NeuroAiD

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NeuroAiD: MLC601 (NeuroAiDTM) was first developed.[1] Since 2018 MLC601 formulation is no longer on the market, and has been replaced by MLC901 (NeuroAiDTMII), a simplified formulation containing only 9 botanical ingredients.[2] It can be administered orally or through a feeding tube.[3]

Research has found the drug to be of no benefit for aiding stroke recovery.[4]

Common side effects include abdominal discomfort, headaches, dry mouth, nausea, vomiting, and diarrhea.[1] Though very rare, some patients have reported serious adverse events in clinical trials (jaundice, hypokalemia, seizures, and recurring strokes).[5]

NeuroAiD was first registered and marketed in China in 2001.[1][6] It was patented in the United States in 2013,[7] but has not been approved by the FDA. NeuroAiD is distributed by Moleac,[8] and is derived from traditional Chinese medicine.[6][5][9] According to the CEO of Moleac, NeuroAiD is sold in at least 25 countries, and 20,000 people have taken it.[10]

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).[11] NeuroAiDTMII, or MLC901, is a simpler form of the medication that only contains the nine herbal components without the animal components.[2] 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.[12][13][14] MLC901 can activate KATP channels, which has a neuroprotective effect against brain ischemia.[15]

Effectiveness

Neuroaid is not effective in aiding recovery after stroke.[4]

Contraindications

The medication is contraindicated in pregnant and breastfeeding women.[16]

Approvals and patents

NeuroAiD was approved by the Sino Food and Drug Administration in August 2001, under the name Danqi Piantan Jiaonang.[11][17] NeuroAiD has also been approved for use in other Asian countries such as Singapore.[18] In 2006, NeuroAiD was also chosen for the Chinese Ministry of Science and Technology's Key Technologies Research & Development program.[19]

In 2013, Moleac filed a patent for NeuroAiD with the European Patent Office, which was eventually approved in 2019.[20] In the same year, Moleac also filed a patent application with the U.S. Patent Office.[7]

