Cholinesterase inhibitors as Alzheimer's therapeutics
K. Sharma
Alzheimer's disease (AD) is one of the most common forms of dementia. AD is a chronic syndrome of the central nervous system that causes a decline in cognitive function and language ability. Cholinergic deficiency is associated with AD, and various cholinesterase inhibitors have been developed for the treatment of AD, including naturally-derived inhibitors, synthetic analogues and hybrids. Currently, the available drugs for AD are predominantly cholinesterase inhibitors. However, the efficacy of these drugs is limited as they may cause adverse side effects and are not able to completely arrest the progression of the disease. Since AD is multifactorial disease, dual and multi-target inhibitors have been developed. The clinical applications and the limitations of the inhibitors used to treat AD are discussed in the present review. Additionally, this review presents the current status and future directions for the development of novel drugs with reduced toxicity and preserved pharmacological activity.
588 sitasi
en
Medicine, Biology
Botulinum Neurotoxins: Biology, Pharmacology, and Toxicology
M. Pirazzini, O. Rossetto, R. Eleopra
et al.
The study of botulinum neurotoxins (BoNT) is rapidly progressing in many aspects. Novel BoNTs are being discovered owing to next generation sequencing, but their biologic and pharmacological properties remain largely unknown. The molecular structure of the large protein complexes that the toxin forms with accessory proteins, which are included in some BoNT type A1 and B1 pharmacological preparations, have been determined. By far the largest effort has been dedicated to the testing and validation of BoNTs as therapeutic agents in an ever increasing number of applications, including pain therapy. BoNT type A1 has been also exploited in a variety of cosmetic treatments, alone or in combination with other agents, and this specific market has reached the size of the one dedicated to the treatment of medical syndromes. The pharmacological properties and mode of action of BoNTs have shed light on general principles of neuronal transport and protein-protein interactions and are stimulating basic science studies. Moreover, the wide array of BoNTs discovered and to be discovered and the production of recombinant BoNTs endowed with specific properties suggest novel uses in therapeutics with increasing disease/symptom specifity. These recent developments are reviewed here to provide an updated picture of the biologic mechanism of action of BoNTs, of their increasing use in pharmacology and in cosmetics, and of their toxicology.
642 sitasi
en
Biology, Medicine
TLR4 Signaling Pathway Modulators as Potential Therapeutics in Inflammation and Sepsis
N. Kuzmich, Konstantin V. Sivak, V. Chubarev
et al.
Toll-Like Receptor 4 (TLR4) signal pathway plays an important role in initiating the innate immune response and its activation by bacterial endotoxin is responsible for chronic and acute inflammatory disorders that are becoming more and more frequent in developed countries. Modulation of the TLR4 pathway is a potential strategy to specifically target these pathologies. Among the diseases caused by TLR4 abnormal activation by bacterial endotoxin, sepsis is the most dangerous one because it is a life-threatening acute system inflammatory condition that still lacks specific pharmacological treatment. Here, we review molecules at a preclinical or clinical phase of development, that are active in inhibiting the TLR4-MyD88 and TLR4-TRIF pathways in animal models. These are low-molecular weight compounds of natural and synthetic origin that can be considered leads for drug development. The results of in vivo studies in the sepsis model and the mechanisms of action of drug leads are presented and critically discussed, evidencing the differences in treatment results from rodents to humans.
561 sitasi
en
Biology, Medicine
Inflammation and cardiovascular disease: From mechanisms to therapeutics
A. Alfaddagh, S. Martin, Thorsten M. Leucker
et al.
