Neuroinflammation in Alzheimer's disease: current evidence and future directions
Abstract
Several attempts have been made to treat Alzheimer's disease (AD) using anti-amyloid strategies with disappointing results. It is clear that the "amyloid cascade hypothesis" alone cannot fully explain the neuronal damage in AD, as evidenced both by autopsy and imaging studies. Neuroinflammation plays a significant role in neurodegenerative diseases, whereas the debate is ongoing about its precise role, whether it is protective or harmful. In this review, we focus on the potential mechanism of glial activation and how local and systemic factors influence disease progression. We focus on neuroinflammation in AD, especially in the earliest stages, a vicious cycle of glial priming, release of pro-inflammatory factors, and neuronal damage. We review the evidence from imaging studies, regarding the temporal relationship between amyloid deposition and neuroinflammation, the influence of systemic inflammation on glial activation, both in acute and chronic stimulation and the relevance of inflammation as a diagnostic and therapeutic target.
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Neuroinflammation is a central hub that modulates both amyloid and tau pathology.
“For example, neuroinflammation is increasingly understood as a central hub that modulates both amyloid and tau pathology [21], while mitochondrial failure and impaired autophagy act as amplifiers of proteotoxic stress [22].”
From Toward a Unified Framework in Molecular Neurobiology of Alzheimer’s Disease: Revisiting the Pathophysiological Hypotheses (2026) · cites this paper as [21]
Neuroinflammation becomes chronic, initiating a cyclic cascade of glial priming, proinflammatory factor release, and neuronal damage.
“Eventually, however, neuroinflammation becomes chronic, initiating a cyclic cascade of glial priming, proinflammatory factor release, and neuronal damage [68].”
After acute inflammatory damage, brain glial cells respond to repair the tissue; if the stimulus persists, it produces an inflammatory chronic state that leads to neuronal dysfunction, injury, and loss.
“After acute inflammatory damage, the brain glial cells respond to repair the tissue. If the stimulus persists, it produces an inflammatory chronic state that leads to neuronal dysfunction, injury, and loss (Streit et al., 2004; Calsolaro and Edison, 2016).”
From The role of microglia in retinal neurodegeneration: Alzheimer’s disease, parkinson, and glaucoma. (2017) · cites this paper as Calsolaro and Edison, 2016
Microglial cells clustered around Aβ deposits have become incapable of removing the amyloid.
“Nonetheless, it seems that microglial cells clustered around Aβ− deposits have become incapable of removing the amyloid (Calsolaro and Edison, 2016).”
From The role of microglia in retinal neurodegeneration: Alzheimer’s disease, parkinson, and glaucoma. (2017) · cites this paper as Calsolaro and Edison, 2016
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BackgroundThe Role of the Microbiota-Gut-Brain Axis in the Development of Alzheimer’s Disease
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- Authors
- Calsolaro, V., & Edison, P.
- Affiliations
- Imperial College London (GB)
- Corresponding author
- Edison, Paul
- Venue
- Alzheimer's & Dementia
- Publisher
- Wiley
- Published
- 2016-05-11
- Volume
- 12
- Issue
- 6
- Pages
- 719-732
- ISSN
- 1552-5260 (ISSN-L)
- 1552-5279
- OpenAlex
- W2358666620
- Cited by
- 1,726
- References
- 96
- Citations by year
- 2026: 130 · 2025: 227 · 2024: 272 · 2023: 244 · 2022: 240 · 2021: 230 · 2020: 170 · 2019: 75 · 2018: 65 · 2017: 59 · 2016: 13
- FWCI
- 6.08
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Alzheimer s & Dementia (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- neuroinflammation, Alzheimer's disease
- MeSH terms
- Alzheimer Disease, Encephalitis, Humans, Cytokines, Neuroimaging
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