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Psychiatric Disorders and Polyphenols: Can They Be Helpful in Therapy?

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Psychiatric Disorders and Polyphenols: Can They Be Helpful in Therapy? Hindawi Publishing Corporation Oxidative Medicine and Cellular Longevity Volume 2015, Article ID 248529, 16 pages http://dx.doi.org/10.1155/2015/248529 Review Article Psychiatric Disorders and Polyphenols: Can They Be Helpful in Therapy? Jana Trebatická1 and Zde^ka >uraIková2 1 Department of Child and Adolescent Psychiatry, Faculty of Medicine, Comenius University and Child University Hospital, 833 40 Bratislava, Slovakia 2Institute of Medical Chemistry, Biochemistry and Clinical Biochemistry, Faculty of Medicine, Comenius University, 813 72 Bratislava, Slovakia Correspondence should be addressed to Zdenkaˇ Duraˇ ckovˇ a;´ [email protected] Received 23 September 2014; Revised 6 February 2015; Accepted 10 February 2015 Academic Editor: Cristina Angeloni Copyright © 2015 J. TrebatickaandZ.´ Duraˇ ckovˇ a.´ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The prevalence of psychiatric disorders permanently increases. Polyphenolic compounds can be involved in modulation of mental health including brain plasticity, behaviour, mood, depression, and cognition. In addition to their antioxidant ability other biomodulating properties have been observed. In the pathogenesis of depression disturbance in neurotransmitters, increased inflammatory processes, defects in neurogenesis and synaptic plasticity, mitochondrial dysfunction, and redox imbalance are observed. Ginkgo biloba, green tea, and Quercus robur extracts and curcumin can affect neuronal system in depressive patients. ADHD patients treated with antipsychotic drugs, especially stimulants, report significant adverse effects; therefore, an alternative treatment is searched for. An extract from Ginkgo biloba and from Pinus pinaster bark, Pycnogenol, could become promising complementary supplements in ADHD treatment. Schizophrenia is a devastating mental disorder, with oxidative stress involved in its pathophysiology. The direct interference of polyphenols with schizophrenia pathophysiology has not been reported yet. However, increased oxidative stress caused by haloperidol was inhibited ex vivo by different polyphenols. Curcumin, extract from green tea and from Ginkgo biloba, may have benefits on serious side effects associated with administration of neuroleptics to patients suffering from schizophrenia. Polyphenols in the diet have the potential to become medicaments in the field of mental health after a thorough study of their mechanism of action. 1. Introduction better detection, prevention based on improvement of life- style factors including diet, and effectiveness of treatment1 [ ]. The prevalence of psychiatric disorders permanently in- Results of many animal and human studies support the creases. In the WHO European Region nearly 4 out of 15 role of different natural polyphenolic compounds in modu- people suffer from major depression and anxiety. Neuropsy- lation of mental health including brain plasticity, behaviour, chiatric disorders are the second cause of disability in Europe mood through anxiolytic, antidepressant-like properties, and and account for 19% in comparison to cardiovascular disor- cognition. Research demonstrates that dietary factors and derswithonly4%.In28countriesofEUwithapopulation exercise can affect the maintenance and development of of 466 million, at least 21 million people were affected by neurons and protect the brain from insult associated with depression, out of which almost 80% are men. The treatment neurological illnesses or injuries [2–7]. of psychiatric disorders is very expensive. The total annual cost of depression in Europe was estimated at Euro 118 billion in 2004, which corresponds to a cost of Euro 253 2. Polyphenolic Compounds per inhabitant. The cost of depression corresponds to 1% of the total economy of Europe. These reasons provide support Polyphenols (known as polyhydroxyphenols)arepredom- for the importance of increased research efforts in this field, inantly secondary metabolites of plants. They belong to 2 Oxidative Medicine and Cellular Longevity 3 2 4 B O 8 O O 5 7 A 6 6 3 OH 5 4 O Flavonoid basic structure Flavane-3-ol Flavanone O O + O OH OH O O Anthocyanidin Flavone-3-ol Flavone Figure 1: Basic flavonoid structures. structural class of organic compounds characterized by the psychiatric disorders (like ADHD) [17], and other chronic presence of large multiples of phenol structural units. These diseases [18]. Since in the pathology of these diseases, in phenol structures underlie the unique physical, chemical, and addition to other factors, oxidative stress has been assumed biological (metabolic, toxic, therapeutic, etc.) properties