Inflammation constitutes a complex, highly conserved cascade of molecular and cellular events. Inflammation has been labeled as “the fire within,” is highly regulated, and is critical to host defense and tissue repair. In general, inflammation is beneficial and has evolved to promote survival. However, inflammation can also be maladaptive when chronically activated and sustained, leading to progressive tissue injury and reduced survival. Examples of a maladaptive response include rheumatologic disease and atherosclerosis. Despite evidence gathered by Virchow over 100 years ago showing that inflammatory white cells play a role in atherogenesis, atherosclerosis was until recently viewed as a disease of passive cholesterol accumulation in the subendothelial space. This view has been supplanted by considerable basic scientific and clinical evidence demonstrating that every step of atherogenesis, from the development of endothelial cell dysfunction to foam cell formation, plaque formation and progression, and ultimately plaque rupture stemming from architectural instability, is driven by the cytokines, interleukins, and cellular constituents of the inflammatory response. Herein we provide an overview of the role of inflammation in atherosclerotic cardiovascular disease, discuss the predictive value of various biomarkers involved in inflammation, and summarize recent clinical trials that evaluated the capacity of various pharmacologic interventions to attenuate the intensity of inflammation and impact risk for acute cardiovascular events.
Molecular Pharmacology of VEGF-A Isoforms: Binding and Signalling at VEGFR2
C. Peach, V. Mignone, M. Arruda
et al.
Vascular endothelial growth factor-A (VEGF-A) is a key mediator of angiogenesis, signalling via the class IV tyrosine kinase receptor family of VEGF Receptors (VEGFRs). Although VEGF-A ligands bind to both VEGFR1 and VEGFR2, they primarily signal via VEGFR2 leading to endothelial cell proliferation, survival, migration and vascular permeability. Distinct VEGF-A isoforms result from alternative splicing of the Vegfa gene at exon 8, resulting in VEGFxxxa or VEGFxxxb isoforms. Alternative splicing events at exons 5–7, in addition to recently identified posttranslational read-through events, produce VEGF-A isoforms that differ in their bioavailability and interaction with the co-receptor Neuropilin-1. This review explores the molecular pharmacology of VEGF-A isoforms at VEGFR2 in respect to ligand binding and downstream signalling. To understand how VEGF-A isoforms have distinct signalling despite similar affinities for VEGFR2, this review re-evaluates the typical classification of these isoforms relative to the prototypical, “pro-angiogenic” VEGF165a. We also examine the molecular mechanisms underpinning the regulation of VEGF-A isoform signalling and the importance of interactions with other membrane and extracellular matrix proteins. As approved therapeutics targeting the VEGF-A/VEGFR signalling axis largely lack long-term efficacy, understanding these isoform-specific mechanisms could aid future drug discovery efforts targeting VEGF receptor pharmacology.
437 sitasi
en
Medicine, Chemistry
Berberine in Cardiovascular and Metabolic Diseases: From Mechanisms to Therapeutics
Xiaojun Feng, A. Sureda, S. Jafari
et al.
Cardiovascular and metabolic diseases (CVMD) are the leading causes of death worldwide, underscoring the urgent necessity to develop new pharmacotherapies. Berberine (BBR) is an eminent component of traditional Chinese and Ayurvedic medicine for more than 2000 years. Recently, BBR has attracted much interest for its pharmacological actions in treating and/or managing CVMD. Recent discoveries of basic, translational and clinical studies have identified many novel molecular targets of BBR (such as AMPK, SIRT1, LDLR, PCSK9, and PTP1B) and provided novel evidences supporting the promising therapeutic potential of BBR to combat CVMD. Thus, this review provides a timely overview of the pharmacological properties and therapeutic application of BBR in CVMD, and underlines recent pharmacological advances which validate BBR as a promising lead drug against CVMD.
COVID-19: Characteristics and Therapeutics
Rameswari Chilamakuri, S. Agarwal
Novel coronavirus (COVID-19 or 2019-nCoV or SARS-CoV-2), which suddenly emerged in December 2019 is still haunting the entire human race and has affected not only the healthcare system but also the global socioeconomic balances. COVID-19 was quickly designated as a global pandemic by the World Health Organization as there have been about 98.0 million confirmed cases and about 2.0 million confirmed deaths, as of January 2021. Although, our understanding of COVID-19 has significantly increased since its outbreak, and multiple treatment approaches and pharmacological interventions have been tested or are currently under development to mitigate its risk-factors. Recently, some vaccine candidates showed around 95% clinical efficacy, and now receiving emergency use approvals in different countries. US FDA recently approved BNT162 and mRNA-1273 vaccines developed by Pfizer/BioNTech and Moderna Inc. for emergency use and vaccination in the USA. In this review, we present a succinct overview of the SARS-CoV-2 virus structure, molecular mechanisms of infection, COVID-19 epidemiology, diagnosis, and clinical manifestations. We also systematize different treatment strategies and clinical trials initiated after the pandemic outbreak, based on viral infection and replication mechanisms. Additionally, we reviewed the novel pharmacological intervention approaches and vaccine development strategies against COVID-19. We speculate that the current pandemic emergency will trigger detailed studies of coronaviruses, their mechanism of infection, development of systematic drug repurposing approaches, and novel drug discoveries for current and future pandemic outbreaks.
