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Herbal medicinal products affecting memory and cognitive disorders

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October 11, 2010 at 7:45 am

Effect of herbal medicinal products on neurotransmission and enhancing cognition

Herbal medicinal products have played a pivotal role in development of CNS-active drugs that affect neurotransmissions in the brain. The interest of CNS-active herbal medicinal products originated from opioid alkaloids, e.g. morphine from Papaver somniferum and the tropane alkaloid cocaine from Erythroxylon coca. Anticholinesterase agents such as physostigmine from Physostigma venosum have shown significant activity on the CNS. This chapter deals with various medicinal plants, and compounds derived from them, which affect neurotransmission related to behaviour and memory dysfunction.

Acorus calamus L. (sweet flag, calamus)

Acorus calamus L. (Araceae) is a semi-aquatic, perennial, aromatic herb with creeping rhizomes. In Ayurveda, herbal medicines with rasayana effects (plants having adaptogen-like properties) are believed to be restorative, to attain longevity, intelligence and freedom from age-related disorders. Acorus calamus is regarded in Ayurvedic medicine as promoting rasayana effects and has been used to treat memory loss. Acorus calamus is used in Ayurvedic medicine on a regular basis for the treatment of loss of memory and other mental disorders. Acorus calamus extract has also been used as a traditional Chinese prescription and its beneficial effects on memory disorder, on learning performance, lipid peroxide content and anti-ageing effect in senescence have been reported. The in-vitro acetylcholinesterase inhibitory effect of hydroalcoholic extract and essential oil of Acorus calamus rhizomes has been reported, based on Ellman’s method. The essential oil showed stronger inhibition than the hydroalcoholic extract. Methanol extracts of Acorus calamus showed significant acetylcholinesterase enzyme inhibition at the concentration 200 µg/mL. Mukherjee et al. (2007) reported the in-vitro acetylcholinesterase inhibitory effect of β-asarone and α-asarone from the Acorus calamus. β-Asarone is at least an order of magnitude more active than its trans isomer α-asarone, so the acetylcholinesterase-inhibitory activity of the oil can be ascribed to β-asarone. Since cognitive performance and memory are related to acetylcholine levels, the acetylcholinesterase-inhibitory effect of the plant may account for its traditional use.

Albizia lebbeck Benth. (lebbeck)

Albizia lebbeck Benth. (Mimosaceae), is a well-known Indian medicinal plant and it has been reported to possess nootropic activity. The saponin-rich n-butanol fraction separated from leaves of Albizia lebbeck has been shown to affect the normal and impaired memory function in rats. Semi-purified saponins at doses of 10, 25 and 50 mg/kg, when administered orally, enhanced the learning and memory of normal and amnesic rats induced by scopolamine. Administration of 10 and 25 mg/kg of the saponin-containing butanol fraction increased the step-down latencies in acquisition and retention period as measured by inflexion ratio on the second and ninth day at levels comparable with the standard nootropic agent piracetum (100 mg/kg) tested in both the passive avoidance ‘step-through test’ using a passive avoidance chamber and the elevated plus maze test.

The nootropic effect of the natural saponins was correlated with concentrations of various neuro-chemicals of the rat brain, since dopamine and GABA levels decreased, and serotonin and noradren-aline increased in the Albizia lebbeck-tteated mice. The memory-enhancing property of the saponin fraction from Albizia lebbeck is considered to be due to inhibition of GABA and enhancement of noradrenaline in the brain. Three active albizia saponins A, B, and C were isolated and identified.

Amaranthus paniculatus L. (amaranth)

Amaranthus paniculatus L. (Amaranthaceae) is said to overcome the problems of psychological stress and affordability and its effects have been tested in stress-induced memory dysfunction. Stress was induced by gamma radiation in mice and methanolic extract of Amaranthus paniculatus at a dose of 600 mg/kg and 800 mg/kg was administered orally for 15 days. It was observed that mice supplemented with the extract, and trained in Hebb William’s maze model D, took less time to reach the goal than those without any treatment. The mice treated with Amaranthus paniculatus were further exposed to gamma radiation by 60Co-beam therapy; the surviving mice took less time to reach their goals than those without plant extract. This finding is explained by presuming that mice supplemented with Amaranthus paniculatus have a lower concentration of free radicals formed by the radiation stress and so less damage occurs to the relevant parts of the brain, therefore leading to sustenance of the learning ability even after irradiation. The study has been correlated with the antioxidative property of nutrients and their effect on maintaining cholinergic neurone integrity, which is essential for maintaining the learning and memory process.

Azadirachta indica A. Juss. (neem)

Azadirachta indica (Meliaceae) is a well-known traditional herb in India and is reported to exert therapeutic effects relating to the CNS. Azardirachitin is a major constituents found in neem. The aqueous extract of leaves at the dose of 500 mg/kg for 7 days significantly improved the memory, which was impaired by cerebral hypoperfusion inducing ischaemic insult. The memory task of the ischaemic rats was tested after 2 weeks of hypoperfusion period in the Morris water maze. The aqueous extract from Azadirachta indica significantly prevented the delay in escape latencies and increased the acquisition memory of rats.

Bacopa monniera L. (brahmi)

Bacopa monnieri L. (Scrophulariaceae) has a long history of use in India as an anti-ageing and memory-enhancing ethnobotanical therapy. It has been mentioned in religious, social and medical treatises of India since the time of Atharvan Ved (800 BC); the first clear reference to its CNS effect is to be found in Charak Sambita, written in the first century AD. It is mentioned in the authentic Ayurvedic treatise, Susrutu Sambita, which describes brahmi as efficacious in the loss of intellect and memory.

The alcoholic extract of brahmi showed a beneficial effect on the acquisition, consolidation and retention of three newly acquired behavioural responses in albino rats. Alcoholic extract of brahmi (40 mg/kg) and its two important chemical constituents, bacosides A and B (10 mg/kg), were investigated for shock-motivated brightness discrimination reaction, active conditioned avoidance and conditioned taste aversion response. Preadministration for 3 days with bacosides A and B significantly improved the acquisition, consolidation and retention in all three behavioural paradigms. Beside this effect bacosides attenuated the retrograde amnesia produced by immobilisation-induced stress, and scopolamine.

In another experiment, standardised Bacopa monniera extract was concluded to be beneficial in animal models of Alzheimer’s disease and elevated levels of their central cholinergic markers such as choline acetyltransferase and acetylcholine. Chronic administration of Bacopa monniera given orally for 12 weeks improved the speed of early information processing, verbal learning rate and memory consolidation in humans. This finding supported previous preclinical animal studies and clinical studies in children and patients with anxiety neurosis. Bacopa monniera interferes with cholinergic transmission and also has some serotonergic modulation.

Celastrus paniculatus Willd. (staff tree)

Celastrus paniculatus (Celastraceae) seeds and seed oil have been used in Ayurvedic medicine for stimulating intellect and sharpening the memory. It has been reported to have beneficial effects in psychiatric patients. Administration of the seed oil, rich in sesquiterpenes, to rats also reversed a scopolamine-induced memory deficit assessed in navigational memory performance, but this effect was not associated with acetylcholinesterase activity. The seed oil (3 g/kg) significantly improved the retention ability of the drug-treated rat passive avoidance paradigm and decreased levels of noradrenaline, dopamine, serotonin and their metabolites. Beside this, the memory-enhancing effect of Celastrus paniculatus was correlated with the antioxidant-enhancing effect of the drug on brain tissue. These data indicate that Celastrus paniculatus oil causes an overall decrease in the turnover of the three central monoamines and implicates the involvement of these aminergic systems in the learning and memory process.

Centella asiatica L. (gotu kola)

Centella asiatica (Umbelliferae) is a reputed ancient Ayurvedic remedy to enhance memory and longevity. The pharmacological basis to explain the reputed anti-amnesic effects of Centella asiatica has been explored experimentally. Studies have shown that the alcoholic extract has a tranquillising effect in rats, which was attributed to α-triterpene and brahmoside. Centella asiatica ethanolic extract was also found to elicit a marked increase in neurite outgrowth in human SH-SY5Y cells in the presence of nerve growth factor. Asiatic acid in Centella ethanolic extract showed marked activity at 1 µg/mL. Neurite elongation by Asiatic acid was completely blocked by the extracellular-signal-regulated kinase (ERK) pathway inhibitor PD 098059 (10 urnol/L). Male Sprague-Dawley rats given Centella ethanolic extract in their drinking water (300-330 mg/kg daily) demonstrated more rapid functional recovery and increased axonal regeneration (larger-calibre axons and greater numbers of myelinated axons) compared with controls, indicating that the axons grew at a faster rate. Further studies showed that the extract of Centella asiatica leaf possessed cholinomimetic action in vivo and that it may also influence cholinergic activity, and thus cognitive function.

Cognitive-enhancing effects have been observed in rats following oral administration of an aqueous extract of Centella asiatica, this effect being associated with an antioxidant mechanism in the CNS. The essential oil from Centella asiatica leaf contains monoterpenes, e.g. α-pinene, β-pinene and γ-terpinene, which are reported to inhibit acetylcholinesterase. However, monoterpene acetylcholinesterase inhibitors are weak compared with the anticholinesterase alkaloid, physostigmine. In view of the relatively weak anticholinesterase activity of monoterpenes reported to date, it is unlikely that they would be therapeutically effective in cognitive disorders. Asiatic acid, a triterpene from Centella asiatica (L.) has been patented as a treatment for dementia and an enhancer of cognition by Hoechst (EP 0 383 171 A2).