References
  1. Venketasubramanian N, Kumar R, Soertidewi L, Abu Bakar A, Laik C, Gan R (November 2015). "The NeuroAiD Safe Treatment (NeST) Registry: a protocol". BMJ Open. 5 (11): e009866. doi:10.1136/bmjopen-2015-009866. PMC 4654343. PMID 26567259.
  2. Heurteaux C, Gandin C, Borsotto M, Widmann C, Brau F, Lhuillier M, et al. (June 2010). "Neuroprotective and neuroproliferative activities of NeuroAid (MLC601, MLC901), a Chinese medicine, in vitro and in vivo". Neuropharmacology. 58 (7): 987–1001. doi:10.1016/j.neuropharm.2010.01.001. PMID 20064536. S2CID 22044836.
  3. 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. doi:10.1016/j.trci.2018.12.001. PMC 6352850. PMID 30723778.
  4. González-Fraile E, Martín-Carrasco M, Ballesteros J (2016). "Efficacy of MLC601 on functional recovery after stroke: A systematic review and meta-analysis of randomized controlled trials". Brain Injury. 30 (3): 267–70. doi:10.3109/02699052.2015.1118764. PMID 26890534.
  5. Siddiqui FJ, Venketasubramanian N, Chan ES, Chen C (2013). "Efficacy and safety of MLC601 (NeuroAiD®), a traditional Chinese medicine, in poststroke recovery: a systematic review". Cerebrovascular Diseases. 35 Suppl 1: 8–17. doi:10.1159/000346231. PMID 23548914.
  6. Tan CN, Choy D, Venketasubramanian N (2020). "NeuroAid II (MLC901) in Haemorrhagic Stroke". Case Reports in Neurology. 12 (Suppl 1): 212–217. doi:10.1159/000508588. PMC 7802497. PMID 33505298.
  7. US 20130287870, Moha Ou Maati H, Lazdunski M, Heurteaux C, Picard D, "Novel uses for traditional Chinese medicines", published 31 October 2013, assigned to Moleac Pte Ltd.
  8. Heurteaux C, Widmann C, Moha ou Maati H, Quintard H, Gandin C, Borsotto M, et al. (2013). "NeuroAiD: properties for neuroprotection and neurorepair". Cerebrovascular Diseases. 35 Suppl 1: 1–7. doi:10.1159/000346228. PMID 23548913.
  9. Widmann C, Gandin C, Petit-Paitel A, Lazdunski M, Heurteaux C (December 2018). "The Traditional Chinese Medicine MLC901 inhibits inflammation processes after focal cerebral ischemia". Scientific Reports. 8 (1): 18062. Bibcode:2018NatSR...818062W. doi:10.1038/s41598-018-36138-0. PMC 6305383. PMID 30584250.
  10. Grens K (2013-07-05). "Herbal stroke remedy no better than dummy pill". Reuters.
  11. Kim I, Pollitt E, Leibel RL, Viteri FE, Alvarez E (September 1984). "Application of receiver-operator analysis to diagnostic tests of iron deficiency in man". Pediatric Research. 18 (9): 916–920. doi:10.1203/00006450-198409000-00025. PMID 6483514.
  12. Heurteaux C, Gandin C, Borsotto M, Widmann C, Brau F, Lhuillier M, et al. (June 2010). "Neuroprotective and neuroproliferative activities of NeuroAid (MLC601, MLC901), a Chinese medicine, in vitro and in vivo". Neuropharmacology. 58 (7): 987–1001. doi:10.1016/j.neuropharm.2010.01.001. PMID 20064536. S2CID 22044836.
  13. Quintard H, Borsotto M, Veyssiere J, Gandin C, Labbal F, Widmann C, et al. (September 2011). "MLC901, a traditional Chinese medicine protects the brain against global ischemia". Neuropharmacology. 61 (4): 622–631. doi:10.1016/j.neuropharm.2011.05.003. PMID 21605573. S2CID 6194484.
  14. Heurteaux C, Widmann C, Moha ou Maati H, Quintard H, Gandin C, Borsotto M, et al. (2013). "NeuroAiD: properties for neuroprotection and neurorepair". Cerebrovascular Diseases. 35 Suppl 1 (Suppl. 1): 1–7. doi:10.1159/000346228. PMID 23548913. S2CID 16589542.
  15. Chen CL, Young SH, Gan HH, Singh R, Lao AY, Baroque AC, et al. (August 2013). "Chinese medicine neuroaid efficacy on stroke recovery: a double-blind, placebo-controlled, randomized study". Stroke. 44 (8): 2093–2100. doi:10.1161/STROKEAHA.113.002055. PMID 23780952. S2CID 11203386.
  16. "Neuroaid Full Prescribing Information, Dosage & Side Effects". MIMS Malaysia. Retrieved 2022-02-18.
  17. Gan R, Lambert C, Lianting J, Chan ES, Venketasubramanian N, Chen C, et al. (2008). "Danqi Piantan Jiaonang does not modify hemostasis, hematology, and biochemistry in normal subjects and stroke patients". Cerebrovascular Diseases. 25 (5): 450–456. doi:10.1159/000126919. PMID 18417963. S2CID 25577836.
  18. Siow CH (2008). "Neuroaid in stroke recovery". European Neurology. 60 (5): 264–266. doi:10.1159/000155220. PMID 18781074.
  19. Chen C, Venketasubramanian N, Gan RN, Lambert C, Picard D, Chan BP, et al. (March 2009). "Danqi Piantang Jiaonang (DJ), a traditional Chinese medicine, in poststroke recovery". Stroke. 40 (3): 859–863. doi:10.1161/STROKEAHA.108.531616. PMID 19164787.
  20. EP 2838545A1, Moha Ou Maati H, Lazdunski M, Heurteaux C, Picard D, "Composition comprising herbs", published 31 October 2013, assigned to Moleac Pte Ltd.
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