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Brain & Heart Oxidative stress and neurological disorders

both pharmacological and non-pharmacological therapies However, the precise mechanism of cellular physiology
due to the multifaceted nature of symptoms and the remains undefined. It is well-established that oxidative
irreversible damage occurring at multiple levels, such as stress triggers a cascade of events leading to neuronal
molecular, cellular, intercellular, and synaptic interactions. damage. Given the multifaceted nature of these diseases,
Early diagnosis and understanding of the disease’s etiology their underlying mechanisms remain elusive. Further,
can help alleviate symptoms, and numerous clinical trials comprehensive studies are required to elucidate the signals
and preclinical are underway. Medications approved by induced by oxidative stress that contributes to physiological
the United States Food and Drug Administration (US alternations in organs or neurons. Biomarkers of oxidative
FDA) to reduce symptoms and alleviate disability include stress hold promise as diagnostic tools and therapeutic
acetylcholine inhibitors such as donepezil, galantamine, targets for early detection. Antioxidant therapy, along
rivastigmine, and N-methyl-d-aspartate antagonists. with a diet rich in antioxidants such as flavonoids,
These medications are often combined with other drugs, polyphenolic acids, lipoic acid, and vitamins, can serve as
such as benzodiazepines for anxiety and acetaminophen effective therapies. One significant consequence of ROS
for sleep issues and pain relief. Risperidone is sometimes production is the overactivation of glutamate receptors.
prescribed for severe agitation and psychosis. In later Therapeutic agents targeting these approaches show
stages, Alzheimer’s disease may manifest significant promise. Administering antioxidant therapy early, before
neuropsychiatric symptoms and behavioral issues, neuronal loss, could prove beneficial. Several intriguing
including language difficulties, disorientation, and therapies, such as monoclonal antibodies against protein
changes in sleep cycle and mood swings. accumulation, modulation of calcium homeostasis, and
anti-inflammatory agents, could complement antioxidant
8.3.3. Antibody-based immunotherapies therapy in combination treatments. Natural products
The primary pathological cause of Alzheimer’s disease are being investigated and modified to focus on more
reported to date is the abnormal accumulation of biochemical pathways and enzymatic processing, which
amyloid plaques. US FDA has approved two monoclonal may aid in controlling and curing diseases with minimal
antibodies for use as drugs: aducanumab and lecanemab. side effects.
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Numerous clinical trials and in vitro studies have reported
that these are anti-amyloid antibodies capable of slowing Acknowledgments
down the deposition of amyloid and reducing cognitive None.
decline. These anti-amyloid β monoclonal antibodies
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are administrated intravenously to provide passive Funding
immunization. Several other monoclonal antibodies Nihila Khola is a recipient of a fellowship from the Central
are still undergoing phase III clinical trials. All these University of Haryana. Kareena Moar is a recipient of a
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antibodies aim to counteract amyloid accumulation and junior research fellowship from the Haryana State Council
halt the cascade of neurodegeneration. These interventions for Science, Innovation and Technology (HSCIT-3946).
should decelerate the process of neurodegeneration and This agency had no role in the interpretation or writing
functional and cognitive decline. Recently, four FDA- the manuscript. The Indian Council of Medical Research
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approved monoclonal antibodies targeting amyloid β are (ICMR), Government of India, is gratefully acknowledged
in late-phase clinical development, including lecanemab, by Pawan Kumar Maurya for giving financial assistance
aducanumab, gantenerumab, and donanemab. All of (5/10/FR/03/2021-RBMCH).
these are monoclonal IgG antibodies synthesized to act
against amyloid aggregates. Clinical trials investigating Conflict of interest
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these four antibodies provide evidence of the intermediate
effect of the drug on biomarkers and amyloid removal. The authors declare no conflicts of interest.
However, the field of Alzheimer’s disease trials is still Author contributions
progressing, and more additional favorable treatments
for Alzheimer’s disease are likely to be developed in the Conceptualization: Nikhila Khola, Kareena Moar
future (Table 2). Writing-original draft: Kareena Moar
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Writing-review & editing: Pawan Kumar Maurya
9. Conclusion and future perspectives
Ethics approval and consent to participate
Numerous studies have demonstrated the existence of
several chronic pathologies induced by oxidative stress. Not applicable.

Volume 2 Issue 2 (2024) 11 doi: 10.36922/bh.2704