Clitoria ternatea L.

The root of the Indian medicinal plant Clitoria ternatea (Fabaceae) has a reputation for promoting intellectual behaviour. Clitoria ternatea contains the triterpenes taraxerol and taraxerone as major phytoconstituents. Administration of Clitoria ternatea root extract to rats showed an increase in acetylcholine and choline acetyltransferase in rat brain and they were shown to increase the acetylcholinesterase activity in cortical regions. An aqueous extract of the root also increased acetylcholine levels in rat hippocampus, and it was hypothesised that this effect may be due to an increase in acetylcholine synthesis.

Coptis chinensis Franch.

Coptis chinensis (Ranunculaceae) has been used in traditional Chinese medicine for several conditions. Studies have shown that methanol extract fraction of Coptis chinensis improved scopolamine-induced learning and memory deficit in rats. The contained alkaloids berberine and palmatine have been shown to possess acetylcholinesterase inhibition in vitro.

Curcuma longa L. (turmeric)

Curcuma longa (Zingiberaceae) has also been used for culinary purposes. Turmeric has several components with immunomodulatory and antioxidant properties. Curcumin, an antioxidant present in turmeric, has been shown to protect the brain in vivo from ethanol-induced oxidative stress. It modulated glutathione-linked detoxification enzymes and reduced the lipid peroxidation in rat brain under oxidative stress. Some compounds from C. longa, including curcumin, demethoxycurcumin, bisdemethoxycurcumin and calebin-A (and some of its synthetic analogues), were shown to protect PCI 2 cells from β-amyloid insult in vitro, and this activity was suggested to be due to an antioxidant effect.

In another study using a rat intraventricular Aβ infusion model, curcumin at a dose of 25 mg/kg reduced the isoprostane index of oxidative damage, amyloid plaque burden and Aβ-induced spatial memory deficits in the Morris water maze in rats. Curcumin has been shown to lower the oxidised proteins and interleukin-1β in the transgenic mouse model of Alzheimer’s disease.

Ocimum sanctum L. (tulsi)

In Ayurveda, Ocimum sanctum (Lamiaceae) is described as rasayana. These Ayurvedic rasayanas have been reported in literature to improve physical and mental health, increase non-specific resistance of body, promote physiological functions and augment cognition. The aqueous extract of leaves of Ocimum sanctum at a dose of 500 mg/kg for 7 days significantly improved memory in rats, which was impaired by cerebral hypoperfusion-induced ischaemic insult. The memory task of the ischaemic rats was tested after 2 weeks of hypo-perfusion period in the Morris water maze and those treated with Ocimum sanctum extract had delayed escape latencies. This effect was correlated with their ability to reduce the lipid peroxidation, superoxide dismu-tase and increase in tissue sulphydryl groups and ascorbic acid contents of the hypoperfused brain tissue.

Panax ginseng C.A. Mey. (ginseng)

Interest in the use of Panax ginseng (Araliaceae) comes from its purported ‘adaptogen’ or ‘tonic’ activity, which is thought to increase the body’s capacity to tolerate external stresses, leading to increased physical or mental performance. Panax ginseng alone was tested in young (3 months) and old (26 months) rats, on a battery of negatively reinforced learning tests (two-way active avoidance; passive avoidance/step-down; passive avoidance/step-through), and on the Morris water maze. Ginseng (17, 50, 150 mg/kg), administered orally to young rats, increased the number of avoidance responses in the two-way passive avoidance test at all doses tested.

Although an extensive literature documenting adaptogenic effects in laboratory animal systems exists, results from human clinical studies are conflicting and variable. However, there is evidence that extracts of ginseng can have an immunostimulatory effect in humans, and this may contribute to the adaptogen or tonic effects of these plants. The major secondary products present in ginseng roots are an array of triterpene saponins, collectively called ginsenosides. The ginsenosides, of which there are at least 30, glycosylated derivatives of two major aglycones, panaxadiol and panaxatriol, are considered to be the most relevant for pharmacological activity. From laboratory studies, it has been suggested that the pharmacological target sites for these compounds involve the hypothalamus-pituitary-adrenal axis, owing to the observed effects on serum levels of adrenocorticotrophic hormone and corticosterone.

Salvia species (sage)

Several species of Salvia (Lamiaceae) have been reported to have potential activity in CNS.

Al-Yousuf et al. (2002) reported that Salvia aegyptiaca L. is used for treating various unrelated conditions that include nervous disorders, dizziness and trembling. This work examines some effects of the crude acetone and methanol extracts of the plant given at single oral doses of 0.25, 0.5, 1 or 2 g/kg, on the CNS in mice. It is concluded that the crude methanol and acetone extracts of Salvia aegyptiaca have CNS depressant properties, manifested as antinociception and sedation.

Perry et al. (2002) reported that Salvia lavandulaefolia Vahl. (Spanish sage) extracts and constituents have demonstrated anticholinesterase, antioxidant, anti-inflammatory, oestrogenic and CNS depressant (sedative) effects, all of which are currently relevant to the treatment of Alzheimer’s disease. The essential oil inhibits the enzyme acetylcholinesterase from human brain tissue and bovine erythrocyte and individual monoterpenoid constituents inhibit acetylcholinesterase with varying degrees of potency.

In a study in healthy volunteers, essential oil administration produced significant effects on cognition. In a pilot open-label study involving oral administration of the essential oil to patients with Alzheimer’s disease, a significant increase in diastolic and systolic blood pressure was observed in two patients; however, this may have been due primarily to pre-existing hypertension and there were no abnormalities in other vital signs or blood samples during the trial period.

Salvia elegans Vahl, popularly known as mirto, is a shrub that has been widely used in Mexican traditional medicine for the treatment of different CNS diseases, principally anxiety.

The antidepressant and anxiolytic-like effects of hydroalcoholic (60%) extract of Salvia elegans (leaves and flowers) have been reported in mice. The extract, administered orally, was able to increase the percentage of time spent and the percentage of arm entries in the open arms of the elevated plus maze, as well as to increase the time spent by mice in the illuminated side of the light-dark test, and to decrease the immobility time of mice subjected to the forced swimming test. The same extract was not able to modify the spontaneous locomotor activity measured in the open-field test. These results provide support for the potential antidepressant and anxiolytic activity of Salvia elegans. Wake et al. (2000) also reported that S. elegans displayed differential displacement at nicotinic and muscarinic acetylcholine receptors, with the highest [3H](N)-scopolamine displacement.

In a double-blind, placebo-controlled, crossover study, 30 healthy participants received a different treatment in counterbalanced order on each occasion (placebo, 300, 600 mg dried sage leaf). On each day mood was assessed before the dose and at 1 h and 4 h afterwards. Both doses of sage led to improved ratings of mood in the absence of the stressor (that is, in pre-DISS mood scores) post-dose, with the lower dose reducing anxiety and the higher dose increasing ‘alertness’, ‘calmness’ and ‘contentedness’ on the Bond-Lader mood scales. Task performance was improved for the higher dose at both post-dose sessions, but reduced for the lower dose at the later testing session.

Withania somnifera L. (ashwagandha)

Withania somnifera (Solanaceae) root is one of the most highly regarded herbs in Ayurvedic medicine. Withania somnifera, an Ayurvedic rasayana (memory-facilitating drug), was shown to attenuate amnesic effects in animal models of Alzheimer’s disease by reversal of cholinergic dysfunction induced by ibotenic acid. Ayurvedic formulations based on Withania somnifera induced a similar amnesia-reversal effect in rats. The steroidal derivatives sitoindosides IX and from Withania somnifera, augmented learning acquisition and memory in both young and old rats. The root extract of Withania somnifera reversed scopolamine-induced disruption of acquisition and attention and attenuated amnesia following electroconvulsive shock in mice. These effects are attributed to nootropic activity.

The mechanism of this memory-enhancing effect is attributed to enhanced acetylcholinesterase activity and reversed the ibotenic acid altered cholinergic marker such as acetylcholine and choline acetyl transferase. Therefore preferential action is on cholinergic neurotransmission in the cortical and basal forebrain areas involved in cognitive function. In another experiment Withania somnifera (50 mg/kg) which contains sitoindosides VII-IX and withaferin A as the major bioactive entities, the relative abundance of these compounds in the extract being responsible for 28-30% significant enhancement of leaning as tested in passive avoidance test in chronically stressed rats.

Neurochemistry of cognition and cognitive dysfunction

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October 8, 2010 at 7:39 am

The human brain is very complex and is based on specialised cells designed to transmit information, called neurones. Neurones are an integral part and basic functional unit of the brain, which contains almost one billion of these cells. The neurones consists of a cell body containing a nucleus and an electricity-conducting fibre called an axon, which also gives rise to many branches before ending at nerve terminals. Neurones send signals by transmitting electrical impulses along their axons. When the signals reach the end of the axons, they trigger the release neurotransmitters, which then bind to receptors in adjacent neurones. This point of vital contact is called the synapse. The synaptic response involves the closing and opening of ion channels, which pass through the cell membranes and enable the ions to flow through them. This phenomenon creates an electrical current that provides tiny voltage changes across the membrane which leads to altered synaptic connectivity.

This network is capable of controlling a vast array of activities, including heart rate, body movement, perception, sexual function, emotions, learning and memory. The organisation and neurotransmitter content of intrinsic cerebral cortical and hippocampal neurones, and those of extrinsic inputs to these regions, are described below with respect to neuronal systems known to be affected in Alzheimer-type dementia. For the intrinsic neurones, particular attention is focused on the neuropeptides such as cholecystokinin, vasoactive intestinal polypeptide, somatostatin and neuropeptide Y, which are apparently stable post mortem and provide biochemical markers that can be used to judge the integrity of neuropeptide-containing cells in dementia.

