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NeuroAiD

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NeuroAiD is a herbal supplement proposed to support functional recovery after strokes.[1] There were two formulations of NeuroAiD: MLC601 (NeuroAiDTM) was first developed.[1] Since 2018 MLC601 formulation is no longer on the market, and has been replaced by MLC901 (NeuroAiDTMII), a simplified formulation containing only 9 botanical ingredients.[2] It can be administered orally or through a feeding tube.[3]

The drug shows no significant benefit in improving outcomes at 3 months in patients with acute ischemic stroke.[4]

NeuroAiD was first registered and marketed in China in 2001.[1][5] It is derived from traditional Chinese medicine.[5][6][7] According to the CEO of Moleac, NeuroAiD is sold in at least 25 countries, and 20,000 people have taken it.[8]

Composition

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NeuroAiD I, or MLC601, is composed of nine herbal components (astragalus root, Salvia miltiorrhiza root, chishao, rhizome lovage, Angelica sinensis root, safflower, peach, thinleaf milkwort root, and grassleaf sweet flag rhizome) and five components derived from animals (Hirudo medicinalis, Eupolyphaga seu steleophaga, Calculus bovis artifactus, Buthus martensii, and Cornu saigae tataricae).[9] NeuroAiDTMII, or MLC901, is a simpler form of the medication that only contains the nine herbal components without the animal components.[2] Since 2018, MLC601 formulation is no longer marketed.

Pharmacology

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Laboratory studies suggest that NeuroAiD can aid with stroke recovery by improving neuroprotection, neurogenesis, and neuroplasticity by amplifying endogenous processes of self-protection and self-repair of the brain.[2][10][11] MLC901 can activate KATP channels, which has a neuroprotective effect against brain ischemia.[12]

Effectiveness

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Neuroaid was statistically no better than placebo in improving stroke recovery at 3 months post-stroke.[13]

Additionally, recent research indicates that NeuroAid improves cognitive functioning after traumatic brain injury[14] and could potentially play a role in treating severe traumatic spinal cord injuries,[15] as well as in slowing down the progression of Alzheimer's disease.[16]

Side effects

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Common side effects include abdominal discomfort, headaches, dry mouth, nausea, vomiting, and diarrhea. Frequently, they can be relieved by reducing the dosage of the medication by 50% for a week. Once the symptoms have resolved, the usual dosage can be resumed.[1] In some rare cases during clinical trials, a few patients experienced serious side effects (jaundice, low potassium levels, recurring strokes).[6]

Contraindications

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The medication is contraindicated in pregnant and breastfeeding women.[17]

Approvals and patents

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NeuroAiD was approved by the Sino Food and Drug Administration in August 2001, under the name Danqi Piantan Jiaonang.[9][18] NeuroAiD has also been approved for use in other Asian countries such as Singapore.[19] In 2006, NeuroAiD was also chosen for the Chinese Ministry of Science and Technology's Key Technologies Research & Development program.[20]

