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Naghavi M, Ong KL, Aali A, Ababneh HS, Abate YH, Abbafati C, Abbasgholizadeh R, Abbasian M, Abbasi-Kangevari M, Abbastabar H, Abd ElHafeez S, Abdelmasseh M, Abd-Elsalam S, Abdelwahab A, Abdollahi M, Abdollahifar MA, Abdoun M, Abdulah DM, Abdullahi A, Abebe M, Abebe SS, Abedi A, Abegaz KH, Abhilash ES, Abidi H, Abiodun O, Aboagye RG, Abolhassani H, Abolmaali M, Abouzid M, Aboye GB, Abreu LG, Abrha WA, Abtahi D, Abu Rumeileh S, Abualruz H, Abubakar B, Abu-Gharbieh E, Abu-Rmeileh NME, Aburuz S, Abu-Zaid A, Accrombessi MMK, Adal TG, Adamu AA, Addo IY, Addolorato G, Adebiyi AO, Adekanmbi V, Adepoju AV, Adetunji CO, Adetunji JB, Adeyeoluwa TE, Adeyinka DA, Adeyomoye OI, Admass BAA, Adnani QES, Adra S, Afolabi AA, Afzal MS, Afzal S, Agampodi SB, Agasthi P, Aggarwal M, Aghamiri S, Agide FD, Agodi A, Agrawal A, Agyemang-Duah W, Ahinkorah BO, Ahmad A, Ahmad D, Ahmad F, Ahmad MM, Ahmad S, Ahmad S, Ahmad T, Ahmadi K, Ahmadzade AM, Ahmed A, Ahmed A, Ahmed H, Ahmed LA, Ahmed MS, Ahmed MS, Ahmed MB, 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K, Deng X, Denova-Gutiérrez E, Deravi N, Dereje N, Dervenis N, Dervišević E, Des Jarlais DC, Desai HD, Desai R, Devanbu VGC, Dewan SMR, Dhali A, Dhama K, Dhimal M, Dhingra S, Dhulipala VR, Dias da Silva D, Diaz D, Diaz MJ, Dima A, Ding DD, Ding H, Dinis-Oliveira RJ, Dirac MA, Djalalinia S, Do THP, do Prado CB, Doaei S, Dodangeh M, Dodangeh M, Dohare S, Dokova KG, Dolecek C, Dominguez RMV, Dong W, Dongarwar D, D'Oria M, Dorostkar F, Dorsey ER, dos Santos WM, Doshi R, Doshmangir L, Dowou RK, Driscoll TR, Dsouza HL, Dsouza V, Du M, Dube J, Duncan BB, Duraes AR, Duraisamy S, Durojaiye OC, Dwyer-Lindgren L, Dzianach PA, Dziedzic AM, E'mar AR, Eboreime E, Ebrahimi A, Echieh CP, Edinur HA, Edvardsson D, Edvardsson K, Efendi D, Efendi F, Effendi DE, Eikemo TA, Eini E, Ekholuenetale M, Ekundayo TC, El Sayed I, Elbarazi I, Elema TB, Elemam NM, Elgar FJ, Elgendy IY, ElGohary GMT, Elhabashy HR, Elhadi M, El-Huneidi W, Elilo LT, Elmeligy OAA, Elmonem MA, Elshaer M, Elsohaby I, Emeto TI, Engelbert 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Ghahramani S, Ghailan KY, Ghasemi MR, Ghasempour Dabaghi G, Ghasemzadeh A, Ghashghaee A, Ghassemi F, Ghazy RM, Ghimire A, Ghoba S, Gholamalizadeh M, Gholamian A, Gholamrezanezhad A, Gholizadeh N, Ghorbani M, Ghorbani Vajargah P, Ghoshal AG, Gill PS, Gill TK, Gillum RF, Ginindza TG, Girmay A, Glasbey JC, Gnedovskaya EV, Göbölös L, Godinho MA, Goel A, Golchin A, Goldust M, Golechha M, Goleij P, Gomes NGM, Gona PN, Gopalani SV, Gorini G, Goudarzi H, Goulart AC, Goulart BNG, Goyal A, Grada A, Graham SM, Grivna M, Grosso G, Guan SY, Guarducci G, Gubari MIM, Gudeta MD, Guha A, Guicciardi S, Guimarães RA, Gulati S, Gunawardane DA, Gunturu S, Guo C, Gupta AK, Gupta B, Gupta MK, Gupta M, Gupta RD, Gupta R, Gupta S, Gupta VB, Gupta VK, Gupta VK, Gurmessa L, Gutiérrez RA, Habibzadeh F, Habibzadeh P, Haddadi R, Hadei M, Hadi NR, Haep N, Hafezi-Nejad N, Hailu A, Haj-Mirzaian A, Halboub ES, Hall BJ, Haller S, Halwani R, Hamadeh RR, Hameed S, Hamidi S, Hamilton EB, Han C, Han Q, Hanif A, Hanifi N, 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A, Lai DTC, Lal DK, Lalloo R, Lallukka T, Lam H, Lám J, Landrum KR, Lanfranchi F, Lang JJ, Langguth B, Lansingh VC, Laplante-Lévesque A, Larijani B, Larsson AO, Lasrado S, Lassi ZS, Latief K, Latifinaibin K, Lauriola P, Le NHH, Le TTT, Le TDT, Ledda C, Ledesma JR, Lee M, Lee PH, Lee SW, Lee SWH, Lee WC, Lee YH, LeGrand KE, Leigh J, Leong E, Lerango TL, Li MC, Li W, Li X, Li Y, Li Z, Ligade VS, Likaka ATM, Lim LL, Lim SS, Lindstrom M, Linehan C, Liu C, Liu G, Liu J, Liu R, Liu S, Liu X, Liu X, Llanaj E, Loftus MJ, López-Bueno R, Lopukhov PD, Loreche AM, Lorkowski S, Lotufo PA, Lozano R, Lubinda J, Lucchetti G, Lugo A, Lunevicius R, Ma ZF, Maass KL, Machairas N, Machoy M, Madadizadeh F, Madsen C, Madureira-Carvalho ÁM, Maghazachi AA, Maharaj SB, Mahjoub S, Mahmoud MA, Mahmoudi A, Mahmoudi E, Mahmoudi R, Majeed A, Makhdoom IF, Malakan Rad E, Maled V, Malekzadeh R, Malhotra AK, Malhotra K, Malik AA, Malik I, Malta DC, Mamun AA, Mansouri P, Mansournia MA, Mantovani LG, Maqsood S, Marasini 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Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:2100-2132. [PMID: 38582094 DOI: 10.1016/s0140-6736(24)00367-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/15/2024] [Accepted: 02/22/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation.
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Global fertility in 204 countries and territories, 1950-2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:2057-2099. [PMID: 38521087 PMCID: PMC11122687 DOI: 10.1016/s0140-6736(24)00550-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/28/2023] [Accepted: 03/15/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Accurate assessments of current and future fertility-including overall trends and changing population age structures across countries and regions-are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to inform policies involving resource and health-care needs, labour supply, education, gender equality, and family planning and support. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 produced up-to-date and comprehensive demographic assessments of key fertility indicators at global, regional, and national levels from 1950 to 2021 and forecast fertility metrics to 2100 based on a reference scenario and key policy-dependent alternative scenarios. METHODS To estimate fertility indicators from 1950 to 2021, mixed-effects regression models and spatiotemporal Gaussian process regression were used to synthesise data from 8709 country-years of vital and sample registrations, 1455 surveys and censuses, and 150 other sources, and to generate age-specific fertility rates (ASFRs) for 5-year age groups from age 10 years to 54 years. ASFRs were summed across age groups to produce estimates of total fertility rate (TFR). Livebirths were calculated by multiplying ASFR and age-specific female population, then summing across ages 10-54 years. To forecast future fertility up to 2100, our Institute for Health Metrics and Evaluation (IHME) forecasting model was based on projections of completed cohort fertility at age 50 years (CCF50; the average number of children born over time to females from a specified birth cohort), which yields more stable and accurate measures of fertility than directly modelling TFR. CCF50 was modelled using an ensemble approach in which three sub-models (with two, three, and four covariates variously consisting of female educational attainment, contraceptive met need, population density in habitable areas, and under-5 mortality) were given equal weights, and analyses were conducted utilising the MR-BRT (meta-regression-Bayesian, regularised, trimmed) tool. To capture time-series trends in CCF50 not explained by these covariates, we used a first-order autoregressive model on the residual term. CCF50 as a proportion of each 5-year ASFR was predicted using a linear mixed-effects model with fixed-effects covariates (female educational attainment and contraceptive met need) and random intercepts for geographical regions. Projected TFRs were then computed for each calendar year as the sum of single-year ASFRs across age groups. The reference forecast is our estimate of the most likely fertility future given the model, past fertility, forecasts of covariates, and historical relationships between covariates and fertility. We additionally produced forecasts for multiple alternative scenarios in each location: the UN Sustainable Development Goal (SDG) for education is achieved by 2030; the contraceptive met need SDG is achieved by 2030; pro-natal policies are enacted to create supportive environments for those who give birth; and the previous three scenarios combined. Uncertainty from past data inputs and model estimation was propagated throughout analyses by taking 1000 draws for past and present fertility estimates and 500 draws for future forecasts from the estimated distribution for each metric, with 95% uncertainty intervals (UIs) given as the 2·5 and 97·5 percentiles of the draws. To evaluate the forecasting performance of our model and others, we computed skill values-a metric assessing gain in forecasting accuracy-by comparing predicted versus observed ASFRs from the past 15 years (2007-21). A positive skill metric indicates that the model being evaluated performs better than the baseline model (here, a simplified model holding 2007 values constant in the future), and a negative metric indicates that the evaluated model performs worse than baseline. FINDINGS During the period from 1950 to 2021, global TFR more than halved, from 4·84 (95% UI 4·63-5·06) to 2·23 (2·09-2·38). Global annual livebirths peaked in 2016 at 142 million (95% UI 137-147), declining to 129 million (121-138) in 2021. Fertility rates declined in all countries and territories since 1950, with TFR remaining above 2·1-canonically considered replacement-level fertility-in 94 (46·1%) countries and territories in 2021. This included 44 of 46 countries in sub-Saharan Africa, which was the super-region with the largest share of livebirths in 2021 (29·2% [28·7-29·6]). 47 countries and territories in which lowest estimated fertility between 1950 and 2021 was below replacement experienced one or more subsequent years with higher fertility; only three of these locations rebounded above replacement levels. Future fertility rates were projected to continue to decline worldwide, reaching a global TFR of 1·83 (1·59-2·08) in 2050 and 1·59 (1·25-1·96) in 2100 under the reference scenario. The number of countries and territories with fertility rates remaining above replacement was forecast to be 49 (24·0%) in 2050 and only six (2·9%) in 2100, with three of these six countries included in the 2021 World Bank-defined low-income group, all located in the GBD super-region of sub-Saharan Africa. The proportion of livebirths occurring in sub-Saharan Africa was forecast to increase to more than half of the world's livebirths in 2100, to 41·3% (39·6-43·1) in 2050 and 54·3% (47·1-59·5) in 2100. The share of livebirths was projected to decline between 2021 and 2100 in most of the six other super-regions-decreasing, for example, in south Asia from 24·8% (23·7-25·8) in 2021 to 16·7% (14·3-19·1) in 2050 and 7·1% (4·4-10·1) in 2100-but was forecast to increase modestly in the north Africa and Middle East and high-income super-regions. Forecast estimates for the alternative combined scenario suggest that meeting SDG targets for education and contraceptive met need, as well as implementing pro-natal policies, would result in global TFRs of 1·65 (1·40-1·92) in 2050 and 1·62 (1·35-1·95) in 2100. The forecasting skill metric values for the IHME model were positive across all age groups, indicating that the model is better than the constant prediction. INTERPRETATION Fertility is declining globally, with rates in more than half of all countries and territories in 2021 below replacement level. Trends since 2000 show considerable heterogeneity in the steepness of declines, and only a small number of countries experienced even a slight fertility rebound after their lowest observed rate, with none reaching replacement level. Additionally, the distribution of livebirths across the globe is shifting, with a greater proportion occurring in the lowest-income countries. Future fertility rates will continue to decline worldwide and will remain low even under successful implementation of pro-natal policies. These changes will have far-reaching economic and societal consequences due to ageing populations and declining workforces in higher-income countries, combined with an increasing share of livebirths among the already poorest regions of the world. FUNDING Bill & Melinda Gates Foundation.
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Yehualashet SS, Yesuf SA, Yezli S, Yiğit A, Yiğit V, Yigzaw ZA, Yismaw Y, Yon DK, Yonemoto N, Younis MZ, Yu C, Yu Y, Yusuf H, Zahid MH, Zakham F, Zaki L, Zaki N, Zaman BA, Zamora N, Zand R, Zandieh GGZ, Zar HJ, Zarrintan A, Zastrozhin MS, Zhang H, Zhang N, Zhang Y, Zhao H, Zhong C, Zhong P, Zhou J, Zhu Z, Ziafati M, Zielińska M, Zimsen SRM, Zoladl M, Zumla A, Zyoud SH, Vos T, Murray CJL. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:2133-2161. [PMID: 38642570 PMCID: PMC11122111 DOI: 10.1016/s0140-6736(24)00757-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/07/2024] [Accepted: 04/12/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. METHODS The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. FINDINGS Global DALYs increased from 2·63 billion (95% UI 2·44-2·85) in 2010 to 2·88 billion (2·64-3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7-17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8-6·3) in 2020 and 7·2% (4·7-10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0-234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7-198·3]), neonatal disorders (186·3 million [162·3-214·9]), and stroke (160·4 million [148·0-171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3-51·7) and for diarrhoeal diseases decreased by 47·0% (39·9-52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54-1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5-9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0-19·8]), depressive disorders (16·4% [11·9-21·3]), and diabetes (14·0% [10·0-17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7-27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6-63·6) in 2010 to 62·2 years (59·4-64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6-2·9) between 2019 and 2021. INTERPRETATION Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. FUNDING Bill & Melinda Gates Foundation.