Neurochemistry of cognition and cognitive dysfunction: cholinergic hypothesis

The first neurochemical was identified 70 years ago as acetylcholine. The neurones that release acetyl-choline are called cholinergic neurones and control the heartbeat and voluntary muscles, causing them to contract. Acetylcholine also serves as a neurotrans-mitter in many regions of the brain and plays an important role in learning and memory function. Mammalian brain contains several groups of cholinergic projection neurones located within the basal forebrain and brainstem. Cholinergic axons exert their neurotransmitter effect through the mediation of nicotinic and muscarinic receptors. Cholinergic neurones and cholinergic neurotransmitter pathways are highly implicated in cognition and cognitive dysfunction. The cholinergic neurones are centred on the medial septum, around the vertical limb of the diagonal band of Broca, around the horizontal limb of the diagonal band of Broca, and are also found around the nucleus basalis of Meynert.

All cholinergic neurones of the human basal fore-brain and brain stem contain the cholinergic enzymes choline acetyltransferase and acetylcholinesterase. Much of the research on the participation of neurotransmitter systems in cognitive decline associated with ageing and Alzheimer’s disease has concentrated on the role of acetylcholine, because of its correlation with the degree of cognitive dysfunction, and learning and memory deficits produced in humans, even though the role of interaction between acetylcholine and other neurotransmitters such as noradrenaline, dopamine, serotonin, γ-aminobutyric acid (GABA) and several neuropeptides affecting cognition are also important. To improve cholinergic transmission, different strategies have been suggested including increased acetylcholine synthesis, the augmentation of pre-synaptic acetylcholine release, and stimulation of postsynaptic acetylcholine muscarinic and nicotinic receptors and reduction of acetylcholine synaptic degradation with cholinesterase inhibitors. Several aspects of the functional features of the cholinergic system are shown in Figure: Functional features of the cholinergic system.

Figure: Functional features of the cholinergic system

Assessment of neurodegeneration

Animal models used for the assessment

Drugs effective in neurodegenerative disease should have several aims: to improve the cognitive impairment, control the behavioural and neurological symptoms, delay the progression of the disease and to prevent the onset. To attain these targets, cell and animal models are needed in which pathogenetic hypothesis and potential effectiveness of new drugs are to be tested, exploiting links between the molecular and biochemical studies on the disease and the reality of human pathology. Animal models of Alzheimer’s disease can provide insight into the neurological and pathological mechanisms of cognitive and behavioural changes in patients. Monitoring of behavioural changes in animal models could both provide insight into the neurobiology of these behavioural changes and help validate the felicity of the model to Alzheimer’s disease. Animal models will play a critical role in further defining the events and processes underlying the final phenotypic expression.

Aged animals models

Aged animals (rats, mice and monkeys) have been investigated on a variety of learning and memory tasks. Aged rodents have been shown to have memory impairment on tasks such as the Morris water maze and passive avoidance tests. This behavioural impairment has provided a model that resembles the neuropsychiatric symptoms commonly observed in Alzheimer’s disease. The senescence-accelerated mouse (SAM) exhibits age-related deficits in learning and memory in the Morris water maze and radial arm maze and decreased acetylcholine synthesis in hippocampus pyramidal neurones. The effect of nerve growth factor (NGF) on cognition of aged rats has been assessed by intraven-tricular infusion of NGF, delayed alternation, Morris water maze, and sensory motor tasks. NGF has been most thoroughly assessed in this setting and has shown effects in rats, which have provided a model for the assessment of cholin-ergic neurones and the cholinoprotective effects of compounds potentially useful in the treatment of Alzheimer’s disease.

Brain lesion models

In concert with the recognition of the importance of the cholinergic deficit in Alzheimer’s disease, early models of the disease concentrated on surgical or chemical lesions of the basal forebrain. Transection of the fornix results in degeneration of cholinergic cells in the basal forebrain. These experiments involved primarily rats, monkeys and baboons, which demonstrated deficits in attention and memory, tested in various maze paradigms such as passive active avoidance, Morris water maze and the eightarm radial arm maze. Lesion studies have focused primarily on the behavioural changes of the animals, with only limited attention to the pathological to the neuropsychiatric symptoms commonly observed in Alzheimer’s disease. Ageing studies are all likely to contribute information important to our understanding of the disease, and none are likely to represent a completely isomorphic model that is fully predictive of the pathogenesis, course, and treatment of human Alzheimer’s disease.

Amyloid beta protein infusion induced model of Alzheimer’s disease

Artificially created amyloid (AS) deposits in normal rats, and transgenic mice overexpressing amyloid precursor protein (APP) are the models in which possible treatments are tested. They are aimed at preventing formation of AS deposits or its transformation in neuritic plaques. Synthetic amyloid beta protein (Aβ1-42) application in vitro, using neuroglial and astrocytes, has also been used to screen various neuroprotective drugs. The injection of synthetic Aβ peptides β12-28, β25-35, and β1-40 into the septum of adult rats induced a marked decrease in basal and potassium-evoked acetylcholine release in the hippocampus. These findings confirmed in vivo the neurotoxic effects of Aβ observed in primary neuronal cell cultures exposed to Aβ peptides.

The multiple mechanisms through which Ap peptides, involving oxidative stress, loss of cellular calcium homeostasis and mitochondrial dysfunction have been reviewed and, in both in-vitro and in-vivo experiments, it has been shown that Aβ neurotoxicity depends on its fibrillary aggregation forming a sheet. These preclinical experiments give support to the hypothesis of the pivotal pathogenetic role of AS deposit in Alzheimer’s disease, throw some light on the molecular mechanisms of AS toxicity, and offer an experimental model for testing potentially useful drugs. Undoubtedly, there are limitations in the validity of intracerebral Ap injections as a model of Alzheimer’s disease.

Amyloid precursor protein transgenic mouse model

The development of transgenic mice, mimicking the genetic mutations occurring in familial Alzheimer’s disease and showing some of the neurochemical and morphological alterations of the disease, is another example of the interactions between clinical and preclinical investigations into this disease. The clinical and genetic investigations have identified the early-onset, familial forms of the disease, and the genes in which autosomal dominant mutations take place. There is a clear recognition of autosomal dominant cases induced by mutations of APP (chromosome 21), presenilin 1 (chromosome 14), or presenilin 2 (chromosome 1), which allowed development of transgenic mouse models of Alzheimer’s disease. These transgenic animals exhibit some of the pathological hallmarks of the disease, including neuritic plaques, although they have not evidenced neurofibrillary tangles and have limited cell death. These models facilitate investigation of the relationship of amyloid deposition to other aspects of the pathology of Alzheimer’s disease, including inflammation, hormonal levels, trophic factor influences, calcium metabolism, amino acid toxicity and apoptosis. However, there has been limited behavioural testing of transgenic mice, but impairments of memory have been reported on the Morris water maze, spatial reference memory and Y-maze alternation tasks.

Apolipoprotein knockout models

Cognitive tasks analogous to the deficits observed in human Alzheimer’s disease need to be developed for application to transgenic, knockout and other models currently used to investigate pathogenesis. Tests of language are obviously not applicable but assessment of attention, memory, spatial orientation and executive function are feasible. A variety of transgenic and knockout apolipoprotein models are available to screen novel molecules for the treatment of the disease. The E-4 allele of apolipoprotein (ApoE-4) confers an increased risk for Alzheimer’s disease and a decreased age of onset. Review of the cognitive testing and behavioural measures of the various available animal models reveals the impoverished state of these assessments and the need to develop new evaluation technologies.

Brain inflammation models

Epidemiological and clinical studies, reporting the efficacy of non-steroidal anti-inflammatory drugs (NSAIDs) in reducing the incidence and progression of Alzheimer’s disease, provided strong support for the critical involvement of inflammatory processes in the pathogenesis of the disease. Brain inflammation is considered to be a pathogenetic link in many neurodegenerative diseases, including Alzheimer’s disease. The long-term lipopolysaccharide (LPS) infusion into the fourth ventricle was followed by astrocyte activation, an increase in microglia cells, an increase in the levels of interleukin (IL)-1β, tumour necrosis factor (TNF)-α, APP mRNA and the degeneration of hippocampal neurones.

In-vitro screening methods for acetylcholinesterase inhibition

Several methods have been reported for the screening of acetylcholinesterase inhibitory activity from herbal medicinal products (HMPs). Acetylcholinesterase inhibition was initially detected by the use of gut-bath pharmacological methods with isolated tissue preparations such as guinea pig ileum. These methods are costly in several respects, including time, animal tissue and amounts of compound needed, so they have been replaced by more sensitive chemical methods. Consideration of the relative merits of various methods that might be useful in studying the time course of acetylcholinesterase activity in very small tissue samples use a combined method reported by Koelle (1951) with a sulphydryl reagent studied by Ellman (1959). This Ellman method is extremely sensitive and is applicable to either small amounts of tissue or to low concentrations of enzyme.

Figure: The detection of acetylcholinesterase activity by Ellman’s method.

