Abstract
Ginkgo biloba is commonly known as maidenhair tree, available as a popular herbal supplementary in Asian, European, and American countries. Extensive in vitro, in vivo, and clinical studies demonstrated and confirmed the neuroprotective effects of a commercial standard ginkgo extract formulation known as EGb-761. Terpene trilactone comprises 5–7 % in EGb-761, collectively called as ginkgolides (G-A, G-B, G-C, G-J, G-K, G-L and G-M) and bilobides. Its clinical application gained popularity in herbal medicine due to treatment of early-stage Alzheimer’s disease, cerebrovascular disorders, PAF antagonism, and vestibular disorders. In addition, ginkgolides showed potent antioxidant activities via scavenging of reactive oxygen and nitrogen species. The physiological dosage of ginkgo extracts ranges between 120 and 240 mg/day in humans, and it is readily available as an over the counter product/supplementary product. According to the recent clinical findings, EGb-761 did not confirm its effect on long-term cognitive functioning, while it showed effectiveness and enhancement in shor-term cognitive and related activities. Ginkgo is generally well tolerated, but in a high dose, it can cause gastric upset, skin allergy, and increase the risk of bleeding in patients with risk factors (anticoagulant or antiplatelet treatment, surgery, etc.). Neuropharmacology, clinical issues of safety and usage are addressed in this book chapter.
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Abbreviations
- 5-HT:
-
5-Hydroxytryptamine
- 8-OHdG:
-
Hydroxyl-deoxyguanosine
- ACh:
-
Acetylcholine
- AD:
-
Alzheimer’s disease
- ADDLs:
-
Amyloid beta-derived diffusible soluble ligands
- APP:
-
Amyloid precursor protein
- ATP:
-
Adenosine triphosphate
- Aβ:
-
Amyloid beta
- BALF:
-
Bronchoalveolar lavage fluid
- BBB:
-
Blood–brain barrier
- BN-52021:
-
Ginkgolide B
- cAMP:
-
Cyclic adenosine monophosphate
- D2 :
-
Dopaminergic receptor 2
- DA:
-
Dopamine
- DMSO:
-
Dimethylsulfoxide
- DNA:
-
Deoxyribonucleic acid
- DSC-MRI:
-
Dynamic susceptibility contrast-enhanced magnetic resonance imaging
- EGb:
-
Ginkgo biloba extract
- EGb-761:
-
Standard ginkgo extract
- FFA:
-
Free fatty acid
- G. biloba :
-
Ginkgo biloba
- G-A:
-
Ginkgolide A
- GABAA :
-
Gamma-amino butyric acid
- G-B:
-
Ginkgolide B
- G-C:
-
Ginkgolide C
- G-J:
-
Ginkgolide J
- G-K:
-
Ginkgolide K
- G-L:
-
Ginkgolide L
- G-M:
-
Ginkgolide M
- GSH:
-
Glutathione
- H2O2 :
-
Hydrogen peroxide
- HO-1:
-
Heme oxygenase-1
- i.p.:
-
Intraperitoneally
- IL:
-
Interleukin
- iNOS:
-
Inducible nitric oxide synthase
- JNK:
-
c-jun N-terminal kinase
- KYNA:
-
Kynurenic acid
- LI-1370:
-
Standard Gingko extract
- MAO:
-
Monoamine oxidase
- MDA:
-
Malondialdeide
- MGluR:
-
Metabotropic glutamate receptor
- MPTP:
-
1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine
- mRNA:
-
Messenger ribose nucleic acid
- MS:
-
Multiple sclerosis
- NCE:
-
Noncontact erection
- NE:
-
Norepinephrine
- NF-kappa B:
-
Nuclear factor kappa B
- NFT:
-
Neurofibrillary tangles
- NIDDM:
-
Non-insulin dependent diabetes mellitus
- NMDA:
-
N-methyl d-aspartate receptor
- NO:
-
Nitric oxide
- P8A:
-
Standard Gingko extract
- PAF:
-
Platelet activating factor
- PBR:
-
Peripheral-type benzodiazepine receptor
- PD:
-
Parkinson’s disease
- PKA:
-
Protein kinase-A
- PVN:
-
Paraventricular nucleus
- RAGE:
-
Receptors for advanced glycation end products
- RNA:
-
Ribose nucleic acid
- RONS:
-
Reactive oxygen and nitrogen species
- ROS:
-
Reactive oxygen species
- USP:
-
United States Pharmacopeia
- VF:
-
Ventricular fibrillation
- VSMCs:
-
Vascular smooth muscle cells
- VT:
-
Ventricular tachycardia
- WHO:
-
World Health Organization
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I wish to thank CSU library for databases and Prof. Patrick Ball for valuable suggestion. I cannot finish without my family inspiration, including my parents, Saba and Ariba.
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Omar, S.H. (2013). Ginkgolides and Neuroprotective Effects. In: Ramawat, K., Mérillon, JM. (eds) Natural Products. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-22144-6_146
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