a mixture of organic solvents. The solubility of the active molecule in the solvent is one of the factors limiting the amount of medicine that can be loaded onto the particle. Particle formation and physical stability are made easier in the non-solvent phase by water-soluble stabilizing compounds [37][40]. There have been reports of particles devoid of stabilizing compounds. The amphiphilic nature of isoprenoid chains allows them to be linked to the active molecule in this situation. Nanoparticles form when the organic component is abruptly dumped or mixed with the aqueous phase. Particle size and polydispersity index are unaffected by nanoprecipitation, which is a reliable process. Instead, it seems that the features of the nanosized system are determined by parameters connected with the formulation used [37][40]. This might be linked to the procedures proposed for the production of nanoprecipitation particles. Nano and submicron particles can only be formed when particular polymer/solvent/nonsolvent ratios are used. As a consequence of the Gibbs–Marangoni effect (interfacial turbulence and thermal inequalities produced by mutual miscibility of the solvent and non-solvent and their varying interfacial tensions), mechanical mixing breaks down the organic phase into drops inside the aqueous phase [38][41]. Submicron-sized droplets of organic solvent diffuse away, causing the material that causes particle precipitation to become insoluble. It has also been suggested that the “ouzo effect”, which relies on the system’s chemical instability, might be a mechanism. In this situation, when aqueous and organic phases are joined, particle-forming molecules are supersaturated, allowing for the generation of “protoparticles” that follow the classic nucleation-and-growth process. Work circumstances must be created in order to enable the spontaneous generation of submicron or nanoscale particle sizes with the lowest polydispersity indices. As nanoprecipitation is difficult to standardize, polymer aggregation results in a wide and asymmetric particle size ranges. Low stabilizing agent concentrations and poor phase mixing are two obvious signs of polymer aggregates: a concentrated organic phase and a high organic phase ratio [37][39][40,42].
2.1.2. Emulsification-Diffusion Method
So-called spontaneous emulsion diffusion describes a method for making biodegradable nanoparticles by dissolving a polymer in a mixture of water-immiscible and water-miscible solvents (such as dichloromethane) [40][43]. The quick dissolving of the miscible solvent causes the formation of a nanoemulsion when this solution is introduced to water. Immiscible liquid evaporates, forming nanoparticles. Nanoemulsions may be created by turbulence produced during solvent displacement, and there is no actual diffusion stage in the process of creating them. Solvent displacement and solvent evaporation are combined in this procedure, making it a hybrid. Due to the use of solely miscible solvents, the modified spontaneous emulsification solvent technique is obviously a method of solvent displacement [41][44].
The technique used to produce diffusion is a key variable in the emulsion diffusion approach. Because dilution water is added, low-solids dispersions are formed. So, armed with this information, it was suggested that the solvent (with a low boiling point) from the internal phase be extracted and then distilled directly into the exterior phase [42][45]. Due to the saturation of the continuous aqueous phase, its rapid displacement will prompt a free flux of the solvent globules to generate an anti-solvent medium, where the material will aggregate in the form of nanoparticles, in such a way that high solid concentrated dispersions (up to 30%) can be prepared from different materials such as polymers (e.g., poly(D,L-lactic acid), poly(!-caprolactone), and other materials. By using an emulsification-diffusion method, Yusuf et al. developed an emulsification solvent diffusion technique for coating with PS80 that reduced SOD1 levels and immobility, while raising acetylcholinesterase levels in Piperine-SLNs produced with Piperine. In addition, histological investigation revealed decreased plaques and tangles [43][46].
2.1.3. Double Emulsion Technique
The most popular techniques for evaporating solvent from emulsions are the single- and double-emulsion procedures. This process uses an organic phase that has been emulsified in an aqueous medium with surfactants or stabilisers before the solvent is evaporated to create the NP [44][47]. Double emulsion solvent technique uses a three-phase process, which is different from the single emulsion solvent method, which uses just two phases. Shear stress during the homogenization process is the fundamental downside of these two methods, which results in poor protein encapsulation effectiveness. The nanoprecipitation approach may help overcome this issue. Dropwise addition to the aqueous media of the organic solvent containing PLGA results in the fast diffusion of the miscible solvent, resulting in the creation of the NPs layer-by-layer method [45][48].