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Solaimanian S, Solanki R, Solanki S, Soliman SSM, Somayaji R, Song Y, Sorensen RJD, Soriano JB, Soyiri IN, Spartalis M, Spearman S, Spencer CN, Sreeramareddy CT, Stachteas P, Stafford LK, Stanaway JD, Stanikzai MH, Stein C, Stein DJ, Steinbeis F, Steiner C, Steinke S, Steiropoulos P, Stockfelt L, Stokes MA, Straif K, Stranges S, Subedi N, Subramaniyan V, Suleman M, Suliankatchi Abdulkader R, Sundström J, Sunkersing D, Sunnerhagen KS, Suresh V, Swain CK, Szarpak L, Szeto MD, Tabaee Damavandi P, Tabarés-Seisdedos R, Tabatabaei SM, Tabatabaei Malazy O, Tabatabaeizadeh SA, Tabatabai S, Tabche C, Tabish M, Tadakamadla SK, Taheri Abkenar Y, Taheri Soodejani M, Taherkhani A, Taiba J, Takahashi K, Talaat IM, Tamuzi JL, Tan KK, Tang H, Tat NY, Taveira N, Tefera YM, Tehrani-Banihashemi A, Temesgen WA, Temsah MH, Teramoto M, Terefa DR, Teye-Kwadjo E, Thakur R, Thangaraju P, Thankappan KR, Thapar R, Thayakaran R, Thirunavukkarasu S, Thomas N, Thomas NK, Tian J, Tichopad A, Ticoalu JHV, Tiruye TY, Tobe-Gai R, Tolani MA, Tolossa T, Tonelli M, Topor-Madry R, Topouzis F, Touvier M, Tovani-Palone MR, Trabelsi K, Tran JT, Tran MTN, Tran NM, Trico D, Trihandini I, Troeger CE, Tromans SJ, Truyen TTTT, Tsatsakis A, Tsermpini EE, Tumurkhuu M, Udoakang AJ, Udoh A, Ullah A, Ullah S, Ullah S, Umair M, Umakanthan S, Unim B, Unnikrishnan B, Upadhyay E, Urso D, Usman JS, Vaithinathan AG, Vakili O, Valenti M, Valizadeh R, Van den Eynde J, van Donkelaar A, Varga O, Vart P, Varthya SB, Vasankari TJ, Vasic M, Vaziri S, Venketasubramanian N, Verghese NA, Verma M, Veroux M, Verras GI, Vervoort D, Villafañe JH, Villalobos-Daniel VE, Villani L, Villanueva GI, Vinayak M, Violante FS, Vlassov V, Vo B, Vollset SE, Volovat SR, Vos T, Vujcic IS, Waheed Y, Wang C, Wang F, Wang S, Wang Y, Wang YP, Wanjau MN, Waqas M, Ward P, Waris A, Wassie EG, Weerakoon KG, Weintraub RG, Weiss DJ, Weiss EJ, Weldetinsaa HLL, Wells KM, Wen YF, Wiangkham T, Wickramasinghe ND, Wilkerson C, Willeit P, Wilson S, Wong YJ, Wongsin U, Wozniak S, Wu C, Wu D, Wu F, Wu Z, Xia J, Xiao H, Xu S, Xu X, Xu YY, Yadav MK, Yaghoubi S, Yamagishi K, Yang L, Yano Y, Yaribeygi H, Yasufuku Y, Ye P, Yesodharan R, Yesuf SA, Yezli S, Yi S, Yiğit A, Yigzaw ZA, Yin D, Yip P, Yismaw MB, Yon DK, Yonemoto N, You Y, Younis MZ, Yousefi Z, Yu C, Yu Y, Zadey S, Zadnik V, Zakham F, Zaki N, Zakzuk J, Zamagni G, Zaman SB, Zandieh GGZ, Zanghì A, Zar HJ, Zare I, Zarimeidani F, Zastrozhin MS, Zeng Y, Zhai C, Zhang AL, Zhang H, Zhang L, Zhang M, Zhang Y, Zhang Z, Zhang ZJ, Zhao H, Zhao JT, Zhao XJG, Zhao Y, Zhao Y, Zhong C, Zhou J, Zhou J, Zhou S, Zhu B, Zhu L, Zhu Z, Ziaeian B, Ziafati M, Zielińska M, Zimsen SRM, Zoghi G, Zoller T, Zumla A, Zyoud SH, Zyoud SH, Murray CJL, Gakidou E. Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:2162-2203. [PMID: 38762324 DOI: 10.1016/s0140-6736(24)00933-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/11/2024] [Accepted: 05/02/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. METHODS The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk-outcome pairs. Pairs were included on the basis of data-driven determination of a risk-outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk-outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk-outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. FINDINGS Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7-9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4-9·2]), smoking (5·7% [4·7-6·8]), low birthweight and short gestation (5·6% [4·8-6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8-6·0]). For younger demographics (ie, those aged 0-4 years and 5-14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9-27·7]) and environmental and occupational risks (decrease of 22·0% [15·5-28·8]), coupled with a 49·4% (42·3-56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9-21·7] for high BMI and 7·9% [3·3-12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6-1·9) for high BMI and 1·3% (1·1-1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4-78·8) for child growth failure and 66·3% (60·2-72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). INTERPRETATION Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions. FUNDING Bill & Melinda Gates Foundation.
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N, Zakzuk J, Zamagni G, Zaman BA, Zaman SB, Zamora N, Zand R, Zandi M, Zandieh GGZ, Zanghì A, Zare I, Zastrozhin MS, Zeariya MGM, Zeng Y, Zhai C, Zhang C, Zhang H, Zhang H, Zhang Y, Zhang Z, Zhang Z, Zhao H, Zhao Y, Zhao Y, Zheng P, Zhong C, Zhou J, Zhu B, Zhu Z, Ziaeefar P, Zielińska M, Zou Z, Zumla A, Zweck E, Zyoud SH, Lim SS, Murray CJL. Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950-2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:1989-2056. [PMID: 38484753 DOI: 10.1016/s0140-6736(24)00476-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/08/2023] [Accepted: 03/06/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020-21 COVID-19 pandemic period. METHODS 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. FINDINGS Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5-65·1] decline), and increased during the COVID-19 pandemic period (2020-21; 5·1% [0·9-9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98-5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50-6·01) in 2019. An estimated 131 million (126-137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7-17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8-24·8), from 49·0 years (46·7-51·3) to 71·7 years (70·9-72·5). Global life expectancy at birth declined by 1·6 years (1·0-2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67-8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4-52·7]) and south Asia (26·3% [9·0-44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. INTERPRETATION Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. FUNDING Bill & Melinda Gates Foundation.
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Catalá-López F, Catapano AL, Caye A, Cegolon L, Cenderadewi M, Cerin E, Chacón-Uscamaita PRU, Chan JSK, Chanie GS, Charan J, Chattu VK, Chekol Abebe E, Chen H, Chen J, Chi G, Chichagi F, Chidambaram SB, Chimoriya R, Ching PR, Chitheer A, Chong YY, Chopra H, Choudhari SG, Chowdhury EK, Chowdhury R, Christensen H, Chu DT, Chukwu IS, Chung E, Coberly K, Columbus A, Comachio J, Conde J, Cortesi PA, Costa VM, Couto RAS, Criqui MH, Cruz-Martins N, Dabbagh Ohadi MA, Dadana S, Dadras O, Dai X, Dai Z, D'Amico E, Danawi HA, Dandona L, Dandona R, Darwish AH, Das S, Das S, Dascalu AM, Dash NR, Dashti M, De la Hoz FP, de la Torre-Luque A, De Leo D, Dean FE, Dehghan A, Dehghan A, Dejene H, Demant D, Demetriades AK, Demissie S, Deng X, Desai HD, Devanbu VGC, Dhama K, Dharmaratne SD, Dhimal M, Dias da Silva D, Diaz D, Dibas M, Ding DD, Dinu M, Dirac MA, Diress M, Do TC, Do THP, Doan KDK, Dodangeh M, Doheim MF, Dokova KG, Dongarwar D, Dsouza HL, Dube J, Duraisamy S, Durojaiye OC, Dutta S, Dziedzic AM, 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CCD, Iyer M, Jaan A, Jacob L, Jadidi-Niaragh F, Jafari M, Jafarinia M, Jafarzadeh A, Jahankhani K, Jahanmehr N, Jahrami H, Jaiswal A, Jakovljevic M, Jamora RDG, Jana S, Javadi N, Javed S, Javeed S, Jayapal SK, Jayaram S, Jiang H, Johnson CO, Johnson WD, Jokar M, Jonas JB, Joseph A, Joseph N, Joshua CE, Jürisson M, Kabir A, Kabir Z, Kabito GG, Kadashetti V, Kafi F, Kalani R, Kalantar F, Kaliyadan F, Kamath A, Kamath S, Kanchan T, Kandel A, Kandel H, Kanmodi KK, Karajizadeh M, Karami J, Karanth SD, Karaye IM, Karch A, Karimi A, Karimi H, Karimi Behnagh A, Kasraei H, Kassebaum NJ, Kauppila JH, Kaur H, Kaur N, Kayode GA, Kazemi F, Keikavoosi-Arani L, Keller C, Keykhaei M, Khadembashiri MA, Khader YS, Khafaie MA, Khajuria H, Khalaji A, Khamesipour F, Khammarnia M, Khan M, Khan MAB, Khan YH, Khan Suheb MZ, Khanmohammadi S, Khanna T, Khatab K, Khatatbeh H, Khatatbeh MM, Khateri S, Khatib MN, Khayat Kashani HR, Khonji MS, khorashadizadeh F, Khormali M, Khubchandani J, Kian S, Kim G, Kim J, Kim MS, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Kivimäki M, Kochhar S, Kolahi AA, Koly KN, Kompani F, Koroshetz WJ, Kosen S, Kourosh Arami M, Koyanagi A, Kravchenko MA, Krishan K, Krishnamoorthy V, Kuate Defo B, Kuddus MA, Kumar A, Kumar GA, Kumar M, Kumar N, Kumsa NB, Kundu S, Kurniasari MD, Kusuma D, Kuttikkattu A, Kyu HH, La Vecchia C, Ladan MA, Lahariya C, Laksono T, Lal DK, Lallukka T, Lám J, Lami FH, Landires I, Langguth B, Lasrado S, Latief K, Latifinaibin K, Lau KMM, Laurens MB, Lawal BK, Le LKD, Le TTT, Ledda C, Lee M, Lee SW, Lee SW, Lee WC, Lee YH, Leonardi M, Lerango TL, Li MC, Li W, Ligade VS, Lim SS, Linehan C, Liu C, Liu J, Liu W, Lo CH, Lo WD, Lobo SW, Logroscino G, Lopes G, Lopukhov PD, Lorenzovici L, Lorkowski S, Loureiro JA, Lubinda J, Lucchetti G, Lutzky Saute R, Ma ZF, Mabrok M, Machoy M, Madadizadeh F, Magdy Abd El Razek M, Maghazachi AA, Maghbouli N, Mahjoub S, Mahmoudi M, Majeed A, Malagón-Rojas JN, Malakan Rad E, Malhotra K, Malik AA, Malik I, Mallhi TH, Malta DC, Manilal A, Mansouri V, Mansournia MA, Marasini BP, Marateb HR, Maroufi SF, Martinez-Raga J, Martini S, Martins-Melo FR, Martorell M, März W, Marzo RR, Massano J, Mathangasinghe Y, Mathews E, Maude RJ, Maugeri A, Maulik PK, Mayeli M, Mazaheri M, McAlinden C, McGrath JJ, Meena JK, Mehndiratta MM, Mendez-Lopez MAM, Mendoza W, Mendoza-Cano O, Menezes RG, Merati M, Meretoja A, Merkin A, Mersha AM, Mestrovic T, Mi T, Miazgowski T, Michalek IM, Mihretie ET, Minh LHN, Mirfakhraie R, Mirica A, Mirrakhimov EM, Mirzaei M, Misganaw A, Misra S, Mithra P, Mizana BA, Mohamadkhani A, Mohamed NS, Mohammadi E, Mohammadi H, Mohammadi S, Mohammadi S, Mohammadshahi M, Mohammed M, Mohammed S, Mohammed S, Mohan S, Mojiri-forushani H, Moka N, Mokdad AH, Molinaro S, Möller H, Monasta L, Moniruzzaman M, Montazeri F, Moradi M, Moradi Y, Moradi-Lakeh M, Moraga P, Morovatdar N, Morrison SD, Mosapour A, Mosser JF, Mossialos E, Motaghinejad M, Mousavi P, Mousavi SE, Mubarik S, Muccioli L, Mughal F, Mukoro GD, Mulita A, Mulita F, Musaigwa F, Mustafa A, Mustafa G, Muthu S, Nagarajan AJ, Naghavi P, Naik GR, Nainu F, Nair TS, Najmuldeen HHR, Nakhostin Ansari N, Nambi G, Namdar Areshtanab H, Nargus S, Nascimento BR, Naser AY, Nashwan AJJ, Nasoori H, Nasreldein A, Natto ZS, Nauman J, Nayak BP, Nazri-Panjaki A, Negaresh M, Negash H, Negoi I, Negoi RI, Negru SM, Nejadghaderi SA, Nematollahi MH, Nesbit OD, Newton CRJ, Nguyen DH, Nguyen HTH, Nguyen HQ, Nguyen NTT, Nguyen PT, Nguyen VT, Niazi RK, Nikolouzakis TK, Niranjan V, Nnyanzi LA, Noman EA, Noroozi N, Norrving B, Noubiap JJ, Nri-Ezedi CA, Ntaios G, Nuñez-Samudio V, Nurrika D, Oancea B, Odetokun IA, O'Donnell MJ, Ogunsakin RE, Oguta JO, Oh IH, Okati-Aliabad H, Okeke SR, Okekunle AP, Okonji OC, Okwute PG, Olagunju AT, Olaiya MT, Olana MD, Olatubi MI, Oliveira GMM, Olufadewa II, Olusanya BO, Omar Bali A, Ong S, Onwujekwe OE, Ordak M, Orji AU, Ortega-Altamirano DV, Osuagwu UL, Otstavnov N, Otstavnov SS, Ouyahia A, Owolabi MO, P A MP, Pacheco-Barrios K, Padubidri JR, Pal PK, Palange PN, Palladino C, Palladino R, Palma-Alvarez RF, Pan F, Panagiotakos D, Panda-Jonas S, Pandey A, Pandey A, Pandian JD, Pangaribuan HU, Pantazopoulos I, Pardhan S, Parija PP, Parikh RR, Park S, Parthasarathi A, Pashaei A, Patel J, Patil S, Patoulias D, Pawar S, Pedersini P, Pensato U, Pereira DM, Pereira J, Pereira MO, Peres MFP, Perico N, Perna S, Petcu IR, Petermann-Rocha FE, Pham HT, Phillips MR, Pinilla-Monsalve GD, Piradov MA, Plotnikov E, Poddighe D, Polat B, Poluru R, Pond CD, Poudel GR, Pouramini A, Pourbagher-Shahri AM, Pourfridoni M, Pourtaheri N, Prakash PY, Prakash S, Prakash V, Prates EJS, Pritchett N, Purnobasuki H, Qasim NH, Qattea I, Qian G, Radhakrishnan V, Raee P, Raeisi Shahraki H, Rafique I, Raggi A, Raghav PR, Rahati MM, Rahim F, Rahimi Z, Rahimifard M, Rahman MO, Rahman MHU, Rahman M, Rahman MA, Rahmani AM, Rahmani S, Rahmani Youshanlouei H, Rahmati M, Raj Moolambally S, Rajabpour-Sanati A, Ramadan H, Ramasamy SK, Ramasubramani P, Ramazanu S, Rancic N, Rao IR, Rao SJ, Rapaka D, Rashedi V, Rashid AM, Rashidi MM, Rashidi Alavijeh M, Rasouli-Saravani A, Rawaf S, Razo C, Redwan EMM, Rekabi Bana A, Remuzzi G, Rezaei N, Rezaei N, Rezaei N, Rezaeian M, Rhee TG, Riad A, Robinson SR, Rodrigues M, Rodriguez JAB, Roever L, Rogowski ELB, Romoli M, Ronfani L, Roy P, Roy Pramanik K, Rubagotti E, Ruiz MA, Russ TC, S Sunnerhagen K, Saad AMA, Saadatian Z, Saber K, SaberiKamarposhti M, Sacco S, Saddik B, Sadeghi E, Sadeghian S, Saeed U, Saeed U, Safdarian M, Safi SZ, Sagar R, Sagoe D, Saheb Sharif-Askari F, Saheb Sharif-Askari N, Sahebkar A, Sahoo SS, Sahraian MA, Sajedi SA, Sakshaug JW, Saleh MA, Salehi Omran H, Salem MR, Salimi S, Samadi Kafil H, Samadzadeh S, Samargandy S, Samodra YL, Samuel VP, Samy AM, Sanadgol N, Sanjeev RK, Sanmarchi F, Santomauro DF, Santri IN, Santric-Milicevic MM, Saravanan A, Sarveazad A, Satpathy M, Saylan