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1.
CNS Drugs ; 36(7): 739-770, 2022 07.
Article in English | MEDLINE | ID: covidwho-1930607

ABSTRACT

While the intranasal administration of drugs to the brain has been gaining both research attention and regulatory success over the past several years, key fundamental and translational challenges remain to fully leveraging the promise of this drug delivery pathway for improving the treatment of various neurological and psychiatric illnesses. In response, this review highlights the current state of understanding of the nose-to-brain drug delivery pathway and how both biological and clinical barriers to drug transport using the pathway can been addressed, as illustrated by demonstrations of how currently approved intranasal sprays leverage these pathways to enable the design of successful therapies. Moving forward, aiming to better exploit the understanding of this fundamental pathway, we also outline the development of nanoparticle systems that show improvement in delivering approved drugs to the brain and how engineered nanoparticle formulations could aid in breakthroughs in terms of delivering emerging drugs and therapeutics while avoiding systemic adverse effects.


Subject(s)
Mental Disorders , Administration, Intranasal , Brain/metabolism , Drug Delivery Systems , Humans , Mental Disorders/drug therapy , Mental Disorders/metabolism , Nose , Pharmaceutical Preparations/metabolism
2.
CNS Neurol Disord Drug Targets ; 21(3): 228-234, 2022.
Article in English | MEDLINE | ID: covidwho-1125178

ABSTRACT

Increasing reports of neurological symptoms in COVID-19 patient's warrant clinicians to adopt and define the standardized diagnostic and managing protocols in order to investigate the linkage of neurological symptoms in COVID-19. Encephalitis, anosmia, acute cerebrovascular disease and ageusia are some of the emerging neurological manifestations which are reported in several cohort studies on hospitalized patients with COVID-19. Although the COVID-19 pandemic is primarily associated with infection of the respiratory tract system, but measures like lockdown and restricted physical movements to control the spread of this infection will certainly have neurobehavioural implications. Additionally, some of the patients with pre-existing neurological manifestations like epilepsy, Parkinson's and Alzheimer's disease are more prone to infection and demand extra care as well as improvised treatment. In this review, we have focused on the neurovirological clinical manifestations associated with the COVID-19 pandemic. Although the prevalence of neurovirological manifestations is rare increasing reports cannot be ignored and needs to be discussed thoroughly with respect to risk analysis and considerations for developing a management strategy. This also helps in defining the burden of neurological disorders associated with COVID-19 patients.


Subject(s)
COVID-19/psychology , COVID-19/therapy , Mental Disorders/psychology , Mental Disorders/therapy , Nervous System Diseases/psychology , Nervous System Diseases/therapy , Angiotensin-Converting Enzyme 2/metabolism , COVID-19/epidemiology , COVID-19/metabolism , Communicable Disease Control/methods , Communicable Disease Control/trends , Humans , Mental Disorders/epidemiology , Mental Disorders/metabolism , Nervous System Diseases/epidemiology , Nervous System Diseases/metabolism , Risk Assessment/methods , Risk Assessment/trends , SARS-CoV-2/metabolism
3.
Scott Med J ; 66(1): 3-10, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1067034

ABSTRACT

BACKGROUND & AIMS: Though viewed as a critical measure to prevent the spread of the virus, a prolonged homestay may result in unfavourable sedentary behaviour and chronic disease risk. This systematic review focuses on sedentary behaviour resulting from this quarantine period which may elevate the cardiovascular disease risk, obesity, hypertension, cancer and mental health illness. METHODS: Evidence of breaking sedentary behaviour and global recommendations were investigated. Potential unanswered questions regarding sedentary behaviour and physical activity during lockdown were explored. RESULTS: Five systematic reviews and six prospective trials explored the effect of sedentarism affecting chronic disease through potential pathophysiological mechanisms. Sedentary behaviour especially prolonged sitting is found to be a pleiotropic risk factor with altered energy expenditure, adipogenic signalling, immunomodulation, autonomic stability and hormonal dysregulation perpetuating underlying chronic diseases such as obesity, cardiovascular disease, cancer and mental health disorders. CONCLUSION: Breaking sitting and physical activity are found to reverse the adverse effects associated with excessive sitting during the lockdown.


Subject(s)
COVID-19/prevention & control , Cardiovascular Diseases/epidemiology , Communicable Disease Control , Mental Disorders/epidemiology , Obesity/epidemiology , Public Policy , Sedentary Behavior , Cardiometabolic Risk Factors , Cardiovascular Diseases/metabolism , Cardiovascular Diseases/physiopathology , Chronic Disease , Exercise , Humans , Mental Disorders/metabolism , Mental Disorders/physiopathology , Neoplasms/epidemiology , Neoplasms/metabolism , Neoplasms/physiopathology , Obesity/metabolism , Obesity/physiopathology , SARS-CoV-2
4.
Int J Mol Sci ; 21(12)2020 Jun 17.
Article in English | MEDLINE | ID: covidwho-738129

ABSTRACT

Exposure to ambient air pollution is a well-established determinant of health and disease. The Lancet Commission on pollution and health concludes that air pollution is the leading environmental cause of global disease and premature death. Indeed, there is a growing body of evidence that links air pollution not only to adverse cardiorespiratory effects but also to increased risk of cerebrovascular and neuropsychiatric disorders. Despite being a relatively new area of investigation, overall, there is mounting recent evidence showing that exposure to multiple air pollutants, in particular to fine particles, may affect the central nervous system (CNS) and brain health, thereby contributing to increased risk of stroke, dementia, Parkinson's disease, cognitive dysfunction, neurodevelopmental disorders, depression and other related conditions. The underlying molecular mechanisms of susceptibility and disease remain largely elusive. However, emerging evidence suggests inflammation and oxidative stress to be crucial factors in the pathogenesis of air pollution-induced disorders, driven by the enhanced production of proinflammatory mediators and reactive oxygen species in response to exposure to various air pollutants. From a public health perspective, mitigation measures are urgent to reduce the burden of disease and premature mortality from ambient air pollution.


Subject(s)
Air Pollutants/adverse effects , Air Pollutants/analysis , Air Pollution/adverse effects , Cerebrovascular Disorders/etiology , Cerebrovascular Disorders/metabolism , Mental Disorders/etiology , Mental Disorders/metabolism , Oxidative Stress , Animals , COVID-19/complications , COVID-19/epidemiology , Cerebrovascular Disorders/epidemiology , Disease Models, Animal , Disease Susceptibility , Global Health , Humans , Inflammation , Mental Disorders/epidemiology , Particulate Matter/adverse effects
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