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      Therapeutic Potential of Diosgenin and Its Major Derivatives against Neurological Diseases: Recent Advances

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          Abstract

          Diosgenin (DG), a well-known steroidal sapogenin, is present abundantly in medicinal herbs such as Dioscorea rhizome, Dioscorea villosa, Trigonella foenum-graecum, Smilax China, and Rhizoma polgonati. DG is utilized as a major starting material for the production of steroidal drugs in the pharmaceutical industry. Due to its wide range of pharmacological activities and medicinal properties, it has been used in the treatment of cancers, hyperlipidemia, inflammation, and infections. Numerous studies have reported that DG is useful in the prevention and treatment of neurological diseases. Its therapeutic mechanisms are based on the mediation of different signaling pathways, and targeting these pathways might lead to the development of effective therapeutic agents for neurological diseases. The present review mainly summarizes recent progress using DG and its derivatives as therapeutic agents for multiple neurological disorders along with their various mechanisms in the central nervous system. In particular, those related to therapeutic efficacy for Parkinson's disease, Alzheimer's disease, brain injury, neuroinflammation, and ischemia are discussed. This review article also critically evaluates existing limitations associated with the solubility and bioavailability of DG and discusses imperatives for translational clinical research. It briefly recapitulates recent advances in structural modification and novel formulations to increase the therapeutic efficacy and brain levels of DG. In the present review, databases of PubMed, Web of Science, and Scopus were used for studies of DG and its derivatives in the treatment of central nervous system diseases published in English until December 10, 2019. Three independent researchers examined articles for eligibility. A total of 150 articles were screened from the above scientific literature databases. Finally, a total of 46 articles were extracted and included in this review. Keywords related to glioma, ischemia, memory, aging, cognitive impairment, Alzheimer, Parkinson, and neurodegenerative disorders were searched in the databases based on DG and its derivatives.

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          Artemisinin-A Gift from Traditional Chinese Medicine to the World (Nobel Lecture).

          Youyou Tu (2016)
          Malaria has long been a devastating and life-threatening global epidemic disease in human history. Artemisinin, the active substance against malaria, was first isolated and tested in the 1970s in China. The important role played by traditional Chinese medicine in the discovery of artemisinin is described by Y. Tu in her Nobel Lecture.
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            Progressive multiple sclerosis: prospects for disease therapy, repair, and restoration of function.

            Multiple sclerosis is a major cause of neurological disability, which accrues predominantly during progressive forms of the disease. Although development of multifocal inflammatory lesions is the underlying pathological process in relapsing-remitting multiple sclerosis, the gradual accumulation of disability that characterises progressive multiple sclerosis seems to result more from diffuse immune mechanisms and neurodegeneration. As a result, the 14 anti-inflammatory drugs that have regulatory approval for treatment of relapsing-remitting multiple sclerosis have little or no efficacy in progressive multiple sclerosis without inflammatory lesion activity. Effective therapies for progressive multiple sclerosis that prevent worsening, reverse damage, and restore function are a major unmet need. In this Series paper we summarise the current status of therapy for progressive multiple sclerosis and outline prospects for the future.
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              Advances in developing novel therapeutic strategies for Alzheimer’s disease

              Alzheimer’s Disease (AD), the most prevalent neurodegenerative disease of aging, affects one in eight older Americans. Nearly all drug treatments tested for AD today have failed to show any efficacy. There is a great need for therapies to prevent and/or slow the progression of AD. The major challenge in AD drug development is lack of clarity about the mechanisms underlying AD pathogenesis and pathophysiology. Several studies support the notion that AD is a multifactorial disease. While there is abundant evidence that amyloid plays a role in AD pathogenesis, other mechanisms have been implicated in AD such as tangle formation and spread, dysregulated protein degradation pathways, neuroinflammation, and loss of support by neurotrophic factors. Therefore, current paradigms of AD drug design have been shifted from single target approach (primarily amyloid-centric) to developing drugs targeted at multiple disease aspects, and from treating AD at later stages of disease progression to focusing on preventive strategies at early stages of disease development. Here, we summarize current strategies and new trends of AD drug development, including pre-clinical and clinical trials that target different aspects of disease (mechanism-based versus non-mechanism based, e.g. symptomatic treatments, lifestyle modifications and risk factor management).
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                Author and article information

                Contributors
                Journal
                Oxid Med Cell Longev
                Oxid Med Cell Longev
                OMCL
                Oxidative Medicine and Cellular Longevity
                Hindawi
                1942-0900
                1942-0994
                2020
                6 March 2020
                : 2020
                : 3153082
                Affiliations
                1Henan Research Center for Special Processing Technology of Chinese Medicine, School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou 450046, China
                2Department of Biochemistry, Department of Biomedical Sciences, Research Center for Aging and Geriatrics, Research Institute of Medical Sciences, Chonnam National University Medical School, Gwangju 501-190, Republic of Korea
                3Department of Medicinal Chemistry, College of Pharmacy JiangXi University of Traditional Chinese Medicine, Nanchang 330004, China
                4College of Biological Engineering, Henan University of Technology, Zhengzhou 450001, China
                5Research Institute of Drug Development, College of Pharmacy, Chonnam National University, Gwangju, Republic of Korea
                6Collaborative Innovation Center for Respiratory Disease Diagnosis and Treatment and Chinese Medicine Development of Henan Province, Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, China
                Author notes

                Guest Editor: Roman Fischer

                Author information
                https://orcid.org/0000-0002-9922-6389
                https://orcid.org/0000-0002-3672-3345
                https://orcid.org/0000-0002-5422-2931
                https://orcid.org/0000-0002-2452-6184
                https://orcid.org/0000-0002-2714-9353
                Article
                10.1155/2020/3153082
                7079249
                32215172
                684e3d69-6ea0-4b26-bf86-de8aada9c836
                Copyright © 2020 Bangrong Cai et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 20 August 2019
                : 16 December 2019
                : 30 December 2019
                Funding
                Funded by: Doctoral Scientific Research Start-up Foundation from Henan University of Technology
                Award ID: 00104311-2019-33
                Funded by: 2020 Key Technologies R&D Program of Henan Province
                Categories
                Review Article

                Molecular medicine
                Molecular medicine

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