benzofurans and Cerebral-Small-Vessel-Diseases

Vascular cognitive impairment without dementia is very common among the aged and tends to progress to dementia, but there have been no proper large-scale intervention trials dedicated to it. Vascular cognitive impairment without dementia caused by subcortical ischemic small vessel disease (hereinafter, subcortical Vascular cognitive impairment without dementia) represents a relatively homogeneous disease process and is a suitable target for therapeutic trials investigating Vascular cognitive impairment without dementia. Preclinical trials showed that dl-3-n-butylphthalide (NBP) is effective for cognitive impairment of vascular origin.. In this randomized, double-blind, placebo-controlled trial, we enrolled patients aged 50-70 years who had a diagnosis of subcortical Vascular cognitive impairment without dementia at 15 academic medical centers in China. Inclusion criteria included a clinical dementia rating ≥0.5 on at least one domain and global score ≤0.5; a mini-mental state examination score ≥20 (primary school) or ≥24 (junior school or above); and brain magnetic resonance imaging consistent with subcortical ischemic small vessel disease. Patients were randomly assigned to NBP 200 mg three times daily or matched placebo (1:1) for 24 weeks according to a computer-generated randomization protocol. All patients and study personnel were masked to treatment assignment. Primary outcome measures were the changes in Alzheimer's disease assessment scale-cognitive subscale (ADAS-cog) and clinician's interview-based impression of change plus caregiver input (CIBIC-plus) after 24 weeks. All patients were monitored for adverse events (AEs). Outcome measures were analyzed for both the intention-to-treat (ITT) population and the per protocol population.. This study enrolled 281 patients. NBP showed greater effects than placebo on ADAS-cog (NBP change -2.46 vs. placebo -1.39; P = .03; ITT) and CIBIC-plus (80 [57.1%] vs. 59 [42.1%] patients improved; P = .01; ITT). NBP-related AE were uncommon and primarily consisted of mild gastrointestinal symptoms.. Over the 6-month treatment period, NBP was effective for improving cognitive and global functioning in patients with subcortical vascular cognitive impairment without dementia and exhibited good safety.

Topics: Aged; Benzofurans; Cerebral Small Vessel Diseases; China; Cognition Disorders; Double-Blind Method; Female; Humans; Male; Middle Aged; Neuroprotective Agents; Neuropsychological Tests

The aim of this study was to investigate the effect of 3-n-butylphthalide (NBP) on the apoptosis of nerve cells in vascular dementia (VaD) model rats caused by cerebral small vessel disease (CSVD), and to explore its regulatory mechanism.. The model of VaD was successfully established in rats by carotid artery ligation. All rats were randomly divided into three groups, including the sham operation group, model group and NBP group. The neurobehavioral score was used to verify whether the model was successfully established. The changes in learning and memory abilities of rats were detected via water maze experiment. The levels of Bcl-2-associated X protein (Bax) and cysteinyl aspartate specific proteinase-3 (Caspase-3) in the serum of rats was detected by enzyme-linked immunosorbent assay (ELISA). Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay was adopted to detect the apoptosis of nerve cells in brain tissues of rats. Moreover, the protein levels of phosphorylated phosphatidylinositol-3-kinase (PI3K) and phosphorylated protein kinase B (Akt) in brain tissues of rats were measured using Western blotting.. Compared with the sham operation group, the neurobehavioral score of rats increased significantly, whereas learning and memory abilities decreased markedly in the model group. The levels of Bax and Caspase-3 in rat serum were remarkably up-regulated, and the apoptosis rate of nerve cells in brain tissues of rats increased significantly in the model group as well. Meanwhile, the levels of phosphorylated PI3K and phosphorylated Akt were notably declined. Compared with the model group, the neurobehavioral score decreased markedly, while learning and memory abilities were remarkably improved in the NBP group. The levels of Bax and Caspase-3 in rat serum were significantly down-regulated, and the apoptosis rate of nerve cells in brain tissues of rats were reduced in the NBP group. Furthermore, the protein levels of phosphorylated PI3K and phosphorylated Akt were remarkably elevated in the NBP group.. NBP can improve the morphology of brain tissue cells and the learning and memory abilities, and inhibit the apoptosis of nerve cells in VaD model rats with CSVD. The possible underlying mechanism may be related to the activation of the PI3K/Akt signaling pathway.

Topics: Animals; Apoptosis; bcl-2-Associated X Protein; Behavior, Animal; Benzofurans; Brain Chemistry; Carotid Artery Diseases; Caspase 3; Cerebral Small Vessel Diseases; Male; Maze Learning; Neurons; Neuroprotective Agents; Oncogene Protein v-akt; Phosphatidylinositol 3-Kinases; Rats; Rats, Sprague-Dawley; Signal Transduction

Salvianolic acid B is one of the key water‑soluble components of Salvia extract. It has been verified that salvianolic acid B possesses multiple pharmacological activities, it protects against myocardial infarction, however additionally improves injury of myocardial ischemia‑reperfusion. The present study, the possible effects of salvianolic acid B on cognitive deficits and angiogenesis in cerebral small vessel disease were investigated. Salvianolic acid B was identified to recover cognitive deficits and neurocytes, reduce inflammation, oxidative stress and neurocyte apoptosis (caspase‑3 and Bax protein expression) in cerebral small vessel disease rats. In addition, salvianolic acid B upregulated signal transducer and activator of transcription 3 (STAT3) phosphorylation protein expression, and induced vascular endothelial growth factor (VEGF) and VEGF receptor 2 protein expression in cerebral small vessel disease rats. In conclusion, the results demonstrated that salvianolic acid B recovers cognitive deficits and angiogenesis in the cerebral small vessel disease rat model via STAT3/VEGF signaling pathway.

Topics: Animals; Apoptosis; bcl-2-Associated X Protein; Behavior, Animal; Benzofurans; Caspase 3; Cerebral Small Vessel Diseases; Cognitive Dysfunction; Cytokines; Disease Models, Animal; Glutathione; Male; Neovascularization, Physiologic; Oxidative Stress; Rats; Rats, Sprague-Dawley; Signal Transduction; STAT3 Transcription Factor; Superoxide Dismutase; Vascular Endothelial Growth Factor A