An update on novel approaches for diagnosis and treatment of SARS-CoV-2 infection

The ongoing pandemic of coronavirus disease 2019 (COVID-19) has made a serious public health and economic crisis worldwide which united global efforts to develop rapid, precise, and cost-efficient diagnostics, vaccines, and therapeutics. Numerous multi-disciplinary studies and techniques have been designed to investigate and develop various approaches to help frontline health workers, policymakers, and populations to overcome the disease. While these techniques have been reviewed within individual disciplines, it is now timely to provide a cross-disciplinary overview of novel diagnostic and therapeutic approaches summarizing complementary efforts across multiple fields of research and technology. Accordingly, we reviewed and summarized various advanced novel approaches used for diagnosis and treatment of COVID-19 to help researchers across diverse disciplines on their prioritization of resources for research and development and to give them better a picture of the latest techniques. These include artificial intelligence, nano-based, CRISPR-based, and mass spectrometry technologies as well as neutralizing factors and traditional medicines. We also reviewed new approaches for vaccine development and developed a dashboard to provide frequent updates on the current and future approved vaccines

Advances in treatment of mild cognitive impairment (MCI) and dementia : a review of promising non-pharmaceutical modalities

Currently, available mainstream approaches used to treat mild cognitive impairment (MCI) and dementia are limited. In view of the high prevalence rate of Alzheimer’s disease (AD) and other forms of dementia and the enormous social and financial burden associated with dementia on a global scale, developing more effective and more cost-effective ways to treat MCI and dementia is an urgent priority. This chapter reviews research findings on promising non-pharmaceutical approaches being investigated for their potential clinical applications in treating symptoms of cognitive impairment and behavioral dysregulation associated with dementia, reducing the risk of developing dementia, and slowing rate of progression of cognitive decline in individuals with Mild Cognitive Impairment (MCI) or dementia. Non-pharmaceutical treatment approaches covered include diet, exercise, single and compound herbal formulas used in Asian medicine, herbals used in Western countries, select other natural products including dehydroepiandrosterone, idebenone, acetyl-L-carnitine, alpha lipoic acid, phosphatidylserine and phosphatidic acid, select vitamins, nPUFAs and probiotics. Other non-pharmaceutical modalities reviewed include chelating agents; non-invasive brain stimulation techniques employing weak electrical current, sound and light; music therapy; cognitive training; electroencephalography (EEG) biofeedback; multi-modal interventions; Wander gardens; sensory stimulation interventions; massage, mindfulness, and energetic therapies (Healing Touch, Therapeutic Touch, taichi and qigong). Although select natural products are supported by compelling research evidence, most modalities reviewed in this chapter are supported by limited findings. Large prospective placebo-controlled studies are needed to further elucidate mechanisms of action, verify the efficacy of the various non-pharmaceutical modalities, and identify safe and appropriate treatment protocols for MCI and dementia

The effects of Fenugreek on controlling glucose in diabetes mellitus : an overview of scientific evidence

Trigonella foenum-graecum L. (fenugreek) from Fabaceae has been used as herbal medicine to treat various disorders worldwide since antiquity. Recent evidence from preclinical and clinical studies have shown the potential of fenugreek to control hyperglycemia in diabetes mellitus. Antihyperglycaemic properties of fenugreek are mainly attributed to its bioactive constituents, mainly 4-hydroxyisoleucin, galactomannan, diosgenin and trigonelline. The potential mechanisms underlying antidiabetic activity of fenugreek and its substances are associated with β cell regeneration, increasing insulin secretion, improving the insulin-signalling pathway in adipocytes and liver cells, modulating enzymes related to glucose metabolism and inhibiting glucose resorption from the gastrointestinal tract. Given the large body of evidence, fenugreek and its bioactive constituents have a strong potential to be used as complementary medicines for controlling glucose in diabetes mellitus. This review aims to discuss the effect of fenugreek in the management of hyperglycaemia from preclinical and clinical studies and the underlying mechanisms of actions

Saffron for mild cognitive impairment and dementia : a systematic review and meta-analysis of randomised clinical trials