M, Sayyah M, Scarmeas N, Schlaich MP, Schuermans A, Schwarzinger M, Schwebel DC, Selvaraj S, Sendekie AK, Sengupta P, Senthilkumaran S, Serban D, Sergindo MT, Sethi Y, SeyedAlinaghi S, Seylani A, Shabani M, Shabany M, Shafie M, Shahabi S, Shahbandi A, Shahid S, Shahraki-Sanavi F, Shahsavari HR, Shahwan MJ, Shaikh MA, Shaji KS, Sham S, Shama ATT, Shamim MA, Shams-Beyranvand M, Shamsi MA, Shanawaz M, Sharath M, Sharfaei S, Sharifan A, Sharma M, Sharma R, Shashamo BB, Shayan M, Sheikhi RA, Shekhar S, Shen J, Shenoy SM, Shetty PH, Shiferaw DS, Shigematsu M, Shiri R, Shittu A, Shivakumar KM, Shokri F, Shool S, Shorofi SA, Shrestha S, Siankam Tankwanchi AB, Siddig EE, Sigfusdottir ID, Silva JP, Silva LMLR, Sinaei E, Singh BB, Singh G, Singh P, Singh S, Sirota SB, Sivakumar S, Sohag AAM, Solanki R, Soleimani H, Solikhah S, Solomon Y, Solomon Y, Song S, Song Y, Sotoudeh H, Spartalis M, Stark BA, Starnes JR, Starodubova AV, Stein DJ, Steiner TJ, Stovner LJ, Suleman M, Suliankatchi Abdulkader R, Sultana A, Sun J, Sunkersing D, Sunny A, Susianti H, Swain CK, Szeto MD, Tabarés-Seisdedos R, Tabatabaei SM, Tabatabai S, Tabish M, Taheri M, Tahvildari A, Tajbakhsh A, Tampa M, Tamuzi JJLL, Tan KK, Tang H, Tareke M, Tarigan IU, Tat NY, Tat VY, Tavakoli Oliaee R, Tavangar SM, Tavasol A, Tefera YM, Tehrani-Banihashemi A, Temesgen WA, Temsah MH, Teramoto M, Tesfaye AH, Tesfaye EG, Tesler R, Thakali O, Thangaraju P, Thapa R, Thapar R, Thomas NK, Thrift AG, Ticoalu JHV, Tillawi T, Toghroli R, Tonelli M, Tovani-Palone MR, Traini E, Tran NM, Tran NH, Tran PV, Tromans SJ, Truelsen TC, Truyen TTTT, Tsatsakis A, Tsegay GM, Tsermpini EE, Tualeka AR, Tufa DG, Ubah CS, Udoakang AJ, Ulhaq I, Umair M, Umakanthan S, Umapathi KK, Unim B, Unnikrishnan B, Vaithinathan AG, Vakilian A, Valadan Tahbaz S, Valizadeh R, Van den Eynde J, Vart P, Varthya SB, Vasankari TJ, Vaziri S, Vellingiri B, Venketasubramanian N, Verras GI, Vervoort D, Villafañe JH, Villani L, Vinueza Veloz AF, Viskadourou M, Vladimirov SK, Vlassov V, Volovat SR, Vu LT, Vujcic IS, Wagaye B, Waheed Y, Wahood W, Walde MT, Wang F, Wang S, Wang Y, Wang YP, Waqas M, Waris A, Weerakoon KG, Weintraub RG, Weldemariam AH, Westerman R, Whisnant JL, Wickramasinghe DP, Wickramasinghe ND, Willekens B, Wilner LB, Winkler AS, Wolfe CDA, Wu AM, Wulf Hanson S, Xu S, Xu X, Yadollahpour A, Yaghoubi S, Yahya G, Yamagishi K, Yang L, Yano Y, Yao Y, Yehualashet SS, Yeshaneh A, Yesiltepe M, Yi S, Yiğit A, Yiğit V, Yon DK, Yonemoto N, You Y, Younis MZ, Yu C, Yusuf H, Zadey S, Zahedi M, Zakham F, Zaki N, Zali A, Zamagni G, Zand R, Zandieh GGZ, Zangiabadian M, Zarghami A, Zastrozhin MS, Zeariya MGM, Zegeye ZB, Zeukeng F, Zhai C, Zhang C, Zhang H, Zhang Y, Zhang ZJ, Zhao H, Zhao Y, Zheng P, Zhou H, Zhu B, Zhumagaliuly A, Zielińska M, Zikarg YT, Zoladl M, Murray CJL, Ong KL, Feigin VL, Vos T, Dua T. Global, regional, and national burden of disorders affecting the nervous system, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Neurol 2024; 23:344-381. [PMID: 38493795 PMCID: PMC10949203 DOI: 10.1016/s1474-4422(24)00038-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. METHODS We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. FINDINGS Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378-521), affecting 3·40 billion (3·20-3·62) individuals (43·1%, 40·5-45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7-26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6-38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5-32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7-2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. INTERPRETATION As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed. FUNDING Bill & Melinda Gates Foundation.
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Kaur B, Kaur R, Vivesh, Rani S, Bhatti R, Singh P. Small Peptides Targeting BACE-1, AChE, and A-β Reversing Scopolamine-Induced Memory Impairment: A Multitarget Approach against Alzheimer's Disease. ACS Omega 2024; 9:12896-12913. [PMID: 38524457 PMCID: PMC10955571 DOI: 10.1021/acsomega.3c09069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/04/2024] [Accepted: 01/11/2024] [Indexed: 03/26/2024]
Abstract
Based on the biochemical understanding of Alzheimer's disease, here, we report the design, synthesis, and biological screening of a series of compounds against this neuro-disorder. Adopting the multitarget approach, the catalytic processes of BACE-1 and AChE were targeted, and thereby, compounds 15, 22, 25, 26, 27, and 30 were identified with IC50 in the submicromolar range against these two enzymes. Further, compounds 15 and 25 displayed more than 50% inhibition of β-amyloid aggregation. Implying their physiological use, the compounds exhibited appreciable biological membrane permeability as observed through the parallel artificial membrane permeability experiment. Supporting these results, treatment of the mice with the test compounds reversed their scopolamine-affected memory impairment, where the highest healing effect was seen in the case of compound 25. Overall, the combination of molecular modeling and experimental studies provided highly effective molecules against Alzheimer's disease.
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Affiliation(s)
- Baljit Kaur
- Department
of Chemistry, Guru Nanak Dev University, Amritsar 143005, India
| | - Rajbir Kaur
- Department
of Chemistry, Guru Nanak Dev University, Amritsar 143005, India
| | - Vivesh
- Department
of Chemistry, Guru Nanak Dev University, Amritsar 143005, India
| | - Sudesh Rani
- Department
of Chemistry, Guru Nanak Dev University, Amritsar 143005, India
| | - Rajbir Bhatti
- Department
of Pharmaceutical Sciences, Guru Nanak Dev
University, Amritsar 143005, India
| | - Palwinder Singh
- Department
of Chemistry, Guru Nanak Dev University, Amritsar 143005, India
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Singh L, Bhatti R. Signaling Pathways Involved in the Neuroprotective Effect of Osthole: Evidence and Mechanisms. Mol Neurobiol 2024; 61:1100-1118. [PMID: 37682453 DOI: 10.1007/s12035-023-03580-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/14/2023] [Indexed: 09/09/2023]
Abstract
Neurodegenerative diseases constitute a major threat to human health and are usually accompanied by progressive structural and functional loss of neurons. Abnormalities in synaptic plasticity are involved in neurodegenerative disorders. Aberrant cell signaling cascades play a predominant role in the initiation, progress as well as in the severity of these ailments. Notch signaling is a pivotal role in the maintenance of neural stem cells and also participates in neurogenesis. PI3k/Akt cascade regulates different biological processes including cell proliferation, apoptosis, and metabolism. It regulates neurotoxicity and mediates the survival of neurons. Moreover, the activated BDNF/TrkB cascade is involved in promoting the transcription of genes responsible for cell survival and neurogenesis. Despite significant progress made in delineating the underlying pathological mechanisms involved and derangements in cellular metabolic promenades implicated in these diseases, satisfactory strategies for the clinical management of these ailments are yet to be achieved. Therefore, the molecules targeting these cell signaling cascades may emerge as useful leads in developing newer management strategies. Osthole is an important ingredient of traditional Chinese medicinal plants, often found in various plants of the Apiaceae family and has been observed to target these aforementioned mediators. Until now, no review has been aimed to discuss the possible molecular signaling cascades involved in osthole-mediated neuroprotection at one platform. The current review aimed to explore the interplay of various mediators and the modulation of the different molecular signaling cascades in osthole-mediated neuroprotection. This review could open new insights into research involving diseases of neuronal origin, especially the effect on neurodegeneration, neurogenesis, and synaptic plasticity. The articles gathered to compose the current review were extracted by using the PubMed, Scopus, Science Direct, and Web of Science databases. A methodical approach was used to integrate and discuss all published original reports describing the modulation of different mediators by osthole to confer neuroprotection at one platform to provide possible molecular pathways. Based on the inclusion and exclusion criteria, 32 articles were included in the systematic review. Moreover, literature evidence was also used to construct the biosynthetic pathway of osthole. The current review reveals that osthole promotes neurogenesis and neuronal functioning via stimulation of Notch, BDNF/Trk, and P13k/Akt signaling pathways. It upregulates the expression of various proteins, such as BDNF, TrkB, CREB, Nrf-2, P13k, and Akt. Activation of Wnt by osthole, in turn, regulates downstream GSK-1β to inhibit tau phosphorylation and β-catenin degradation to prevent neuronal apoptosis. The activation of Wnt and inhibition of oxidative stress, Aβ, and GSK-3β mediated β-catenin degradation by osthole might also be involved in mediating the protection against neurodegenerative diseases. Furthermore, it also inhibits neuroinflammation by suppressing MAPK/NF-κB-mediated transcription of genes involved in the generation of inflammatory cytokines and NLRP-3 inflammasomes. This review delineates the various underlying signaling pathways involved in mediating the neuroprotective effect of osthole. Modulation of Notch, BDNF/Trk, MAPK/NF-κB, and P13k/Akt signaling pathways by osthole confers protection against neurodegenerative diseases. The preclinical effects of osthole suggest that it could be a valuable molecule in inspiring the development of new drugs for the management of neurodegenerative diseases and demands clinical studies to explore its potential. An effort has been made to unify the varied mechanisms and target sites involved in the neuroprotective effect of osthole. The comprehensive description of the molecular pathways in the present work reflects its originality and thoroughness. The reviewed literature findings may be extrapolated to suggest the role of othole as a "biological response modifier" which contributes to neuroprotection through kinase modulatory, immunomodulatory, and anti-oxidative activity, which is documented even at lower doses. The current review attempts to emphasize the gaps in the existing literature which can be explored in the future.
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Affiliation(s)
- Lovedeep Singh
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, 143005, Punjab, India.
- University Institute of Pharma Sciences, Chandigarh University, Mohali, 140413, Punjab, India.
| | - Rajbir Bhatti
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, 143005, Punjab, India.
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Singh L, Kaur H, Chandra Arya G, Bhatti R. Neuroprotective potential of formononetin, a naturally occurring isoflavone phytoestrogen. Chem Biol Drug Des 2024; 103:e14353. [PMID: 37722967 DOI: 10.1111/cbdd.14353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/17/2023] [Accepted: 09/04/2023] [Indexed: 09/20/2023]
Abstract
The increased prevalence of neurological illnesses is a burgeoning challenge to the public healthcare system and presents greater financial pressure. Formononetin, an O-methylated isoflavone, has gained a lot of attention due to its neuroprotective potential explored in several investigations. Formononetin is widely found in legumes and several types of clovers including Trifolium pratense L., Astragalus membranaceus, Sophora tomentosa, etc. Formononetin modulates various endogenous mediators to confer neuroprotection. It prevents RAGE activation that results in the inhibition of neuronal damage via downregulating the level of ROS and proinflammatory cytokines. Furthermore, formononetin also increases the expression of ADAM-10, which affects the pathology of neurodegenerative disease by lowering tau phosphorylation, maintaining synaptic plasticity, and boosting hippocampus neurogenesis. Besides these, formononetin also increases the expression of antioxidants, Nrf-2, PI3K, ApoJ, and LRP1. Whereas, reduces the expression of p65-NF-κB and proinflammatory cytokines. It also inhibits the deposition of Aβ and MAO-B activity. An inhibition of Aβ/RAGE-induced activation of MAPK and NOX governs the protection elicited by formononetin against inflammatory and oxidative stress-induced neuronal damage. Besides this, PI3K/Akt and ER-α-mediated activation of ADAM10, ApoJ/LRP1-mediated clearance of Aβ, and MAO-B inhibition-mediated preservation of dopaminergic neurons integrity are the major modulations produced by formononetin. This review covers the biosynthesis of formononetin and key molecular pathways modulated by formononetin to confer neuroprotection.