References

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  1. ^ a b c d Venketasubramanian N, Kumar R, Soertidewi L, Abu Bakar A, Laik C, Gan R (November 2015). "The NeuroAiD Safe Treatment (NeST) Registry: a protocol". BMJ Open. 5 (11): e009866. doi:10.1136/bmjopen-2015-009866. PMC 4654343. PMID 26567259.
  2. ^ a b c Heurteaux C, Gandin C, Borsotto M, Widmann C, Brau F, Lhuillier M, et al. (June 2010). "Neuroprotective and neuroproliferative activities of NeuroAid (MLC601, MLC901), a Chinese medicine, in vitro and in vivo". Neuropharmacology. 58 (7): 987–1001. doi:10.1016/j.neuropharm.2010.01.001. PMID 20064536. S2CID 22044836.
  3. ^ Chen CL, Sharma PR, Tan BY, Low C, Venketasubramanian N (2019). "The Alzheimer's disease THErapy with NEuroaid (ATHENE) study protocol: Assessing the safety and efficacy of Neuroaid II (MLC901) in patients with mild-to-moderate Alzheimer's disease stable on cholinesterase inhibitors or memantine-A randomized, double-blind, placebo-controlled trial". Alzheimer's & Dementia. 5: 38–45. doi:10.1016/j.trci.2018.12.001. PMC 6352850. PMID 30723778.
  4. ^ González-Fraile E, Martín-Carrasco M, Ballesteros J (2016). "Efficacy of MLC601 on functional recovery after stroke: A systematic review and meta-analysis of randomized controlled trials". Brain Injury. 30 (3): 267–70. doi:10.3109/02699052.2015.1118764. PMID 26890534. S2CID 23647180.
  5. ^ a b Tan CN, Choy D, Venketasubramanian N (2020). "NeuroAid II (MLC901) in Haemorrhagic Stroke". Case Reports in Neurology. 12 (Suppl 1): 212–217. doi:10.1159/000508588. PMC 7802497. PMID 33505298.
  6. ^ a b Siddiqui FJ, Venketasubramanian N, Chan ES, Chen C (2013). "Efficacy and safety of MLC601 (NeuroAiD®), a traditional Chinese medicine, in poststroke recovery: a systematic review". Cerebrovascular Diseases. 35 (Suppl 1): 8–17. doi:10.1159/000346231. PMID 23548914.
  7. ^ Widmann C, Gandin C, Petit-Paitel A, Lazdunski M, Heurteaux C (December 2018). "The Traditional Chinese Medicine MLC901 inhibits inflammation processes after focal cerebral ischemia". Scientific Reports. 8 (1): 18062. Bibcode:2018NatSR...818062W. doi:10.1038/s41598-018-36138-0. PMC 6305383. PMID 30584250.
  8. ^ Grens K (2013-07-05). "Herbal stroke remedy no better than dummy pill". Reuters.
  9. ^ a b Kim I, Pollitt E, Leibel RL, Viteri FE, Alvarez E (September 1984). "Application of receiver-operator analysis to diagnostic tests of iron deficiency in man". Pediatric Research. 18 (9): 916–920. doi:10.1203/00006450-198409000-00025. PMID 6483514.
  10. ^ Quintard H, Borsotto M, Veyssiere J, Gandin C, Labbal F, Widmann C, et al. (September 2011). "MLC901, a traditional Chinese medicine protects the brain against global ischemia". Neuropharmacology. 61 (4): 622–631. doi:10.1016/j.neuropharm.2011.05.003. PMID 21605573. S2CID 6194484.
  11. ^ Heurteaux C, Widmann C, Moha ou Maati H, Quintard H, Gandin C, Borsotto M, et al. (2013). "NeuroAiD: properties for neuroprotection and neurorepair". Cerebrovascular Diseases. 35 (Suppl. 1): 1–7. doi:10.1159/000346228. PMID 23548913. S2CID 16589542.
  12. ^ Chen CL, Young SH, Gan HH, Singh R, Lao AY, Baroque AC, et al. (August 2013). "Chinese medicine neuroaid efficacy on stroke recovery: a double-blind, placebo-controlled, randomized study". Stroke. 44 (8): 2093–2100. doi:10.1161/STROKEAHA.113.002055. PMID 23780952. S2CID 11203386.
  13. ^ Christopher L.H. Chen, Sherry H.Y. Young, Herminigildo H. Gan, Rajinder Singh, Annabelle Y. Lao, Alejandro C. Baroque, Hui Meng Chang, John Harold B. Hiyadan, Carlos L. Chua, Joel M. Advincula, Sombat Muengtaweepongsa, Bernard P.L. Chan, H. Asita de Silva, Somchai Towanabut, Nijasri C. Suwanwela, Niphon Poungvarin, Siwaporn Chankrachang, K.S. Lawrence Wong, Gaik Bee Eow, Jose C. Navarro, Narayanaswamy Venketasubramanian, Chun Fan Lee, Marie-Germaine Bousser (2013). "Chinese Medicine Neuroaid Efficacy on Stroke Recovery: A Double-Blind, Placebo-Controlled, Randomized Study". Stroke. 44 (8) (Stroke ed.): 2093–2100. doi:10.1161/STROKEAHA.113.002055. PMID 23780952. S2CID 11203386.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  14. ^ Ming-Che Tsai, Ching-Ping Chang, Syue-Wei Peng, Kai-Sheng Jhuang, Yi-Hsien Fang, Mao-Tsun Lin, Thomas Chang-Yao Tsao (2015). "Therapeutic Efficacy of Neuro AiD™ (MLC 601), a Traditional Chinese Medicine, in Experimental Traumatic Brain Injury". Journal of Neuroimmune Pharmacology. 10 (1) (Journal of Neuroimmune Pharmacology ed.): 45–54. doi:10.1007/s11481-014-9570-0. ISSN 1557-1904. PMID 25331680. S2CID 957001.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  15. ^ Ramesh Kumar, Ohnmar Htwe, Azmi Baharudin, Shaharuddin Abdul Rhani, Kamalnizat Ibrahim, Jagdeep Singh Nanra, Muhindra Gsangaya, Hezery Harun, Khairrudin Kandar, Maatharasi Balan, Shawn Peh, Yogesh Pokharkar, Abhinay Ingole & Mohammad Hisam Ariffin (2022). "Spinal cord injury – assessing tolerability and use of combined rehabilitation and NeuroAiD (SATURN) study – primary results of an exploratory study". The Journal of Spinal Cord Medicine. 46 (4) (Stroke ed.): 682–686. doi:10.1080/10790268.2022.2067972. PMC 10274548. PMID 35604343.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  16. ^ Ramesh Kumar, Ohnmar Htwe, Azmi Baharudin, Shaharuddin Abdul Rhani, Kamalnizat Ibrahim, Jagdeep Singh Nanra, Muhindra Gsangaya, Hezery Harun, Khairrudin Kandar, Maatharasi Balan, Shawn Peh, Yogesh Pokharkar, Abhinay Ingole & Mohammad Hisam Ariffin (2022). "Christopher L.H. Chen, Qingshu Lu, Rajesh Babu Moorakonda, Nagaendran Kandiah, Boon Yeow Tan, Steven Gayoles Villaraza, Jemelle Cano, Narayanaswamy Venketasubramanian, Alzheimer's Disease THErapy With NEuroaid (ATHENE): A Randomized Double-Blind Delayed-Start Trial". Journal of the American Medical Directors Association. 23 (3): 379–386. ISSN 1525-8610.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  17. ^ "Neuroaid Full Prescribing Information, Dosage & Side Effects". MIMS Malaysia. Retrieved 2022-02-18.
  18. ^ Gan R, Lambert C, Lianting J, Chan ES, Venketasubramanian N, Chen C, et al. (2008). "Danqi Piantan Jiaonang does not modify hemostasis, hematology, and biochemistry in normal subjects and stroke patients". Cerebrovascular Diseases. 25 (5): 450–456. doi:10.1159/000126919. PMID 18417963. S2CID 25577836.
  19. ^ Siow CH (2008). "Neuroaid in stroke recovery". European Neurology. 60 (5): 264–266. doi:10.1159/000155220. PMID 18781074.
  20. ^ Chen C, Venketasubramanian N, Gan RN, Lambert C, Picard D, Chan BP, et al. (March 2009). "Danqi Piantang Jiaonang (DJ), a traditional Chinese medicine, in poststroke recovery". Stroke. 40 (3): 859–863. doi:10.1161/STROKEAHA.108.531616. PMID 19164787.
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