Title:Current and Near-Future Treatment of Alzheimer’s Disease
Volume: 20
Issue: 6
Author(s): Kazimierz Gąsiorowski, Jadwiga Barbara Brokos, Marta Sochocka, Michał Ochnik, Justyna Chojdak-Łukasiewicz, Katarzyna Zajączkowska, Michał Fułek and Jerzy Leszek*
Affiliation:
- Department of
Psychiatry, Wrocław Medical University, Wrocław, Poland
Keywords:
Alzheimer’s disease, inflammation, oxidative stress, Wnt-β catenin pathway, combination therapy, brain insulin resistance.
Abstract: Recent findings have improved our understanding of the multifactorial nature of AD.
While in early asymptomatic stages of AD, increased amyloid-β synthesis and tau hyperphosphorylation
play a key role, while in the latter stages of the disease, numerous dysfunctions of homeostatic
mechanisms in neurons, glial cells, and cerebrovascular endothelium determine the rate of progression
of clinical symptoms. The main driving forces of advanced neurodegeneration include increased
inflammatory reactions in neurons and glial cells, oxidative stress, deficiencies in neurotrophic
growth and regenerative capacity of neurons, brain insulin resistance with disturbed metabolism
in neurons, or reduction of the activity of the Wnt-β catenin pathway, which should integrate
the homeostatic mechanisms of brain tissue. In order to more effectively inhibit the progress of
neurodegeneration, combination therapies consisting of drugs that rectify several above-mentioned
dysfunctions should be used. It should be noted that many widely-used drugs from various pharmacological
groups, "in addition" to the main therapeutic indications, have a beneficial effect on neurodegeneration
and may be introduced into clinical practice in combination therapy of AD. There is
hope that complex treatment will effectively inhibit the progression of AD and turn it into a slowly
progressing chronic disease. Moreover, as the mechanisms of bidirectional communication between
the brain and microbiota are better understood, it is expected that these pathways will be harnessed
to provide novel methods to enhance health and treat AD.
