Saffron (Crocus sativus L.) in Ocular Diseases: A Narrative Review of the Existing Evidence from Clinical Studies

Abstract

Saffron (Crocus sativus L.) and its main constituents, i.e., crocin and crocetin, are natural carotenoid compounds, which have been reported to possess a wide spectrum of properties and induce pleiotropic anti-inflammatory, anti-oxidative, and neuroprotective effects. An increasing number of experimental, animal, and human studies have investigated the effects and mechanistic pathways of these compounds in order to assess their potential therapeutic use in ocular diseases (e.g., in age related macular degeneration, glaucoma, and diabetic maculopathy). This narrative review presents the key findings of published clinical studies that examined the effects of saffron and/or its constituents in the context of ocular disease, as well as an overview of the proposed underlying mechanisms mediating these effects.

Bioaccessibility and Pharmacokinetics of a Commercial Saffron (Crocus sativus L.) Extract

“…Besides the culinary role of saffron, safranal and crocin isomers show bioactive properties with several therapeutics and pharmacological applications [6][7][8], altogether with other antioxidant compounds such as kaempferol derivatives [9,10]. By contrast, the interest of picrocrocin is limited since it is poorly absorbed in the gut [11].…”

“…Nowadays, the clinical evidences of saffron extracts have been accumulated and has been postulated as a complementary therapy in several medical conditions. In particular, to delay the occurrence of the symptoms and effects of degenerative ocular diseases [8] and to prevent and treat mood disorders and mild-to-severe depression without side-effects, even in people with unremitted depression treated with antidepressant medication [12][13][14][15][16]. In depression, different mechanisms of actions have been proposed to explain the functional properties of saffron such as reuptake inhibitors of monoamines, N-methyl-Daspartate receptor (NMDA) antagonism, and gamma-aminobutyric acid (GABA) agonism [17,18].…”

“…e anti-inflammatory, antioxidant, and neuroprotective properties may explain its positive effect on the eye [8,20].…”

Mitochondrial Dysfunction as a Novel Target for Neuroprotective Nutraceuticals in Ocular Diseases

“…A hydrophilic saffron extract standardized to 3% crocin reduces higher IOP values and activated microglia cells [155]. Saffron has been shown to have beneficial effects for ocular diseases in clinical studies (see a recent review [156]). However, a recent clinical study shows short-term saffron supplementation had no significant effects on the visual acuity and focal ERG in Stargardt disease/fundus flavimaculatus (STG/FF) patients with ATP binding cassette subfamily A member 4 (ABCA4) gene mutations [157].…”

Potential Therapeutic Benefit of NAD+ Supplementation for Glaucoma and Age-Related Macular Degeneration

“…Its age-related depletion affects the biological coping mechanisms associated with inflammation, oxidative stress, and accumulation of damaged molecules [ 16 ]. All these alterations are intrinsically linked to retinal degenerative pathologies, such as glaucoma and AMD, and with compelling evidence that NAD + supplementation would be a promising intervention in these diseases [ 17 ], alone or possibly in combination with other nutraceutical agents such as saffron [ 18 , 19 ] and zeaxanthin [ 20 , 21 ], or pyruvate [ 22 ], which together provide neuroprotection by targeting multiple disease mechanisms. This review focuses on the shared pathophysiological mechanisms of glaucoma and AMD and the potential role that NAD + may play in their mitigation.…”