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Celastrol: A Spectrum of Treatment Opportunities in Chronic Diseases.

ABSTRACT: The identification of new bioactive compounds derived from medicinal plants with significant therapeutic properties has attracted considerable interest in recent years. Such is the case of the Tripterygium wilfordii (TW), an herb used in Chinese medicine. Clinical trials performed so far using its root extracts have shown impressive therapeutic properties but also revealed substantial gastrointestinal side effects. The most promising bioactive compound obtained from TW is celastrol. During the last decade, an increasing number of studies were published highlighting the medicinal usefulness of celastrol in diverse clinical areas. Here we systematically review the mechanism of action and the therapeutic properties of celastrol in inflammatory diseases, namely, rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel diseases, osteoarthritis and allergy, as well as in cancer, neurodegenerative disorders and other diseases, such as diabetes, obesity, atherosclerosis, and hearing loss. We will also focus in the toxicological profile and limitations of celastrol formulation, namely, solubility, bioavailability, and dosage issues that still limit its further clinical application and usefulness.

SUBMITTER: Cascao R

PROVIDER: S-EPMC5471334 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Celastrol: A Spectrum of Treatment Opportunities in Chronic Diseases.

Cascão Rita R Fonseca João E JE Moita Luis F LF

Frontiers in medicine 20170615

The identification of new bioactive compounds derived from medicinal plants with significant therapeutic properties has attracted considerable interest in recent years. Such is the case of the <i>Tripterygium wilfordii</i> (TW), an herb used in Chinese medicine. Clinical trials performed so far using its root extracts have shown impressive therapeutic properties but also revealed substantial gastrointestinal side effects. The most promising bioactive compound obtained from TW is celastrol. Durin ...[more]

PMID: 28664158

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Project description:Interventions: Randomized order of colonoscopy type (conventional versus FUSE colonoscopy) to determine the miss rates of colonoscopy type. The intervention is the use of the FUSE colonoscope which is a colonoscope that incorporates 3 cameras on the colonoscope tip to provide a panoramic 330-degree field of view. .The size and function of the FUSE colonoscope is otherwise the same as the conventional colonoscope (control). Both instruments visualise the internal lining of the bowel and permit the identification and removal of neoplasia. All subjects will have both procedures performed back-to-back (crossover tandem colonoscopy) but the order of the procedure will be randomized. The effect is that the second procedure will determine if lesions were missed during the first procedure, and which colonoscope can identify more neoplasia. Both colonoscopies are expected to be equivalent in duration, taking 15-25 minutes. Quality indicator is that colonoscopy withdrawal should be of at least 6 minutes to improve the chances of not missing pathology. Both colonoscopies are conducted by investigators who are experienced in surveillance colonoscopies and accredited endoscopists. The histopathologists are from the Department of Pathology and familiar with the identification and interpretation of IBD dysplasia. Where dysplasia is found, a second gastrointestinal pathologist will assist with the grading through consensus. Both pathologists are blinded to the order of the colonoscopy (which is coded). There is no need for a wash out, as this is not a drug trial. The second colonoscopy is inserted as soon as the processor is connected and switched on, which usually takes 4-5 minutes. The patient remains under sedation during the intervening period and we wish to keep that as brief a Primary outcome(s): Dysplasia miss rates on a per-lesion analysis [Following completion of both colonoscopies and histological confirmation of the lesions removed during the procedures. ] Study Design: Purpose: Diagnosis; Allocation: Randomised controlled trial; Masking: Blinded (masking used);Assignment: Crossover;Type of endpoint: Safety/efficacy

Dataset Information

Celastrol: A Spectrum of Treatment Opportunities in Chronic Diseases.

Publications

Celastrol: A Spectrum of Treatment Opportunities in Chronic Diseases.

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