The principle of this colorimetric method is the measurement of the rate of production of thio-choline, as acetylthiocholine is hydrolysed by the acetylcholinesterase enzyme. Thiocholine reacts with Ellman reagent [5,5'-dithiobis-(2-nitro-benzoic acid) (DTNB)] to produce 2-nitrobenzoate-5-mercaptothiocholine and 5-thio-2-nitrobenzoate (Figure: The detection of acetylcholinesterase activity by Ellman’s method). This product has a yellow chromophore that can be detected at 405 nm. The reaction with the thiol has been shown to be sufficiently rapid so as not to be rate limiting in the measurement of the enzyme, and in the concentrations used does not inhibit the enzymatic hydrolysis. The absorbance obtained using a standard volume of a known concentration of the substrate with a fixed dose of acetylcholinesterase is compared with that in the presence of an added compound or extract, a significant reduction indicating an inhibitory role for the substance added.

This visible spectroscopy procedure requires several millilitres of reaction mixture and it was sometimes difficult to obtain enough material to show an effect. The development of the method for use on a smaller scale, using microtitre well plates and a microplate reader, has been introduced and has enabled determinations to be performed with a much higher throughput. Microtitre plate assay method requires smaller amounts of reagents and test substances.

The Ellman reaction has also been adapted for thin-layer chromatography (TLC) bioautography assay for acetylcholinesterase inhibitory activity. The TLC plate is developed in the usual way. After development, enzyme-inhibitory activities of the developed spots were detected by spraying the substrate, dye and enzyme based on Ellman’s method. After incubating the plates, white spots on a yellow background showed inhibition of acetylcholinesterase. A false-positive test is carried out, to confirm any acetylcholinesterase-inhibiting activity arising from inhibition of thiocholine hydrolysis caused by the enzyme. To detect false-positive reactions, the plate is sprayed with substrate, dye and enzyme without test compounds. After a few minutes incubation, a yellow background appeared, the occurrence of white spots indicating false-positive reactions.

A similar method for TLC detection has been introduced by Marston et al. (2002), which uses acetylnaphthol as the substrate and measures the amount of naphthol, the reaction product formed, by its chromogenic reaction with Fast Blue B salt.

High-performance liquid chromatography (HPLC) with online coupled ultraviolet, mass spectrometric and biochemical detection methods for the identification of acetylcholinesterase inhibitors has also been developed. This uses a reverse-phase column with the column eluate being split into two streams, one with an ultraviolet detector and the other connected to a biochemical detection system. This latter system consisted of the eluant being mixed with acetylcholinesterase and DTNB before the online introduction of acetylthiocholine. The intensity of the reaction product was measured at 405 nm by means of a spectrophotometer as an indication of the amount of thiocholine-DTNB product formed. A HPLC method for the detection of acetylcholinesterase inhibition on immobilised acetylcholinesterase column and high-performance liquid chromatography with online coupled ultraviolet, mass spectrometric and biochemical detection for acetylcholinesterase inhibitory activity has also been reported.

Herbal antioxidant products

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October 5, 2010 at 12:56 pm

The ethnomedical literature contains a large number of plants that can be used against diseases, in which ROS are thought to play a major role. A large number of plants and phytoconstituents possess antioxidant properties (Table: Potent antioxidant plants and their phytoconstituents) and many of them are now articles of commerce, claiming to prevent or reduce diseases associated with high levels of ROS. Antioxidants can also be used in the preservation of food products. An important source of antioxidants is the diet, which contains numerous plants with antioxidant activity, including the spices and condiments. The traditional medical literature describes the potential role of spices as a source of many vitamins and as domestic remedies for many human diseases and the consumption of fruits and vegetables, olive oil, red wine and tea is inversely correlated with rates of incidence of many diseases.

Table: Potent antioxidant plants and their phytoconstituents

Plants Family Part used Phytoconstituents
Artemisia monata Asteraceae Aerial Luteolin-7-O-rutinoside and Esculctin
Andrographis paniculata Acanthaceae Arial parts Andrographolide 14-deoxy-11-oxo-andrographolide, neo-andrographolide
Allium sativum Liliaceace Bulb Garlicin, allicin, S-allylcysteine, S-allylmercaptocysteine, allin, allixin, N-acetyl-S-allylcysteine
Anoectochilus formosanus Orchidaceae Whole plant Kinsenone (diarylpentanoid) andflavonoid glycosides
Asparagus racemosus Liliaceae Rhizomes Shatavarin, coniferin and undecanyl cetanoate
Broussonetia papyrifera Moraceae Leaf Broussoflavonols
Bacopa monniera Scrophulariaceae Whole plant BacosideA3, bacosaponin C
Bulbine capitata Asphodelaceae Root Isofuranonaphthoquinones
Burkea africana Leguminosae Bark Proanthocyanidins
Cedrus decodara Pinaceae Heartwood Matairesinol
Crocus sativus Iridaceae Stigmas Crocin
Curcuma longa Zingiberaceae Rhizhomes Curcumin, turmeric antioxidant protein
Chrysophyllum cainito Sapotaceae Seeds, fruits Quercetin and other polyphenols
Corylus colurna Betulaceae Leaves Flavonoids
Crataegus monogyna Rosaceae Leaves, flowers and fruits Flavonoids, proanthocyanidins, catechins
Cyanchum wilfordii Asclepiadaceae Roots Cynandione A and a biacetophenone
Dalbergia odorifera Fabaceae Root Benzophenone derivative and flavonoids
Dirca palustris Thymelaeaceae Twigs Five novel phenolic glycosides
Daphniphyllum calycinum Daphniphyllaceae Leaf Flavonoid glycoside
Dracaena cinnabari Ruscaceae (Dracaenaceae) Whole plant Homoisoflavonoids
Ephemerantha lonchophylla Orchidaceae Stem Dihydrostilbene, phenantherene
Eucalyptus globulus Myrtaceae Leaves Ellagic acid
Eriobotrya japonica Rosaceae Leaves Flavonoids; chlorogenic acid, quercetin-3-sambubioside, methyl chlorogenate kaempferol, quercetin-3-rhamnoside
Emblica officinalis Euphorbiaceae Fruits Emblicanin A and B, gallic acid, punigluconin and pedunculagin
Ficus bengalensis Moraceae Bark Rhamnoside and cellobioside
Garcinia subelliptica Clusiaceae Wood Three prenylated xanthones
Garcinia kola Clusiaceae Seeds Kolaviron (biflavones)
Camellia sinensis Theaceae Leaf Epigallocatechin, gallocatechin and epigallocatechin gallate
Hordeum vulgare Poaceae Leaves Isovitexin derivatives
Glycyrrhiza glabra Leguminosae Roots Glabridin
Ginkgo biloba Ginkgoaceae Leaf Ginkgolides, bilobalide, sciadopitysin, ginkgetin, bilobetin
Helenium aromaticum Compositae Whole plant Sesquiterpene lactones; helenalin, mexicanin-l, linifolin A, geigerinin
Hedyotis diffusa Rubiaceae Fresh aerial New acylflavonol diglycoside; kaempferol and quercetin derivatives, flavonol and iridoid glycosides
Hierochloe odorata Poaceae Aerial Benzophenanthrone derivatives
Hibiscus syriacus Malvaceae Root bark Lignans: hibiscuside, syringaresinol, E&Z feruloyltyraminesand isoflavonoids
Hypericum erectum Hypericaceae Aerial Flavonoids-quercetrin, hyperoside, isoquercetrin, orientin
Helichrysum picardii Asteraceae Aerial Gnaphalin
Iryanthera lancifolia Poaceae Pericarps Two dihydrochalcones and two flavonolignans
Amaranthaceae Aerial Waxes, β-sitosterol, cam, pestrol and methoxy flavone
Iberis amara Brassicaceae Seeds 6-O-sinapoyl sucrose
Lavandula angustifolia Lamiaceae Aerial Phenolics-romarinic acid, caffeic acid, luteolin and methyl carnosoate
Larix gmelini Pinaceae Wood Dihydroquercetin
Mahonia aquifolium Berberidaceae Root and leaf Alkaloids
Muscari racemosum Liliaceae Flower homoisoflavonoids
Magnolia coco Magnoliaceae Stem Lignans-sesamin, fargesin, syringaresinol
Myrica gale Myricaceae Fruit Flavonoids-C-methylated dihydrochalcones, myrigalone A & B
Mangifera indica Anacardiaceae Leaves, bark, fruits Mangiferin, myricetin, protocatechuic acid, quercetin, friedelin, gallic acid, homomangiferin, kaempferol and lupeol
Nelumbo nucifera Nymphaeaceae Rhizomes, seed, leaves, flower Gallic acid
Panax pseudoginseng Araliaceae Roots Trilinolein
Phyllostachys edulis Poaceae Leaves Chlorogenic acid derivatives
Punica granatum Punicaceae Fruits Flavonoids
Prunus cerasus Rosaceae Fruits Cholorgenic acid methylester derivatives
Prunus amygdalus Rosaceae Fruit skin Catechin, protocatechinic acid and flavonoids
Phaseolus aureus Fabaceae Seeds Flavonoids
Pteleopsis hylodendron Combretaceae Stem bark Ellagic acid derivatives
Psoralea corylifolia Leguminosae Seeds Monoterpene phenol-bakuchiol
Pistacia weinmannifolia Anacardiaceae Leaves Pistafolia A
Picrorhiza kurroa Scrophulariaceae Roots and rhizomes Picrovil
Panax ginseng Araliaceae Roots Ginsenosides
Palm spp. Arecaceae Oil Tocotrienols
Podocarpus nagi Podocarpaceae Root bark Totarane diterpenoids
Rosmarinus officinalis Lamiaceae Leaves Diterpenoids
Salvia officinalis Lamiaceae Leaves Phenolics-abietane diterpenes, caffeoyl glycosides, rosmarinic acid
Saururus chinensis Sauruaceae parts Underground Machilin-D
Saururus cernuus Saururaceae Whole plant Feruloylgeraniol derivative
Silybum marianum Asteraceae Seeds Silybin, silymarin
Spinacia oleracea Amaranthaceae Leaves p-Coumaric acid derivative and flavonoids
Terminalta catappa Euphorbiaceae Leaves Punicalagin and punicalin
Terminalia bellerica Com beta ceae Fruits Gallic acid, ellagic acid, ethyl gallate, galloyl glucose, chebulagic acid, bellericanin
Telekia speciosa Asteraceae Leaves and Roots Sesquiterpene lactones
Vaccinium myrtillus Ericaceae Leaves Anthocyanosides
Vitex rotundifolia Verbenaceae Fruits Labdane and abietane-type diterpenoids
Withania somnifera Solanaceae Root Glycowithanolides
Triticum aestivum Poaceae Leaves Ferulic acid dehydrodimers
Vitis vinifera Vitaceae Fruits and seeds Proanthocyanidinsand resveratrol
Zingiber cassumunar Zingiberaceae Rhizome Cassumunin A & B (cucurminoids)
Zingiber officinalis Zingiberaceae Rhizome 6-gingerol

