Current and Near-Future Treatment of Alzheimer's Disease

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, in the later 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, one should use combination therapies consisting of drugs that rectify several of the above-mentioned dysfunctions. It should be noted that many of widely-used drugs from various pharmacological groups, "in addition" to the main therapeutic indications, also have a beneficial effect on neurodegeneration and may be introduced into clinical practice in combination therapy of AD. There is a real 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 method to enhance health and treat AD.