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Affiliation(s)
- Lovedeep Singh
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
- University Institute of Pharma Sciences, Chandigarh University, Mohali, India
| | - Harpreet Kaur
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
| | - Girish Chandra Arya
- University Institute of Pharma Sciences, Chandigarh University, Mohali, India
| | - Rajbir Bhatti
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
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Gill TK, Mittinty MM, March LM, Steinmetz JD, Culbreth GT, Cross M, Kopec JA, Woolf AD, Haile LM, Hagins H, Ong KL, Kopansky-Giles DR, Dreinhoefer KE, Betteridge N, Abbasian M, Abbasifard M, Abedi K, Adesina MA, Aithala JP, Akbarzadeh-Khiavi M, Al Thaher Y, Alalwan TA, Alzahrani H, Amiri S, Antony B, Arabloo J, Aravkin AY, Arumugam A, Aryal KK, Athari SS, Atreya A, Baghdadi S, Bardhan M, Barrero LH, Bearne LM, Bekele AB, Bensenor IM, Bhardwaj P, Bhatti R, Bijani A, Bordianu T, Bouaoud S, Briggs AM, Cheema HA, Christensen SWM, Chukwu IS, Clarsen B, Dai X, de Luca K, Desye B, Dhimal M, Do TC, Fagbamigbe AF, Farokh Forghani S, Ferreira N, Ganesan B, Gebrehiwot M, Ghashghaee A, Graham SM, Harlianto NI, Hartvigsen J, Hasaballah AI, Hasanian M, Hassen MB, Hay SI, Heidari M, Hsiao AK, Ilic IM, Jokar M, Khajuria H, Khan MJ, Khanal P, Khateri S, Kiadaliri A, Kim MS, Kisa A, Kolahi AA, Krishan K, Krishnamoorthy V, Landires I, Larijani B, Le TTT, Lee YH, Lim SS, Lo J, Madani SP, Malagón-Rojas JN, Malik I, Marateb HR, Mathew AJ, Meretoja TJ, Mesregah MK, Mestrovic T, Mirahmadi A, Misganaw A, Mohaghegh S, Mokdad AH, Momenzadeh K, Momtazmanesh S, Monasta L, Moni MA, Moradi Y, Mostafavi E, Muhammad JS, Murray CJL, Muthu S, Nargus S, Nassereldine H, Neupane S, Niazi RK, Oh IH, Okati-Aliabad H, Oulhaj A, Pacheco-Barrios K, Park S, Patel J, Pawar S, Pedersini P, Peres MFP, Petcu IR, Petermann-Rocha FE, Poursadeqiyan M, Qattea I, Qureshi MF, Rafferty Q, Rahimi-Dehgolan S, Rahman M, Ramasamy SK, Rashedi V, Redwan EMM, Ribeiro DC, Roever L, Safary A, Sagoe D, Saheb Sharif-Askari F, Sahebkar A, Salehi S, Shafaat A, Shahabi S, Sharma S, Shashamo BB, Shiri R, Singh A, Slater H, Smith AE, Sunuwar DR, Tabish M, Tharwat S, Ullah I, Valadan Tahbaz S, Vasankari TJ, Villafañe JH, Vollset SE, Wiangkham T, Yonemoto N, You Y, Zare I, Zheng P, Vos T, Brooks PM. Global, regional, and national burden of other musculoskeletal disorders, 1990-2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol 2023; 5:e670-e682. [PMID: 37927903 PMCID: PMC10620749 DOI: 10.1016/s2665-9913(23)00232-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Background Musculoskeletal disorders include more than 150 different conditions affecting joints, muscles, bones, ligaments, tendons, and the spine. To capture all health loss from death and disability due to musculoskeletal disorders, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) includes a residual musculoskeletal category for conditions other than osteoarthritis, rheumatoid arthritis, gout, low back pain, and neck pain. This category is called other musculoskeletal disorders and includes, for example, systemic lupus erythematosus and spondylopathies. We provide updated estimates of the prevalence, mortality, and disability attributable to other musculoskeletal disorders and forecasted prevalence to 2050. Methods Prevalence of other musculoskeletal disorders was estimated in 204 countries and territories from 1990 to 2020 using data from 68 sources across 23 countries from which subtraction of cases of rheumatoid arthritis, osteoarthritis, low back pain, neck pain, and gout from the total number of cases of musculoskeletal disorders was possible. Data were analysed with Bayesian meta-regression models to estimate prevalence by year, age, sex, and location. Years lived with disability (YLDs) were estimated from prevalence and disability weights. Mortality attributed to other musculoskeletal disorders was estimated using vital registration data. Prevalence was forecast to 2050 by regressing prevalence estimates from 1990 to 2020 with Socio-demographic Index as a predictor, then multiplying by population forecasts. Findings Globally, 494 million (95% uncertainty interval 431-564) people had other musculoskeletal disorders in 2020, an increase of 123·4% (116·9-129·3) in total cases from 221 million (192-253) in 1990. Cases of other musculoskeletal disorders are projected to increase by 115% (107-124) from 2020 to 2050, to an estimated 1060 million (95% UI 964-1170) prevalent cases in 2050; most regions were projected to have at least a 50% increase in cases between 2020 and 2050. The global age-standardised prevalence of other musculoskeletal disorders was 47·4% (44·9-49·4) higher in females than in males and increased with age to a peak at 65-69 years in male and female sexes. In 2020, other musculoskeletal disorders was the sixth ranked cause of YLDs globally (42·7 million [29·4-60·0]) and was associated with 83 100 deaths (73 600-91 600). Interpretation Other musculoskeletal disorders were responsible for a large number of global YLDs in 2020. Until individual conditions and risk factors are more explicitly quantified, policy responses to this burden remain a challenge. Temporal trends and geographical differences in estimates of non-fatal disease burden should not be overinterpreted as they are based on sparse, low-quality data. Funding Bill & Melinda Gates Foundation.
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Devi M, Sharma P, Sharma N, Kaur S, Devi M, Kaur S, Sharma K, Raghav N, Singh L, Bhatti R, Kumar M, Bhalla V. Beyond Molecular Recognition: A Perylene Bisimide Derivative as a Functional Mimic of Chlorpyrifos. Chem Asian J 2023; 18:e202300406. [PMID: 37602577 DOI: 10.1002/asia.202300406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/19/2023] [Accepted: 08/19/2023] [Indexed: 08/22/2023]
Abstract
Supramolecular assemblies of perylene bisimide derivative (PBI-SAH) have been developed which show 'turn-on' detection of chlorpyrifos in aqueous media, apple residue and blood serum. Differently from the already reported fluorescent probes for the detection of CPF, PBI-SAH assemblies also show affinity for acetylcholinesterase (AChE) which endow the PBI-SAH molecules with mixed inhibitory potential to restrict the AChE catalysed hydrolysis of acetylthiocholine (ATCh) in MG-63 cell lines (in vitro) and in mice (in vivo). The molecular docking studies support the inhibitory activity of PBI-SAH assemblies and their potential to act as safe insecticide with high benefit to harm ratio. The insecticidal potential of PBI-SAH derivative has been examined against Spodoptera litura (S. litura) and these studies demonstrate its excellent insecticidal activity (100 % mortality in nineteen days). To the best of our knowledge, this is the first report regarding development of PBI-SAH assemblies which not only detect chlorpyrifos but also mimic AChE inhibitory activity of CPF to show promising aptitude as safe insecticide.
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Affiliation(s)
- Minakshi Devi
- Department of Chemistry, UGC Centre for Advanced Study-II, Guru Nanak Dev University, Amritsar, 143005, Punjab, India
| | - Pooja Sharma
- Department of Chemistry, UGC Centre for Advanced Study-II, Guru Nanak Dev University, Amritsar, 143005, Punjab, India
| | - Neha Sharma
- Department of Botanical and Environmental Sciences, UGC Centre for Advanced Study-II, Guru Nanak Dev University, Amritsar, 143005, Punjab, India
| | - Satwinderjeet Kaur
- Department of Botanical and Environmental Sciences, UGC Centre for Advanced Study-II, Guru Nanak Dev University, Amritsar, 143005, Punjab, India
| | - Meena Devi
- Department of Zoology, UGC Centre for Advanced Study-II, Guru Nanak Dev University, Amritsar, 143005, Punjab, India
| | - Sanehdeep Kaur
- Department of Zoology, UGC Centre for Advanced Study-II, Guru Nanak Dev University, Amritsar, 143005, Punjab, India
| | - Kavita Sharma
- Department of chemistry, Kurukshetra University, Kurukshetra, 136119, Haryana, India
| | - Neera Raghav
- Department of chemistry, Kurukshetra University, Kurukshetra, 136119, Haryana, India
| | - Lovedeep Singh
- Department of Pharmaceutical Sciences, UGC Centre for Advanced Study-II, Guru Nanak Dev University, Amritsar, 143005, Punjab, India
| | - Rajbir Bhatti
- Department of Pharmaceutical Sciences, UGC Centre for Advanced Study-II, Guru Nanak Dev University, Amritsar, 143005, Punjab, India
| | - Manoj Kumar
- Department of Chemistry, UGC Centre for Advanced Study-II, Guru Nanak Dev University, Amritsar, 143005, Punjab, India
| | - Vandana Bhalla
- Department of Chemistry, UGC Centre for Advanced Study-II, Guru Nanak Dev University, Amritsar, 143005, Punjab, India
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Singh L, Kaur N, Bhatti R. Neuroprotective potential of biochanin-A and review of the molecular mechanisms involved. Mol Biol Rep 2023; 50:5369-5378. [PMID: 37039995 DOI: 10.1007/s11033-023-08397-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/17/2023] [Indexed: 04/12/2023]
Abstract
Biochanin-A is a naturally occurring plant phytoestrogen, which mimics specific the agonistic activity of estrogens. Biochanin-A is known to possess numerous activities, including neuroprotective, anti-diabetic, hepatoprotective, anti-inflammatory, antioxidant, and antimicrobial activities, along with the anticancer activity. Neuroinflammation is thought to play a pivotal pathological role in neurodegenerative disease. Sustained neuroinflammatory processes lead to progressive neuronal damage in Parkinson's and Alzheimer's disease. Activation of PI3K/Akt cascade and inhibition of MAPK signaling cascade have been observed to be responsible for conferring protection against neuroinflammation in neurodegenerative diseases. An increased oxidative stress promotes neuronal apoptosis via potentiating the TLR-4/NF-κB and inhibiting PI3K/Akt signaling mediated increase in pro-apoptotic and decreases in antiapoptotic proteins. Various authors have explored biochanin-A's neuroprotective effect by using various cell lines and animal models. Biochanin-A has been reported to mediate its neuroprotective via reducing the level of oxidants, inflammatory mediators, MAPK, TLR-4, NF-κB, NADPH oxidase, AchE, COX-2 and iNOS. Whereas, it has been observed to increase the level of anti-oxidants, along with phosphorylation of PI3K and Akt proteins. The current review has been designed to provide insights into the neuroprotective effect of biochanin-A and possible signaling pathways leading to protection against neuroinflammation and apoptosis in the central nervous system. This review will be helpful in guiding future researchers to further explore biochanin A at a mechanistic level to obtain useful lead molecules.
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Affiliation(s)
- Lovedeep Singh
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, India.
- University Institute of Pharma Sciences, Chandigarh University, Mohali, Punjab, India.
| | - Navneet Kaur
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Rajbir Bhatti
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, India
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Raghuvanshi R, Nuthakki VK, Singh L, Singh B, Bharate SS, Bhatti R, Bharate SB. Identification of plant-based multitargeted leads for Alzheimer's disease: In-vitro and in-vivo validation of Woodfordia fruticosa (L.) Kurz. Phytomedicine 2021; 91:153659. [PMID: 34332286 DOI: 10.1016/j.phymed.2021.153659] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/01/2021] [Accepted: 07/12/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) is a complex neurodegenerative disease with no availability of disease-modifying therapeutics. The complex etiology and recent failures in clinical trials indicate the need for multitargeted agents. PURPOSE The present study aims to discover new plant-based multitargeted anti-AD leads. METHODS A library of plant extracts was screened for inhibition of acetylcholinesterase (AChE), butyrylcholinesterase (BChE), and beta-site amyloid precursor protein cleaving enzyme 1 (BACE-1). The secondary metabolites of active extracts were also tested, followed by enzyme-kinetics and molecular modeling to understand the mechanism of inhibition. The most active extract was investigated for in-vivo anti-dementia activity in behavioral mice models. RESULTS Among the library of 105 extracts, Woodfordia fruticosa (SBE-80) and Bergenia ciliata (SBE-65) extracts displayed significant inhibition of all three enzymes. Gallic acid, one of the constituents of both plants, shows moderate inhibition of AChE and BACE-1. Catechin-3-O-gallate (CG), another constituent of SBE-65, inhibits EeAChE, rHuAChE, and eqBChE with IC50's of 29.9, 1.77, and 8.4 µM, respectively; along with a mild-inhibition of BACE-1. Ellagic acid, the constituent of SBE-80, inhibits BACE-1 with an IC50 value of 16 µM. The W. fruticosa extract SBE-80 at the dose of 25 mg/kg QD × 9 (PO) displayed memory-enhancing activity in Morris Water Maze and Passive Avoidance Test in Swiss albino mice. Treatment with SBE-80 also inhibits AChE in-vivo; whereas, a non-significant decrease in the serum TBARS was observed. CONCLUSION W. fruticosa is identified for the first time as an anti-AD lead candidate. The in-vitro and in-vivo data presented herein and the documented safety profile of W. fruticosa indicate its strong potential for preclinical development as a botanical drug for dementia/AD.
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Affiliation(s)
- Rinky Raghuvanshi
- Natural Products & Medicinal Chemistry Division, CSIR-Indian Institute of Integrative Medicine, Canal Road, Jammu-180001, India; Academy of Scientific & Innovative Research (AcSIR), Ghaziabad-201002, India
| | - Vijay K Nuthakki
- Natural Products & Medicinal Chemistry Division, CSIR-Indian Institute of Integrative Medicine, Canal Road, Jammu-180001, India
| | - Lovedeep Singh
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar-143005, Punjab, India
| | - Bikarma Singh
- Academy of Scientific & Innovative Research (AcSIR), Ghaziabad-201002, India; Biodiversity and Applied Botany Division, CSIR-Indian Institute of Integrative Medicine, Canal Road, Jammu-180001, India; Botanical Garden Division, CSIR- National Botanical Research Institute, Lucknow-226001, UP, India
| | - Sonali S Bharate
- PK-PD Toxicology & Formulation Division, CSIR-Indian Institute of Integrative Medicine, Canal Road, Jammu-180001, India; Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS, V.L. Mehta Road, Vile Parle (W), Mumbai-400056, India
| | - Rajbir Bhatti
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar-143005, Punjab, India
| | - Sandip B Bharate
- Natural Products & Medicinal Chemistry Division, CSIR-Indian Institute of Integrative Medicine, Canal Road, Jammu-180001, India; Academy of Scientific & Innovative Research (AcSIR), Ghaziabad-201002, India.
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Kaur A, Bhatti R. Understanding the phytochemistry and molecular insights to the pharmacology of Angelica archangelica L. (garden angelica) and its bioactive components. Phytother Res 2021; 35:5961-5979. [PMID: 34254374 DOI: 10.1002/ptr.7206] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 05/23/2021] [Accepted: 06/17/2021] [Indexed: 01/17/2023]
Abstract
Plant-derived molecules have enduring usefulness in treating diseases, and herbal drugs have emerged as a vital component of global therapeutic demand. Angelica archangelica L. (A. archangelica), commonly known as garden angelica, is an aromatic food plant used in culinary procedures as a flavoring agent. In the traditional medicine system, it is regarded as an "Angel plant" due to its miraculous curative power. This review aims to provide a comprehensive summary of the plant's taxonomic profile, ethnopharmacology, Phytochemistry, and pharmacological activities. Various in vivo and in vitro experiments have validated that the plant possesses broad pharmacological potential. The biological activities attributed to the plant include anti-anxiety activity, anti-convulsant activity, cognition enhancer, antiviral activity, cholinesterase inhibitory potential, antiinflammatory activity, gastroprotective activity, and radioprotective activity. The beneficial effects of the plant are credited to its bioactive components, that is, coumarins and volatile oils. The review summarizes the pharmacological activities of crude extract and its bioactive fractions and has also explored their target-oriented effects. This review will be of value in undertaking further investigations on the plant with regard to exploring mechanism-based pharmacological approaches on A. archangelica.
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Affiliation(s)
- Anudeep Kaur
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
| | - Rajbir Bhatti
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
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Kumari P, Singh P, Kaur J, Bhatti R. Design, Synthesis, and Activity Evaluation of Stereoconfigured Tartarate Derivatives as Potential Anti-inflammatory Agents In Vitro and In Vivo. J Med Chem 2021; 64:9550-9566. [PMID: 34137625 DOI: 10.1021/acs.jmedchem.1c00880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Preclinical and clinical data reveal that inflammation is strongly correlated with the pathogenesis of a number of diseases including those of cancer, Alzheimer, and diabetes. The inflammatory cascade involves a multitude of cytokines ending ultimately with the activation of COX-2/LOX for the production of prostaglandins and leukotrienes. While the available inhibitors for these enzymes suffer from nonoptimal selectivity, in particular for COX-2, we present here the results of purposely designed tartarate derivatives that exhibit favorable selectivity and significant effectiveness against COX-2 and LOX. Integrated approaches of molecular simulation, organic synthesis, and biochemical/physical experiments identified 15 inhibiting COX-2 and LOX with respective IC50 4 and 7 nM. At a dose of 5 mg kg-1 to Swiss albino mice, 15 reversed algesia by 65% and inflammation by 33% in 2-3 h. We find good agreement between experiments and simulations and use the simulations to rationalize our observations.