Skeletal Aging and Osteoporosis: Mechanisms and Therapeutics
Abhishek Chandra, J. Rajawat
Bone is a dynamic organ maintained by tightly regulated mechanisms. With old age, bone homeostasis, which is maintained by an intricate balance between bone formation and bone resorption, undergoes deregulation. Oxidative stress-induced DNA damage, cellular apoptosis, and cellular senescence are all responsible for this tissue dysfunction and the imbalance in the bone homeostasis. These cellular mechanisms have become a target for therapeutics to treat age-related osteoporosis. Genetic mouse models have shown the importance of senescent cell clearance in alleviating age-related osteoporosis. Furthermore, we and others have shown that targeting cellular senescence pharmacologically was an effective tool to alleviate age- and radiation-induced osteoporosis. Senescent cells also have an altered secretome known as the senescence associated secretory phenotype (SASP), which may have autocrine, paracrine, or endocrine function. The current review discusses the current and potential pathways which lead to a senescence profile in an aged skeleton and how bone homeostasis is affected during age-related osteoporosis. The review has also discussed existing therapeutics for the treatment of osteoporosis and rationalizes for novel therapeutic options based on cellular senescence and the SASP as an underlying pathogenesis of an aging bone.
Recent advances of PLGA micro/nanoparticles for the delivery of biomacromolecular therapeutics.
D. Ding, Qingdi Zhu
Recent advancements in biopharmaceutical industry have facilitated the development of novel bioactive macromolecular therapeutics. One of the challenges towards the clinical use of these biomacromolecules lies in the selection of appropriate carriers to protect, deliver and release them in vivo to maximize their pharmacological effects. Micro/nanoparticles made from biodegradable poly (d,l-lactic-co-glycolic acid) (PLGA) have been explored as delivery vehicles for therapeutics. Due to their excellent biocompatibility and controllable biodegradability, PLGA micro/nanoparticles could protect macromolecules from instant degradation in vivo while allowing tunable release rate and profile. In this review, recent progress in the design, fabrication/formulation and application of PLGA based micro/nanoparticles for the controlled delivery of biomacromolecules are discussed. Special focuses will be on the novel loading methods and releasing mechanisms of macromolecules as well as the in vivo applications of therapeutic macromolecule-loaded PLGA micro/nanoparticles.
308 sitasi
en
Materials Science, Medicine
Molecular Mechanisms and Emerging Therapeutics for Osteoporosis
J. Noh, Young-Woong Yang, Haiyoung Jung
Osteoporosis is the most common chronic metabolic bone disease. It has been estimated that more than 10 million people in the United States and 200 million men and women worldwide have osteoporosis. Given that the aging population is rapidly increasing in many countries, osteoporosis could become a global challenge with an impact on the quality of life of the affected individuals. Osteoporosis can be defined as a condition characterized by low bone density and increased risk of fractures due to the deterioration of the bone architecture. Thus, the major goal of treatment is to reduce the risk for fractures. There are several treatment options, mostly medications that can control disease progression in risk groups, such as postmenopausal women and elderly men. Recent studies on the basic molecular mechanisms and clinical implications of osteoporosis have identified novel therapeutic targets. Emerging therapies targeting novel disease mechanisms could provide powerful approaches for osteoporosis management in the future. Here, we review the etiology of osteoporosis and the molecular mechanism of bone remodeling, present current pharmacological options, and discuss emerging therapies targeting novel mechanisms, investigational treatments, and new promising therapeutic approaches.