Sukhorukov et al. devised the approach for the production of vesicular particles. Adsorbed polymer layers may be applied to a colloidal template using either the polymer solution and washing or the addition of a miscible solvent to reduce polymer solubility. Chitosan, heparin, polylysine, protamine sulfurate, gelatine, and dextran sulphate are examples of common polymers that may have polyanionic or polycationic characteristics [46][47][49,50].
2.2. Green Method of Synthesis of Nanoparticles
Research and development in materials science and technology is entering a new phase in which “green synthesis” methodologies and technologies are becoming more popular. A major benefit to environmentally friendly synthesis of materials and nanomaterials will be improved by regulation, control, clean-up, and remediation of the production process.
‘Green synthesis’ is necessary in order to prevent the generation of undesirable or dangerous by-products via the development of dependable, long-lasting, and environmentally friendly synthesis methods. In order to attain this purpose, it is critical to make use of appropriate solvent systems and natural resources. The use of metallic nanoparticles in the green synthesis of biological materials has been widely accepted (e.g., bacteria, fungi, algae, and plant extracts). Using plant extracts to synthesise metal and metal oxide nanoparticles is one of the more straightforward green synthesis techniques accessible, especially when compared to bacteria- and fungus-mediated approaches. Biogenic nanoparticles are a grouping of these compounds.
Various reaction factors, such as solvent, temperature, pressure, and pH conditions, influence green synthesis methods based on biological precursors (acidic, basic, or neutral). Many plant extracts, particularly those from leaves, include potent phytochemicals, such as ketones, aldehydes, flavonoids, amides and terpenoids, carboxylic acids, phenols and ascorbic acids, that may be used to synthesize metal and metal oxide nanoparticles [48][49][51,52].
3. Role of Phyto-Nanomedicine on Neurodegenerative Diseases Treatment
Neurodegenerative Diseases (ND) are basically disorders related to age and are prevailing rapidly worldwide due to the increased elderly population in recent years. The actual problem however is not the increasing prevalence but the lack of effective treatment. As per published evidence from the past, NDs were discovered in the early 1900s, however, presently, no effective treatments for these disorders are found in modern society. Integrative medicine can sometimes delay the progression of these diseases or exhibit protective effects. It is believed by scientists that with the development of integrative medicine and modern science, the former will progressively take a more and more significant role in the treatment of ND [49][50][52,53].
A series of synthetic drugs have shown positive results for the treatment of some common NDs including Autism, PD, AD, and other chronic illnesses. The use of synthetic drugs is associated with many side effects, which make them inappropriate for regular treatment. Considering the adverse effects of these synthetic drugs, scientists have made a soft turn towards the utilization of phytochemicals, as they have minimal side effects. The antioxidative, anticholinesterase, anti-inflammatory, and anti-amyloid properties of phytochemicals makes phytochemicals a promising therapeutic agent [51][52][54,55].
In consideration that current therapeutics seem to be inadequate treatment for the above-mentioned disorders, scientists are exploring their options with plant-based drugs using nanotechnological approaches. Nanotheranostics is one such approach which is gaining wide attractions from the scientific community at a global level for the treatment of ND. It uses nanoparticles for the simultaneous diagnosis as well as for treatment. Research findings of Tripathi et al. [53][56] reveal that this treatment has been receiving significance in the medical field because it is extremely aggressive and specifically targets the affected area. Moreover, alterations with respect to type of disease and personalization based on the needs of the patient can be met, which further increases the applicability of the approach [54][57]. A novel nanotheranostic system has been developed by chemical engineers, which uses adjustable light that activates nanoparticles and opens new applicability in the field [55][58].
In the subsequent sections thwe researchers will discuss in detail the various types of plant-based medicines that are utilized in ND treatments along with the conventional approaches and recent trends in the plant-derived nanomedicine discovered so far.
3.1. Types of Phyto-Medicines Available for Treatment
- ▪Acorus calamus
Acorus calamus, also commonly referred to as sweet flag, belongs to the family Acoraceae and acts as a nervous system rejuvenator and has beneficial effects on the brain through memory enhancement, learning behaviour, and performance modification. Acorus calamus consists of a majority of α-and β-asarone while β-asarone brings about the suppression of beta-amyloid-induced neuronal apoptosis observed in the hippocampus through the downregulation of Bcl-w and Bcl-2, which further causes the activation of caspase-3 and phosphorylation of c-Jun N-terminal kinase (JNK). Apart from the above-mentioned benefits parts, of Acorus calamus also showed an inhibitory result on AChE with an IC50 value of 188 μg/mL. It has also shown positive results by improving the dopaminergic nerve function, and thus acts as neuroprotective for PD [56][59].
