Mild Cognitive Impairment Clinical Trial
Official title:
Investigating the Efficacy of Ergothioneine to Delay Cognitive Decline in Mild Cognitively Impaired Subjects
With the growing burden of dementia (including Alzheimer's disease), and the lack of
efficacious therapies, there is an urgent need to identify new therapeutics.
Ergothioneine (ET) is a naturally occurring thiol derivative of histidine, obtained solely
through diet and is able to accumulate in the body and brain, through the action of a
specific transporter, OCTN1. In addition to a wide variety of in vitro and in vivo (animal)
studies demonstrating the antioxidant, anti-inflammatory properties of ET, several studies
have demonstrated the neuroprotective potential of ET in various cell and animal models.
Based on the ability of ET to counteract the underlying pathology of AD dementia, it is
hypothesize that ET supplementation may prevent cognitive decline, especially in individuals
at risk of cognitive impairment. This will be assessed using a randomized, double blinded,
placebo-controlled, intervention study to test the ability of ET to delay or reverse
cognitive impairment in elderly individuals with mild cognitive impairment.
Ergothioneine (ET) is a naturally occurring thiol/thione obtained in humans solely through
diet. It is able to accumulate in specific cells and tissues (including the brain), via a
specific transporter, OCTN1, at high levels. Although the exact physiological function(s) of
ET have yet to be elucidated, numerous reports have demonstrated that this compound can
scavenge reactive oxygen species (such as hydroxyl radicals, hypochlorous acid, and
peroxynitrite), modulate inflammation, and chelate divalent metal ions. These processes are
all implicated in the pathology of dementia. Various studies in cell and animal models have
also highlighted the potential neuroprotective capabilities of ET following insult by various
neurotoxic agents such as cisplatin and amyloid beta peptide.
Studies demonstrated that ET dose-dependently protected PC12 cells against beta
amyloid-induced apoptotic death, and later was shown to protect against neuronal injury
caused by direct administration of amyloid beta into the mouse hippocampus, thereby
increasing scores in active avoidance and water maze tests. ET also dose-dependently extend
lifespan of a transgenic Caenorhabditis elegans model of AD by reducing amyloid oligomer
formation. Other studies also demonstrated that ET is also able to attenuate oxidative stress
and prevents cognitive deficits in a D-galactose-induced dementia mouse model; protect
against N-methyl-D-aspartate-induced cytotoxicity in rat retinal neurons; and prevent
cisplatin-induced neuronal damage in cell cultures and mice.
To date no studies have evaluated the therapeutic ability of ET, clinically, to delay or halt
cognitive decline. Prior studies administering pure ET to humans provide insights into the
pharmacokinetics and demonstrate the safety of this compound, laying the foundations for this
clinical study. The present proposal will shed light onto a relatively lesser known natural
compound and the therapeutic capabilities it possesses, which has the potential to
significantly impact the economic and societal burdens of dementia.
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