Book Review Cite This: J. Nat. Prod. XXXX, XXX, XXX−XXX
pubs.acs.org/jnp
Review of A Paradigm Shift to Prevent and Treat Alzheimer’s Disease: From Monotargeting Pharmaceuticals to Pleiotropic Plant Polyphenols pharmacology of polyphenols is remarkably capable of functioning as primary and secondary prevention agents simultaneously. Chapters 5 and 6 switch the focus from prevention to the treatment of clinical AD. In Chapter 5, the authors provide a detailed account of various critical therapeutic targets and hallmarks of AD including Abeta, Tau protein, neuroinflammation, oxidative stress, and sirtuin 1. At the end of the discussion of each target, there is a list of supporting evidence demonstrating the favorable impact of polyphenols on individual therapeutic targets. Chapter 5 is the highlight of the book because (i) it provides a detailed insight into the molecular mechanisms implicated in AD, which befittingly depicts the multidimensional pathogenesis of the disease, and (ii) it enlists supporting evidence how multiple pathogenic pathways could be impacted by only one type of polyphenol. This chapter also includes multiple summary tables that clearly show the far-reaching potential of plant polyphenols in targeting multiple targets in AD. On the other hand, Chapter 6 primarily focuses on the pleiotropic pharmacology of plant polyphenols in the context of AD. The authors argue that a better therapeutic model for AD as compared to monotherapy would be broader targeting and beneficial collateral effects. The chapter goes on to discuss a long list of research studies that demonstrate the effects of a range of polyphenols on multiple key molecular pathways that are involved in AD. Part III contains Chapter 7, a review of the clinical trials of Ginkgo biloba extract 761 (EGb 761). In this chapter, the authors include a total of 24 clinical trials with salient findings and conclusions discussed under each trial. It is to be noted that out of 24 clinical trials, 16 show positive outcomes, while only 8 show a negative or inconclusive outcome, which is consistent with the positive pitch of the book for polyphenols and is reflected in the Mayo Clinic grading of this product. The chapter might have benefitted from inclusion of clinical trials of additional polyphenol extracts such as curcumin and EGCB. The chapter ends with an emphasis given to strict scrutiny (pharmaceutical grade) and rational basis for polyphenols. Additional information about the strict quality control requirement for a pharmaceutical product would have benefitted the text since adulteration and impurities are highly prevalent in natural products, which may drastically impact the therapeutic outcome. In summary, this reference book will be beneficial to neuroscientists, neurologists, natural products researchers, and students in these disciplines. Although this book is not meant for laymen, it could still benefit the novice reader since a significant portion of text contains easy-to-follow language, especially Parts I and III, which may not require a full understanding of medical terminology. The book could have
J. Nat. Prod. Downloaded from pubs.acs.org by UNIV OF SOUTH DAKOTA on 09/20/18. For personal use only.
A Paradigm Shift to Prevent and Treat Alzheimer’s Disease: From Monotargeting Pharmaceuticals to Pleiotropic Plant Polyphenols. By Howard Friel and Sally Frautschy. Academic Press. 2017. 290 pp. $199.90. ISBN 9780128122594. Alzheimer disease (AD) is a complex neurogenerative disorder characterized by severe memory and cognitive impairment. Considerable research efforts during the past several decades have led to the development of only a handful of drugs for AD that are approved by the U.S Food and Drug Administration. A significant number of these drugs were developed based on the monotargeting approach of the disease. Even with these developments, there has been a deficiency of an effective treatment for AD, since the current therapies have only little impact on the progression of the disease. A plethora of recent research has demonstrated that natural products especially plant polyphenols have favorable effects on AD. This notion is further corroborated by the fact that a diet rich in polyphenols is associated with a low risk of AD. Therefore, there is an urgent need to change the scientific perception to explore the full potential of natural products. In addition, there is a need to educate the people outside the scientific fraternity about the potential benefits of natural products to reduce the risk of AD, if any. The text A Paradigm Shift to Prevent and Treat Alzheimer’s Disease, by Friel and Frautschy, is an important step in this direction and is therefore timely and highly relevant. The book gives a new perspective not only to the treatment but also to the fundamental research in the field of AD. The book consists of three major sections, Pleiotropism (Part I), Pleiotropism and Alzheimer’s Disease (Part II), and Rational Basis versus Strict Scrutiny (Part III). Part I contains two chapters that discuss the basic differences between monoversus multitargeting therapeutic approaches. Chapter 1 provides the possible rationale for how the one-compound− one-target approacha typical pharmaceutical therapeutic paradigmhas failed for AD, a complex multifaceted disorder. Chapter 2 cites and reviews several recent studies from the literature that provide an account of pleiotropic pharmacology of well-studied polyphenols especially of those derived from a few ancient foods of medicinal value, e.g., green tea, red wine, olive oil, turmeric, and Gingko biloba. This chapter essentially cements the foundation for a pharmacological basis of therapeutic usage of polyphenols for AD as detailed in the next chapters. Part II contains four chapters (3−6) broadly covering the mechanistic rationales for the prevention and treatment of AD with polyphenols. In Chapters 3 and 4, the authors redefine the five stages of the AD-related disease process listed by the National Institute of Aging (NIA) by introducing a stage 0. On the basis of the new classification they further categorize the primary and secondary prevention of the disease. The authors cite several evidences supporting the idea that pleiotropic © XXXX American Chemical Society and American Society of Pharmacognosy
A
DOI: 10.1021/acs.jnatprod.8b00686 J. Nat. Prod. XXXX, XXX, XXX−XXX
Journal of Natural Products
Book Review
benefitted by inclusion of cartoons, diagrams, and figures particularly for representing the mechanisms of action in Chapters 5 and 6. The cost of the book should be lower to increase the readership.
Mohd Shahid Faaieza Khan Alexander Ahern
■
Chicago State University Chicago, Illinois, United States
AUTHOR INFORMATION
Notes
The authors declare no competing financial interest.
B
DOI: 10.1021/acs.jnatprod.8b00686 J. Nat. Prod. XXXX, XXX, XXX−XXX