Background: Saffron (stigma of Crocus sativus L.) from Iridaceae family is a well-known traditional herbal medicine that has been used for hundreds of years to treat several diseases such as depressive mood, cancer and cardiovascular disorders. Recently, anti-dementia property of saffron has been indicated. However, the effects of saffron for the management of dementia remain controversial. The aim of the present study is to explore the effectiveness and safety of saffron in treating mild cognitive impairment and dementia. Methods: An electronic database search of some major English and Chinese databases was conducted until 31st May 2019 to identify relevant randomised clinical trials (RCT). The primary outcome was cognitive function and the secondary outcomes included daily living function, global clinical assessment, quality of life (QoL), psychiatric assessment and safety. Rev-Man 5.3 software was applied to perform the meta-analyses. Results: A total of four RCTs were included in this review. The analysis revealed that saffron significantly improves cognitive function measured by the Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-cog) and Clinical Dementia Rating Scale-Sums of Boxes (CDR-SB), compared to placebo groups. In addition, there was no significant difference between saffron and conventional medicine, as measured by cognitive scales such as ADAS-cog and CDR-SB. Saffron improved daily living function, but the changes were not statistically significant. No serious adverse events were reported in the included studies. Conclusions: Saffron may have the potential to improve cognitive function and activities of daily living in patients with Alzheimer’s disease and mild cognitive impairment (MCI). However, due to limited high-quality studies there is insufficient evidence to make any recommendations for clinical use. Further clinical trials on larger sample sizes are warranted to shed more light on its efficacy and safety

Genus Rosa : a review of ethnobotany, phytochemistry and traditional aspects according to Islamic Traditional Medicine (ITM)

Rosa spp. is an important genus in the Rosaceae family which is a source of medicinal natural products, particularly polyphenolic and terpenoid compounds and is used in several traditional medicines such as Islamic Traditional Medicine (ITM) to cure various diseases. Plants in this genus are known to possess anti-inflammatory, antidiabetic, anti-constipation, cardioprotective and neuroprotective activities. Furthermore, phytochemical investigations have reported Rosa species to contain a wide range of chemical compounds including quercetin, kaempferol, catechin, citronellol, limonene, lycopene, carvacrol, thymol, ascorbic acid (vitamin C), rosmarinic acid, etc. The current review is an attempt to cover the available findings on the ethnobotany and photochemistry of this genus as well as its medicinal aspects in ITM

Safety evaluation of crocin (a constituent of saffron) tablets in healthy volunteers

Objective(s): Crocin is the chemical ingredient primarily responsible for the color of saffron. It has different pharmacological effects such as antioxidant, anticancer and memory improving activities. Crocin tablets were evaluated for short-term safety and tolerability in healthy adult volunteers. Materials and Methods: The study was a randomized, double-blind, placebo-controlled design consisting of one month treatment of crocin tablets. Volunteers who fulfilled inclusion and exclusion criteria were randomized into 2 groups of 22 each (males and females) and received 20 mg crocin tablets or placebo. General measures of health were recorded during the study such as hematological, biochemical, hormonal and urinary parameters in pre and post-treatment periods. Results: No major adverse events were reported during the trial. Crocin tablets did not change the above parameters except that it decreased amylase, mixed white blood cells and PTT in healthy volunteers after one month. Conclusion: This clinical safety evaluation showed a relatively safe and normal profile for crocin in healthy volunteers at the given doses within the trial period

Antitumor activity of PEGylated nanoliposomes containing crocin in mice bearing C26 colon carcinoma

Crocin is a pharmacologically active component of Crocus sativus. It is an unusual water-soluble carotenoid responsible for the red color of saffron. In various studies, the anticancer effect of saffron and its constituents has been established. Polyethylene glycolated nanoliposomes with a size range up to 200 nm are suitable for encapsulation of cytotoxic drugs and can target tumors passively through the enhanced permeation and retention effect. The aim of this study was to develop a nanoliposomal formulation containing crocin with a higher therapeutic index for the treatment of cancer. Four formulations of polyethylene glycolated nanoliposomes containing 25 mg/ml crocin were prepared with hydrogenated soy phosphatidylcholine, cholesterol, and methoxy-polyethylene glycol (MW 2000)-distearoylphosphatidylcholine at different molar ratios by a solvent evaporation method plus extrusion. Then the liposomes were characterized for their size, zeta potential, crocin encapsulation, release properties, and in vitro cytotoxicity against C26 colon carcinoma cells. Based on in vitro results, the best formulation was selected for an in vivo study, and its antitumor activity was evaluated in BALB/c mice bearing C26 colon carcinoma. The IC50 of crocin itself against C26 colon carcinoma was 0.73 mM. The characterization of the best formulation was as follow: Z-average size: 127.6 ± 1.5 nm; polydispersity index: 0.087 ± 0.018; zeta potential: − 21.7 mV ± 6.7; % encapsulation: 84.62 ± 0.59; % release after 168 hours in RPMI 1640 containing 30% FBS: 16.26 ± 0.01%. Liposomal crocin at doses of 50 and 100 mg/kg significantly decreased tumor size and increased survival rate compared with PBS and crocin in buffer (100 mg/kg) groups. The results of this study indicated that liposomal encapsulation of crocin could increase its antitumorigenic activity. Thus, to obtain an optimal dose for use in humans, the formulation merits further investigation