The promises and perils of psychedelic pharmacology for psychiatry
Tristan D. McClure-Begley, B. Roth
Metal–Curcumin Complexes in Therapeutics: An Approach to Enhance Pharmacological Effects of Curcumin
S. Prasad, D. Dubourdieu, Ajay Srivastava
et al.
Curcumin, an active component of the rhizome turmeric, has gained much attention as a plant-based compound with pleiotropic pharmacological properties. It possesses anti-inflammatory, antioxidant, hypoglycemic, antimicrobial, neuroprotective, and immunomodulatory activities. However, the health-promoting utility of curcumin is constrained due to its hydrophobic nature, water insolubility, poor bioavailability, rapid metabolism, and systemic elimination. Therefore, an innovative stride was taken, and complexes of metals with curcumin have been synthesized. Curcumin usually reacts with metals through the β-diketone moiety to generate metal–curcumin complexes. It is well established that curcumin strongly chelates several metal ions, including boron, cobalt, copper, gallium, gadolinium, gold, lanthanum, manganese, nickel, iron, palladium, platinum, ruthenium, silver, vanadium, and zinc. In this review, the pharmacological, chemopreventive, and therapeutic activities of metal–curcumin complexes are discussed. Metal–curcumin complexes increase the solubility, cellular uptake, and bioavailability and improve the antioxidant, anti-inflammatory, antimicrobial, and antiviral effects of curcumin. Metal–curcumin complexes have also demonstrated efficacy against various chronic diseases, including cancer, arthritis, osteoporosis, and neurological disorders such as Alzheimer’s disease. These biological activities of metal–curcumin complexes were associated with the modulation of inflammatory mediators, transcription factors, protein kinases, antiapoptotic proteins, lipid peroxidation, and antioxidant enzymes. In addition, metal–curcumin complexes have shown usefulness in biological imaging and radioimaging. The future use of metal–curcumin complexes may represent a new approach in the prevention and treatment of chronic diseases.
Efficacy of a digital therapeutics system in the management of essential hypertension: the HERB-DH1 pivotal trial
K. Kario, A. Nomura, N. Harada
et al.
Abstract Aims Digital therapeutics is a new approach to facilitate the non-pharmacological treatment of hypertension using software programmes such as smartphone applications and/or device algorithms. Based on promising findings from a small pilot trial, the HERB Digital Hypertension 1 (HERB-DH1) pivotal trial investigated the efficacy of digital therapeutics in patients with hypertension not receiving antihypertensive medication. Methods and results This prospective, open-label, randomized controlled study was performed at 12 sites in Japan. Patients with hypertension [office systolic blood pressure (SBP) 140 to <180 mmHg and 24 h SBP ≥130 mmHg] were randomly assigned 1:1 to the digital therapeutics group (HERB system + standard lifestyle modification) or control group (standard lifestyle modification alone). The primary efficacy endpoint was the mean change in 24 h ambulatory SBP from baseline to 12 weeks; key secondary efficacy endpoints were mean changes in office and home blood pressure (BP) from baseline to 12 weeks. All analyses were conducted in the full analysis set population. Between December 2019 and June 2020, 390 patients were randomly assigned to the digital therapeutics group (n = 199) or control (n = 191) group. Between-group differences in 24-h ambulatory, home, and office SBPs at 12 weeks were −2.4 (95% confidence interval −4.5 to −0.3), −4.3 (−6.7 to −1.9), and −3.6 (−6.2 to −1.0) mmHg, respectively. No major programme-related safety events occurred up to 24 weeks. Conclusion The HERB-DH1 pivotal study showed the superiority of digital therapeutics compared with standard lifestyle modification alone to reduce 24-h ambulatory, home, and office BPs in the absence of antihypertensive medications.
A practical guide for transparent reporting of research on natural products in the British Journal of Pharmacology: Reproducibility of natural product research
A. Izzo, Mauro M Teixeira, S. Alexander
et al.