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Rani A, Singh A, Kaur J, Singh G, Bhatti R, Gumede N, Kisten P, Singh P, Sumanjit, Kumar V. 1H-1,2,3-triazole grafted tacrine-chalcone conjugates as potential cholinesterase inhibitors with the evaluation of their behavioral tests and oxidative stress in mice brain cells. Bioorg Chem 2021; 114:105053. [PMID: 34120027 DOI: 10.1016/j.bioorg.2021.105053] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 05/27/2021] [Accepted: 06/01/2021] [Indexed: 01/06/2023]
Abstract
The present paper explicates the synthesis of 1H-1,2,3-triazole tethered tacrine-chalcone conjugates and evaluation of their AChE and BuChE inhibitory activity. In-vitroAChE inhibition assay revealed three compounds, 9h, 9i, and 11f, being more potent than the standard drug tacrine and further evaluated against butyrylcholinesterase. The present study was extended to investigate the anti-amnestic effect of promising compoundson scopolamine-induced behavioral and neurochemical changes in mice. Inclined plane model and Elevated plus-maze model were performed to assess general limb motor activity and anxiety-like behavior, respectively, in mice pre-treated with scopolamine. Oxidative stress parameters reduced glutathione contents (GSH) and lipid peroxidation products (TBARS) in the brain homogenates as estimated using ex-vivo studies. Furthermore, molecular docking studies were performed for the potent compounds to decipher the mechanism of observed activities.
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Affiliation(s)
- Anu Rani
- Department of Chemistry, Guru Nanak Dev University, Amritsar 143005, Punjab, India
| | - Amandeep Singh
- Department of Chemistry, Guru Nanak Dev University, Amritsar 143005, Punjab, India
| | - Jashanpreet Kaur
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar 143005, India
| | - Gurjit Singh
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar 143005, India
| | - Rajbir Bhatti
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar 143005, India
| | - Njabulo Gumede
- Department of Chemistry, Mangosuthu University of Technology, P.O. Box 12363, Jacobs 4026, South Africa
| | - Prishani Kisten
- School of Chemistry and Physics, University of KwaZulu-Natal, P/Bag X54001, Westville, Durban, South Africa
| | - Parvesh Singh
- School of Chemistry and Physics, University of KwaZulu-Natal, P/Bag X54001, Westville, Durban, South Africa
| | - Sumanjit
- Department of Chemistry, Guru Nanak Dev University, Amritsar 143005, Punjab, India
| | - Vipan Kumar
- Department of Chemistry, Guru Nanak Dev University, Amritsar 143005, Punjab, India.
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Sharma A, Kaur R, Kaur J, Garg S, Bhatti R, Kaur A. An endophytic Schizophyllum commune Fr. exhibits in-vitro and in-vivo antidiabetic activity in streptozotocin induced diabetic rats. AMB Express 2021; 11:58. [PMID: 33881650 PMCID: PMC8060376 DOI: 10.1186/s13568-021-01219-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 04/09/2021] [Indexed: 03/06/2023] Open
Abstract
The present study aimed at isolation of endophytic basidiomycetous fungi and evaluation of their in-vitro and in-vivo antidiabetic potential. Preliminary screening for in-vitro activity was carried out using α-glucosidase inhibition assay. An endophytic isolate Sch1 (isolated from Aloe vera), identified to be Schizophyllum commune Fr. on molecular basis, exhibiting more than 90% α-glucosidase inhibitiory activity was selected for further studies. Detailed in-vivo investigations for antidiabetic potential of ethyl acetate extract of S. commune (Sch1), at two different doses, were carried out in streptozotocin induced diabetic Wistar rats. Treatment of diabetic rats with S. commune extract caused significant decrease in blood glucose level and increase in body weight after 14 days experimental period. It significantly restored renal parameters including creatinine, blood urea nitrogen, fractional excretion of sodium, and potassium level in diabetic rats. Improvement in lipid profile and level of antioxidant parameters viz. reduced glutathione, thiobarbituric acid reactive species, and superoxide anion generation was also observed after treatment. Liver enzymes (serum glutamic pyruvic transaminase, serum glutamic-oxaloacetic transaminases, and alkaline phosphatase) homeostasis was found to be markedly improved in diabetic rats administered with S. commune extract. The effects were more pronounced at higher concentration and comparable to acarbose which was used as positive control. Phytochemical analysis revealed the presence of phenolics and terpenoids in the ethyl acetate extract. This is the first report highlighting the therapeutic potential of an endophytic S. commune in the management of diabetes.
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Singh L, Kaur A, Singh AP, Bhatti R. Daphnetin, a natural coumarin averts reserpine-induced fibromyalgia in mice: modulation of MAO-A. Exp Brain Res 2021; 239:1451-1463. [PMID: 33677656 DOI: 10.1007/s00221-021-06064-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 02/13/2021] [Indexed: 12/11/2022]
Abstract
Fibromyalgia is a common, chronic, and generalized pain syndrome that is often associated with comorbid depression. The etiology of fibromyalgia is complex; most researchers have documented that the hallmark symptoms are due to the central nervous system's abnormal functioning. Neurotransmitters such as serotonin, norepinephrine, and glutamate, have been reported to be key regulators of fibromyalgia syndrome. Daphnetin is a 7, 8 dihydroxy coumarin widely distributed in Thymelaeaceae family plants, possessing various activities such as anti-arthritic, anti-tumor, anti-malarial, and anti-parasitic. The present study was designed to explore the potential of daphnetin against reserpine-induced fibromyalgia in mice. In mice, a fibromyalgia-like state was achieved by injecting reserpine (0.5 mg/kg, s.c) continuously for 3 days. All behavioral tests were conducted on the 4th and 6th day of experimentation. Reserpine administration significantly increased the mechanical hypersensitivity in electronic von Frey (eVF) and pressure application measurement (PAM) tests. It also increased the immobility period and time to reach the platform in force swim test (FST) and Morris water maze (MWM) test, respectively. In the biochemical analysis, reserpine treatment upregulated the monoamine oxidase-A (MAO-A) activity and level of glutamate, tumor necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1β), and thiobarbituric acid reactive substances (TBARS). Whereas, it decreased the level of glutathione (GSH), dopamine, serotonin, and norepinephrine. Daphnetin pretreatment attenuated the behavioral and biochemical changes induced by reserpine. Thus, the current investigation results delineate that daphnetin might exert its protective effect by inhibiting inflammatory stress and MAO-A-mediated neurotransmitter depletion and oxidative stress.
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Affiliation(s)
- Lovedeep Singh
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Anudeep Kaur
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Amrit Pal Singh
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Rajbir Bhatti
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, India.
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Singh A, Singh L, Singh P, Bhatti R. Biological Evaluation of Aegle marmelos Fruit Extract and Isolated Aegeline in Alleviating Pain -Depression Dyad: In Silico Analysis of Aegeline on MAO-A and iNOS. ACS Omega 2021; 6:2034-2044. [PMID: 33521442 PMCID: PMC7841774 DOI: 10.1021/acsomega.0c04739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 12/29/2020] [Indexed: 05/07/2023]
Abstract
Pain and depression have been assessed to co-occur in up to 80% of patients, and this comorbidity is more debilitating and pricier for the patients as compared to either of these disorders alone. Aegle marmelos is a well-known medicinal plant with a broad spectrum of pharmacological activities. Aegeline is a relatively unexplored molecule present in Aegle marmelos. Therefore, the current investigation aims to explore the potential of Aegle marmelos fruit extract (AMFE) and isolated aegeline against the reserpine-induced pain-depression dyad. In the current investigation, aegeline was isolated from AMFE, followed by spectroscopic characterization, i.e., using NMR and mass analyses. AMFE (200 mg kg-1 p.o) and aegeline (10 mg kg-1 p.o.) were administered to reserpinized (0.5 mg kg-1 s.c.) mice, and clorgyline (3 mg kg-1 i.p.) was taken as the standard drug. AMFE and aegeline significantly alleviated the reserpine-induced reduction in a pain threshold and an increase in immobility as observed in behavioral tests of pain and depression, respectively. In silico molecular docking studies of aegeline showed a good binding interaction at the active sites of MAO-A and iNOS. The in vivo analysis showed that AMFE and aegeline treatment significantly decreased the monoamine oxidase-A (MAO-A) activity, serum interleukin-6 (IL-6) level, and lipid peroxidation, along with an increase in the reduced glutathione level in comparison to the reserpine-treated group. Immunofluorescence studies also showed that AMFE and aegeline abrogated the reserpine-induced increase in iNOS expression. Conclusively, the results delineate that AMFE and aegeline might exert a protective effect via downregulating the MAO-A hyperactivity, IL-6 level, oxidative and nitrosative stress.
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Affiliation(s)
- Amrit
Pal Singh
- Department
of Pharmaceutical Sciences, Guru Nanak Dev
University, Amritsar 143005, India
| | - Lovedeep Singh
- Department
of Pharmaceutical Sciences, Guru Nanak Dev
University, Amritsar 143005, India
| | - Palwinder Singh
- Department
of Chemistry, Guru Nanak Dev University, Amritsar 143005, India
| | - Rajbir Bhatti
- Department
of Pharmaceutical Sciences, Guru Nanak Dev
University, Amritsar 143005, India
- . Phone: 0183-2258802-9
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Singh L, Kaur A, Garg S, Bhatti R. Skimmetin/osthole mitigates pain-depression dyad via inhibiting inflammatory and oxidative stress-mediated neurotransmitter dysregulation. Metab Brain Dis 2021; 36:111-121. [PMID: 32870425 DOI: 10.1007/s11011-020-00604-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 07/20/2020] [Indexed: 12/14/2022]
Abstract
Pain and depression are often co-existing pathological states that promote mutual severity resulting in limited efficacy of current treatment strategies. Thus, there is a need to develop an efficacious alternate treatment regimen for pain-depression dyad. Skimmetin and osthole are molecules of natural origin that have been explored for an anti-hyperglycemic, anti-bacterial, anti-fungal, and anti-diabetic activities in preclinical studies. in animal models. The current study has been designed to explore the beneficial effect of skimmetin/osthole in reserpine-induced pain-depression dyad in mice. Female Swiss albino mice (n = 6) were challenged with reserpine (0.5 mg/kg s.c.) for the first 3 days to induce a pain-depression dyad-like state. Skimmetin (10 mg/kg i.p.) and osthole (10 mg/kg i.p.) were administered for 5 days consecutively, starting from the first day of study. Reserpine treatment significantly reduced the pain threshold in the pressure application measurement (PAM) and electronic von frey (eVF) test. In forced swim test (FST) and Morris water maze (MWM) test mice displayed an increased immobility time and latency to reach platform respectively. Biochemical results showed an increased level of TNF-α, IL-1β, TBARS, glutamate, and reduced level of GSH, norepinephrine, and serotonin in the reserpine treated group. Reserpine treatment also increased brain MAO-A activity. Skimmetin/osthole treatment was found to attenuate the behavioral and biochemical alterations induced by reserpine. The results of the current investigation delineated that skimmetin/osthole may exert anti-nociceptive, anti-depressant, and improved cognition via inhibiting inflammatory and oxidative stress-mediated neurotransmitter dysregulation.
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Affiliation(s)
- Lovedeep Singh
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
| | - Anudeep Kaur
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
| | - Saweta Garg
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
| | - Rajbir Bhatti
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India.
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Singla P, Garg S, Bhatti R, Peeters M, Singh O, Mahajan RK. Solubilization of hydrophobic drugs clozapine and oxcarbazepine in the lower and higher molecular weight pluronic mixed micelles-a physicochemical, In vitro release and In vitro anti-oxidant study. J Mol Liq 2020. [DOI: 10.1016/j.molliq.2020.113816] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kaur A, Singh N, Bhatti MS, Bhatti R. Optimization of extraction conditions of Angelica archangelica extract and activity evaluation in experimental fibromyalgia. J Food Sci 2020; 85:3700-3710. [PMID: 33047814 DOI: 10.1111/1750-3841.15476] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/27/2020] [Accepted: 09/08/2020] [Indexed: 01/17/2023]
Abstract
The plant Angelica archangelica, owing to its magnificent therapeutic effectiveness in folklore medicine system, has been regarded as an "angel plant." The current investigation was aimed to optimize extraction conditions of A. archangelica roots and to investigate in vivo role of optimized extract in fibromyalgia. Plant material (dried roots) was subjected to methanol extraction at variable temperature (40 to 60 °C) and time (12 to 36 hr) conditions as per two-factorial design strategy, and responses in terms of antioxidant activity were determined. The optimized extraction conditions were found to be temperature of 60 °C and time of 36 hr. HPLC fingerprinting indicated the presence of coumarins in extract. To induce fibromyalgia, the mice were administered reserpine at a dose of 0.5 mg/kg. Mice were orally treated with 100, 200, and 400 mg/kg extract, and magnitude of fibromyalgia was quantified. In comparison to reserpine group, the extract treatment attenuated pain as shown by significant increase in paw withdrawal threshold against mechanical stimuli (P < 0.05), improved motor ability indicated by increase in fall-off time in inclined plane test (P < 0.05), improved locomotion indicated by increased square crossings in open field test (P < 0.05), and improved cognition as shown by significant reduction in time to reach platform in Morris water maze test and passive avoidance task test (P < 0.05). Extract treatment significantly halted reserpine-induced rise in serum cytokine level (P < 0.05) and brain oxidative stress (P < 0.05). Angelica archangelica extract exerted its beneficial effects in fibromyalgia possibly through the attenuation of oxidative stress-mediated inflammatory cascade. PRACTICAL APPLICATION: Leads from natural products have become an integral part of drug designing processes and have high acceptability due to their better tolerance. The optimization of extraction conditions of plant yields better results and could reduce the processing time, thus increasing its industrial value.
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Affiliation(s)
- Anudeep Kaur
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
| | - Nirmal Singh
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, India
| | - Manpreet Singh Bhatti
- Department of Botanical and Environmental Sciences, Guru Nanak Dev University, Amritsar, India
| | - Rajbir Bhatti
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
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Kaur A, Singh L, Garg S, Kaur H, Singh N, Bhatti R. Involvement of Oxidative Stress and Nerve Growth Factor in Behavioral and Biochemical Deficits of Experimentally Induced Musculoskeletal Pain in Mice: Ameliorative Effects of Heraclin. J Mol Neurosci 2020; 71:347-357. [PMID: 32676972 DOI: 10.1007/s12031-020-01656-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 07/01/2020] [Indexed: 01/11/2023]
Abstract
Musculoskeletal pain is a widespread complex regional pain syndrome associated with altered emotional and cognitive functioning along with heightened physical disability that has become a global health concern. Effective management of this disorder and associated disabilities includes accurate diagnosis of its biomarkers and instituting mechanism-based therapeutic interventions. Herein, we explored the role of heraclin, a plant-derived molecule, in musculoskeletal pain and its underlying mechanistic approaches in an experimental mouse model. Reserpine (0.5 mg/kg) for 3 consecutive days evoked hyperalgesia, motor incoordination, lack of exploratory behavior, anxiety, and cognition lapse in mice. Reserpine-challenged mice displayed higher serum cytokine level, altered brain neurotransmitter content, elevated brain and muscle oxidative stress, and upregulated brain nerve growth factor receptor expression. Treatment with heraclin (10 mg/kg for 5 consecutive days) exerted analgesic effect and improved motor coordination and memory deficits in mice. Heraclin arrested serum cytokine rise, normalized brain neurotransmitter content, reduced tissue oxidative stress, and downregulated the nerve growth factor receptor expression. Therefore, it may be suggested that heraclin exerts beneficial effects against reserpine-induced musculoskeletal pain disorder possibly through the attenuation of NGFR-mediated pain and inflammatory signaling. Graphical Abstract.