- ▪Allium sativum
Allium sativum, commonly known as garlic, belongs to the family Amaryllidaceae and has been used since ancient times for its medicinal properties. It was used for cardiovascular disease as well as for the prevention and treatment of other metabolic diseases such as hyperlipidemia, atherosclerosis, thrombosis, dementia, hypertension, diabetes, and cancer. S-allyl cysteine (SAC), one of the major constituents found in aged garlic extract (AGE), has been extensively studied. SAC has indirect and direct antioxidant activity. Besides bringing about a decrease in lipid peroxidation and DNA fragmentation, it also causes a reduction in oxidation and nitration. In the Parkinsonian models, namely 1-methyl-4-phenyl pyridinium (MPP) and 6-hydroxydopamine (6-OHDA), SAC causes a protection of dopamine levels, prevents oxidative damage and causes peroxidation of lipids. [57][60].
- ▪Bacopa monnieri
Bacopa monnieri (Linn), popularly called “Brahmi” (family Scrophulariaceae), is a herb found in tropical countries such as India. Steroidal bacosides (A and B) and saponins are the main active compounds present in Bacopa monnieri. These active compounds are responsible for enhancing memory and learning. Other constituents include bacopa saponins F, E, and D, flavonoids, phytosterols, and alkaloids. Superoxide SOD, CAT, GPx, and glutathione reductase (GSR) activity is enhanced by Bacoside A. Therefore, the levels of glutathione in the brain are upregulated significantly. Bacoside A inhibits lipid peroxidation by modifying the activity of enzymes such as Hsp 70 and cytochrome P450 in the brain. It also improves the activities of adenosine triphosphatases (ATPases), maintains ionic equilibrium, and restores level of selenium and zinc in the brain. The reduction in aggregation of alpha-synuclein protein by Bacopa monnieri was also found by researchers [58][61].
- ▪Centella asiatica
Centella asiatica belonging to the Apiaceae (Umbelliferae) family and has been demonstrated to possess a neuroprotective property. Since ancient times, it was part of the Ayurvedic system as an alternative medicine for bringing about memory improvement. Centella asiatica decreases Aβ deposition in the brain, exhibits potent antioxidant activity and can scavenge free radicals, causes a reduction in ferric ions, and brings about a restoration of GSH levels through an upregulation of glutathione-S-transferase activity. Chen et al. [59][62] carried out a study which suggested that Centella asiatica ethanolic extract causes the suppression of Aβ-induced neurotoxicity through the enhancement of the antioxidative-based defence system in IMR32 and PC12 differentiated cells. Amelioration of decrease in AChE activity due to colchicine-induction, neuronal damage through induction of asiaticoside occurring through nitric oxide inhibition, also reflects the neuroprotective effect of Centella asiatica [60][63].
- ▪Curcuma longa
Turmeric, derived from the plant Curcuma longa, belonging to the Zingiberaceae family, is a gold-coloured spice and has been used traditionally as medicine for a variety of diseases [61][62][64,65]. Curcumin, turmeric’s principal constituent, has several known neuroprotective actions. In patients afflicted with AD, studies have shown that curcumin potentially binds to Aβ peptides, preventing aggregate formation of new amyloid deposits as well as promoting the de-aggregation of the existing amyloid deposits. Analogues of curcumin, namely desmethoxycurcumin and bis-desmethoxycurcumin, have also shown protective ability against Aβ-induced oxidative stress. Moreover, curcumin causes the inhibition of Aβ oligomerization and formation of fibril, causes a macrophage enhancement of Aβ uptake, and inhibits the A beta-heme complex peroxidase activity. Other components of turmeric such as curcuminoids and polyphenolic compounds attenuate mitochondrial dysfunction, inflammatory response induction, and oxidative stress in the presence of inflammatory cytokines such as iNOS and COX-2. Curcuminoids can also bind to Aβ plaques, causing inhibition of amyloid accumulation and its aggregation in the brain [60][63].