Conclusions This editorial illustrates major requirements that authors should con- sider before submitting articles to BJP (see Table 3 for authors' check- list). It also highlights some common shortcomings in natural product pharmacological research, which could be prevented if experiments have appropriate planning and experimental design. BJP is a leading journal in the pharmacological field, in which important new advances are published, and thus, novelty is a major determinant of acceptance for publication. Studies showing the effect of natural products, without a substantial investigation into the mode of action, are not considered. Articles limited to repetition of well- known data or that report similar pharmacological activities of similar chemical compounds are generally not suitable for BJP. The editors of BJP recognize the wealth of opportunity for thera- peutics that comes from the natural world and are keen to publish excellent natural product pharmacology that advances understanding of mechanisms of both physiological and pathological processes or that identifies potential new therapeutics.
202 sitasi
en
Medicine, Computer Science
Open Biomedical Knowledge Graphs at Scale: Construction, Federation, and AI Agent Access with Samyama Graph Database
Madhulatha Mandarapu, Sandeep Kunkunuru
Biomedical knowledge is fragmented across siloed databases -- Reactome for pathways, STRING for protein interactions, ClinicalTrials.gov for study registries, DrugBank for drug vocabularies, DGIdb for drug-gene interactions, SIDER for side effects. We present three open-source biomedical knowledge graphs -- Pathways KG (118,686 nodes, 834,785 edges from 5 sources), Clinical Trials KG (7,774,446 nodes, 26,973,997 edges from 5 sources), and Drug Interactions KG (32,726 nodes, 191,970 edges from 3 sources) -- built on Samyama, a high-performance graph database written in Rust. Our contributions are threefold. First, we describe a reproducible ETL pattern for constructing large-scale KGs from heterogeneous public data sources, with cross-source deduplication, batch loading (Python Cypher and Rust native loaders), and portable snapshot export. Second, we demonstrate cross-KG federation: loading all three snapshots into a single graph tenant enables property-based joins across datasets. Third, we introduce schema-driven MCP server generation for LLM agent access, evaluated on a new BiomedQA benchmark (40 pharmacology questions): domain-specific MCP tools achieve 98% accuracy vs. 85% for schema-aware text-to-Cypher and 75% for standalone GPT-4o, with zero schema errors. All data sources are open-license. The combined federated graph (7.9M nodes, 28M edges) loads in approximately 3 minutes on commodity cloud hardware, with single-KG queries completing in 80-100ms and cross-KG federation joins in 1-4s
Multi-Objective Alignment of Language Models for Personalized Psychotherapy
Mehrab Beikzadeh, Yasaman Asadollah Salmanpour, Ashima Suvarna
et al.
Mental health disorders affect over 1 billion people worldwide, yet access to care remains limited by workforce shortages and cost constraints. While AI systems show therapeutic promise, current alignment approaches optimize objectives independently, failing to balance patient preferences with clinical safety. We survey 335 individuals with lived mental health experience to collect preference rankings across therapeutic dimensions, then develop a multi-objective alignment framework using direct preference optimization. We train reward models for six criteria -- empathy, safety, active listening, self-motivated change, trust/rapport, and patient autonomy -- and systematically compare multi-objective approaches against single-objective optimization, supervised fine-tuning, and parameter merging. Multi-objective DPO (MODPO) achieves superior balance (77.6% empathy, 62.6% safety) compared to single-objective optimization (93.6% empathy, 47.8% safety), and therapeutic criteria outperform general communication principles by 17.2%. Blinded clinician evaluation confirms MODPO is consistently preferred, with LLM-evaluator agreement comparable to inter-clinician reliability.
Talking to an AI Mirror: Designing Self-Clone Chatbots for Enhanced Engagement in Digital Mental Health Support
Mehrnoosh Sadat Shirvani, Jackie Liu, Thomas Chao
et al.