of to play a role, dietary flavonoids have been suggested to particular members of the class. The name derives from the exert health benefits through antioxidant mechanisms. In ancient Greek word ó (polus, meaning “many, much”) experiments in vitro, flavonoids exert a significant antioxi- and the word phenol which refers to a chemical structure dant [8, 19]andredoxmodulating[20]ability.Polyphenols formed by attaching a hydroxyl (–OH) group to an aromatic act as strong antioxidants in vitro through the numerous phenyl ring. They are divided into three groups according mechanisms, such as radical scavenging, metal ions (Fe, Cu, to their hydrolytic cleavage products: (i) tannins: derivatives and others) chelation, and the modulation of antioxidant of catechin or gallic acid with mostly antioxidant properties enzyme activities [8, 21]. In the scavenging ability the position [8], (ii) phenylpropane derivatives (lignans, ellagitannins, and the number of phenolic –OH groups play a role through cinnamic acid derivatives, and others); for example, higher donation of a hydrogen atom from their hydroxyl groups dietary intake of lignans is associated with better cognitive to radicals, resulting in radical moiety elimination. During functions in postmenopausal women [9] or extract of ellag- this reaction, phenoxyl radical is formed that can form stable itannins from oak wood reduced many of key symptoms compound and terminates radical reaction via reaction with of chronic fatigue [10], and (iii) flavonoids: phenolic com- another radical [20]. pounds spread in the plant kingdom. They include more than Upon consumption of food, polyphenols are available in 4000 different derivatives and their list constantly increases. the form of esters, glycosides, or polymers that cannot be Formation of so many derivatives is possible due to the absorbed in the intestine. The original molecules of polyphe- substitution of hydrogen atoms by hydroxyl, methoxyl, and nolic compounds are hydrolyzed by microbial enzymes in other groups at different sites of the basic structures. The colon and transformed via methylation, sulfation, and glu- basic flavonoid structures include the following: flavan-3- curonidation to derivatives of original molecules followed by ols (epicatechin and gallocatechin), flavanones (naringenin their absorption in the colon and travelling through blood and hesperidin), flavones (apigenin and luteolin), flavone-3- to various tissues and organs such as the brain. However, ol (quercetin and myricetin), anthocyanidins (cyanidin and duetothediversesusceptibilitiesofphenoliccompoundsto pelargonidin), and isoflavones (genistein and daidzein) [11] colonenzymemetabolism,theirbioavailabilitycanvaryfrom (Figure 1). very low to very high [22, 23]. The low bioavailability and Polyphenols occur in food (vegetables and fruits) either transformation of polyphenolic compounds in vivo to differ- as free monomers (quercetin and catechin) or oligomers ent derivatives lead to their low direct antioxidant activity in (procyanidins). They are bound to saccharides as glycosides comparison to other low-molecular weight antioxidants, such or occasionally they are found as free aglycones. After as vitamins C and E and uric acid [24]. ingestion, flavonoids can undergo biotransformation to their However, in addition to antioxidant activities polyphe- metabolites which can be detected in plasma reaching con- nols at low concentration can exert also other biological −1 centration of about 1 mol⋅L [12, 13]. effects in vivo. Polyphenols can participate in modulation Consumption of polyphenol-rich foods is associated with of different signaling pathways, thus influencing the fate a lower incidence of coronary heart disease, myocardial of cells [25] including nerve cells via influencing the infarction [14], cancer [15], neurodegenerative diseases [16], neuronal survival, regeneration, development, or death [26]. Oxidative Medicine and Cellular Longevity 3 Polyphenolic compounds possess also antimutagenic ability It is believed that in pathology of psychiatric disorders [27], vasodilating [28], antithrombic [29], antiapoptotic [30], alsooxidativestressplaysarole(Figure 2). Oxidative stress and anti-inflammatory31 [ ]effects. is defined as the disbalance between production of free Anti-inflammatory effects of polyphenols in cerebral radicals and/or reactive oxygen species/reactive nitrogen tissue can be realised via binding to various receptors. species (ROS/RNS) and antioxidant defence in favour of Flavonoid-induced receptor stimulation can modulate active ROS/RNS leading to oxidative damage to lipids, proteins, and state of different kinases, such as the mitogen-activated pro- DNA and thus to the dysfunction of cells and organs [25]. tein (MAP) kinase (naringenin),
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