NeuroAiD explained

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NeuroAiD: MLC601 (NeuroAiDTM) was first developed.[1] Since 2018 MLC601 formulation is no longer on the market, and has been replaced by MLC901 (NeuroAiDTMII), a simplified formulation containing only 9 botanical ingredients.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

NeuroAiD was first registered and marketed in China in 2001.[1] [4] It is derived from traditional Chinese medicine.[4] [5] [6] According to the CEO of Moleac, NeuroAiD is sold in at least 25 countries, and 20,000 people have taken it.[7]

Composition

NeuroAiD I, or MLC601, is composed of nine herbal components (astragalus root, Salvia miltiorrhiza root, chishao, rhizome lovage, Angelica sinensis root, safflower, peach, thinleaf milkwort root, and grassleaf sweet flag rhizome) and five components derived from animals (Hirudo medicinalis, Eupolyphaga seu steleophaga, Calculus bovis artifactus, Buthus martensii, and Cornu saigae tataricae).[8] NeuroAiDTMII, or MLC901, is a simpler form of the medication that only contains the nine herbal components without the animal components.[9] Since 2018, MLC601 formulation is no longer marketed.

Pharmacology

Laboratory studies suggest that NeuroAiD can aid with stroke recovery by improving neuroprotection, neurogenesis, and neuroplasticity by amplifying endogenous processes of self-protection and self-repair of the brain.[9] [10] [11] MLC901 can activate KATP channels, which has a neuroprotective effect against brain ischemia.[12]

Effectiveness

Neuroaid was statistically no better than placebo in improving stroke recovery at 3 months post-stroke.[13] Additionally, recent research indicates that NeuroAid improves cognitive functioning after traumatic brain injury[14] and could potentially play a role in treating severe traumatic spinal cord injuries,[15] as well as in slowing down the progression of Alzheimer's disease.[16]

Side effects

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

Contraindications

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

Approvals and patents

NeuroAiD was approved by the Sino Food and Drug Administration in August 2001, under the name Danqi Piantan Jiaonang.[8] [18] NeuroAiD has also been approved for use in other Asian countries such as Singapore.[19] In 2006, NeuroAiD was also chosen for the Chinese Ministry of Science and Technology's Key Technologies Research & Development program.[20]

Notes and References

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

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