Title:Incorporating Natural Products, Pharmaceutical Drugs, Self-Care and Digital/Mobile Health Technologies into Molecular-Behavioral Combination Therapies for Chronic Diseases
VOLUME: 11 ISSUE: 2
Author(s):Grzegorz Bulaj, Margaret M. Ahern, Alexis Kuhn, Zachary S. Judkins, Randy C. Bowen and Yizhe Chen
Affiliation:Department of Medicinal Chemistry, College of Pharmacy, Skaggs Pharmacy Institute, University of Utah, 30 South 2000 East, Salt Lake City, Utah 84112, USA.
Keywords:Drug-resistant epilepsy, refractory epilepsy, inflammation, addiction, cognitive behavioral therapy, brain-derived
neurotropic factor, music, Mozart, video games.
Abstract:Merging pharmaceutical and digital (mobile health, mHealth) ingredients
to create new therapies for chronic diseases offers unique opportunities for natural
products such as omega-3 polyunsaturated fatty acids (n-3 PUFA), curcumin,
resveratrol, theanine, or α-lipoic acid. These compounds, when combined with
pharmaceutical drugs, show improved efficacy and safety in preclinical and clinical
studies of epilepsy, neuropathic pain, osteoarthritis, depression, schizophrenia,
diabetes and cancer. Their additional clinical benefits include reducing levels of
TNFα and other inflammatory cytokines. We describe how pleiotropic natural
products can be developed as bioactive incentives within the network pharmacology
together with pharmaceutical drugs and self-care interventions. Since approximately
50% of chronically-ill patients do not take pharmaceutical drugs as prescribed, psychobehavioral
incentives may appeal to patients at risk for medication non-adherence. For epilepsy, the incentive-based
network therapy comprises anticonvulsant drugs, antiseizure natural products (n-3 PUFA, curcumin
or/and resveratrol) coupled with disease-specific behavioral interventions delivered by mobile medical
apps. The add-on combination of antiseizure natural products and mHealth supports patient
empowerment and intrinsic motivation by having a choice in self-care behaviors. The incentivized
therapies offer opportunities: (1) to improve clinical efficacy and safety of existing drugs, (2) to catalyze
patient-centered, disease self-management and behavior-changing habits, also improving health-related
quality-of-life after reaching remission, and (3) merging copyrighted mHealth software with natural
products, thus establishing an intellectual property protection of medical treatments comprising the
natural products existing in public domain and currently promoted as dietary supplements. Taken
together, clinical research on synergies between existing drugs and pleiotropic natural products, and their
integration with self-care, music and mHealth, expands precision/personalized medicine strategies for
chronic diseases via pharmacological-behavioral combination therapies.