Alzheimer's Disease as a Major Public Health Concern: Role of Dietary Saponins in Mitigating Neurodegenerative Disorders and Their Underlying Mechanisms.

Saponins are triterpenoid or steroidal glycosides and are an important group of naturally occurring compounds of plant origin. They exhibit diverse pharmacological potentials including radical scavenging, as well as neuroprotective, anti-diabetic and anti-inflammatory activities, owing to their diverse chemical scaffolds. Saponins consist of an aglycone part (non-sugar) and a glycone part (sugar) and have at least one glycosidic (C-O sugar bond) linkage present between the glycone and aglycone mostly at C-3. On the basis of the aglycone part, saponins are classified into triterpenoid glycosides, steroid glycosides and alkaloid glycosides. Saponins exhibit neuroprotective activities against various disorders of the central nervous system (CNS) including stroke, Alzheimer's disease (AD), Huntington's disease (HD) and Parkinson's disease (PD). They mediate their therapeutic effects by modulation of various pathological targets. This study highlights various neuroprotective mechanisms of saponins including free radical scavenging, modulation of neuroprotective signaling pathways, activation of neurotrophic factors, modulation of neurotransmitters, inhibition of BACE1 enzyme and tau hyper-phosphorylation. The study concludes that saponins have considerable efficacy against various pathological targets of neurological disorders, especially AD, and might be an important source of leads against neurodegenerative disorders.

Hepatoprotective Effects of (-) Epicatechin in CCl4-Induced Toxicity Model Are Mediated via Modulation of Oxidative Stress Markers in Rats.

OBJECTIVE: (-) Epicatechin (EP) is a naturally occurring antioxidant flavonoid found in some green plants. The current study was designed to evaluate the potential role of antioxidant mechanisms in the hepatoprotective properties of EP using the carbon tetrachloride (CCl4)-induced acute liver injury model. MATERIALS AND METHODS: Rats (n = 7 per group) were divided into five groups including control group, (-) epicatechin group (20 mg·kg-1 body weight), CCl4 group (1 mL-1 body weight), CCl4-EP treatment group, and CCl4-silymarin (SILY) group. The levels of enzymes including hepatic malondialdehyde (MDA), glutathione (GSH), catalase (CAT), glutathione S-transferase (GST), nitric oxide synthase (NOS), glutathione peroxidase (GPx), and cytochrome P450 (CYP450) were analyzed via enzyme-linked immunosorbent assay (ELISA). Histological studies were performed on all groups to assess the regenerative effects of test sample and compare it with the control group. RESULTS: Test compound EP and standard drug silymarin (SILY) considerably reduced liver function enzyme levels in the blood, which were raised by CCl4 administration, and increased serum albumin and total protein (TP) concentrations. The hepatic malondialdehyde (MDA) level was considerably declined, whereas glutathione (GSH), catalase (CAT), glutathione S-transferase (GST), nitric oxide synthase (NOS), glutathione peroxidase (GPx), and cytochrome P450 (CYP450) levels were upregulated in the EC-treated groups. The hepatoprotective results of the study were further confirmed via the histological assessments, which indicated a regeneration of the damaged hepatic tissue in treated rats. CONCLUSIONS: The results of this study revealed a significant protective efficacy of EP against CCl4-induced liver injury, which was potentially mediated via upregulation of antioxidant enzymes and direct scavenging effects of the compound against free radicals.

Predicting different factors that affect hospital utilization and outcomes Among diabetic patients admitted with hypoglycemia using structural equation modeling.

BACKGROUND: Hypoglycemia (HG) is a common complication among diabetic patients. Many diabetics who experience HG are admitted to hospitals and usually utilize more resources. While plenty of studies examined multiple HG risk factors, there is limited knowledge about the correlation between different risk factors of HG and their impact on utilization. OBJECTIVE: To identify key factors influencing utilization among diabetic HG patients and to examine the mechanisms and interactions between those factors. DESIGN: A quantitative, non-experimental, and retrospective design that is based on the selection of the study subjects from the Healthcare Cost and Utilization Project National database for the years of 2012-2014. We employed Andersen Behavioral Model of Health Services Use as the main framework for this study. RESULTS: Structural Equation Modeling was used as the main multivariate statistical method for the analysis. Total sample size was 4822 patients. We found that diabetes complications, renal disease, hypertension, and high Charlson comorbidity index score had the strongest impact on length of stay (LoS) as well as total charge. Geographical location of patients strongly influenced total charge. Age had an indirect impact on LoS and total charge. LIMITATIONS: The use of secondary data seems to be the primary limitation for this study as some relevant risk factors for hypoglycemia were not available in the database. CONCLUSIONS: This study examined the multilevel character of different factors leading to high utilization of healthcare services among HG patients admitted to hospitals. Findings of this study help clinicians and policy makers to formulate policies and protocols that aid in providing efficient care to HG patients with less utilization of resources.