Oxidative stress hypothesis in Alzheimer’s disease
Abstract
The major hurdle in understanding Alzheimer's disease (AD) is a lack of knowledge about the etiology and pathogenesis of selective neuron death. In recent years, considerable data have accrued indicating that the brain in AD is under increased oxidative stress and this may have a role in the pathogenesis of neuron degeneration and death in this disorder. The direct evidence supporting increased oxidative stress in AD is: (1) increased brain Fe, Al, and Hg in AD, capable of stimulating free radical generation; (2) increased lipid peroxidation and decreased polyunsaturated fatty acids in the AD brain, and increased 4-hydroxynonenal, an aldehyde product of lipid peroxidation in AD ventricular fluid; (3) increased protein and DNA oxidation in the AD brain; (4) diminished energy metabolism and decreased cytochrome c oxidase in the brain in AD; (5) advanced glycation end products (AGE), malondialdehyde, carbonyls, peroxynitrite, heme oxygenase-1 and SOD-1 in neurofibrillary tangles and AGE, heme oxygenase-1, SOD-1 in senile plaques; and (6) studies showing that amyloid beta peptide is capable of generating free radicals. Supporting indirect evidence comes from a variety of in vitro studies showing that free radicals are capable of mediating neuron degeneration and death. Overall, these studies indicate that free radicals are possibly involved in the pathogenesis of neuron death in AD. Because tissue injury itself can induce reactive oxygen species (ROS) generation, it is not known whether this is a primary or secondary event. Even if free radical generation is secondary to other initiating causes, they are deleterious and part of a cascade of events that can lead to neuron death, suggesting that therapeutic efforts aimed at removal of ROS or prevention of their formation may be beneficial in AD.
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Alzheimer's disease is perpetually accompanied by elevated oxidative cellular stress in the brain, yielded by elevated production of free radicals, reduced polyunsaturated fatty acid, elevated protein and DNA oxidation, elevated lipid peroxidation, and aggregation and accumulation of amyloid-beta.
“In fact, a vast amount of evidence indicates that AD is perpetually accompanied by elevated oxidative cellular stress in the brain, yielded by the elevated production of free radicals, reduced polyunsaturated fatty acid, elevated protein and DNA oxidation, elevated lipid peroxidation, and the aggregation and accumulation of Aβ, which cause oxidative stress [28].”
From The Multifaceted Role of Neuroprotective Plants in Alzheimer’s Disease Treatment (2022) · cites this paper as [28]
The oxidative stress hypothesis can be applied to other neurodegenerative diseases such as Parkinson's disease and amyotrophic lateral sclerosis, where accumulation of oxidative damage over time leads to late-life onset and progressive nature.
“The oxidative stress hypothesis can be applied to other neurodegenerative diseases, such as Parkinson’s Disease (PD) and Amyotrophic Lateral Sclerosis (ALS) where the accumulation of oxidative damage over time leads to the late life onset and to the progressive nature of these diseases [29].”
From Role of Oxidative Damage in Alzheimer’s Disease and Neurodegeneration: From Pathogenic Mechanisms to Biomarker Discovery (2021) · cites this paper as [29]
Decreased levels of phosphatidylcholine, phosphatidylethanolamine, and the phospholipid precursors choline and ethanolamine have been described in Alzheimer's disease and are considered specific for the pathogenic mechanism of AD; the depletion is referred to increased ROS-mediated lipid peroxidation.
“Decreased levels of phosphatidylcholine, phosphatidylethanolamine and the phospholipid precursors, choline and ethanolamine, have been described in AD and are considered specific for the pathogenic mechanism of AD. The depletion of phospholipids in AD has been referred to an increase of ROS-mediated lipid peroxidation [29].”
From Role of Oxidative Damage in Alzheimer’s Disease and Neurodegeneration: From Pathogenic Mechanisms to Biomarker Discovery (2021) · cites this paper as [29]
Protein oxidation, nucleic acid oxidation, and lipid peroxidation are markers of oxidative stress described as early alterations in the Alzheimer's disease brain, supporting the oxidative stress hypothesis of AD pathogenesis.
“All of these markers of OS have been described as an early alteration in the AD brain, and this concept has been used in the past to support the ‘oxidative stress hypothesis’ in the pathogenesis of AD [20,28,29,30].”
From Role of Oxidative Damage in Alzheimer’s Disease and Neurodegeneration: From Pathogenic Mechanisms to Biomarker Discovery (2021) · cites this paper as [29]
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- Authors
- Markesbery, W. R.
- Corresponding author
- Markesbery, William R.
- Venue
- Free Radical Biology and Medicine
- Publisher
- Elsevier BV
- Published
- 1997-01
- Volume
- 23
- Issue
- 1
- Pages
- 134-147
- ISSN
- 0891-5849 (ISSN-L)
- OpenAlex
- W2049192526
- Cited by
- 2,383
- References
- 207
- Citations by year
- 2026: 24 · 2025: 40 · 2024: 59 · 2023: 75 · 2022: 74 · 2021: 86 · 2020: 94 · 2019: 114 · 2018: 99 · 2017: 104 · 2016: 98 · 2015: 110 · 2014: 108 · 2013: 90 · 2012: 96
- FWCI
- 9.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Free Radical Biology and Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute on Aging (P50AG005144, P01AG005119)
- Topics
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Biochemistry › Antioxidant Activity and Oxidative Stress
- Keywords
- Alzheimer's disease, oxidative stress, free radicals, reactive oxygen species, neuronal cell death, lipid peroxidation, 4-hydroxynonenal, protein oxidation, DNA oxidation, advanced glycation end products, heme oxygenase-1, superoxide dismutase 1, amyloid-beta, neurofibrillary tangles, amyloid plaques, energy metabolism, cytochrome c oxidase, metal ions
- MeSH terms
- Alzheimer Disease, Antioxidants, DNA Damage, Free Radicals, Humans, Neurons, Lipid Peroxidation, Amyloid beta-Peptides, Neurofibrillary Tangles, Cell Death, Oxidative Stress
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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