Spices and herbs, particularly from the Lamiaceae family, demonstrate strong antioxidant properties and a shortage of antioxidants in the diet might enable diseases caused by reactive oxygen species to arise. Many vegetables and fruits used as foods are particularly rich in natural antioxidant nutrients, e.g. including vitamin C, the tocopherols and carotenoids. Phenolic antioxidants such as flavonoids, tannins, coumarins, xanthenes and more recently, procyanidins, have been shown to scavenge radicals in a dose-dependent manner and therefore are viewed as promising therapeutic potential for free-radical pathologies. A sufficient supply of antioxidants from the diet might help to prevent or delay the occurrence of pathological changes associated with oxidative stress. When diet fails to meet the antioxidant requirements, dietary supplement might be used to enhance health but more needs to be done to test this hypothesis by good clinical studies. Consumer demand for healthy food products provides an opportunity to develop food rich in antioxidants as new functional foods or nutraceuticals.

Gingko biloba (ginkgo)

Gingko biloba extract is widely used in traditional medicine for a great number of therapeutical properties. A large number of studies confirm the antioxidant nature of the extract and its phytoconstituents.

A study by Butnaru et al. (1997) in rats showed that the treatment with this extract before stress inhibited the post-stress growth MDA concentration and the process of stress ulcer formation. Gingko protects against cardiac ischaemia and reperfusion injury and these effects are shown to be dependent on its antioxidant properties. Its in-vivo free-radical scavenging action and proof of its haematological properties in rats was confirmed. Gingko biloba extract and kaem-ferol isolated from it were demonstrated to be antioxidant in a lipid peroxidation assay. Gingko biloba extracts have properties indicative of potential neuroprotective ability. From the n-butanol extract of Gingko biloba leaves, flavonoids were isolated, which showed strong antioxidant activities in DPPH and cytochrome-c reduction assays using the HL-60 cell culture system.

Bacopa monniera (brahmi)

Bacopa monniera is a component of several popular drugs of the Ayurvedic system of medicine. Its ethanol extract showed strong protection against lipid peroxidation induced by ferrous sulphate and cumene hydroperoxide. Bacopa monniera alcohol extract exerted a hepatoprotective effect against morphine-induced liver toxicity, which was found to be related to its antioxidant nature. The effect of a standardised extract of Bacopa monniera was assessed on rat brain frontal cortical, striatial and hippocampal reactive oxygen species, catalase and glutathione peroxi-dase activities and the results indicated a significant antioxidant effect.

Mangifera indica (mango)

The standardised aqueous extract of crude mango stem bark showed a powerful scavenger activity of hydroxyl radicals and hypochlorous acid and acted as an iron chelator. The extract also showed a significant inhibitory effect on the peroxidation of rat brain phospholipid and inhibited DNA damage by bleomycin or copper phenanthrolin system. Oral administration of an M. indica extract (QF 808) was found to reduce ischaemia-induced neuronal loss and oxidative damage in gerbil brain. QF 808 has the ability to scavenge free radicals involved in microsome peroxidation. An aqueous decoction of mango bark has been developed in Cuba on an industrial scale to be used as a nutritional supplement, cosmetic and phytomedicine. It is useful in preventing the production of reactive oxygen species and oxidative tissue damage in vivo. Polyphenols including mangiferin were found to be the major constituents. Mangiferin has shown to be able to maintain the cellular oxidant/antioxidant balance.

Curcuma longa (turmeric and curcumin)

Curcuma longa and a large number of its constituents exhibit potent antioxidant properties in several models. Curcumin and its sodium salt have been shown to have a strong antioxidant activity. Curcumin exhibited a significant time- and concentration-dependent effect on lipid peroxidation induced by radiation and other curcumin analogues exhibited an antioxidant activity stronger than α-tocopherol. Turmeric antioxidant proteins isolated from the aqueous extract of turmeric were found to prevent Ca2+-stimulated ATPase from inactivation in the presence of promoters of lipid peroxidation, as well as the depletion of the thiol content during peroxidation.

Withania somnifera (ashwagandha)

Witbania somnifera is used as an antistress adaptogen. Its glycowithanolides showed antioxidant effects in chronic footshock stress-induced perturbations of oxidative free-radical scavenging enzyme and lipid peroxidation in rats. Administration of plant extract, along with equivalent doses of lead acetate for 20 days, significantly decreased lipid peroxidation and increased reactive oxygen species and catalase, thus retaining normal peroxida-tive status of the tissues. The antioxidant effects depend on the presence of steroidal lactones, the withanolides.

Allium sativum (garlic)

The inhibitory property of garlic on reactive oxygen species generation and lipid peroxidation has been reported in a number of in-vitro studies. Banerjee et al. (2002) showed that chronic garlic intake dependently augmented endogenous antioxidants, which might have important direct cytoprotective effects on the heart, especially in the event of oxidative stress-induced injury. Diallyl sulphide is a flavour component from garlic and is found to attenuate lipid peroxidation in mice infected with Tricbinella spiralis. Antioxidant activity of the diallyl sulphide garlicin was due to its ability to scavenge peroxyl or alkoxyl radical intermediates of lipid peroxidation. Allicin, another component, may have multiple mechanisms of action, acting both as a stronger chain-breaking antioxidant and as an inhibitor of first chain reaction by scavenging an initiating radical species.

Punica granatum (pomegranate)

Punica granatum fermented juice and seed oil flavonoids exhibited antioxidant activities and the methanol extract of pomegranate demonstrated potent antioxidant activity using various in-vitro models. Three major anthocyanidins isolated from Punica granatum fruits showed free-radical scavenging activity and inhibitory effects on lipid peroxidation in rat brain homogenates.

Ocimum sanctum (tulsi, holy basil)

An aqueous extract of the leaves of Ocimum sanctum has been found to protect mice against radiation lethality and bone marrow damage and had strong radical scavenging activity in vitro. The extract also protected against radiation-induced lipid peroxidation, where GSH and antioxidant enzymes play an important role in protection. The hydroalcoholic extract, investigated against isoproterenol-induced myocardial infraction in rats, caused a significant reduction in GSH, SOD, LDH and TBARS levels, thus demonstrating antioxidant and cardioprotective effects.

Garcinia

Garcinia kola, Garcinia indica, Garcinia subelliptica, Garcinia atroviridis and several other Garcinia species were found to possess strong antioxidant activity and a large number of active constituents isolated from Garcinia kola fruits possess inhibitory activity against lipid peroxidation. Kolaviron, a mixture of Garcinia biflavonoids 1 and 2 and kolaflavonone isolated from Garcinia kola seed extract, acts as an in-vivo natural antioxidant and effective hepatoprotective and is as effective as BHA in rats. Garcinol, a polyisoprenylated benzophenone derivative isolated from Garcinia indica fruit rind, has shown potent free-radical scavenging activity and was able to scavenge both hydrophilic and hydrophobic reactive oxygen species, the activity being stronger than that of DL-α-tocopherol. Oral administration prevented acute ulceration in rats induced by indometacin and water-immersion stress caused by radical formation.

Emblica officinalis

The fruits of Emblica officinalis contain polyphenolic compounds such as emblicanin A and B which have been reported to exhibit antioxidant activity in vitro and in vivo. A study showed that emblicanin A and B preserve erthrocytes against oxidative stress induced by asbestos, a generator of superoxide radical. The active tannoids administered intra-peritoneally for 7 days showed augmentation of brain SOD, catalase and reduction in lipid peroxidation. The results indicate that the antioxidant activity may reside in these tannoids rather than vitamin C itself. Pretreatment with the butanol extract of the water fraction of Emblica officinalis fruits, orally administrated to rats for 10 consecutive days, was found to prevent indometacin-induced gastric ulcer; this activity was attributed to its antioxidant property.

Salvia officinalis (sage)

Salvia is an important genus, widely cultivated and used in flavouring and folk medicine. It is a rich source of polyphenols, and a large number of these are apparently constructed from the caffeic acid building block. Salvia officinalis 50% methanol extract demonstrated considerable inhibition of lipid peroxidation in both enzyme-dependent and enzyme-independent systems and supercritical fluid extracts of Salvia officinalis also showed antioxidant activity. Salvia officinalis leaves and terpenoids and flavonoids showed strong antioxidant properties using DPPH and by the oil stability index method. Various constituents such as rosmarinic acid, abietene diterpenes and caffeoyl-glycosides have been identified as antioxidant principles. The extracts of other Salvia species also displayed considerable concentration-dependent antioxidative effects that were comparable with those of Salvia officinalis.