- ▪Celastrus paniculatus Wild
Celastrus paniculatus Wild, commonly called as Jyotishmati, belongs to the Celastraceae family. Traditionally, it was administered as a powerful appetite stimulant, brain tonic, and emetic. Phytochemical studies show the presence of a sesquiterpene, evoninoate, alkaloids paniculatine A and B, wifornine F celapagine, celapanine, celastrine, celapanigine, polyalcohols such as malkanginnol, paniculate diolmalangunin, and malkanguniol, triterpenoids, and sterols such as β-amyrin and β-sitosterol. Scientific studies suggested that Celastrus paniculatus water extract modulated the glutamate receptor function that protects neurons against toxicity produced by the glutamate and resulted in the improvement in memory and learning. It also causes a noteworthy decrease in the MDA level in the brain, which is an important marker of oxidative damage, with simultaneously significantly increases in levels of glutathione and CAT; two endogenous antioxidants in the brain [60][63]. Jakka et al. [63][66] investigated research that explained the neurotrophic potential in Celastrus paniculata Wild whole plant methanolic extract (CPPME). A significant decrease was also seen in AChE and enhanced neurotrophic activity, which ultimately improved spatial memory formation in scopolamine-induced amnesia.
- ▪Coriandrum sativum L
Coriandrum sativum L., also referred to as dhanya, belongs to the family Apiaceae [27][30]. The major phytochemicals present include flavonoids such as quercetin 3-glucoronide, and polyphenolics such as protocatechinic acid, glycitin, and caffeic acid. In seeds, the flavonoid content was reported at a concentration of 12.6 quercetin equivalents/kg and the polyphenolic concentration was reported at 12.2 gallic acid equivalents/kg [64][65][67,68]. A study reported that the Coriandrum sativum extract caused an increase in total protein concentration and enzyme levels of CAT, SOD, GSH, and reduced the size of cerebral infarct, calcium levels, and lipid peroxidation (LPO) in the experimental rat. Scopolamine- and diazepam-induced memory deficits were also decreased by Coriandrum sativum leaves. The leaves also show an antioxidant property, having radical scavenging activity of DPPH with lipoxygenase inhibition and phospholipid peroxidation inhibition activity, which contribute to its memory enhancement effect [66][69].
- ▪Galanthus nivalis
Galanthus nivalis, referred to commonly as snowdrop, belongs to the family Amaryllidaceae. Galantamine is the major constituent found in the bulbs and flowers of Galanthus nivalis and is a tertiary iso-quinoline alkaloid. The neuroprotective effect exerted by Galantamine is associated with a dual action. The drug is a competitive and selective AChE inhibitor and can stimulate nicotinic receptors, which further enhance cognition and memory [67][70].
- ▪Ginkgo biloba
Gingko biloba belongs to the Ginkgoaceae family and is considered a ‘living fossil’. Its extract majorly consists of flavonoids, whose fraction accounts to 24%. It mainly comprises of flavanols such as, isorhamnetin, quercetin, kaempferol, and terpene lactones, which account to a concentration of 6% and further comprise diterpenic lactones such as ginkgolides A, B, C, J and M, and a sesquiterpene tri lactone-bilobalide. The extract exhibits neuroprotection by several mechanisms such as membrane lipid peroxidation inhibition, anti-inflammatory activity, as well as through direct inhibition of amyloid-b aggregation and anti-apoptotic activities. The flavonoid fraction of Ginkgo biloba (G. biloba) extract has a free-radical scavenging property as well as anti-oxidative effects, while bilobalide has been associated with a decrease in damage caused due to excitotoxicity and global brain ischemia-induced death of neuronal cells. Extract of G. biloba in the brain significantly inhibits the AChE activity, which indicates that the level of acetylcholine has increased considerably. Flavonoids alter several biological processes through interaction with signalling pathways, effects on protein neuronal expression, which is imperative for plasticity and repair of the synapse, variation in cerebral blood flow, and neuropathological inhibition of processes in certain cortical regions. A study by Dash SK presented that the G. biloba extract causes a decline in cortical Aβ levels through a reduction in cholesterol levels as free and circulating cholesterols affect amyloid genesis [68][71].