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Affiliation(s)
- Anudeep Kaur
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
| | - Lovedeep Singh
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
| | - Saweta Garg
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
| | - Harmanpreet Kaur
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
| | - Nirmal Singh
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, India
| | - Rajbir Bhatti
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India.
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Singh L, Kaur A, Garg S, Singh AP, Bhatti R. Protective Effect of Esculetin, Natural Coumarin in Mice Model of Fibromyalgia: Targeting Pro-Inflammatory Cytokines and MAO-A. Neurochem Res 2020; 45:2364-2374. [DOI: 10.1007/s11064-020-03095-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/04/2020] [Accepted: 07/09/2020] [Indexed: 10/23/2022]
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Kaur M, Kaur B, Kaur J, Kaur A, Bhatti R, Singh P. Role of water in cyclooxygenase catalysis and design of anti-inflammatory agents targeting two sites of the enzyme. Sci Rep 2020; 10:10764. [PMID: 32612190 PMCID: PMC7329864 DOI: 10.1038/s41598-020-67655-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 06/12/2020] [Indexed: 11/15/2022] Open
Abstract
While designing the anti-inflammatory agents targeting cyclooxygenase-2 (COX-2), we first identified a water loop around the heme playing critical role in the enzyme catalysis. The results of molecular dynamic studies supported by the strong hydrogen-bonding equilibria of the participating atoms, radical stabilization energies, the pKa of the H-donor/acceptor sites and the cyclooxygenase activity of pertinent muCOX-2 ravelled the working of the water–peptide channel for coordinating the flow of H·/electron between the heme and Y385. Based on the working of H·/electron transfer channel between the 12.5 Å distant radical generation and the radical disposal sites, a series of molecules was designed and synthesized. Among this category of compounds, an appreciably potent anti-inflammatory agent exhibiting IC50 0.06 μM against COX-2 and reversing the formalin induced analgesia and carageenan induced inflammation in mice by 90% was identified. Further it was revealed that, justifying its bidentate design, the compound targets water loop (heme bound site) and the arachidonic acid binding pockets of COX-2.
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Affiliation(s)
- Manpreet Kaur
- UGC Sponsored Centre for Advanced Studies, Department of Chemistry, Guru Nanak Dev University, Amritsar, 143005, India
| | - Baljit Kaur
- UGC Sponsored Centre for Advanced Studies, Department of Chemistry, Guru Nanak Dev University, Amritsar, 143005, India
| | - Jagroop Kaur
- UGC Sponsored Centre for Advanced Studies, Department of Chemistry, Guru Nanak Dev University, Amritsar, 143005, India
| | - Anudeep Kaur
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, 143005, India
| | - Rajbir Bhatti
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, 143005, India
| | - Palwinder Singh
- UGC Sponsored Centre for Advanced Studies, Department of Chemistry, Guru Nanak Dev University, Amritsar, 143005, India.
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Kaur A, Garg S, Shiekh BA, Singh N, Singh P, Bhatti R. In Silico Studies and In Vivo MAO A Inhibitory Activity of Coumarins Isolated from Angelica archangelica Extract: An Approach toward Antidepressant Activity. ACS Omega 2020; 5:15069-15076. [PMID: 32637779 PMCID: PMC7330908 DOI: 10.1021/acsomega.0c00887] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 06/02/2020] [Indexed: 05/08/2023]
Abstract
The current investigation was aimed at in vivo MAOA inhibitory activity of coumarins angelicin, bergapten, and scopoletin isolated from the roots of Angelica archangelica. The isolated compounds were screened for MAOA (pdb ID 2Z5y) binding through molecular docking studies. The molecular docking results displayed that bergapten has a maximum affinity for MAOA, followed by angelicin and scopoletin. In silico prediction of physicochemical parameters indicated that maximum blood-brain barrier (BBB) permeability was observed with angelicin (2.3), followed by bergapten (2.0) and least with scopoletin (0.644). In consonance to the results of molecular docking studies, appreciable in vivo antidepressant activity of angelicin and bergaptan was observed over the mouse model of reserpine-induced depression. The modulation of MAOA in the antidepressant effect of extract and its isolated fractions was also determined. Biochemical examination of the brain tissue indicated that bergapten has maximum MAOA inhibitory activity while scopoletin fails to inhibit brain MAOA.
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Affiliation(s)
- Anudeep Kaur
- Department
of Pharmaceutical Sciences, Guru Nanak Dev
University, Amritsar 143005, India
| | - Saweta Garg
- Department
of Pharmaceutical Sciences, Guru Nanak Dev
University, Amritsar 143005, India
| | - Bilal Ahmad Shiekh
- Department
of Chemistry, Guru Nanak Dev University, Amritsar 143005, India
| | - Nirmal Singh
- Department
of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala 147002, India
| | - Palwinder Singh
- Department
of Chemistry, Guru Nanak Dev University, Amritsar 143005, India
| | - Rajbir Bhatti
- Department
of Pharmaceutical Sciences, Guru Nanak Dev
University, Amritsar 143005, India
- . Phone: 0183-2258802-9, ext. 3543. Cell: 09417278858
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Singh G, Kaur J, Kaur M, Singh P, Bhatti R. Anti-nociceptive and anti-inflammatory effect of imperatorin: evidences for involvement of COX-2, iNOS, NFκB and inflammatory cytokines. Int J Neurosci 2019; 130:176-185. [PMID: 31524564 DOI: 10.1080/00207454.2019.1667789] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Aim: The objective of the current investigation was to explore the analgesic effect of naturally occurring furanocoumarin, imperatorin and the involvement of inducible cyclooxygenase (COX-2), inducible nitric oxide synthase (iNOS), NFκB and cytokines in the observed effect.Materials and methods: Anti-nociceptive effect was explored by inducing chemical hyperalgesia using acetic acid and formalin in mice. ED50 of imperatorin was calculated in acetic acid model. Modulation of cyclooxygenase and nitric oxide pathway by imperatorin was examined by stimulator/precursor challenge with substance P and L-arginine, respectively and quantification of COX-2, iNOS and NFκB expression by immunohistochemical analysis in spinal tissues. Involvement of inflammatory cytokines TNF-α and IL-1β was investigated using LPS challenge and subsequent ELISA analysis of these inflammatory mediators in serum. Carrageenan inflicted paw edema was employed to explore the anti-inflammatory activity of imperatorin.Results: A significant reduction in the nociceptive behaviour was observed with imperatorin treatment in acetic acid and formalin test. ED50 of imperatorin was found to be 4.53 mg/kg. Pre-treatment with substance P and L-arginine significantly attenuated the anti-nociceptive activity of imperatorin in formalin test. Immunohistochemical findings revealed marked decrease in spinal COX-2, iNOS and NFκB expression. Imperatorin administration significantly reduced LPS induced rise in level of TNF-α and IL-1β dose dependently. In carrageenan-induced paw edema test, maximum possible anti-inflammatory effect of imperatorin was evident after 240 min of carrageenan administration.Conclusion: Current investigation revealed that anti-nociceptive and anti-inflammatory potential of imperatorin is probably mediated through the attenuation of COX-2, iNOS, NFκB activity and reduction in circulatory cytokines.
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Affiliation(s)
- Gurjit Singh
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
| | - Jashanpreet Kaur
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
| | - Manpreet Kaur
- Department of Chemistry, Guru Nanak Dev University, Amritsar, India
| | - Palwinder Singh
- Department of Chemistry, Guru Nanak Dev University, Amritsar, India
| | - Rajbir Bhatti
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
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Kaur B, Kaur M, Kaur N, Garg S, Bhatti R, Singh P. Engineered Substrate for Cyclooxygenase-2: A Pentapeptide Isoconformational to Arachidonic Acid for Managing Inflammation. J Med Chem 2019; 62:6363-6376. [PMID: 31244108 DOI: 10.1021/acs.jmedchem.9b00823] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Beyond the conventional mode of working of anti-inflammatory agents through enzyme inhibition, herein, COX-2 was provided with an alternate substrate. A proline-centered pentapeptide isoconformational to arachidonic acid, which exhibited appreciable selectivity for COX-2, overcoming acetic acid- and formalin-induced pain in rats to almost 80%, was treated as a substrate by the enzyme. Remarkably, COX-2 metabolized the pentapeptide into small fragments consisting mainly of di- and tripeptides that ensured the safe breakdown of the peptide under in vivo conditions. The kinetic parameter Kcat/Km for COX-2-mediated metabolism of the peptide (6.3 × 105 M-1 s-1) was quite similar to 9.5 × 105 M-1 s-1 for arachidonic acid. Evidenced by the molecular dynamic studies and the use of Y385F COX-2, it was observed that the breakage of the pentapeptide has probably been taken place through H-bond activation of the peptide bond by the side chains of Y385 and S530.
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Singh G, Singh A, Singh P, Bhatti R. Bergapten Ameliorates Vincristine-Induced Peripheral Neuropathy by Inhibition of Inflammatory Cytokines and NFκB Signaling. ACS Chem Neurosci 2019; 10:3008-3017. [PMID: 31064179 DOI: 10.1021/acschemneuro.9b00206] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Bergapten, a furanocoumarin derivative found in a variety of medicinal plants, is documented to possess anti-inflammatory activity. However, whether bergapten is useful in alleviating the symptoms as well as the progress of peripheral neuropathy is not yet studied. The current investigation has been designed to explore the effect of bergapten on vincristine-induced neuropathic pain. Rats were grouped as normal, neuropathic control (vincristine), gabapentin, and bergapten treated groups with five animals in each group. Vincristine (100 μg/kg, i.p.) was administered for 10 days with 2 days break. Gabapentin (60 mg/kg, i.p.) and bergapten (10 mg/kg i.p.) treatments were given once daily for 14 days. The animals were assessed for hyperalgesia and allodynia. After 14 days, animals were sacrificed to detect plasma pro-inflammatory cytokines (TNF α, IL-1β), spinal cord, and sciatic nerve oxidative stress and expression of iNOS, COX-2, and NFkB in the spinal cord. There was a marked reduction in pain behaviors in the bergapten group as compared to the vincristine group. Bergapten also attenuated pro-inflammatory cytokines (TNFα and IL-1β), oxidative stress, and expression of NFkB, COX-2, and iNOS. Overall the current study concludes that bergapten could serve as a potential lead to drug development for the treatment of neuropathic pain.
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Singh L, Kaur A, Bhatti MS, Bhatti R. Possible Molecular Mediators Involved and Mechanistic Insight into Fibromyalgia and Associated Co-morbidities. Neurochem Res 2019; 44:1517-1532. [PMID: 31004261 DOI: 10.1007/s11064-019-02805-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 04/12/2019] [Accepted: 04/13/2019] [Indexed: 12/12/2022]
Abstract
Fibromyalgia is a chronic complex syndrome of non-articulate origin characterized by musculoskeletal pain, painful tender points, sleep problems and co-morbidities including depression, migraine. The etiopathogenesis of fibromyalgia is complex, variable and remains inconclusive. The etiological factors that have been defined include stress, genetic predisposition and environmental components. As per the reports of the American College of Rheumatology (ACR) the prevalence of fibromyalgia varies from 2 to 22% among the general population with poor diagnostic features primarily pain. Fibromyalgia encompasses a spectrum of co-morbid conditions with multifarious pathogenesis. The highly prevalent manifestations of fibromyalgia include heterogeneous pain and aches. Biochemical and neurobiological elements of fibromyalgia include neurotransmitters, hypothalamic pituitary adrenal axis (HPA axis), inflammatory cytokines, monoaminergic pathway, opioid peptides, sex hormones, nerve growth factor (NGF) and local free radical insult. An imbalance in the serotonergic system is the major underlying etiological factor that has been explored most widely. Owing to complex interplay of diverse pathophysiological pathways, overlapping co-morbidities such as depression have been clinically observed. Therapeutic management of fibromyalgia involves both non pharmacological and pharmacological measures. The current review presents various dysregulations and their association with symptoms of fibromyalgia along with their underlying neurobiological aspects.
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Affiliation(s)
- Lovedeep Singh
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Anudeep Kaur
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Manpreet S Bhatti
- Department of Botanical and Environmental Sciences, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Rajbir Bhatti
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, India.
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Singh P, Kaur S, Kumari P, Kaur B, Kaur M, Singh G, Bhatti R, Bhatti M. Tailoring the Substitution Pattern on 1,3,5-Triazine for Targeting Cyclooxygenase-2: Discovery and Structure–Activity Relationship of Triazine–4-Aminophenylmorpholin-3-one Hybrids that Reverse Algesia and Inflammation in Swiss Albino Mice. J Med Chem 2018; 61:7929-7941. [DOI: 10.1021/acs.jmedchem.8b00922] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Singh P, Kaur J, Kaur H, Kaur A, Bhatti R. Synergy of Physico-chemical and Biological Experiments for Developing a Cyclooxygenase-2 Inhibitor. Sci Rep 2018; 8:10005. [PMID: 29968808 PMCID: PMC6030096 DOI: 10.1038/s41598-018-28408-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 06/04/2018] [Indexed: 12/16/2022] Open
Abstract
The physiological consequences of COX-2 overexpression in the development of cancer, diabetes and neurodegenerative diseases have made this enzyme a promising therapeutic target. Herein, COX-2 active site was analyzed and new molecules were designed. We identified a highly potent molecule (S)-3a with IC50 value and the selectivity for COX-2 0.6 nM and 1666, respectively. The MTD of (S)-3a was 2000 mg kg-1 and its pharmacokinetic studies in rat showed t1/2 7.5 h. This compound reversed acetic acid induced analgesia and carragennan induced inflammation by 50% and 25% in rat when used at a dose 10 mg kg-1. Mechanistically, it was found that compound (S)-3a inhibits COX-2. Overall, the combination of physico-chemical and biological experiments facilitated the development of a new lead molecule to anti-inflammatory drug.
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Affiliation(s)
- Palwinder Singh
- Department of Chemistry, Centre for Advanced Studies, Guru Nanak Dev University, Amritsar, 143005, India.
| | - Jagroop Kaur
- Department of Chemistry, Centre for Advanced Studies, Guru Nanak Dev University, Amritsar, 143005, India
| | - Harpreet Kaur
- Department of Chemistry, Centre for Advanced Studies, Guru Nanak Dev University, Amritsar, 143005, India
| | - Anudeep Kaur
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, 143005, India
| | - Rajbir Bhatti
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, 143005, India
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Kaur S, Kumari P, Singh G, Bhatti R, Singh P. Design and Synthesis of Aza-/Oxa Heterocycle-Based Conjugates as Novel Anti-Inflammatory Agents Targeting Cyclooxygenase-2. ACS Omega 2018; 3:5825-5845. [PMID: 30023927 PMCID: PMC6044720 DOI: 10.1021/acsomega.8b00445] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 05/17/2018] [Indexed: 05/13/2023]
Abstract
A library of hybrid molecules was procured by the combination of triazine-indole adduct with morpholine/piperidine/pyrrolidine and pyrazole/pyrimidine/oxindole moieties. Enzyme immunoassays on cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) identified compound 6 having an IC50 value of 20 nM for COX-2 and 3000 nM for COX-1. The significant reduction in the formation of prostaglandin E2 in the lipopolysaccharide-treated (COX-2-activated) human whole blood, almost no change in the production of thromboxane B2 in the calcium ionophore-treated (COX-1-activated) sample of human whole blood, and the mechanistic studies on Swiss albino mice ensured that compound 6 is selective for COX-2. The association constant (Ka) of compound 6 with COX-2 was found to be of the order of 0.48 × 106 M-1. The diffusion spectroscopy experiments and relaxation time (T1) calculations of compound 6 in the presence of COX-2 assisted in identifying the site-specific interactions of 6 with the enzyme, and these results fall into nice correlation with the theoretical data obtained from molecular docking and quantitative structure-activity relationship studies. With maximum tolerable dose >2000 mg kg-1, compound 6 made 68 and 32% reduction in formalin-induced analgesia and carrageenan-induced inflammation in Swiss albino mice.