Vitis vinifera (grapevine)

Resveratrol is a polyphenolic stilbene occurring in grapes and various other medicinal plants and has been the subject of a considerable amount of recent research. It has been identified as a potential cancer chemopreventive agent and its presence in red wine has been suggested to be linked to the low incidence of heart diseases in France. It acts as a powerful antioxidant, both by classic hydroxyl radical scavenging and also via a novel glutathione-sparing mechanism. Various studies have demonstrated the effects of resveratrol on biological mechanisms involved in cardioprotec-tion. These include modulation of lipid turnover, inhibition of eicosanoid production, prevention of low-density lipoprotein oxidation and inhibition of platelet aggregation.

Based on the quantity and diversity data available on the biological activity of resveratrol, it has to be considered to be a very promising chemoprotector and chemotherapeutic. Urgent investigation on its bioavailability and effects on in-vivo systems, especially in humans, are necessary. Martinez and Moreno (2000) showed that resveratrol treatment caused a significant impairment of COX-2 induction, stimulated by lipopolysaccharides and phorbol esters or by O2- or H2O2 exposure. It also significantly decreased [3H]arachidonic acid release induced by these agents. These results support the anti-inflammatory action of resveratrol.

Silybum marianum (milk thistle)

Silybum marianum fruits are reported to exert antioxidant and free-radical scavenging action. Silymarin and silybin, the flavonolignans present, were found to be the active constituents. Silymarin prevents doxorubicin-mediated damage to rat heart membrane primarily through free radical scavenging. Oral administration of silybin protected against iron-induced hepatotoxicity in vivo and can be used in chelation therapy of chronic iron overload.

Conclusions

It is obvious that a large number of plants possess strong antioxidant potential and these include commonly used fruits, vegetables and spices. Concentration of total phenols in the plant show close correlation with the antioxidant activity, so it is useful to determine the total phenol content of the plants before antioxidant screening. A large number of plants have been tested, based on their uses in folklore and have been found to be active, and still there is scope for antioxidant screening of a large number of plants belonging to families rich in antioxidants. Fermented extracts have been found to be more potent and the production of low-molecular-weight compounds during fermentation is responsible for the action. There is scope for evaluation of antioxidant properties of fermented extracts of plants known to possess strong antioxidant properties.

Antioxidants

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October 2, 2010 at 12:49 pm

Free radicals are chemical species possessing one or more unpaired electrons and can be considered as a fragment of molecules that are extremely reactive and short lived. They are produced continuously in cells, either as accidental byproducts of metabolism or deliberately (for example, during phagocytosis). Unpaired electrons usually make a molecule more reactive than the corresponding non-radical. The molecule acts as an electron acceptor and essentially ‘steals’ electrons from other molecules. Free radicals are referred to as oxidising agents since they cause other molecules to donate their electrons. Free radicals can be formed by the homolytic cleavage of a covalent bond of a normal molecule, with each fragment retaining one unpaired electron; by the loss of a single electron from a normal molecule; or by the addition of a single electron to a normal molecule.

The most common cellular oxygen free radicals are superoxide radical (02-), hydroxyl radical (OH·) and nitric oxide (NO). Other molecules, such as hydrogen peroxide (H202) and peroxynitrate (ONOO·) are not free radicals themselves but can lead to their generation through various chemical reactions.

Oxygen free radicals and related molecules are often classified together as reactive oxygen species (ROS), to signify their ability to promote oxidative changes within the cell.

All aerobic organisms produce free radicals, predominantly superoxide, formed as a side product during the reduction of molecular oxygen by mitochondria. An average cell utilises 1013 molecules of 02 per day. It is estimated that 1 % of respired molecular oxygen will form ROS, thus approximately 1011 ROS are produced by each cell in a day. Cells normally employ a number of defence mechanisms against damage induced by free radicals. Oxidative stress is the term referring to the imbalance between generation of reactive oxygen species and the activity of the antioxidant defences.

There is increasing evidence to support the involvement of free-radical reactions in several human diseases since reactive oxygen species play a role in a variety of normal regulatory systems, the de-regulation of which may play an important role in inflammation. ROS and other free radicals have long been known to be mutagenic and have more recently emerged as mediators of other phenotypic and genotypic changes causing mutations and neoplasia.

In the last decade, evidence has accumulated that the free-radical process known as lipid peroxidation plays a crucial and causative role in the pathogenesis of atherosclerosis, cancer, myocardial infarction and also in ageing. Participation of free-radical oxidative interactions in promoting tissue injury in conditions such as brain trauma, ischaemia, toxicity and also in neurodegenerative diseases such as Parkinson’s disease, Alzheimer’s dementia, multiple sclerosis and lipofuscinosis are now well documented. The involvement of ROS in the pathogenesis of several lung diseases has also been suggested while the pioneering studies on the role of reactive oxygen species reactions in the genesis and the expression of cellular and tissue damage has been carried out mainly in the liver, using acute rat poisoning with carbon tetrachloride.

Studies in experimental models have incriminated ROS as primary mediators in the pathogenesis of renal injury. Diabetes mellitus is also associated with oxidative reactions, particularly those that are catalysed by decompartmentalised transition metals, but their causative significance in diabetic tissue damage remains to be established.

In 1956, Harman proposed the free-radical theory of ageing, the assumption that ageing results from random deleterious effects of tissue brought about by ROS and it is very likely that reactive oxygen species contribute considerably to the development of stochastic disorders observed during the progress of ageing.

In recent years, increasing experimental and clinical data have provided compelling evidence for the involvement of oxygen free radicals in the three main disorders of prematurity — chronic lung disease, retinopathy of prematurity and intraventicular haemorrhage, the hypothesis being that oxygen-centred radical and related reactive oxygen metabolites are formed too rapidly to be detoxified by antioxidant defence mechanisms.

Defence against free radicals: antioxidants

Antioxidant defences fall in to two main categories, those whose role is to prevent the generation of free radicals and those that intercept any radicals that are generated. They exist in both the aqueous and membrane compartments of cells and can be enzymes or non-enzymes. Various animal studies have shown that antioxidants delay or protect against the oxidative damage produced by the free-radical reaction and a protective role against ailments mediated by free radicals is now well established.

Antioxidants are exogenous (natural or synthetic) or endogenous compounds acting in several ways, including removal of O2, scavenging reactive oxygen/ nitrogen species or their precursors, inhibition of reactive oxygen species formation and binding metal ions needed for catalysis of ROS generation and up-regulation of endogenous antioxidant defences. The protective efficacy of antioxidants depends on the type of reactive oxygen species that is generated, the place of generation and the severity of the damage. The natural antioxidant system can be classified into two major groups: endogenous enzymes and low-molecular-weight antioxidants.

Endogenous enzymes include extensively studied enzymes such as superoxide dismutase (SOD), cata-lase, glutathione peroxidases, DT diaphorase, and glutathione-regenerating enzyme systems. Some enzymatic systems such as SOD and catalase act specifically against reactive oxygen species, while certain other enzyme systems reduce thiols. The low-molecular-weight antioxidants can be further classified into directly acting antioxidants (e.g. scavengers and chain-breaking antioxidants) and indirectly acting antioxidants (e.g. chelating agents). The directly acting antioxidants are extremely important for defence against oxidative stress. Direct scavenging of ROS is one of the many antioxidant actions required to restore oxidative equilibrium once it is lost in different pathologies. This subgroup of antioxidants currently contains several hundred compounds including ascorbic acid (vitamin C), retinoic acid (vitamin A), melatonin, lipoic acids, polyphenols, and carotenoids, being derived from dietary and herbal sources. The hypothesis that restoring redox equilibrium through activation of intracellular signals is also an important step of the antioxidation process is gaining increasing support. It is likely that the trapping of excess free radicals could restore redox equilibrium in the initial states of cellular oxidative stress.

Free radicals in various diseases

According to Halliwell and Gutteridge (1999), oxidative stress occurs in most human diseases, although this is not the same as saying that it is the cause of most diseases. The increase in free radicals may be secondary to the disease process. Free radicals are very short lived and difficult to study in vivo. Direct detection of free radicals is possible with electron spin resonance, but it is very expensive and complex, so a variety of surrogate markers to ascertain free-radical activity must be used. Developing accurate methods to measure biomarkers for DNA damage and lipid peroxidation is challenging and methods in the current literature include urine levels of F2-isoprostanes as a biomarker for lipid peroxidation, measurement of oxidised low-density lipoprotein (LDL), use of a chemical mutagenic product of fat oxidation, and 8-oxo-deoxyguanosine, associated with a decline in mitochondrial function. There have also been efforts to detect changes in the levels of antioxidants such as SOD, glutathione or vitamin E in the body in response to oxidative stress, to identify many conditions associated with free-radical formation, but results have not been consistent. The implications of the presence of ROS in cardiovascular, pulmonary, carcinogenesis, diabetes and neurological diseases as well as inflammation are currently under intense investigation.

It is easy to appreciate that the lungs are vulnerable to inhaled agents, e.g. ozone, nitrogen dioxide, sulphur dioxide and other toxins, that stimulate reactive oxygen species production. ROS can stimulate lipid peroxidation and oxidation of DNA bases in the lungs. The irritant effect of smoke also activates lung macrophages and neutrophils with resultant production of additional ROS. Chronic lung inflammation such as asbestosis, asthma and cystic fibrosis is also associated with elevated markers of oxidative stress so reactive oxygen species may contribute to the ongoing pathology.