Herbal medicines and phytochemicals for obsessive-compulsive disorder

Obsessive–compulsive disorder (OCD) is a relatively prevalent mental disorder that poses significant health burdens on the community. Although current conventional medications have good efficacy for many patients, they can elicit a range of associated adverse effects. Plant‐based compounds have been evaluated for different mental disorders, with a range of anxiolytic properties revealed. To determine the current evidence in the area, we conducted a systematic review using the electronic databases including PubMed, Scopus, and the Cochrane Library up to June 12, 2019, for pharmacological and clinical evidence of herbal medicines and phytochemicals with antiobsessive–compulsive effects. Additional search criteria were employed for locating research on the underpinning mechanisms of action. Results revealed that tentative low‐quality evidence exists for several plant medicines, including Crocus sativus, Silybum marianum, Echium amoenum, Hypericum perforatum, and Withania somnifera, along with several natural molecules, including crocin, cannabidiol, and curcumin. Although more research is needed to confirm effectiveness, present preclinical studies indicate that monoamine pathway modulation (in particular serotonin reuptake inhibition) may be the most important anti‐OCD mechanism among the studied natural compounds

A review on the phytochemistry, ethnobotanical uses and pharmacology of Borago species

Ethnopharmacological relevance: Borago L., (family Boraginaceae) is a small genus of annual or perennial herbs with branched flowers, which is commonly found in the Mediterranean region. Some species known as Gavzabȃn in Asian and some African countries are traditionally used instead of Borago. Aims of the review: The purpose of this study was to provide comprehensive scientific information on phytochemistry, traditional uses and pharmacological activities of Borago species to provide an insight into further research on the therapeutic potential of these plants. In many studies, it has been shown that different parts of Borago species, including leaves, flowers, seeds, roots and aerial parts possess numerous ethnobotanical values. Materials and methods: All ethnobotanical, phytochemical, pharmacological, and clinical data were collected from online journals, magazines and books (all of which were published in English, Arabic, and Persian) from 1968 to 2018. Electronic databases such as Google, Google Scholar, PubMed, Science Direct, Researchgate, and other online collections were used. Results: The phytochemical studies on five species showed a wide range of phytochemicals belonging to different classes of secondary metabolites. From a pharmacological point of view, different extracts and fractions, essential oils, and pure compounds isolated from various Borago species have shown diverse activities in in vitro, in vivo, and clinical studies confirming various traditional uses of Borago genus. Conclusion: Considering the reported activities of the Borago genus both in traditional and modern medicine, further studies on biological aspects and identification of the mechanism of action for drug discovery are highly required

Phytochemistry, traditional uses and pharmacological profile of rose hip : a review

Background: The fruit of genus Rosa, known as "rose hip", is frequently used in different traditional medicines. Rose hips have long been used to treat kidney stones, gastroenteric ailments, hypertension and respiratory problems such as bronchitis, cough and cold. Aim: This review is focused on the ethnopharmacological uses of rose hip as well as phytochemical and pharmacological aspects. Results: Ethno-medical uses of rose hip have been recorded in many countries since a long time. Approximately, 129 chemical compounds have been isolated and identified from rose hip. This fruit contains some major active components such as flavonoids, tannins, anthocyanin, phenolic compounds, fatty oil, organic acids and inorganic compounds. Scientific studies have suggested a wide range of pharmacological activities for rose hip including antioxidant, anti-inflammatory, anti-obesity, anti-cancer, hepatoprotective, nephroprotective, cardioprotective, antiaging, anti H. pylori, neuroprotective and antinociceptive activities. In particular, the rose hip powder and extract have been reported to exert therapeutic effects on arthritis. Conclusion: Some of the ethnomedical indications of rose hip, such as nephroprotective and gastroproetctive actions, have been confirmed by preclinical pharmacological studies. Additional investigations on the pharmacological effects of rose hip as well as evidence from randomized controlled trials are essential to assess the therapeutic value of this natural product