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Affiliation(s)
- Sukhmeet Kaur
- Department
of Chemistry—Centre for Advanced Studies and Department of
Pharmaceutical Sciences, Guru Nanak Dev
University, Amritsar 143005, India
| | - Priya Kumari
- Department
of Chemistry—Centre for Advanced Studies and Department of
Pharmaceutical Sciences, Guru Nanak Dev
University, Amritsar 143005, India
| | - Gurjit Singh
- Department
of Chemistry—Centre for Advanced Studies and Department of
Pharmaceutical Sciences, Guru Nanak Dev
University, Amritsar 143005, India
| | - Rajbir Bhatti
- Department
of Chemistry—Centre for Advanced Studies and Department of
Pharmaceutical Sciences, Guru Nanak Dev
University, Amritsar 143005, India
| | - Palwinder Singh
- Department
of Chemistry—Centre for Advanced Studies and Department of
Pharmaceutical Sciences, Guru Nanak Dev
University, Amritsar 143005, India
- E-mail: (P.S.)
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Singh G, Bhatti R, Mannan R, Singh D, Kesavan A, Singh P. Osthole ameliorates neurogenic and inflammatory hyperalgesia by modulation of iNOS, COX-2, and inflammatory cytokines in mice. Inflammopharmacology 2018; 27:949-960. [PMID: 29736690 DOI: 10.1007/s10787-018-0486-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 04/20/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND Osthole is a bioactive component reported in medicinal plants such as Angelica pubescens and Cnidium monnieri, known for analgesic activity. However, the toxicity, median effective dose (ED50), and dual modulation of nitric oxide and cyclooxygenase pathways along with inflammatory cytokines of osthole are yet to be determined. METHODS The animals (mice) were assessed for general behaviour and mortality in varying doses (50, 300, and 2000 mg kg-1) of osthole for acute toxicity over 14 days. The analgesic activity was investigated using acetic acid and formalin-induced hyperalgesia, and anti-inflammatory activity was explored in carrageenan-induced paw oedema. ED50 of osthole was calculated using Design Expert software. Involvement of nitric oxide and cyclooxygenase pathways was investigated by agonist challenges with L-arginine and substance P, respectively. The expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) was determined in spinal sections by immunohistochemical analysis. Lipopolysaccharide (LPS) challenge was used to assess in vivo effect on inflammatory cytokines (TNFα and IL-6). RESULTS Acute toxicity studies revealed no behavioural abnormality or mortality on osthole treatment and unremarkable histological findings. Osthole was found to significantly decrease acetic acid and formalin-induced hyperalgesia (ED50 = 5.43 mg kg-1) and carrageenan-induced paw oedema with no toxicity symptoms. Osthole produced a marked decrease in iNOS and COX-2 expression as well as TNFα and IL-6. The findings corroborate to modulation of iNOS and COX-2 and inflammatory cytokines by osthole. This study provides promising insights and prospects for application of osthole in pain management.
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Affiliation(s)
- Gurjit Singh
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, 143005, India
| | - Rajbir Bhatti
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, 143005, India.
| | - Rahul Mannan
- Department of Pathology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India
| | - Drishtant Singh
- Department of Molecular Biology and Biochemistry, Guru Nanak Dev University, Amritsar, India
| | - Anup Kesavan
- Department of Molecular Biology and Biochemistry, Guru Nanak Dev University, Amritsar, India
| | - Palwinder Singh
- Department of Chemistry, Guru Nanak Dev University, Amritsar, India
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Singh G, Singh G, Bhatti R, Gupta M, Kumar A, Sharma A, Singh Ishar MP. Indolyl-isoxazolidines attenuate LPS-stimulated pro-inflammatory cytokines and increase survival in a mouse model of sepsis: Identification of potent lead. Eur J Med Chem 2018; 153:56-64. [PMID: 29656890 DOI: 10.1016/j.ejmech.2018.04.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 03/24/2018] [Accepted: 04/02/2018] [Indexed: 01/18/2023]
Abstract
A library of indolyl-isoxazolidines (6-9) has been synthesized by regio- and stereoselective microwave irradiated 1,3-dipolar cycloadditions of C-(3-indolyl)-N-phenylnitrone (2') with variedly substituted dipolarophiles (3'-5') and screened for their anti-inflammatory activities through inhibition of pro-inflammatory cytokines such as TNF-α and IL-6. Amongst the evaluated compounds (6-9), bicyclic isoxazolidine (9a) was found to exhibit significant inhibitory potential against LPS induced human IL-6 and TNF-α in THP-1 cells. Compound 9a was further assessed for in vivo analgesic and anti-inflammatory activities via acetic acid induced writhing and carrageenan induced paw edema models in mice, respectively. The results showed that compound possesses potent anti-inflammatory-analgesic activity comparable to indomethacin and did not show toxicity up to a 2000 mg kg-1 dose as evidenced by histopathological studies. Consequently, the most active compound 9a was also evaluated against LPS-induced septic death and exhibited a significant protection in in vivo mouse model. Taken all together, the results suggest that the compound 9a is able to attenuate pro-inflammatory cytokines such as IL-6 and TNF-α; accelerate resolution of inflammation, and also increased survival rate of septic mice. Therefore, these "lead" isoxazolidines can be used as promising candidate for further analgesic/anti-inflammatory drug design and development.
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Affiliation(s)
- Gagandeep Singh
- Bio-Organic and Photochemistry Laboratory, Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, 143 005, Punjab, India
| | - Gurjit Singh
- Bio-Organic and Photochemistry Laboratory, Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, 143 005, Punjab, India
| | - Rajbir Bhatti
- Bio-Organic and Photochemistry Laboratory, Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, 143 005, Punjab, India
| | - Mehak Gupta
- Cancer Pharmacology Division, Indian Institute of Integrative Medicine (CSIR), Jammu, 180001, India
| | - Ajay Kumar
- Cancer Pharmacology Division, Indian Institute of Integrative Medicine (CSIR), Jammu, 180001, India
| | - Ankita Sharma
- Cancer Pharmacology Division, Indian Institute of Integrative Medicine (CSIR), Jammu, 180001, India
| | - Mohan Paul Singh Ishar
- Bio-Organic and Photochemistry Laboratory, Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, 143 005, Punjab, India; Vice Chancellor, Maharaja Ranjit Singh Punjab Technical University, Badal Road, Bathinda, India.
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Singh P, Kaur S, Sharma A, Kaur G, Bhatti R. TNF-α and IL-6 inhibitors: Conjugates of N-substituted indole and aminophenylmorpholin-3-one as anti-inflammatory agents. Eur J Med Chem 2017; 140:92-103. [DOI: 10.1016/j.ejmech.2017.09.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 09/01/2017] [Accepted: 09/03/2017] [Indexed: 01/01/2023]
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Kaur S, Kaur A, Singh G, Bhatti R. Mercurius solubilis attenuates scopolamine-induced memory deficits and enhances the motor coordination in mice. Int J Neurosci 2017; 128:219-230. [DOI: 10.1080/00207454.2017.1382494] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Simranjeet Kaur
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
| | - Anudeep Kaur
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
| | - Gurjit Singh
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
| | - Rajbir Bhatti
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India
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Singh G, Singh G, Bhatti R, Gupta V, Mahajan A, Singh P, Singh Ishar MP. Rationally designed benzopyran fused isoxazolidines and derived β 2,3,3-amino alcohols as potent analgesics: Synthesis, biological evaluation and molecular docking analysis. Eur J Med Chem 2016; 127:210-222. [PMID: 28063353 DOI: 10.1016/j.ejmech.2016.12.052] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 11/27/2016] [Accepted: 12/24/2016] [Indexed: 12/14/2022]
Abstract
Based on structure activity analysis of morphine related opiates, we have synthesized some novel benzopyran fused isoxazolidines (2a-e) and derived conformationally constrained β2,3,3-amino alcohols (3a-e), which were evaluated in vivo for their anti-nociceptive activity through acetic acid induced writhing test (peripheral) and formalin induced algesia (central). Results showed that, compound 2a possesses significant opioid agonist activity. Further, molecular docking analysis reveals that compound 2a binds to δ-opioid receptor (DOR) with comparatively better D-score than to μ (MOR) and κ (KOR) receptors. Compound 2a did not show any toxicity up to a 2000 mg kg-1 dose.
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Affiliation(s)
- Gagandeep Singh
- Bio-Organic and Photochemistry Laboratory, Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, 143 005, Punjab, India
| | - Gurjit Singh
- Bio-Organic and Photochemistry Laboratory, Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, 143 005, Punjab, India
| | - Rajbir Bhatti
- Bio-Organic and Photochemistry Laboratory, Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, 143 005, Punjab, India
| | - Vivek Gupta
- Post-Graduate Department of Physics & Electronics, University of Jammu, Jammu Tawi, 180 006, India
| | - Ajay Mahajan
- Cancer Pharmacology Division, Indian Institute of Integrative Medicine (CSIR), Jammu, 180001, India
| | - Palwinder Singh
- Department of Chemistry, UGC Sponsored Centre for Advanced Studies, Guru Nanak Dev University, Amritsar, 143 005, Punjab, India
| | - Mohan Paul Singh Ishar
- Bio-Organic and Photochemistry Laboratory, Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, 143 005, Punjab, India.
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Singh P, Kaur S, Kaur J, Singh G, Bhatti R. Rational Design of Small Peptides for Optimal Inhibition of Cyclooxygenase-2: Development of a Highly Effective Anti-Inflammatory Agent. J Med Chem 2016; 59:3920-34. [DOI: 10.1021/acs.jmedchem.6b00134] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Palwinder Singh
- UGC
Sponsored Centre for Advanced Studies - Department of Chemistry and ‡Department of Pharmaceutical
Sciences, Guru Nanak Dev University, Amritsar 143005, India
| | - Sukhmeet Kaur
- UGC
Sponsored Centre for Advanced Studies - Department of Chemistry and ‡Department of Pharmaceutical
Sciences, Guru Nanak Dev University, Amritsar 143005, India
| | - Jagroop Kaur
- UGC
Sponsored Centre for Advanced Studies - Department of Chemistry and ‡Department of Pharmaceutical
Sciences, Guru Nanak Dev University, Amritsar 143005, India
| | - Gurjit Singh
- UGC
Sponsored Centre for Advanced Studies - Department of Chemistry and ‡Department of Pharmaceutical
Sciences, Guru Nanak Dev University, Amritsar 143005, India
| | - Rajbir Bhatti
- UGC
Sponsored Centre for Advanced Studies - Department of Chemistry and ‡Department of Pharmaceutical
Sciences, Guru Nanak Dev University, Amritsar 143005, India
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40
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Affiliation(s)
- Palwinder Singh
- Department
of Chemistry, Guru Nanak Dev University, Amritsar, 143005, India
| | - Jagroop Kaur
- Department
of Chemistry, Guru Nanak Dev University, Amritsar, 143005, India
| | - Gurjit Singh
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, 143005, India
| | - Rajbir Bhatti
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, 143005, India
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Singh P, Prasher P, Dhillon P, Bhatti R. Indole based peptidomimetics as anti-inflammatory and anti-hyperalgesic agents: Dual inhibition of 5-LOX and COX-2 enzymes. Eur J Med Chem 2015; 97:104-23. [PMID: 25956953 DOI: 10.1016/j.ejmech.2015.04.044] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 04/10/2015] [Accepted: 04/20/2015] [Indexed: 12/13/2022]
Abstract
The indoles bearing a tosyl group at N-1 and a dipeptide substituent at C-3 were screened for anti-inflammatory and anti-hyperalgesic activities. Some of the compounds made significant reduction in the dextran induced swelling and capsaicin induced pain in the albino mice. About 95% reversal in capsaicin induced pain occurred in the presence of 5 mg kg(-1) of compound 7b, 7d and 7h while diclofenac showed 90% reversal when its 10 mg kg(-1) dose was used. In order to examine the mode of action of these compounds; COX-1, COX-2 and 5-LOX enzyme immunoassays were performed. The IC50 of compound 7b for COX-2 and 5-LOX were in the nM range: 5-LOX, IC50 = 2.0 nM; COX-2, IC50 = 6.3 nM, selectivity for COX-2 over COX-1 was 351. The interactions of the compounds with COX-2 and 5-LOX were supported by the physical parameters including Ki, Ka and ΔG. The most potent compounds 7b, 7d and 7h showed no toxicity to the animals and were identified as the promising leads for anti-inflammatory drugs.
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Affiliation(s)
- Palwinder Singh
- UGC Sponsored Centre for Advanced Studies, Department of Chemistry, Guru Nanak Dev University, Amritsar 143005, India
| | - Parteek Prasher
- UGC Sponsored Centre for Advanced Studies, Department of Chemistry, Guru Nanak Dev University, Amritsar 143005, India
| | - Parvirti Dhillon
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar 143005, India
| | - Rajbir Bhatti
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar 143005, India
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Sehajpal J, Kaur T, Bhatti R, Singh AP. Role of progesterone in melatonin-mediated protection against acute kidney injury. J Surg Res 2014; 191:441-7. [PMID: 24878191 DOI: 10.1016/j.jss.2014.04.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 04/08/2014] [Accepted: 04/09/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Melatonin is released by pineal gland and maintains circadian rhythm in the body. It has been reported as renoprotective agent because of its antioxidant property. Recently, a cross talk between progesterone and melatonin has been observed in various preclinical studies. The present study investigated the involvement of progesterone receptors in melatonin-mediated protection against ischemia reperfusion induced acute kidney injury (AKI) in rats. MATERIALS AND METHODS The rats were subjected to bilateral renal ischemia for 40 min followed by reperfusion for 24 h to induce AKI. The AKI was assessed by measuring creatinine clearance, serum urea, uric acid level, potassium level, fractional excretion of sodium, lactate dehydrogenase activity, and microproteinuria. The oxidative stress in renal tissues was assessed by quantification of myeloperoxidase activity, thiobarbituric acid reactive substances, superoxide anion generation, reduced glutathione level, and catalase activity. The hematoxylin-eosin staining was carried out to observe histopathologic changes in renal tissues. The melatonin (4 and 10 mg/kg, intraperitoneally) and progesterone receptor antagonist mifepristone (5 mg/kg, intraperitoneally) were used in the present study. RESULTS The renal ischemia reperfusion induced AKI as indicated by significant change in serum, urinary, and tissue parameters that was ameliorated by prior treatment with melatonin. No significant difference in serum progesterone level was observed between various groups used in the present study. The prior administration of mifepristone abolished melatonin-mediated protection against AKI. CONCLUSIONS It is concluded that melatonin treatment affords protection against ischemia reperfusion induced AKI. Moreover, progesterone receptors are essentially involved in mediating protective role of melatonin against AKI in rats.