The brain may be especially sensitive to oxidative damage. Oxidative stress can damage neurones and glial cells in a manner similar to other issues: via products of lipid peroxidation that are neurotoxic, DNA damage, etc. Reper-fusion injury also occurs in the brain after a stroke and superoxide produced during reperfusion results in abnormalities of cerebral vascular responses and blood-brain barrier permeability. Extracellular gluta-mate levels in the brain increase rapidly during ischaemia, leading to increased production of OH radicals, calcium ion imbalance and increased neurotoxicity. If bleeding occurs with the stroke, normally sequestered iron molecules are released and may initiate harmful free-radical chain reactions. Neurodegenerative diseases associated with ROS include Parkinson’s, Alzheimer’s, and many others. It is possible that although the initiators of the disease state vary, free radicals are involved in a common pathway that leads to neural cell death.

The acute inflammatory response is typically beneficial to the organism, being a major defence against microorganisms and normally self-limited. However, the superoxide-producing neutrophil itself is destroyed in the process and healthy surrounding cells may also be damaged. With chronic inflammation, such as in rheumatoid arthritis, the overall impact of the continued generation of free radicals is deleterious. Degradation of hyaluronic acid (synovial fluid) is driven by the presence of OH. These radicals may be produced by phagocytic cells in the joint, by changes in tissue oxygenation caused by swelling, followed by reperfusion, or by some of the drugs used to treat RA. A role for reactive oxygen species in the endothelial dysfunction associated with diabetes was proposed and levels of manganese superoxide dismutase have been reported to be decreased in streptozotocin-induced diabetes in rats. Normalising mitochondrial O2 has been shown to block pathways involved in hyperglycaemic damage. Consistent with these observations, SOD pretreatment improved vasodilation in isolated aortic rings from streptozo-tocin diabetic rats. Levels of O2 are also increased in hyperinsulinaemic rats, which is believed to be related to activation of NAD(P)H oxidase.

The progression of heart failure is associated with programmed cell death or apoptosis, which studies suggest occurs in response to ischaemia, reperfusion, pressure overload and in dilated cardiomyopathies. Oxidative stress may also be critical for the activation of apoptosis in dilated cardiomyopathies.

Free radicals in cardiovascular diseases

Cardiovascular disease is a heterogeneous group of disorders that affects the heart and blood vessels. The diseases are characterised by angina pectoris, hypertension, congestive heart failure, acute myocardial infarction (heart attacks), stroke and arrhythmia. There is now considerable biochemical, physiological and pharmacological data to support a connection between free-radical reactions and cardiovascular tissue injury. Evidence shows that these disease conditions are directly or indirectly related to oxidative damage and share common mechanisms of molecular and cellular damage. As these mechanisms are elucidated, it may be possible to improve the techniques for clinical and pharmacological intervention.

Ischaemia-reperfusion myocardial injury

Exposure of myocardial tissue to a brief, transient ischaemia, followed by reperfusion, has attracted much attention in recent years as an explanation for some cardiac diseases. Myocardial ischaemia occurs when myocardial oxygen demand exceeds oxygen supply. Unless reversed, this situation results in cell injury and, clinically, myocardial infarction. Logically, reperfusion of ischaemic myocardium is recognised as potentially beneficial, because mortality is directly proportional to infarct size, and this latter to the severity and duration of ischaemia. Reperfusion of the ischaemic myocardium can restore oxygen and substrates to the ischaemic myocardial cells, but this process may create another form of myocardial damage termed ‘reperfusion injury’. Thus, restoration of a normal blood flow in the heart by methods such as angioplasty, thrombolytic agents or cardiopulmonary bypass can lead to specific lesions (arrhythmias, deficit in contractility, necrosis), the importance of which also depends on the duration of ischaemia.

Evidence suggests that this may be due, in part, to the generation of toxic reactive oxygen species. The active involvement of ROS in the ischaemia-reperfusion damage is demonstrated by direct and indirect experimental evidences. Direct evidence arises from the possibility of measuring radicals in myocardial tissue by electron spin resonance (ESR) and spin trapping methodology; indirect evidence by the measurement of the products of free-radical attack on biological substrates (e.g. malondialdehyde as a measure of lipid peroxidation extent), and intracellular and extracellular antioxidant capacity. Experimental findings suggest that in ischaemic tissue there is an impairment of antioxidant mechanisms. Evidence to support this statement comes also from the cardioprotective effects of agents capable of inducing antioxidant enzymes in the heart and from the beneficial effects of several enzymatic free-radical scavengers, anti-oxidants and iron chelators in reperfused myocardium.

Free-radical hypothesis of atherosclerosis

Considerable in-vivo evidence, animal and human, supports the important role of reactive oxygen species in atherosclerotic coronary heart disease. While the exact mechanisms for atherogenesis are not completely understood, recent studies suggest that oxidative modification of low-density lipoproteins (LDL) is a critical factor. LDL may be oxidatively modified by all major cell types of the arterial wall via their extracellular release of reactive oxygen species (ROS). Hydroxyl radicals (thus formed) may initiate the peroxidation of long-chain polyunsaturated fatty acids within LDL, giving rise to conjugated dienes and lipid hydroperoxy radicals (LOO·). This process is self propagating, since LOO· can attack adjacent fatty acids until complete fatty acid chain fragmentation occurs. A number of highly reactive products then accumulate in the LDL particle, including malondialdehyde and lysophos-phatides, which interact with the amino side chain of the apoprotein B 100 and modify it to form new epitopes that are not recognised by the LDL receptor.

Hypertension

Essential hypertension (EH) appears associated with increased superoxide anion and hydrogen peroxide production, as well as decreased antioxidant capacity. The involvement of reactive oxygen species in EH is also suggested by the observation of increased level of lipid peroxides and decreased concentrations of antioxidant vitamin E in plasma of EH patients. Recently, Simi et al. (1998) have shown that patients with EH have plasma concentrations of free-radical scavengers lower than healthy normotensive subjects. The elevated consumption of plasma antioxidants was accompanied by increased activity of extracellular antioxidant enzymes (glutathione peroxidase and SOD), suggesting that ROS production in EH overwhelms antioxidant defence capacity. Oxidative stress in patients with EH is accompanied with the decreased red blood cell counts and decreased SOD and glutathione peroxidase activity in neutrophils.

Chronic heart failure

Chronic heart failure is a state characterised by a number of processes that may promote reactive oxygen species generation in vivo, including cytokine activation, recurrent hypoxia-reperfusion, possibly genetic susceptibilities and activation of the renin-angiotensin system. There are a number of potential cellular sources implicated in enhanced ROS generation in chronic heart failure. It has recently been demonstrated that patients with chronic heart failure may have increased leucocyte 02- production, which is, in turn, related to severity of disease. Other sources of enhanced ROS generation in human chronic heart failure are both the myocardium and peripheral blood vessels. Increased activity of myocardial NADPH oxidase has been reported in heart failure.

Myocardial damage

Reactive oxygen species (ROS) have direct effects on cellular structure and function and may be integral signalling molecules in myocardial remodelling and failure. ROS result in a phenotype characterised by hypertrophy and apoptosis in isolated cardiac myocytes. ROS have also been shown to activate matrix metalloproteinase (MMP) in cardiac fibroblasts. Myocardial MMP activity is increased in the failing heart and an MMP inhibitor has been shown to limit early left ventricular dilatation in a murine model of myocardial infarction (MI). Hayashidani et al. (2003) showed significant improvement in the survival after MI in MMP-2 knockout mice, which was mainly attributable to the inhibition of early cardiac rupture and the development of subsequent LV dysfunction. Because MMP can be activated by reactive oxygen species, one proposed mechanism of ventricular remodelling is the activation of MMPs secondary to increased ROS production. Sustained MMP activation might influence the structural properties of the myocardium by providing an abnormal extracellular environment with which the myocytes interact. Kinugawa et al. (2000) demonstrated that the OH scavenger, dimethylthiourea, inhibits the activation of MMP-2 in association with the development of ventricular remodelling and failure. These data raise the interesting possibility that increased ROS after MI can be a stimulus for myocardial MMP activation, which might play an important role in the development of HF.

Left ventricular hypertrophy

In animal models of heart failure, levels of ROS are elevated and cardiac protection is observed with antioxidant treatment. The increase in ROS associated with left ventricular hypertrophy appears to be NAD(P)H oxidase-dependent. Myocardial NAD(P)H oxidase activity is elevated and expression of p22phox, gp91phox, p67phox and p47phox is increased in left ventricular tissue from guinea pigs after aortic banding. The gp91phox containing NAD(P)H oxidase has been shown to play an important role in the cardiac hypertrophic response to Ang II in mice. It has been suggested that the increase in ROS is responsible for impaired endothelial regulation of left ventricular relaxation observed in moderate pressure overload left ventricular hypertrophy.

