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Multi-Target and Synergistic Therapeutic Strategies in Modern Drug Discovery

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pharmacology".

Deadline for manuscript submissions: closed (30 April 2026) | Viewed by 582

Special Issue Editor


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Guest Editor
NutraPharmaLab, Department of Pharmacy, University of Naples Federico II, Via Domenico Montesano 59, 80131 Naples, Italy
Interests: food chemistry; nutraceuticals; antioxidants; chromatography; mass spectrometry; metabolomics; analytical chemistry; botanicals; phytochemistry; natural compounds; skin diseases; biomarkers
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Special Issue Information

Dear Colleagues,

The growing recognition that most human diseases are multifactorial and network-based has challenged the traditional “one drug–one target” paradigm. Conditions such as metabolic and cardiovascular disorders, cancer, neurodegenerative diseases, and chronic inflammation arise from the dysregulation of multiple interconnected molecular pathways. Consequently, multi-target and synergistic therapeutic strategies have emerged as powerful alternatives for improving efficacy, overcoming resistance, and minimizing adverse effects.

This Special Issue will highlight advances in polypharmacology, drug repurposing, and combination therapy, including the development of dual- and multi-mechanistic compounds, rationally designed drug combinations, and multi-component formulations from both synthetic and natural sources. We particularly welcome studies integrating computational and network pharmacology, molecular modeling, chemoinformatics, and AI-assisted screening with in vitro, in vivo, and ex vivo pharmacological investigations. Contributions exploring omics-based profiling, nanotechnology-driven delivery systems, and research on nutraceuticals, phytocomplexes, and bioactive mixtures with complementary biological actions are also encouraged. Importantly, we invite studies that bridge preclinical discoveries with translational and clinical research, including early-phase or proof-of-concept clinical trials evaluating the safety, efficacy, and mechanistic rationale of synergistic or multi-target strategies. By integrating chemical, biological, computational, and clinical perspectives, this Special Issue will promote a multidisciplinary understanding of how synergistic and multi-target paradigms derived from natural combinations to rationally engineered therapeutics can advance innovation in modern drug discovery and precision medicine.

Dr. Vincenzo Piccolo
Guest Editor

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Keywords

  • multi-target and synergistic therapeutic strategies
  • drug design
  • combination therapy
  • polypharmacology
  • drug re-purposing

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Published Papers (1 paper)

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Research

34 pages, 4695 KB  
Article
Selective Anti-Giardial Action of Indirubin: Biochemical and Functional Evidence for Inhibition of Triosephosphate Isomerase and Aldose Reductase in Giardia lamblia
by Luis Antonio Flores-López, Gabriela López-Herrera, Yoalli Martínez-Pérez, Elías Jaime Matadamas-Ortiz, Saúl Gómez-Manzo, Gloria Hernández-Alcántara, Angélica González-Maciel, Rafael Reynoso-Robles, Beatriz Hernández-Ochoa, Laura Chino-Ríos, Diego González-Gómez, Leonardo Valente Arteaga-Padilla, Sergio Enríquez-Flores and Ignacio De la Mora-de la Mora
Int. J. Mol. Sci. 2026, 27(10), 4167; https://doi.org/10.3390/ijms27104167 - 7 May 2026
Viewed by 245
Abstract
The emergence of clinical resistance to conventional antigiardials underscores the need for compounds with novel mechanisms of action. This study demonstrates that indirubin exerts antigiardial activity by targeting important metabolic enzymes in Giardia lamblia. Indirubin induced a concentration-dependent decrease in trophozoite proliferation and [...] Read more.
The emergence of clinical resistance to conventional antigiardials underscores the need for compounds with novel mechanisms of action. This study demonstrates that indirubin exerts antigiardial activity by targeting important metabolic enzymes in Giardia lamblia. Indirubin induced a concentration-dependent decrease in trophozoite proliferation and viability, correlating with reduced activity of native triosephosphate isomerase and aldose reductase. Using recombinant enzymes, indirubin directly inhibited triosephosphate isomerase and aldose reductase, with the parasite enzymes showing greater susceptibility than their human orthologs. Structural and computational analyses suggest preferential binding of indirubin at the dimer interface of triosephosphate isomerase and within the NADP(H)-binding pocket of aldose reductase. The dual enzymatic inhibition was concordant with methylglyoxal accumulation, extensive protein carbonylation, and the formation of advanced glycation end products. These effects culminated in apoptotic-like death and severe ultrastructural damage, including alteration of the adhesive disc and microtubule networks. By targeting vulnerabilities in the metabolic and redox pathways of G. lamblia through a multifactorial mechanism distinct from current therapies, our findings support indirubin as a promising candidate for the treatment of giardiasis. Full article
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