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Affiliation(s)
- Jyotsna Sehajpal
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Tajpreet Kaur
- Department of Pharmacology, Khalsa College of Pharmacy, Amritsar, Punjab, India
| | - Rajbir Bhatti
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Amrit Pal Singh
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, India.
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Shaveta, Singh A, Kaur M, Sharma S, Bhatti R, Singh P. Rational design, synthesis and evaluation of chromone-indole and chromone-pyrazole based conjugates: identification of a lead for anti-inflammatory drug. Eur J Med Chem 2014; 77:185-92. [PMID: 24631898 DOI: 10.1016/j.ejmech.2014.03.003] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 02/09/2014] [Accepted: 03/02/2014] [Indexed: 02/02/2023]
Abstract
Conjugates of chromone-indole and chromone-pyrazole were screened for cyclooxygenase-2 (COX-2), cyclooxygenase-1 (COX-1) and 5-lipoxygenase (5-LOX) inhibitory activities. Compounds 8 and 9 were identified as preferred inhibitors of COX-2 over the other two enzymes. Their IC50 for COX-2 was 29 nM and 20 nM, respectively and selectivity indices (SI) for COX-2 over COX-1 was 46 and 337. NMR, mass spectral studies and molecular modelling also indicated preferential interactions of compounds 8 and 9 with COX-2. Tested on albino mice against capsaicin induced algesia, compound 8 exhibited analgesic potential comparable to diclofenac. In addition to the biological profile, the desirable physico-chemical properties of these compounds make them promising leads for anti-inflammatory drugs.
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Affiliation(s)
- Shaveta
- Department of Chemistry, UGC Sponsored Centre for Advanced Studies, Guru Nanak Dev University, Amritsar, Punjab 143005, India
| | - Amrinder Singh
- Department of Chemistry, UGC Sponsored Centre for Advanced Studies, Guru Nanak Dev University, Amritsar, Punjab 143005, India
| | - Matinder Kaur
- Department of Chemistry, UGC Sponsored Centre for Advanced Studies, Guru Nanak Dev University, Amritsar, Punjab 143005, India
| | - Surbhi Sharma
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar 143005, India
| | - Rajbir Bhatti
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar 143005, India
| | - Palwinder Singh
- Department of Chemistry, UGC Sponsored Centre for Advanced Studies, Guru Nanak Dev University, Amritsar, Punjab 143005, India.
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Sethi N, Bhatti R, Ishar M. In vivo pharmacological profile of substituted (3-pyridyl)-2-phenylisoxazolidine analogues of nicotine as novel antinociceptives. Res Pharm Sci 2014; 9:59-67. [PMID: 25598800 PMCID: PMC4292182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Nicotinic ligands have been studied as novel therapeutic interventions in pain therapeutics since a long time. Several nicotinic agonists have been withdrawn from later stages of clinical trials due to lack of efficacy or narrow therapeutic window. These have been documented to act in the central nervous system and produce a wide range of pharmacological effects, including memory enhancing and analgesic actions, antianxiety, antidepressant and muscle coordination. Taking cognizance of the wide pharmacological profile of nicotine and its ligands, it was decided to evaluate some novel isoxazolidine analogues of nicotine for their potential as analgesics, using animal models like Eddy's hot plate and Tail immersion method. The compounds showed marked decrease in hyperalgesic response as compared to pentazocine at a wide range of doses. They were well tolerated as none of the compounds was found to have any seizure potential or mortality even at the highest doses. Thus, these compounds can be developed as potent antinociceptives with better safety profile than nicotine and other currently available pain therapeutics.
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Affiliation(s)
- N. Sethi
- Bio-organic and Phytochemistry Laboratory, Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar 143005, India
| | - R. Bhatti
- Bio-organic and Phytochemistry Laboratory, Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar 143005, India
| | - M.P.S. Ishar
- Bio-organic and Phytochemistry Laboratory, Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar 143005, India,Corresponding author: M.P.S. Ishar Tel. 0091 183 6544820, Fax. 0091 183 2258820
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Singh P, Shaveta, Sharma S, Bhatti R. Rationally designed hybrid molecules with appreciable COX-2 inhibitory and anti-nociceptive activities. Bioorg Med Chem Lett 2014; 24:77-82. [DOI: 10.1016/j.bmcl.2013.11.080] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 11/08/2013] [Accepted: 11/28/2013] [Indexed: 11/26/2022]
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Bhatti R, Sharma S, Singh J, Singh A, Ishar MPS. Effect of Aegle marmelos (L.) Correa on alloxan induced early stage diabetic nephropathy in rats. Indian J Exp Biol 2013; 51:464-469. [PMID: 23926695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Diabetic nephropathy (DN) has a complex pathogenesis and poor prognosis due to the lack of therapeutic interventions. The present study investigates the effect of A. marmelos leaf extract (AME) on early alloxan induced DN. The treatment with AME was found to significantly decrease the fasting blood sugar, total cholesterol, blood urea, creatinine and renal TBARS and increased the levels of renal reduced glutathione and catalase significantly as compared to the diabetic control group. The maximum dose-dependent protection was observed at a dose of 200 mg kg(-1). Histological examination revealed marked reversal of the morphological derangements with AME treatment as indicated by a decrease in glomerular expansion, tubular dilatation and inflammatory cells. The present results conclude that AME treatment has a significant ameliorative effect on early changes induced in the kidneys by alloxan and improves the outcome of DN.
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Affiliation(s)
- Rajbir Bhatti
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, India.
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Dhuria RS, Bhatti R, Bhatti MS, Singh P, Whitcomb PJ, Thukral AK. Experimental design optimization for electrochemical removal of gentamicin: toxicity evaluation and degradation pathway. Water Sci Technol 2013; 67:2017-2024. [PMID: 23656945 DOI: 10.2166/wst.2013.076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Electrochemical degradation of gentamicin was achieved using a laboratory scale electrochemical reactor by optimizing pH, current density and treatment time. A two step statistical optimization was performed as per factorial design and center composite design (CCD). A Pareto chart was used for selecting statistically significant effects and an analysis of variance (ANOVA) table indicated significant curvature. Thus adding additional experimental runs improved the model fitting through a second order model. Maximum degradation was predicted at a pH of 6.7, 70 A m(-2) and 45 min. The experimental data fitted well through a reduced quadratic model with R(2) equal to 0.945. The toxicity of degradation products as determined by disc diffusion assay employing Pseudomonas aeruginosa strain was found to be reduced by 55%. The degradation pathway of gentamicin was studied using mass spectral (MS) analysis. Pure gentamicin showed a molecular ion peak at m/z 478 ([M + 1](+)), and after addition of NaCl as electrolyte, the mass peak was observed at m/z 523. After 15 min of electrochemical treatment, a new peak appeared at m/z 316 due to the loss of one pyran moiety. After 45 min of electrochemical treatment, another peak appeared at m/z of 478 due to loss of two Na(+) from gentamicin.
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Affiliation(s)
- Radhey S Dhuria
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, India
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Bhatti R, Singh J, Saxena AK, Suri N, Ishar MPS. Pharmacognostic standardisation and antiproliferative activity of Aegle marmelos (L.) Correa leaves in various human cancer cell lines. Indian J Pharm Sci 2013; 75:628-34. [PMID: 24591736 PMCID: PMC3928725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 09/01/2013] [Accepted: 09/15/2013] [Indexed: 11/25/2022] Open
Abstract
Therapeutic management of cancer is a great clinical challenge and alternative medicines are being extensively explored to have integrated approach to cure cancer. Aegle marmelos (L.) Correa (Rutaceae) is known for its hypoglycaemic, radioprotective, antidiarrhoeal and many other pharmacological activities. The present study is designed to carryout pharmacognostic standardisation and evaluation of antiproliferative activity of the leaf extracts Aegle marmelos (L.) Correa (Rutaceae) and the chromatographic fractions of the most active extract. Hexane, petroleum ether, chloroform and ethanol extracts of the shade dried leaves were prepared by soxhelation and antiproliferative activity was assessed using human cancer cell lines of lung (A-549), colon (CoLo-05), ovary (IGR-OV-1), prostrate (PC3), leukaemia (THP-1) and breast (MCF-7) cancer. Bioactivity-derived fractionation was carried out for most active extract by column chromatography. The phytochemical studies indicated alkaloids, anthraquinones, terpenoids in the alcohol, chloroform extracts and tannins, terpenoids, reducing sugars in the petroleum ether and hexane extracts. Ethanol extract showed maximum inhibition in colon and breast carcinoma cell lines at a dose of 100 μg/ml. Column chromatography of the ethanol extract yielded five fractions. Out of this, fractions 2, 4 and 5 showed significant inhibition in leukaemia cell line with IC50 of 12.5, 86.2 and >100 μg/ml for fractions 2, 4 and 5, respectively. High-performance thin layer chromatography of the fraction 2 revealed imperatorin as one of the major phytoconstituents. Among the different extracts investigated, ethanol extract exhibited significant antiproliferative activity and its fraction 2 containing furanocoumarin imperatorin showed antiproliferative activity against leukaemia cell line with IC50 of 12.5 μg/ml.
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Affiliation(s)
- Rajbir Bhatti
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar-143 005, India,Address for correspondence E-mail:
| | - J. Singh
- Departments of Pharmacology, Government Medical College, Amritsar-143 001, India
| | - A. K. Saxena
- Indian Institute of Integrative Medicine, Jammu–180 016, India
| | - Nitasha Suri
- Indian Institute of Integrative Medicine, Jammu–180 016, India
| | - M. P. S. Ishar
- Indian Institute of Integrative Medicine, Jammu–180 016, India,Present address: Vice-Chancellor, University of Jammu, Jammu and Kashmir, India
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Bhatti R, Sharma S, Singh J, Ishar MPS. Ameliorative effect of Aegle marmelos leaf extract on early stage alloxan-induced diabetic cardiomyopathy in rats. Pharm Biol 2011; 49:1137-1143. [PMID: 22014262 DOI: 10.3109/13880209.2011.572077] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE The pathogenesis of diabetic cardiomyopathy (DCM) is complex, and the therapeutic options available to treat DCM are limited. The present study was designed to investigate the effect of Aegle marmelos (L.) Correa (Rutaceae) leaf extract on early stage DCM in alloxan-induced diabetic rats. METHODS Diabetes was induced in Wistar rats (150-200 g) by injecting alloxan (150 mg kg(-1); i.p.). Ethanol extract of A. marmelos leaves was administered at varying doses (100, 200, and 400 mg kg(-1)) and tolbutamide (100 mg kg(-1)) as standard. Fasting blood glucose (FBG), total cholesterol, thiobarbituric acid reactive substances (TBARS), reduced glutathione (GSH), catalase (CAT), superoxide dismutase (SOD), lactate dehydrogenase (LDH) and creatine kinase (CK) were determined by standard methods. RESULTS A. marmelos extract (AME) was found to decrease the levels of FBG, total cholesterol, TBARS, LDH and CK, and increase the levels of GSH, CAT and SOD dose dependently as compared to diabetic control groups. The maximum dose-dependent decrease in TBARS (63.46%), LDH (34.04%), CK (53.14%), and increase in GSH (64.91%), CAT (59.34%), SOD (69.65%) was evident at an optimum dose of 200 mg kg(-1). Histopathological studies revealed salvage in the morphological derangements as indicated by absence of necrosis and marked decrease in inflammatory cells in AME-treated groups as compared to diabetic control. CONCLUSIONS The present investigations conclude that treatment with AME attenuates the severity and improves the myocardium in the early stages of alloxan-induced DCM at a dose of 200 mg kg(-1).
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Affiliation(s)
- Rajbir Bhatti
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, India.
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Li SP, Moule RN, Seah ML, Rainbow S, Bhatti R, Steer KA, Windmill E, Makris A. Abstract P4-03-03: Lower Vitamin D Levels Are Highly Prevalent in Women with Breast Cancer. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p4-03-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: The objectives of this study were to determine the prevalence of vitamin D insufficiency or deficiency as measured by serum 25-hydroxyvitamin D (25-OHD) in women with breast cancer and relate this to age, ethnic group, disease stage, and seasonal variation. Methods: Levels of serum 25-OHD were requested on blood samples collected from 129 female patients with histologically-proven breast cancer (median age 61 years; range, 30-88). Vitamin D deficiency was defined as serum 25-OHD less than 12.5 nmol/L, insufficiency as 12.5 to 50 nmol/L, and sufficient levels as greater than 50 nmol/L. The prevalence of inadequate (insufficient or deficient) vitamin D levels and median 25-OHD values were calculated for the cohort as a whole and analysed according to age, ethnicity (Asian (Indian/Pakistani), White and other), disease stage (early versus metastatic), and seasons. Statistical analysis was performed using non-parametric methods and a significance level set at a two-tailed p-value < 0.05.
Results: Overall 52% of women had inadequate levels of 25-OHD (45% deficient, 7% insufficient; median 29 nmol/L). There was no relationship with age. Lower levels were more common in Asian women (n=56) (64%; 16% deficient, 48% insufficient) compared with white women (n=65) (40%; all insufficient) and other (n=8) (62.5%; all insufficient). 25-OHD levels were significantly lower overall in Asian women in comparison with white women (median 36.5 versus 60 nmol/L; p=0.0002). When disease stage was considered, 54% of women with early breast cancer had inadequate 25-OHD levels (n=103) (7% deficient, 47% insufficient) in comparison with 42% of women with metastatic disease (n=26) (8% deficient, 34% insufficient) although overall levels were not significantly different between groups. There was no seasonal variation in 25-OHD levels.
Conclusion: The prevalence of insufficient or deficient vitamin D levels as assessed by 25-OHD in women with breast cancer, especially in the Asian population, is high. Our findings suggest that all patients with breast cancer should have routine testing of vitamin D status and if appropriate, offered adequate vitamin D supplementation.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-03-03.
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Affiliation(s)
- SP Li
- Mount Vernon Cancer Centre, Northwood, Middlesex, United Kingdom; Northwick Park Hospital, Harrow, Middlesex, United Kingdom
| | - RN Moule
- Mount Vernon Cancer Centre, Northwood, Middlesex, United Kingdom; Northwick Park Hospital, Harrow, Middlesex, United Kingdom
| | - M-L Seah
- Mount Vernon Cancer Centre, Northwood, Middlesex, United Kingdom; Northwick Park Hospital, Harrow, Middlesex, United Kingdom
| | - S Rainbow
- Mount Vernon Cancer Centre, Northwood, Middlesex, United Kingdom; Northwick Park Hospital, Harrow, Middlesex, United Kingdom
| | - R Bhatti
- Mount Vernon Cancer Centre, Northwood, Middlesex, United Kingdom; Northwick Park Hospital, Harrow, Middlesex, United Kingdom
| | - KA Steer
- Mount Vernon Cancer Centre, Northwood, Middlesex, United Kingdom; Northwick Park Hospital, Harrow, Middlesex, United Kingdom
| | - E Windmill
- Mount Vernon Cancer Centre, Northwood, Middlesex, United Kingdom; Northwick Park Hospital, Harrow, Middlesex, United Kingdom
| | - A. Makris
- Mount Vernon Cancer Centre, Northwood, Middlesex, United Kingdom; Northwick Park Hospital, Harrow, Middlesex, United Kingdom
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