Neuroprotective strategies involving ROS in Alzheimer disease
Open accessAbstract
Alzheimer disease (AD) is a neurodegenerative disorder in which oxidative stress is a key hallmark. It occurs early in disease pathogenesis and can exacerbate its progression. Several causes of oxidative stress have been determined over the years. First, mitochondria play an important role in the generation and accumulation of free radicals. In addition to mitochondria, inflammation can also induce oxidative damage, especially via microglia, and microglia are also important for Aβ clearance. In AD, both mitochondrial function and inflammatory response are affected, leading to increased ROS formation and oxidative damage to lipid, proteins, and nucleic acids. Some other sources have also been identified. From these findings, various neuroprotective strategies against ROS-mediated damages have been elaborated in AD research. This review recapitulates some of the major strategies used to prevent oxidative stress and disease progression. Outcomes from in vitro and in vivo studies using models of AD are encouraging. However, only a few clinical trials have provided positive results in terms of slowing down cognitive decline. Nonetheless, there is still hope for improved compounds that would better target pathways implicated in ROS production. In fact, facilitating the endogenous antioxidant system by modulating transcription has great promise for AD therapy.
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Oxidative stress markers increase even in the preclinical phase and during mild cognitive impairment, while antioxidant therapies in animal models delay the disease course and improve cognitive functions.
“Oxidative stress markers increase even in the preclinical phase and during MCI, while antioxidant therapies in animal models have been shown to delay the disease course and improve cognitive functions [122, 123].”
From Targeted Nanoparticles for Drug Delivery Across the Blood–Brain Barrier in Early and Late Stages of Alzheimer's Disease: A Review (2026) · cites this paper as [123]
The Introduction (page unavailable) reports elevated oxidation markers in people with MCI and describes oxidative stress as an early event, before hallmark pathology. The neuroprotective-strategies sections (page unavailable) report improved memory and reduced amyloid pathology in treated AD mice, but do not establish that antioxidant therapies delayed the disease course in those models; the explicit report of slowed disease progression concerns patients. (LLM, conf=0.82)
Experimental — accuracy not yet measuredIn advanced Alzheimer's disease, the effectiveness of antioxidant therapy is significantly reduced, with numerous unsuccessful clinical trials reporting minimal cognitive improvements.
“In contrast, in advanced AD—characterized by widespread neuronal damage and complex pathological remodeling—the effectiveness of antioxidant therapy is significantly reduced. Numerous unsuccessful clinical trials have reported minimal cognitive improvements in patients at advanced disease stages [123–125].”
From Targeted Nanoparticles for Drug Delivery Across the Blood–Brain Barrier in Early and Late Stages of Alzheimer's Disease: A Review (2026) · cites this paper as [123]
The Concluding remarks (page unavailable) say treatment timing is critical and success in human trials is less frequent, noting that disease may be well advanced by diagnosis. They also report mixed trial results, including studies finding no difference from placebo. The paper does not establish significantly reduced effectiveness specifically in patients with advanced AD or show that numerous trials in that group found minimal cognitive improvement. (LLM, conf=0.84)
Experimental — accuracy not yet measuredTargeting reactive oxygen species and oxidative stress is more effective during the early stages of Alzheimer's disease than in advanced stages.
“Scientific evidence clearly indicates that targeting ROS and oxidative stress is more effective during the early stages of AD than in advanced stages.”
From Targeted Nanoparticles for Drug Delivery Across the Blood–Brain Barrier in Early and Late Stages of Alzheimer's Disease: A Review (2026) · cites this paper as [123]
The Concluding remarks say treatment timing is critical and suggest that earlier treatment in animal models may help explain why results are better than in human trials, where disease may be advanced at diagnosis. The paper presents this as a possible explanation, not clear evidence that targeting ROS is more effective in early-stage than advanced-stage AD patients. (LLM, conf=0.86)
Experimental — accuracy not yet measuredReactive oxygen species-targeting strategies exhibit the greatest efficacy in early Alzheimer's disease, before irreversible neuronal damage occurs.
“In summary, ROS-targeting strategies exhibit the greatest efficacy in early AD, before irreversible neuronal damage occurs [122, 123].”
From Targeted Nanoparticles for Drug Delivery Across the Blood–Brain Barrier in Early and Late Stages of Alzheimer's Disease: A Review (2026) · cites this paper as [123]
The Concluding remarks (page not provided) say treatment timing is extremely critical and suggest that early treatment in animal models may help explain their better outcomes than human trials begun after diagnosis. The paper does not establish that ROS-targeting strategies have their greatest efficacy in early AD or identify irreversible neuronal damage as the cutoff. (LLM, conf=0.86)
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The Multifaceted Roles of DJ-1 as an Antioxidant
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- Authors
- Dumont, M., & Beal, M. F.
- Affiliations
- Weill Cornell Medicine (US)
- Corresponding author
- Dumont, Magali
- Venue
- Free Radical Biology and Medicine
- Publisher
- Elsevier BV
- Published
- 2011-09
- Volume
- 51
- Issue
- 5
- Pages
- 1014-1026
- ISSN
- 0891-5849 (ISSN-L)
- PMC
- PMC3070183
- OpenAlex
- W2080084871
- Cited by
- 402
- References
- 188
- Citations by year
- 2026: 12 · 2025: 19 · 2024: 21 · 2023: 20 · 2022: 21 · 2021: 22 · 2020: 26 · 2019: 28 · 2018: 19 · 2017: 36 · 2016: 28 · 2015: 29 · 2014: 36 · 2013: 34 · 2012: 34
- FWCI
- 2.76
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Free Radical Biology and Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute on Aging (R01AG20729, R01AG020729, P01AG014930, P01-AG14930)
- Topics
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Neurology › Neurological Disorders and Treatments
- Keywords
- Alzheimer's disease, reactive oxygen species, oxidative stress, neuroprotection, mitochondria, microglia, neuroinflammation, amyloid-beta clearance, antioxidant defense, transcriptional regulation, neurodegeneration, cognitive decline
- MeSH terms
- Alzheimer Disease, Animals, Antioxidants, Clinical Trials as Topic, Disease Models, Animal, Humans, Inflammation, Mitochondria, Oxidation-Reduction, Reactive Oxygen Species, Microglia, Oxidative Stress, Disease Progression, Neuroprotective Agents, Molecular Targeted Therapy
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