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Pharmaceutical Sector Update

Updated: Dec 8, 2023

Key points:


  • Psychological/spiritual problems are actually physical problems in the nervous system.

  • Insufficient protein intake hinders muscle building and may also affect neurotransmission (brain function).

  • Exercise, laughter and certain foods can trigger the release of endorphins

  • The human brain relies primarily on amino acids and their derivatives as neurotransmitters. Remember to eat a balanced diet!


Please note that Sparc team is not a professional healthcare provider and we would like to share our view (from investment angle) about the advance in medicals.


From a Social Responsibility or ESG perspective, by investing in companies developing treatments, fund managers contribute to reducing the burden of these diseases and supporting healthcare inclusivity.


In general, mental disorders involve issues at the molecular and atomic levels of the nervous system. Conditions like depression, which might seem like psychological problems, actually stem from substance-level problems in the nervous system. When there's an issue, it needs to be addressed. So, if there are effective medications, they should be taken. Stubbornly enduring might pose a higher risk. For other mental disorders, seeking professional medical help is even more crucial.


Additionally, psychotropic medications may have some side effects, and dosage needs to be adjusted based on the individual's condition, requiring guidance from a specialist.


Recent year's studies on brain-related diseases such as depression, bipolar disorder, schizophrenia, Parkinson's disease, Alzheimer's disease, epilepsy, etc., have been progressing. The mechanistic studies of these diseases are quite profound, and there is clinical trial evidence for drugs targeting these mechanisms, making the landscape clearer.


For Depression, currently marketed drugs mainly aim to increase serotonin, norepinephrine, and dopamine concentrations or sensitivity in synaptic clefts. Key drugs include duloxetine, venlafaxine, etc. The latest FDA-approved drug for depression is the NMDA receptor antagonist Auvelity, which has shown good efficacy per medical research reports.


Regarding Bipolar Disorder, it is about manic symptoms accompany depression. Medications like lamotrigine, quetiapine, etc., show good efficacy.


Dopamine is a delicate neurotransmitter, a chemical messenger that transmits signals in the brain and other areas of the nervous system. It plays a crucial role in various functions, including mood regulation, pleasure, reward, motivation, and motor control. Dopamine deficiency manifests as Parkinson's disease, while excess dopamine leads to Schizophrenia.


Dopamine's friend is Endorphin. Endorphins are endogenous opioids produced by the body, often referred to as "feel-good" neurotransmitters. Endorphins are released in response to stress and pain and are known to create a sense of euphoria. They act as natural painkillers and contribute to the "runner's high" experienced during prolonged exercise. Activities like exercise, laughter, and certain foods can trigger their release.


There are relatively fewer drugs for Parkinson's disease, sadly. Mainly, dopamine replacement therapy is used with levodopa preparations like carbidopa-levodopa. Dopamine receptor agonists like pramipexole are also used. Excessive levodopa supplementation can lead to symptoms resembling schizophrenia in Parkinson's patients. Parkinson's disease often presents with symptoms of depression and requires concurrent treatment with antidepressants.


The cause of Alzheimer's disease is unclear, but the pathogenic mechanism is basically understood. In the past two years, two amyloid beta antibody drugs have been approved, confirming this mechanistic hypothesis. Besides a few genetic causes, the scientific community suspects brain infection by dental plaque bacteria, leading to immune system activation and amyloid beta deposition, ultimately damaging nerve cells.


Schizophrenia's medications primarily aim to reduce dopamine concentrations in synaptic clefts or inhibit receptors in the dopamine pathway. Examples include dopamine receptor antagonists such as olanzapine, risperidone, etc. The latest target is the M4 muscarinic acetylcholine receptor agonist, which has not yet been released in the market.


The main mechanism of Epilepsy is abnormal activation of neural signals. Currently marketed drugs act as GABAA receptor agonists, inhibiting neural signal transmission. The latest target under research is the Kv7.2/7.3 potassium channel opener, showing promising results but not yet on the market.


The human brain relies mainly on amino acids and their derivatives as neuromediators for signal transmission. For instance, dopamine originates from loramic acid, serotonin from tryptophan, while glutamate and glycine serve as neurotransmitters. GABA, on the other hand, is derived from glutamic acid. Only acetylcholine and norepinephrine are not amino acids. Amino acids, being abundant in human cells, prove convenient and essential for effective nerve signal transmission. This emphasizes the adaptability of biological evolution to available materials.


Therefore, insufficient protein intake may not only hinder muscle building but could also impact brain function. Ensure a well-balanced diet for optimal health.







References:


The NMDA receptor antagonist Auvelity


M4 muscarinic acetylcholine receptor agonist


GABAA receptor agonist


Kv7.2/7.3 potassium channel opener




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