Natural Products, Medicinal Plants and Traditional Medicines

Biography

Biography: Dario Rusciano

Abstract

Age-dependent Macular Degeneration (AMD), Diabetic Retinopathy (DR) and Primary Open Angle Glaucoma (POAG) claim each year the sight of many thousand patients worldwide. There is no cure for these diseases and the best we can do is to try and slow down their progression. Therefore, early diagnosis is mandatory so that palliative treatments can be started as soon as possible. In the absence of a definitive drug treatment for each of these pathologies, food supplements play a relevant role in the control of their progression. Animal models of disease have allowed establishing the way food supplements may work and provide a proof of concept of how they may interfere with the mechanisms behind the progression of each disease, encouraging further verification in clinical trials. POAG is a pathology in which the elevated Intraocular Pressure (IOP) is a major risk factor that triggers the progressive death of retinal ganglion cells (RGC: Forming the optic nerve), finally leading to loss of vision. Therefore, the two main strategies for POAG control are the reduction of IOP and the neuroprotection to increase the survival chances of RGC. Food supplements based on Coleus forskohlii extracts enriched in forskolin and homotaurine have shown a good efficacy, both preclinical and clinical, in controlling POAG progression. AMD is another kind of retinal degenerative disease, in which the prolonged oxidative stress during a lifetime produces an amount of debris (the so-called ‘drusen’) that accumulates between the pigmented epithelium layer (on which photoreceptors rest) and the choroid. The consequent inflammatory events, in which activated macrophages play a determinant role, eventually lead to the breaking of the thin Bruch’s membrane that separates the retina from the nutritive choroid (made of a capillary network), triggering the invasion of blood vessels into the macular region of the retina (normally avascular). The resulting hemorrhages and edemas dramatically impair vision. Food supplements based on a specific and calibrated fatty acids mixture appear to be able to control the inflammatory process, decrease the damage at the retina and improve its physiological response. Similarly, a different, but analogue, fatty acid formulation has been shown to be able to delay the neurological damage (including the optic nerve) caused by demyelination in a model system of autoimmune induced encephalopathy. DR is a common complication of diabetes, occurring when there is an insufficient control of blood sugar levels. Long term hyperglycemia causes a constant oxidative stress, resulting in endothelial dysfunction and angiopathies that also involve the retina among other organs. Hemorrhages, edemas and focal ischemias characterize the early stages; neovessel formation and invasion into the macular region are typical of the late stages. Food supplements are needed in this case, endowed with the properties to control blood sugar levels and protect endothelial cells from oxidative damage and the capillaries from degenerating events. Lipoic acid, omega-3 fatty acids, resveratrol, ginkgo biloba, chromium are some of the components of food supplements that may help in the early and late stages of this disease.