Panax Ginseng in the treatment of Alzheimer's disease and vascular dementia

Wang, zhiyong; Zhang, Zhen; Liu, Jiangang; Guo, Mingdong; Li, Hao

doi:10.1016/j.jgr.2023.03.001

Cited by 24 publications

(11 citation statements)

References 91 publications

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“…All of this is underpinned by the significant developmental activity of disease-modifying therapies in AD, as shown in the 2023 annual review published by Cummings et al (2023) . The result is little room for VCID in research programs of large pharmaceutical companies, even in its most severe form of VaD ( Wang et al, 2023 ). It is in this environment that the market release of MLC-SLT in Singapore took place in October 2022.…”

Section: Discussionmentioning

confidence: 99%

“…For example, ginsenosides act on various targets involved in the pathophysiology of dementia, such as the regulation of synaptic neuroplasticity and the cholinergic system, the inhibition of Aβ peptide aggregation and of hyperphosphorylation of tau, anti-inflammatory properties, as well as antioxidant and anti-apoptosis effects. The other active components of Pg, such as gintonin, oligosaccharides, polysaccharides and ginseng proteins, also have documented promising effects on AD and VaD ( Wang et al, 2023 ). The favourable effects of TCM containing ginseng have also been reported in preclinical and clinical studies for the treatment of AD and VaD.…”

Section: Sailuotong (Mlc-slt) Development Outcomesmentioning

confidence: 99%

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A review of SaiLuoTong (MLC-SLT) development in vascular cognitive impairment and dementia

Ampil,

Ong,

Krespi

et al. 2024

Front. Pharmacol.

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The dementia epidemic, attributed to aging populations, represents a growing socio-economic burden. It is estimated that in 2019 about 55 million people worldwide were living with dementia. With many possible causes of dementia and the possibility of mixed dementia combining Alzheimer’s disease (AD) and vascular dementia the question is whether diagnostic uncertainty exists or whether diagnostic constructs based on single etiologies are incorrect. Vascular Cognitive Impairment and Dementia (VCID) designates the extent of cognitive dysfunctions from the most benign state to that of dementia, of vascular origin. We reviewed epidemiological, pathophysiological and clinical data on VCID with a focus on VaD, as well as key data on the development of a new therapeutic solution, SaiLuoTong (MLC-SLT). From documentary research executed on different web sources (PubMed, Clintrials.gov, Z-library and Google), our initial selection for the short review of VCID and VaD was based on keywords contained in each paragraph subtitles of this article with exclusion of publications in a language other than English or published before 2010. For the review of SaiLuoTong development, there was just the language exclusion criterion. Sorted by relevance and publication date, 47 references were selected from 140 shortlisted for review. With new evidence-based classification systems, vascular cognitive impairment was proposed as umbrella term covering all forms of cognitive deficits related to vascular causes. The scope of application expanded with the VCID which includes VaD and mixed pathologies. No drugs are approved for the treatment of VaD by major Western regulatory agencies, while some traditional Chinese medicines are registered in China. VCID treatment should have a dual focus: managing the underlying cerebrovascular disease and dementia symptoms. This is the objective set for the development of the MLC-SLT, the essential data of which are reviewed in detail. To strengthen VCID and VaD research, consensus groups should attempt to consolidate scattered local research initiatives into coordinated international programs. In two VaD clinical trials, MLC-SLT improved cognitive symptoms and activities of daily living, with good safety and potential disease-modifying effect. In a placebo-controlled study in 325 patients with mild to moderate VaD and randomized according to a delayed-start design, MLC-SLT demonstrated significant improvement in memory tests and performance in executive function tasks, expanding its place in the management of VCID. At week 26, changes in VADAS-cog scores (SD) from baseline were 23.25 (0.45) for MLC-SLT 180 mg bid), 23.05 (0.45) for MLC-SLT 120 mg bid (both p < 0.0001), and 20.57 (0.45) for placebo (p = 0.15). At week 52, differences between both groups MLC-SLT and placebo were 2.67 and 2.48, respectively (p < 0.0001), without significant difference between MLC-SLT groups.