- ▪Glycyrrhiza glabra
Glycyrrhiza glabra, widely referred to as Yashti-madhuh or liquorice, belongs to the Leguminosae family. Its major constituent is a flavonoid called Glabridin, which possesses multiple pharmacological activities such as anticancer, antiviral, anti-ulcer antioxidant, anti-diabetic, immunomodulatory activity, anti-inflammatory activity, antimicrobial activity, and anticonvulsant activity. Liquorice significantly increased learning and memory, however, research has indicated that its consumption improves general intelligence rather than short-term memory. In the brain, glabridin decreases the MDA level, and increases the superoxide dismutase level while reducing glutathione levels. A study suggested that G. glabra administration restored the decreased concentration of dopamine and glutamate in the brain and decreased activity of AChE [69][72].
- ▪Hypericum perforatum
Hypericum perforatum is also known as millepertuis or hypericum. It belongs to the family Hypericaceae. Although it is found worldwide, it is mainly native to Europe, northern Africa, and western Asia. The main active component of H. perforatum is Hyperoside. Hypericin, kaempferol, biapigenin, and quercetin comprise the other constituents. The extract of H. perforatum has been reported to behave as a protector against NADPH-dependent (enzymatic) and Fe2+ and ascorbate-dependent (non-enzymatic) peroxidation of lipids in the cortical region of the brain. The extract also protects brain cells from cytotoxicity brought about by glutamate through the reduction of glutathione loss, overload of calcium, and cell death mediated through ROS. The ethanolic extract of H. perforatum may also bring about an improvement of microglial viability through the reduction of toxicity by amyloid-beta in AD. Hypericum perforatum inhibits AChE and MDA formation in the brain and increases the concentration of SOD, GPx and CAT. Therefore, H. perforatum also has the capability to bind to iron ions, has scavenging activity for hydroxyl radicals, and behaves as an antioxidant [70][73].
- ▪Lycopodium serratum
Lycopodium is also referred to as ground pines or creeping cedar. It belongs to the family Lycopodiaceae, which comprises a family of fern-allies. Its leaves contain a single, unbranched vascular strand and are microphylls. The major constituent is huperzine A, which is a potential therapeutic agent by researchers for treating AD. The alkaloid, which has been isolated from Lycopodium serratum, has been used for treating inflammation, fever, and blood disorders for many decades. It acts as a highly reversible, potent, and selective inhibitor of AChE and is comparable to the potency observed by galantamine, physostigmine, tacrine, and donepezil. Huperzine A is considered to be a strong candidate for therapy in AD. It has been found that huperzine A causes a noteworthy upregulation in AChE levels in rat brains and is associated with protective effects such as amyloid precursor protein metabolism regulation, oxidative stress protection mediated by Aβ, apoptosis, dysfunction of mitochondria, and anti-inflammation [71][74].
- ▪Melissa officinalis
Melissa officinalis L. (Lamiaceae) leaves are commonly referred to as lemon balm and have been used traditionally for spasmolytic and nerve calming effects. The leaves produce a calming and soothing effect through interaction with the GABAA benzodiazepine receptor. Its extracts contain flavonoids, namely quercitrin, apigenin, luteolin along with phenolic acids. The derivatives of these products inhibit enzymes such as monoamine oxidases (MAO) and AChE, which scavenge these free radicals and prevent apoptosis. Enzymatic inhibition of the above-mentioned enzymes leads to alleviation of depression symptoms. Research also suggests that Melissa officinalis produces protective effects in the PC12 cell line and protects neurons from oxidative stress [72][75].
- ▪Ocimum sanctum
Ocimum sanctum is commonly referred to as ‘Tulsi’ in Hindi and in English, ‘Holy Basil’. It belongs to the Labiatae family. The plant is reported to contain glycosides, alkaloids, saponins, tannins, vitamin C, citric acid, tartaric acid, and maleic acid. Research conducted by Kusindarta et al. [73][76] indicated that an ethanolic extract derived from the leaves of Ocimum sanctum may stimulate and restore choline acetyltransferase expression in human ageing cerebral microvascular endothelial cells and could provide nerve protection and increased production of Ach, which may enhance memory and cognitive ability. Scientific studies reveal that the hydro-alcoholic extract of Ocimum sanctum exhibits strong antioxidant activity against DPPH and hydroxyl radicals, which possibly occur due to the presence of a high number of polyphenols and flavonoids. It inhibits peroxidation of lipids, ROS generation, damage to DNA, and depolarization of membranes. It also decreases the enzymatic leakage of lactate dehydrogenase, preserves cellular morphology, restores superoxide dismutase, and catalyses enzyme levels, thereby preventing neuronal damage [74][77].
