The present and future of pharmacotherapy of Alzheimer's disease: a comprehensive review
Abstract
Alzheimer's disease (AD) is a generalized term used for the loss in memory and other intellectual abilities on levels serious enough to interfere with daily life. It accounts for 60-80% of dementia cases. The characteristic features include aggregation of Amyloid-Beta (Aβ) plaques and Tau Protein Tangles in the nervous tissue of brain. Another important aspect associated with development of AD is the decrease in levels of Acetylcholine (ACh) in brain. The conventional pharmacotherapy of AD employs the use of compounds that inhibit the enzyme acetylcholinesterase (e.g. donepezil, rivastigmine) thereby elevating the levels of Acetylcholine in nervous tissue of brain. Lately, another drug has come into picture for treatment of AD i.e.memantine. It is a Glutamatergic antagonist that protects the nervous tissue against glutamate mediated excitotoxicity. However, both these classes of drugs provide only the symptomatic relief. There has been a desperate need arising since the past few decades for evolution of a drug that could treat the underlying causes of AD and thereby halt its development in susceptible individuals. There are several plants and derived products which have been employed for their benefits against the symptoms and complications of AD. Some novel drugs having the potential to moderate AD are under clinical trials. This review presents a comprehensive overview of the existing and the upcoming potential treatments for AD.
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The formation of amyloid oligomers is primarily responsible for neurotoxicity and commences the amyloid cascade.
“The formation of amyloid oligomers is primarily responsible for neurotoxicity and commences the amyloid cascade.”
From An update on the novel and approved drugs for Alzheimer disease (2022) · cites this paper as Anand et al., 2017
Local inflammation, oxidation, excess glutamate, and tau hyperphosphorylation are components of the amyloid cascade.
“Local inflammation, oxidation, production of excess glutamate known as exitootoxicity, and tau hyperphosphorylation are all components of the cascade [Anand et al., 2017].”
From An update on the novel and approved drugs for Alzheimer disease (2022) · cites this paper as Anand et al., 2017
According to the amyloid hypothesis, Aβ production in the brain sets off a chain of events that leads to the clinical symptoms of Alzheimer's disease.
“According to the “amyloid hypothesis,” Aβ production in the brain sets off a chain of events that leads to the clinical symptoms of AD.”
From An update on the novel and approved drugs for Alzheimer disease (2022) · cites this paper as Anand et al., 2017
Aβ peptides with Aβ38, Aβ40, and Aβ42 as the most common variants are produced after sequential cleavage of amyloid precursor protein (APP) by β-secretase (BACE1) and γ-secretase.
“Aβ peptides with Aβ38, Aβ40, and Aβ42 as the most common variants are produced after the sequential cleavage of the large precursor protein amyloid precursor protein (APP) by the 2 enzymes, β-secretase (BACE1) and γ-secretase.”
From Current and Future Treatments in Alzheimer Disease: An Update (2020) · cites this paper as [6]
Aβ is not formed if APP is first cleaved by α-secretase instead of β-secretase.
“Nevertheless, Aβ is not formed if APP is first acted on and cleaved by the enzyme α-secretase instead of β-secretase.6”
From Current and Future Treatments in Alzheimer Disease: An Update (2020) · cites this paper as [6]
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References 73 · Cited by 174
- Authors
- Anand, A., Patience, A. A., Sharma, N., & Khurana, N.
- Affiliations
- Lovely Professional University (IN)
- Corresponding author
- Khurana, Navneet
- Venue
- European Journal of Pharmacology
- Publisher
- Elsevier BV
- Published
- 2017-11
- Volume
- 815
- Pages
- 364-375
- ISSN
- 0014-2999 (ISSN-L)
- OpenAlex
- W2757601767
- Cited by
- 174
- References
- 73
- Citations by year
- 2026: 7 · 2025: 12 · 2024: 25 · 2023: 22 · 2022: 24 · 2021: 24 · 2020: 23 · 2019: 19 · 2018: 17
- FWCI
- 2.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Pharmacology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Pharmacology › Cholinesterase and Neurodegenerative Diseases
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- Alzheimer's disease, pharmacotherapy, acetylcholinesterase inhibitors, memantine, amyloid plaques, acetylcholine depletion, excitotoxicity, novel drug candidates, symptomatic treatment
- MeSH terms
- Alzheimer Disease, Animals, Drug Therapy, Humans
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