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      A literature perspective on the pharmacological applications of yohimbine

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          Abstract

          Introduction: Phytochemicals have garnered much attention because they are useful in managing several human diseases. Yohimbine is one such phytochemical with significant pharmacological potential and could be exploited for research by medicinal chemists. It is an indole alkaloid obtained from various natural/synthetic sources.

          Aims and Results: The research on yohimbine started early, and its use as a stimulant and aphrodisiac by humans has been reported for a long time. The pharmacological activity of yohimbine is mediated by the combined action of the central and peripheral nervous systems. It selectively blocks the pre and postsynaptic α 2-adrenergic receptors and has a moderate affinity for α1 and α2 subtypes. Yohimbine also binds to other behaviourally relevant monoaminergic receptors in the following order: α-2 NE > 5HT-1A>, 5HT-1B > 1-D > D3 > D2 receptors.

          Conclusion: The current review highlights some significant findings that contribute to developing yohimbine-based drugs. It also highlights the therapeutic potential of yohimbine against selected human diseases. However, further research is recommended on the pharmacokinetics, molecular mechanisms, and drug safety requirements using well-designed randomized clinical trials to produce yohimbine as a pharmaceutical agent for human use.

          Key Messages
          • Yohimbine is a natural indole alkaloid with significant pharmacological potential.

          • Humans have used it as a stimulant and aphrodisiac from a relatively early time.

          • It blocks the pre- and postsynaptic α2-adrenergic receptors that could be exploited for managing erectile dysfunction, myocardial dysfunction, inflammatory disorders, and cancer.

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          Most cited references117

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          The Pathogenesis of Polycystic Ovary Syndrome (PCOS): The Hypothesis of PCOS as Functional Ovarian Hyperandrogenism Revisited.

          Polycystic ovary syndrome (PCOS) was hypothesized to result from functional ovarian hyperandrogenism (FOH) due to dysregulation of androgen secretion in 1989-1995. Subsequent studies have supported and amplified this hypothesis. When defined as otherwise unexplained hyperandrogenic oligoanovulation, two-thirds of PCOS cases have functionally typical FOH, characterized by 17-hydroxyprogesterone hyperresponsiveness to gonadotropin stimulation. Two-thirds of the remaining PCOS have FOH detectable by testosterone elevation after suppression of adrenal androgen production. About 3% of PCOS have a related isolated functional adrenal hyperandrogenism. The remaining PCOS cases are mild and lack evidence of steroid secretory abnormalities; most of these are obese, which we postulate to account for their atypical PCOS. Approximately half of normal women with polycystic ovarian morphology (PCOM) have subclinical FOH-related steroidogenic defects. Theca cells from polycystic ovaries of classic PCOS patients in long-term culture have an intrinsic steroidogenic dysregulation that can account for the steroidogenic abnormalities typical of FOH. These cells overexpress most steroidogenic enzymes, particularly cytochrome P450c17. Overexpression of a protein identified by genome-wide association screening, differentially expressed in normal and neoplastic development 1A.V2, in normal theca cells has reproduced this PCOS phenotype in vitro. A metabolic syndrome of obesity-related and/or intrinsic insulin resistance occurs in about half of PCOS patients, and the compensatory hyperinsulinism has tissue-selective effects, which include aggravation of hyperandrogenism. PCOS seems to arise as a complex trait that results from the interaction of diverse genetic and environmental factors. Heritable factors include PCOM, hyperandrogenemia, insulin resistance, and insulin secretory defects. Environmental factors include prenatal androgen exposure and poor fetal growth, whereas acquired obesity is a major postnatal factor. The variety of pathways involved and lack of a common thread attests to the multifactorial nature and heterogeneity of the syndrome. Further research into the fundamental basis of the disorder will be necessary to optimally correct androgen levels, ovulation, and metabolic homeostasis.
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            Quantifying the chemical beauty of drugs.

            Drug-likeness is a key consideration when selecting compounds during the early stages of drug discovery. However, evaluation of drug-likeness in absolute terms does not reflect adequately the whole spectrum of compound quality. More worryingly, widely used rules may inadvertently foster undesirable molecular property inflation as they permit the encroachment of rule-compliant compounds towards their boundaries. We propose a measure of drug-likeness based on the concept of desirability called the quantitative estimate of drug-likeness (QED). The empirical rationale of QED reflects the underlying distribution of molecular properties. QED is intuitive, transparent, straightforward to implement in many practical settings and allows compounds to be ranked by their relative merit. We extended the utility of QED by applying it to the problem of molecular target druggability assessment by prioritizing a large set of published bioactive compounds. The measure may also capture the abstract notion of aesthetics in medicinal chemistry.
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              Inflammation: The Common Pathway of Stress-Related Diseases

              While modernization has dramatically increased lifespan, it has also witnessed that the nature of stress has changed dramatically. Chronic stress result failures of homeostasis thus lead to various diseases such as atherosclerosis, non-alcoholic fatty liver disease (NAFLD) and depression. However, while 75%–90% of human diseases is related to the activation of stress system, the common pathways between stress exposure and pathophysiological processes underlying disease is still debatable. Chronic inflammation is an essential component of chronic diseases. Additionally, accumulating evidence suggested that excessive inflammation plays critical roles in the pathophysiology of the stress-related diseases, yet the basis for this connection is not fully understood. Here we discuss the role of inflammation in stress-induced diseases and suggest a common pathway for stress-related diseases that is based on chronic mild inflammation. This framework highlights the fundamental impact of inflammation mechanisms and provides a new perspective on the prevention and treatment of stress-related diseases.
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                Author and article information

                Journal
                Ann Med
                Ann Med
                Annals of Medicine
                Taylor & Francis
                0785-3890
                1365-2060
                20 October 2022
                2022
                20 October 2022
                : 54
                : 1
                : 2861-2875
                Affiliations
                [a ]Department of Biochemistry and Biotechnology, Centre for Research and Development, PRIST University , Vallam, Thanjavur, India
                [b ]Department of Medical Laboratory Technology, MIMS College of Allied Health Sciences, ASTER MIMS Academy, Malappuram, Kerala University of Health Sciences , Kerala, India
                [c ]Toxicology and Forensic Science Unit, King Fahd Medical Research Center, King Abdulaziz University , Jeddah, Saudi Arabia
                [d ]Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University , Jeddah, Saudi Arabia
                [e ]Hematology Research Unit, King Fahd Medical Research Center, King Abdulaziz University , Jeddah, Saudi Arabia
                [f ]Laboratory Department, King Abdul-Aziz Hospital, Ministry of Health , Jeddah, Saudi Arabia
                [g ]Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University , Jeddah, Saudi Arabia
                Author notes
                CONTACT Shams Tabrez shamstabrez1@ 123456gmail.com King Fahd Medical Research Center, King Abdulaziz University , P.O. Box 80216, Jeddah 21589, Saudi Arabia
                Author information
                https://orcid.org/0000-0003-4550-415X
                Article
                2131330
                10.1080/07853890.2022.2131330
                9590431
                36263866
                27f2ec3e-8ac6-4fde-8d5f-c3d868dd0cd0
                © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Figures: 5, Tables: 2, Pages: 15, Words: 9870
                Categories
                Review Article
                Pharmacology

                Medicine
                yohimbine,indole alkaloid,phytochemical,pharmacology,α2-receptor antagonist
                Medicine
                yohimbine, indole alkaloid, phytochemical, pharmacology, α2-receptor antagonist

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