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Section: Discussionmentioning

confidence: 99%

Section: Sailuotong (Mlc-slt) Development Outcomesmentioning

confidence: 99%

A review of SaiLuoTong (MLC-SLT) development in vascular cognitive impairment and dementia

Ampil,

Ong,

Krespi

et al. 2024

Front. Pharmacol.

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“…Ginseng contains at least three active components: ginseng ginsenosides, ginseng polysaccharides, and gintonin [ [35] , [36] , [37] ]. Ginsenosides were the first compounds isolated from ginseng and belong to a class of plant glycosides called ginseng saponins.…”

Section: What Are the Active Molecules Of Ginseng Extract Responsible...mentioning

confidence: 99%

Emerging evidence that ginseng components improve cognition in subjective memory impairment, mild cognitive impairment, and early Alzheimer's disease dementia

Lee,

Kim,

Kim

et al. 2024

Journal of Ginseng Research

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“…Researchers established behavioral as well as biochemical traits linked to dementia of vascular origin using animal models with metabolic abnormalities [ 3 ]. Research has shown a strong link between cardiovascular disease, involving the heart and blood vessels, and cerebrovascular disease, involving the brain, and subsequent cognitive impairment and dementia [ 2 , 4 ]. Atomoxetine (AXT) is a secondary amino compound used to treat a wide range of neurological disorders and developmental difficulties.…”

Section: Introductionmentioning

confidence: 99%

Development of Atomoxetine-Loaded NLC In Situ Gel for Nose-to-Brain Delivery: Optimization, In Vitro, and Preclinical Evaluation

Mohanty,

Alsaidan,

Zafar

et al. 2023

Pharmaceutics

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The present study investigates the brain-targeted efficiency of atomoxetine (AXT)-loaded nanostructured lipid carrier (NLC)-laden thermosensitive in situ gel after intranasal administration. AXT-NLC was prepared by the melt emulsification ultrasonication method and optimized using the Box–Behnken design (BBD). The optimized formulation (AXT-NLC) exhibited particle size PDI, zeta potential, and entrapment efficiency (EE) of 108 nm, 0.271, −42.3 mV, and 84.12%, respectively. The morphology of AXT-NLC was found to be spherical, as confirmed by SEM analysis. DSC results displayed that the AXT was encapsulated within the NLC matrix. Further, optimized NLC (AXT-NLC13) was incorporated into a thermosensitive in situ gel using poloxamer 407 and carbopol gelling agent and evaluated for different parameters. The optimized in situ gel (AXT-NLC13G4) formulation showed excellent viscosity (2532 ± 18 Cps) at 37 °C and formed the gel at 28–34 °C. AXT-NLC13-G4 showed a sustained release of AXT (92.89 ± 3.98% in 12 h) compared to pure AXT (95.47 ± 2.76% in 4 h). The permeation flux through goat nasal mucosa of AXT from pure AXT and AXT-NLC13-G4 was 504.37 µg/cm2·h and 232.41 µg/cm2·h, respectively. AXT-NLC13-G4 intranasally displayed significantly higher absolute bioavailability of AXT (1.59-fold higher) than intravenous administration. AXT-NLC13-G4 intranasally showed 51.91% higher BTP than pure AXT (28.64%) when administered via the same route (intranasally). AXT-NLC13-G4 showed significantly higher BTE (207.92%) than pure AXT (140.14%) when administered intranasally, confirming that a high amount of the AXT reached the brain. With the disrupted performance induced by L-methionine, the AXT-NLC13-G4 showed significantly (p < 0.05) better activity than pure AXT as well as donepezil (standard). The finding concluded that NLC in situ gel is a novel carrier of AXT for improvement of brain delivery by the intranasal route and requires further investigation for more justification.

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Panax Ginseng in the treatment of Alzheimer's disease and vascular dementia

Cited by 24 publications

References 91 publications

A review of SaiLuoTong (MLC-SLT) development in vascular cognitive impairment and dementia

A review of SaiLuoTong (MLC-SLT) development in vascular cognitive impairment and dementia

Emerging evidence that ginseng components improve cognition in subjective memory impairment, mild cognitive impairment, and early Alzheimer's disease dementia

Development of Atomoxetine-Loaded NLC In Situ Gel for Nose-to-Brain Delivery: Optimization, In Vitro, and Preclinical Evaluation

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