Impact of HMGB1, RAGE, and TLR4 in Alzheimer’s Disease (AD): From Risk Factors to Therapeutic Targeting
Open accessAbstract
Alzheimer’s disease (AD) is a devastating neurodegenerative disorder and a leading cause of dementia, with accumulation of amyloid-beta (Aβ) and neurofibrillary tangles (NFTs) as defining pathological features. AD presents a serious global health concern with no cure to date, reflecting the complexity of its pathogenesis. Recent evidence indicates that neuroinflammation serves as the link between amyloid deposition, Tau pathology, and neurodegeneration. The high mobility group box 1 (HMGB1) protein, an initiator and activator of neuroinflammatory responses, has been involved in the pathogenesis of neurodegenerative diseases, including AD. HMGB1 is a typical damage-associated molecular pattern (DAMP) protein that exerts its biological activity mainly through binding to the receptor for advanced glycation end products (RAGE) and toll-like receptor 4 (TLR4). RAGE and TLR4 are key components of the innate immune system that both bind to HMGB1. Targeting of HMGB1, RAGE, and TLR4 in experimental AD models has demonstrated beneficial effects in halting AD progression by suppressing neuroinflammation, reducing Aβ load and production, improving spatial learning, and inhibiting microglial stimulation. Herein, we discuss the contribution of HMGB1 and its receptor signaling in neuroinflammation and AD pathogenesis, providing evidence of its beneficial effects upon therapeutic targeting.
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Targeting HMGB1, RAGE, or TLR4 with antibodies, inhibitors, or antagonists can reduce neuroinflammation, Aβ and tau pathology, and improve cognitive function in AD models.
“evidence from AD models have demonstrated that targeting HMGB1, RAGE, or TLR4 with antibodies, inhibitors, or antagonists can reduce neuroinflammation, Aβ and tau pathology, and improve cognitive function. 92”
From Senescence, brain inflammation, and oligomeric tau drive cognitive decline in Alzheimer's disease: Evidence from clinical and preclinical studies (2024) · cites this paper as [92]
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Cai, Y., Liu, J., Wang, B., Sun, M., & Yang, H. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.856376 · Cited by 351 · see citing works
van Oostveen, W. M., & de Lange, E. C. M. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22042110 · Cited by 297 · see citing works
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Microglia and Astrocytes in Alzheimer’s Disease: Significance and Summary of Recent Advances
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Islam, R., Choudhary, H. H., Zhang, F., Mehta, H., Yoshida, J., Thomas, A. J., & Hanafy, K. (2025) · Scientific Reports · doi:10.1038/s41598-025-96456-y · Cited by 22 · see citing works
- Authors
- Paudel, Y. N., Angelopoulou, E., Piperi, C., Othman, I., Aamir, K., & Shaikh, M. F.
- Affiliations
- Monash University Malaysia (MY)
- National and Kapodistrian University of Athens (GR)
- Taylor's University (MY)
- Corresponding author
- Paudel, Yam Nath
- Piperi, Christina
- Shaikh, Mohd. Farooq
- Venue
- Cells
- Publisher
- MDPI AG
- Published
- 2020-02-07
- Volume
- 9
- Issue
- 2
- Pages
- 383
- ISSN
- 2073-4409 (ISSN-L)
- PMC
- PMC7072620
- OpenAlex
- W3005173199
- Cited by
- 257
- References
- 136
- Citations by year
- 2026: 35 · 2025: 43 · 2024: 35 · 2023: 49 · 2022: 42 · 2021: 33 · 2020: 18 · 2019: 2
- FWCI
- 4.46
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- Cells (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- Monash University Research Portal (Monash University) (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Charles Sturt University Research Output (CRO) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Monash University
- Monash University Malaysia
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Advanced Glycation End Products research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Keywords
- Alzheimer's disease, HMGB1, RAGE, TLR4, neuroinflammation, damage-associated molecular patterns, amyloid-beta, neurofibrillary tangles, microglia, innate immunity, therapeutic targeting, neurodegeneration
- MeSH terms
- Receptor for Advanced Glycation End Products, Alzheimer Disease, Animals, Humans, Risk Factors, HMGB1 Protein, Toll-Like Receptor 4, Molecular Targeted Therapy
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