Metformin and Its Sulfenamide Prodrugs Inhibit Human Cholinesterase Activity
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The results of epidemiological and pathophysiological studies suggest that type 2 diabetes mellitus (T2DM) may predispose to Alzheimer’s disease (AD). The two conditions present similar glucose levels, insulin resistance, and biochemical etiologies such as inflammation and oxidative stress. The diabetic state also contributes to increased acetylcholinesterase (AChE) activity, which is one of the factors leading to neurodegeneration in AD. The aim of this study was to assess in vitro the effects of metformin, phenformin, and metformin sulfenamide prodrugs on the activity of human AChE and butyrylcholinesterase (BuChE) and establish the type of inhibition. Metformin inhibited 50% of the AChE activity at micromolar concentrations (2.35 μ mol/mL, mixed type of inhibition) and seemed to be selective towards AChE since it presented low anti‐BuChE activity. The tested metformin prodrugs inhibited cholinesterases (ChE) at nanomolar range and thus were more active than metformin or phenformin. The cyclohexyl sulfenamide prodrug demonstrated the highest activity towards both AChE (IC 50 = 890 nmol/mL, noncompetitive inhibition) and BuChE (IC 50 = 28 nmol/mL, mixed type inhibition), while the octyl sulfenamide prodrug did not present anti‐AChE activity, but exhibited mixed inhibition towards BuChE (IC 50 = 184 nmol/mL). Therefore, these two bulkier prodrugs were concluded to be the most selective compounds for BuChE over AChE. In conclusion, it was demonstrated that biguanides present a novel class of inhibitors for AChE and BuChE and encourages further studies of these compounds for developing both selective and nonselective inhibitors of ChEs in the future.
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Increased BChE activity, especially in the hippocampus and temporal cortex, may exacerbate cognitive decline by promoting amyloid-beta aggregation and plaque formation.
“Additionally, increased BChE activity, especially in the hippocampus and temporal cortex, may exacerbate this cognitive decline by promoting amyloid-beta aggregation and plaque formation, which are key features of AD [94,95].”
From Cholinesterase Inhibitors from Plants and Their Potential in Alzheimer’s Treatment: Systematic Review (2025) · cites this paper as [95]
The Discussion (page not provided) says BuChE activity increases as Alzheimer’s disease progresses and reports that BuChE inhibition in aged rats improved cognitive function and decreased amyloid deposits. It does not identify the hippocampus or temporal cortex as sites of increased BuChE activity, or say that BuChE promotes amyloid-beta aggregation and plaque formation. (LLM, conf=0.85)
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- [50]Greig N. H. Utsuki T. Ingram D. K. Selective butyrylcholinesterase inhibition elevates brain acetylcholine, augments learning and lowers Alzheimer β-amyloid peptide in rodent Proceedings of the National Academy of Sciences of the United States of America 2005 102 17213 17218 10.1073/pnas.0508575102 2-s2.0-28044437122 16275899 PMC1288010 · DOI
- [56]Greig N. H. Utsuki T. Ingram D. K. Selective butyrylcholinesterase inhibition elevates brain acetylcholine, augments learning and lowers Alzheimer beta-amyloid peptide in rodent Proceedings of the National Academy of Sciences of the United States of America 2005 102 17213 17218 10.1073/pnas.0508575102 2-s2.0-28044437122 16275899 PMC1288010 · DOI
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Belavadi, S., & Kadiri, S. K. (2026) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2026.178913 · Cited by 1 · see citing works
Betting on Metformin and their Signature Modality in Realm of Cancer Therapy
Khan, S. A. (2021) · American Journal of Biomedical Science & Research · doi:10.34297/ajbsr.2021.13.001856
Effects of Metformin and N-Acetylcysteine on Dyslipidemia in Streptozotocin-Induced Diabetic Rats
Bajwa, N. S., Sadaqat, S., Khan, W. U., Mohsin, M., Memon, M., Aslam, M. W., & Masud, R. (2022) · Pakistan Journal of Medical and Health Sciences · doi:10.53350/pjmhs2216596
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Mehmood, T., Zahid, M., Shah, S. W. A., Ghias, M., Ahmad, M., Khan, A., Zahoor, M., Alotaibi, A., & Ullah, R. (2026) · Open Chemistry · doi:10.1515/chem-2025-0285
- Authors
- Markowicz-Piasecka, M., Sikora, J., Mateusiak, Ł., Mikiciuk-Olasik, E., & Huttunen, K. M.
- Affiliations
- Medical University of Lodz (PL)
- University of Eastern Finland (FI)
- Corresponding author
- Markowicz-Piasecka, Magdalena
- Venue
- Oxidative Medicine and Cellular Longevity
- Publisher
- Wiley
- Published
- 2017-01
- Volume
- 2017
- Issue
- 1
- Pages
- 7303096-7303096
- ISSN
- 1942-0994 (ISSN-L)
- 1942-0900
- PMC
- PMC5523189
- OpenAlex
- W2732828256
- Cited by
- 32
- References
- 60
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 1 · 2023: 6 · 2022: 6 · 2021: 4 · 2020: 3 · 2019: 2 · 2018: 1
- FWCI
- 1.15
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Oxidative Medicine and Cellular Longevity (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UEF eRepo (University of Eastern Finland) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Academy of Finland (294227)
- Uniwersytet Medyczny w Lodzi (503/3-015-01/503-31-004)
- Narodowe Centrum Nauki (2016/21/D/NZ7/01548)
- Topics
- Health Sciences › Medicine › Pharmacology › Cholinesterase and Neurodegenerative Diseases
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Enzyme function and inhibition
- Keywords
- metformin, acetylcholinesterase inhibition, butyrylcholinesterase inhibition, phenformin, biguanides, mixed-type inhibition, non-competitive inhibition, Alzheimer's disease, type 2 diabetes, cholinesterase inhibitors
- MeSH terms
- Acetylcholinesterase, Butyrylcholinesterase, Cholinesterase Inhibitors, Diabetes Mellitus, Type 2, Female, Humans, Male, Metformin, Prodrugs, Sulfamerazine, GPI-Linked Proteins
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