- ▪Panax Ginseng
Ginseng belongs to the Araliaceae family and is prominently found in north-east Asia. It is used world-wide for boosting energy. Ginseng may provide neuroprotection against neuronal degradation through various mechanisms such as production of a reduction in the β-amyloid deposition or glutamate-induced excitotoxicity in a dose-dependent manner, thereby preventing apoptosis and neuronal death, improving routine in a passive-avoidance learning paradigm, and protecting neurons possibly through its potential to suppress cellular AChE activity and enhance cholinergic metabolism [75][78].
- ▪Rosmarinus officinalis
Rosemary, commonly known as Satapatrika, belongs to the Lamiaceae family. It contains many essential oils such as eugenol, carvacrol, oleanolic acid, and ursolic acid, and thymol constituent’s antioxidants such as ferulic acid and carnosic acid, which can be used against cyanide-induced damage in brain. A neuroprotective effect is also seen, which can be cultured and human-induced, as has been observed in rodents, cell-derived neurons, and pluripotent stem cells in vivo and in vitro in various parts of the brain in non-Swiss albino mouse models. It also possesses cytoprotective, anti-apoptotic, and anti-inflammatory activities that also add on to its neuroprotective mechanism [76][79].
- ▪Salvia officinalis
Salvia officinalis belongs to the Lamiaceae family, and is well-known and reputed for improving memory, as it has been traditionally used as a memory enhancing agent. Carnosic acid and rosmarinic acid are the active ingredients found in S. officinalis. These components are known to have potential pharmacological activity such as antioxidant and anti-inflammatory properties as well as a low AChE inhibitory effect. It inhibits ROS formation, peroxidation of lipids, fragmentation of DNA, activation of caspase-3, and hyperphosphorylation of protein tau. Clinical evidence that has been obtained may help to prevent or reduce the symptoms of dementia. A small pilot trial involving the oral administration of S. officinalis essential oil to 11 patients that possessed mild-to-moderate symptoms of AD improved cognitive function significantly [77][80].
- ▪Terminalia chebula
Terminalia chebula (T. chebula), also known as “King of Medicines” in Tibet, belongs to Combretaceae family. It has been widely used as traditional medicine in Ayurveda, Siddha, Unani, and Homeopathy. It contains compounds such as arjungenin, triterpene sarjunglucoside 1, and the tannins, chebulosides 1 and 2, chebulic acid, chebulinic acid, tannic acid, ellagic acid, 2,4-chebulyi–β-D-glucopyranose, gallic acid, ethyl gallate, punicalaginterflavin A, and terchebin. It also has presence of flavonoids such as rutins, luteolin, and quercetin. A study reported that T. chebula exhibits anxiolytic activity and is equivalent to standard drug diazepam. T. chebula has good pharmacological activities relevant to dementia therapy and possesses antioxidant activity comparable to radical scavengers such as quercetin, reflecting 95% activity, and showing an inhibitory concentration (IC50) value of 2.2 μg/mL. T. chebula fruit extract also shows protective effect neuronal cells against ischemia, reduces least production, and stimulates microglia cells death rate by lipopolysaccharide [78][81].
- ▪Tinospora cordifolia
Tinospora cordifolia (T. cordifolia) belongs to the Menispermaceae family, which is commonly known as giloe. Chemical constituents extracted from the plant are alkaloids, diterpenoid lactones, steroids, glycosides, and aliphatic acids. T. cordifolia holds a memory increasing property, which is due to immune-stimulation and increased synthesis of acetylcholine. T. cordifolia exhibits the property of scavenging free radical activity against ROS and reactive species of nitrogen, which have been studied through electron paramagnetic resonance spectroscopy. It increases the concentration of glutathione and the expression of the gamma-glutamyl-cysteine ligase and superoxide dismutase of copper-zinc genes, which play a major role in neuronal injury during hypoxia and ischemia. In addition, T. cordifolia significantly decreases the mRNA expressions of iNOS. T. cordifolia also increases the dopamine level of the brain. Thus, T. cordifolia has shown to prevent neurodegenerative changes and enhance cognition, learning, and memory [79][82].