Mental health conversational agents have the potential to deliver valuable therapeutic impact, but low user engagement remains a critical barrier hindering their efficacy. Existing therapeutic approaches have leveraged clients' internal dialogues (e.g., journaling, talking to an empty chair) to enhance engagement through accountable, self-sourced support. Inspired by these, we designed novel AI-driven self-clone chatbots that replicate users' support strategies and conversational patterns to improve therapeutic engagement through externalized meaningful self-conversation. Validated through a semi-controlled experiment (N=180), significantly higher emotional and cognitive engagement was demonstrated with self-clone chatbots than a chatbot with a generic counselor persona. Our findings highlight self-clone believability as a mediator and emphasize the balance required in maintaining convincing self-representation while creating positive interactions. This study contributes to AI-based mental health interventions by introducing and evaluating self-clones as a promising approach to increasing user engagement, while exploring implications for their application in mental health care.
Engagement and Disclosures in LLM-Powered Cognitive Behavioral Therapy Exercises: A Factorial Design Comparing the Influence of a Robot vs. Chatbot Over Time
Mina Kian, Mingyu Zong, Katrin Fischer
et al.
Many researchers are working to address the worldwide mental health crisis by developing therapeutic technologies that increase the accessibility of care, including leveraging large language model (LLM) capabilities in chatbots and socially assistive robots (SARs) used for therapeutic applications. Yet, the effects of these technologies over time remain unexplored. In this study, we use a factorial design to assess the impact of embodiment and time spent engaging in therapeutic exercises on participant disclosures. We assessed transcripts gathered from a two-week study in which 26 university student participants completed daily interactive Cognitive Behavioral Therapy (CBT) exercises in their residences using either an LLM-powered SAR or a disembodied chatbot. We evaluated the levels of active engagement and high intimacy of their disclosures (opinions, judgments, and emotions) during each session and over time. Our findings show significant interactions between time and embodiment for both outcome measures: participant engagement and intimacy increased over time in the physical robot condition, while both measures decreased in the chatbot condition.
HelixDesign-Binder: A Scalable Production-Grade Platform for Binder Design Built on HelixFold3
Jie Gao, Jun Li, Jing Hu
et al.
Protein binder design is central to therapeutics, diagnostics, and synthetic biology, yet practical deployment remains challenging due to fragmented workflows, high computational costs, and complex tool integration. We present HelixDesign-Binder, a production-grade, high-throughput platform built on HelixFold3 that automates the full binder design pipeline, from backbone generation and sequence design to structural evaluation and multi-dimensional scoring. By unifying these stages into a scalable and user-friendly system, HelixDesign-Binder enables efficient exploration of binder candidates with favorable structural, energetic, and physicochemical properties. The platform leverages Baidu Cloud's high-performance infrastructure to support large-scale design and incorporates advanced scoring metrics, including ipTM, predicted binding free energy, and interface hydrophobicity. Benchmarking across six protein targets demonstrates that HelixDesign-Binder reliably produces diverse and high-quality binders, some of which match or exceed validated designs in predicted binding affinity. HelixDesign-Binder is accessible via an interactive web interface in PaddleHelix platform, supporting both academic research and industrial applications in antibody and protein binder development.
NbBench: Benchmarking Language Models for Comprehensive Nanobody Tasks
Yiming Zhang, Koji Tsuda
Nanobodies -- single-domain antibody fragments derived from camelid heavy-chain-only antibodies -- exhibit unique advantages such as compact size, high stability, and strong binding affinity, making them valuable tools in therapeutics and diagnostics. While recent advances in pretrained protein and antibody language models (PPLMs and PALMs) have greatly enhanced biomolecular understanding, nanobody-specific modeling remains underexplored and lacks a unified benchmark. To address this gap, we introduce NbBench, the first comprehensive benchmark suite for nanobody representation learning. Spanning eight biologically meaningful tasks across nine curated datasets, NbBench encompasses structure annotation, binding prediction, and developability assessment. We systematically evaluate eleven representative models -- including general-purpose protein LMs, antibody-specific LMs, and nanobody-specific LMs -- in a frozen setting. Our analysis reveals that antibody language models excel in antigen-related tasks, while performance on regression tasks such as thermostability and affinity remains challenging across all models. Notably, no single model consistently outperforms others across all tasks. By standardizing datasets, task definitions, and evaluation protocols, NbBench offers a reproducible foundation for assessing and advancing nanobody modeling.