Cardiac hypertrophy occurs in response to a sustained increase in cardiac work. The mechanisms underlying this progression from compensated hypertrophy to decompensated heart failure remain poorly understood and incompletely explored. There are data supporting at least a contributory role for alterations in ROS production in the pathophysiology of cardiac hypertrophy. There is substantial evidence from animal studies indicating that reactive oxygen species, and particularly O2, production is increased in cardiac hypertrophy. Recently, Date et al. demonstrated attenuated cardiac hypertrophy in mice subjected to pressure overload following treatment with the free-radical scavenger, N-2-mercaptopropionyl glycine. This is the first evidence in an experimental model suggesting a causal role for ROS in the development of pressure overload hypertrophy. The precise source of reactive oxygen species in this study was not apparent. In a similar study using a guinea pig model of pressure overload, an attenuation of LV hypertrophy was observed in animals treated with vitamin E. Taken together, these data support an important functional role for reactive oxygen species, in particular NADPH oxidase derived ROS, in the development of pressure-overload hypertrophy.

Free radicals in hypercholesterolaemia

Increased levels of O2 generation and attenuated NO mediated responses have been demonstrated in aortic rings from cholesterolfed rabbits. Treatment of the animals with polyethylene glycolated SODs improved endothelium-dependent vasodilation. Supplementation with L-arginine has also been shown to reduce O2 levels and restore NO-mediated responses in cholesterol-fed animals (Boger et al., 1995). O2 levels are also raised in WHHL (Watanabe heritable hyperlipidaemic) rabbits. Multiple mechanisms appear to be involved in O2- production in association with hypercholesterolaemia. Stepp and colleagues provided evidence that in canine carotid arteries eNOS, mechanisms dependent on xanthine oxidase and possibly NAD(P)H-oxidase were involved. Further evidence for the involvement of NAD(P)H oxidase was obtained in WHHL rabbits. In monkeys with atherosclerosis, disease severity is related to O2 levels, and regression of atherosclerosis is associated with decreases in O2 levels and NAD(P)H oxidase activity.

Free radicals in skeletal muscle dysfunction

Oxidative stress could be the mechanistic basis also for muscle fatigue and reduced exercise tolerance in patients with heart failure. This notion is supported by a positive correlation between ROS and exercise intolerance in these patients. Further, Tsutsui et al. (2001) demonstrated that the production of reactive oxygen species was increased in the skeletal muscle homogenates obtained from a murine model of HF and increased ROS were identified as OH originating from O2, which was associated with a concomitant increase in the oxidation of lipids. These results are consistent with the previous studies that the oxidative capacity is reduced and O2 utilisation is inadequate in skeletal muscle mitochondria from patients with heart failure. Skeletal muscle mitochondria from heart failure are associated with a decrease in the activities of complex I and complex III. As has been shown in the failing hearts, the defects in electron transfer function may lead to reactive oxygen species production. ROS may play an important role in the muscle atrophy commonly seen in patients with heart failure through the induction of apoptosis. In addition, ROS impair myoplasmic Ca2+ homeostasis and inhibit the oxidative energy production in the mitochondria, both of which may contribute to the muscle contractile dysfunction. An attempt to attenuate oxidative stress would improve, to some extent, the exercise capacity of patients with heart failure.

Tests for antioxidant activity

Antioxidant activity can be evaluated both in vitro and in vivo. There are potential models for evaluation of the antioxidant activity. Animals such as mice, rats, guinea pigs and rabbits can be used for in-vivo evaluation with the oxidative stress induced by some external chemical agent (e.g. carbon tetrachloride), physical, emotional, mental or environmental stress (e.g. torturing the animals, depriving animals from food, water and sexual activity, increasing noise or temperature of the animal housing). Even surgery can be performed for inducing oxidative stress in rats, e.g. cerebral ischaemia/reperfusion induced oxidative stress in which the induction of ischaemia in rats was performed by occluding bilateral common carotid arteries with clamps for 30 min followed by 24 h reperfusion. Following any of the methods whereby the oxidative stress can be induced in the animals, they should be grouped as treated (at least two or more doses), control and normal animals. In the end of study the animals can be sacrificed to isolate the vital organs. Enzymes such as SOD, catalase and glutathione can be measured in these tissues, together with the extent of lipid peroxidation caused by the oxidative stress, using assays such as barbituric acid reactive substances (TBARS).

In-vitro methods consist of chemical methods in which free radicals can be generated using chemical reactions, e.g. nitric oxide method or chemicals which themselves act as the source of free radicals such as DPPH (2,2-diphenyl-1-picrylhydrazyl). In-vitro methods are also available in which generated free radicals can attack tissues isolated from the animal body leading to the oxidation of lipids present in the tissues, e.g. thiobarbituric acid-reactive substances (TBARS) assay. Details on some of the in-vitro methods used for the evaluation of antioxidant activity are given below.

DPPH radical scavenging assay

The antioxidant activity of the plant extract and pure compounds was assessed on the basis of radical scavenging effect of the stable DPPH free radical, which is purple. Antioxidants react with DPPH, and convert it to 1,1-diphenyl-2-(2,4,6-trinitrophenyl) hydrazine, which is colourless. Reaction mixtures containing test samples (dissolved in DMSO) and 300 µmol/L DPPH ethanolic solutions in 96-well microtitre plates are incubated at 37°C for 30 min, and absorbances measured at 515 nm. The degree of discolouration indicates the scavenging potentials of the antioxidant compounds and IC50 values can be calculated, i.e. the concentration of sample required to scavenge 50% DPPH free radicals. DPPH reagent (0.5% in methanol) can be sprayed on to preparative TLC plates to identify active antioxidant compounds in plant extracts. Active radical scavengers give yellow colour zones against a purple background.

Nitric oxide radical scavenging assay

Nitric oxide (NO·) is a free radical and scavengers of nitric oxide compete with oxygen, leading to reduced production of nitric oxide. NO is generated from sodium nitroprusside and measured by the Griess Illosvoy reagent (Garratt, 1964), which can be modified by using naphthylethylenediamine dihydro-chloride (0.1% w/v) instead of 1-naphthylamine (5%). The extent of NO radical scavenging can be assessed by colorimetry whereby reaction mixtures containing 10 mmol/L sodium nitroprusside, phosphate buffer saline and extracts or standard solution are incubated at 25°C for 150 min. After incubation, 0.5 mL of the reaction mixture is mixed with 1 mL of sulphanilic acid reagent (0.33% in 20% glacial acetic acid) and allowed to stand for 5 min to complete diazotisation. Naphthyl ethylenediamine dihydrochloride is then added, mixed and allowed to stand for 30 min at 25°C and a pink coloured chro-mophore is formed in diffused light whose intensity is measured at 540 nm.

Scavenging of superoxideanion radicals assay

Various cellular enzymes can catalyse chemical reactions involving molecular oxygen, including admission formation of superoxide radicals, which can inactivate vital cell components. Superoxide can be generated by enzymatic oxidation of hypoxanthine with xanthine oxidase and can be detected colori-metrically by nitroblue tetrazolium (NBT) reduction. The reaction is started by adding 100 µL of phenazine methosulphate (PMS) solution (60 µmol/L PMS in 100 mmol/L phosphate buffer, pH 7.4) to the mixture, incubating at 25°C for 5 min, and measuring the absorbance at 560 nm. Decreased absorbance of the reaction mixture indicates increased superoxide anion scavenging activity.

Deoxyribose degradation assay

In this method hydroxyl radicals are generated by incubating a mixture containing KH2PO4-KOH, H2O2, FeCl2-EDTA and deoxyribose. The extent of deoxyribose degradation by the formed hydroxyl radical can be assessed by the thiobarbituric acid method. The typical reaction is started by adding Fe(II) at a final concentration of 6 µmol/L to a 0.5 mL final volume of 20 mmol/L phosphate buffer, 5 mmol/L of 2-deoxyribose, Cu(II) (5 µmol/L) (pH 7.2) and 100 µmol/L H2O2 with and without 10 µmol/L of ascorbate as an iron chelator. Reactions were carried out for 10 min at 25 °C ± 1°C and were stopped by adding of 0.5 mL of 50 mmol/L NaOH containing 4% (w/v) phosphoric acid. After boiling for 15 min, the absorbance of the solution containing the oxidation products is measured at 532 nm.

Thiobarbituric-acid-reactive substances assay

In this method the lipid peroxidation is measured in terms of malondialdehyde (MDA) content following the thiobarbituric acid method of Ohkawa et al. (1979). MDA is formed in vivo and in vitro through oxidation of unsaturated lipids by ROS, and other oxidative agents. Thiobarbituric acid reacts with MDA to form a pink chromogen, which can be detected spectrophotometrically at 532 nm.

β-Carotene-linoleic acid (linoleate) assay

The antioxidant activity is measured by the ability of a compound to minimise the coupled oxidation of linoleic acid and β-carotene in an emulsified aqueous system. β-carotene loses its orange colour when reacting with reactive oxygen species, so colorimetery can be used to investigate the decline in colour caused by oxidative stress. In this method a stock solution of β-carotene and linoleic acid is prepared by dissolving 0.5 mg of β-carotene in 1 mL of chloroform and adding 25 µL of linoleic acid together with 200 mg of Tween 40, evaporating the chloroform and adding 100 mL of aerated water to the residue. To 2.5 mL of this mixture, 300 µL of extract is added and the mixture incubated in boiling water for 2 h together with two blanks, one containing the antioxidant BHT and the other without antioxidant, before measuring the absorbance at 470 nm.

DNA nicking assay

The ability of a test drug to prevent the DNA damage caused by agents such as 2,2′-azobis (2-methylpropionamide) dihydrochloride (APPH) is measured in this method. The test substance is mixed with DNA and APPH, dissolved in phosphate-buffered saline, is added to start the reaction. The resultant mix is developed on agarose gel, elec-trophoresis carried out and then staining with ethidium bromide. DNA bands are visualised under illuminated ultraviolet light and examined for DNA breakage.