- ▪Withania somnifera
Withania somnifera belongs to the family Solanaceae and is popularly known as Ashwagandha or Indian ginseng. The major constituents of Ashwagandha root are two withaferin A, withanolide D, and withanolides. Active glyco-withanolides of Withania somnifera have a significant antioxidant function, which is accomplished by elevating the activities of SOD, CAT, and GPx. It is also reported that Ashwagandha also works as a nerve tonic that boosts energy and rejuvenates the cells. According to Rajasankar et al. [80][83], treatment of PD mice with an oral dose of Withania somnifera root extract (0.1 g/kg body weight) for 1 week or 4 weeks enhanced homo-vanillic acid and dopamine, 3,4-dihydroxy phenyl acetic acid levels in the corpus striatum. Furthermore, the report suggested that Withania somnifera treatment enhances the anti-apoptotic proteins level such as Bcl-2 and depreciates the pro-apoptotic protein level such as Bax in the Maneb–Paraquat-induced dopaminergic neurodegeneration model of PD. Ashwagandha extract has shown to prevent lipid peroxidation and increase antioxidant activity by increasing the free-radical slinking enzymes levels in the brain [60][63].
- ▪Zizyphus Jujube
Jujube fruits are used in Korean and Chinese traditional medicine to reduce anxiety and strengthen the stomach and gastrointestinal system. Jujube seeds comprise large amounts of flavonoid, phenyl glycosides, terpenoid, and alkaloid compounds mucilage, citric acid, malic acid, sugar, organic minerals, vitamin C, and protein. The herb exerts inhibition activity against the release of histamine, cyclooxygenase I and II, and AChE inhibitory activity. Flavonoids present antioxidant properties [60][63]. A compound known as cis-9-octadecenamide (oleamide) extracted from jujube is reported to bring about an upregulation of acetylcholine transferase to 34.1% in the in vitro models, which leads to the increase in acetylcholine level and improves mild-to-moderate cognitive functions, motor coordination, behavioural disorders, learning, and memory [81][84].
3.2. Conventional Approach
As a harsh reality in ND and As, the only hope is symptomatic treatment. The symptomatic treatment therapies rely on slowing down symptoms without addressing the cause and cure of the disease. Apart from symptomatic treatment, the other strategy that is being employed currently is disease modifying-based treatment. Inhibitors of anti-cholinesterase are used as symptomatic treatment, while anti-inflammatory agents and antioxidants are used for disease modifying treatment [82][85]. Current therapies for neurodegenerative and neurological disorders usually are involved in managing symptoms instead of providing significant activity against disease progression. For example, the symptoms of HD are controlled using 75–200 mg/day of tetrabenazine to alleviate involuntary movement (chorea). However, as it acts as a vesicular monoamine transporter inhibitor (VMAT), it causes an interference with both 5-HT (5-hydroxytryptamine) and dopamine (DA) degradation, and, as a result, patients can show neuropsychiatric-based symptoms along with various other side effects [83][86]. Various other first-line treatments such as L-Dopa in PD often cause a multitude of side effects and do not delay progression of the disease. Another example is that of cholinesterase inhibitors such as Donepezil, which is minimally effective in providing improvement in cognition required for AD treatment. The various conventional strategies used currently in the treatment of the two most common NDs, AD and PD, are summarized in detail in Table 1 [84][87].
Table 1. Summary of the various conventional strategies used for the treatment of AD and PD.
In view of the above information, there is an essential requirement for the development of novel therapeutics that possess lesser or tolerable side effects to overcome these disease states, which can further improve the quality of life of the ageing population. Conventional drug delivery strategies, in general, fail to cross the BBB and are therefore less efficacious in terms of treatment [85][88].
| Strategy | Alzheimer’s Disease | Parkinson Disease | ||||||
|---|---|---|---|---|---|---|---|---|
| Modulation of neurotransmitters (approved therapies) |
|
| ||||||
| Disease modifying therapies (under investigation) |
|
| ||||||
| Immunotherapy |
|
|
| |||||
| Gene-based therapy | Regulation of presenilin expression | Expression of synapsin 3 modulation | ||||||
| Other |
|
|