Alzheimer’s disease and attempts to find an effective treatment (Review)
DOI:
https://doi.org/10.56511/JIPBS.2022.v9.i02.pp01-10Abstract
The most common neurodegenerative disease is Alzheimer’s disease (AD) and according to the World Health Organization, there are about 10 million new cases are recorded every year. It seems likely that damage to the brain starts a decade or more before memory and other cognitive problems appear. For most people with late-onset variety, symptoms of Alzheimer’s first appear in their mid-60s. While those with early- onset, signs begin between a person’s 30s and mid-60s. Whereas the exact etiology of the disease is unknown, observational research has suggested many hypotheses that describe the pathogenesis of the disease, as considerable advances in understanding the pathology have contributed to an early diagnosis, particularly the exact neuroanatomical setting of plaques. Accordingly, magnetic resonance imaging has been considered as the primarily adjunctive modality for the constant detection of abnormality. In addition, the analysis of cerebrospinal fluid contents has also been of interest for the diagnosis. These resulted in a broad variety of therapies that considerably control the activity and change the course and prognosis of the disease. In the present review, we evaluate the current state of knowledge on Alzheimer with emphasis on the pathology itself, the diagnosis and common therapeutical approaches accurately used
Keywords:
Alzheimer disease, pathology, Diagnosis, treatmentDownloads
References
Tiwari S, Atluri V, Kaushik A, Yndart A, Nair M. Alzheimer’s disease: Pathogenesis, diagnostics, and therapeutics. International Journal of Nanomedicine . 2019; 14:5541 - 5554. doi:10.2147/IJN.S200490 .
https://www.who.int/news - room/fact - sheets/detail/the - top - 10 - causes - of - death .
https://www.worldlifeexpectancy.com/egypt - alzheimers - dementia .
Sperling RA, Donohue MC, Raman R, et al . Association of Factors with Elevated Amyloid Burden in Clinically Normal Older Individuals. JAMA Neurology . 2020; 77(6):735 - 745. doi:10.1001/jamaneurol.2020.0387 .
Alzheimer’s disease facts and figures. Alzheimer’s and Dementia 2021; 17(3):327 - 406. doi:10.1002/alz.12328 .
Blennow K, de Leon MJ, Zetterberg H. Alzheimer’s Disease 368 ; 2006. http://www.alzgene.org
Reitz C, Brayne C, Mayeux R. Epidemiology of Alzheimer disease. Nature Reviews Neurology . 2011; 7(3):137 - 152. doi:10.1038/nrneurol.2011.2
Gaugler J, James B, Johnson T, Scholz K, Weuve J. 2016 Alzheimer’s disease facts and figures. Alzheimer’s and Dementia . 2016; 12(4):459 - 509. doi:10.1016/j.jalz.2016. 03.001
Ringman JM, Goate A, Masters CL, et al . Genetic Heterogeneity in Alzheimer Disease and Implications for Treatment Strategies. Current Neurology and Neuroscience Reports 2014; 14(11). doi:10.1007/s11910 - 014 - 0499 - 8
Bertram L, Tanzi RE. The genetic epidemiology of neurodegenerative disease. Journal of Clinical Investigation . 2005; 115(6):1449 - 1457. doi:10.1172/JCI24761
Tedde A, Forleo P, Nacmias B, et al . A presenilin - 1 mutation (Leu392Pro) in a familial AD kindred with psychiatric symptoms at onset. Neurology 2000; 55(10):1590 - 1591. doi:10.1212/WNL.55.10.1590
Janssen JC, Beck JA, Campbell TA, et al . Early Onset Familial Alzheimer’s Disease Mutation Frequency in 31 Families . 2003. http://molgen - www.
Brickell KL, Steinbart EJ, Rumbaugh M, et al . Early - Ons et al zheimer Disease in Families With Late - Ons et al zheimer Disease A Potential Important Subtype of Familial Alzheimer Disease . 2006; 63 :1307 - 1311 .
Yuyama K, Sun H, Usuki S, et al . A potential function for neuronal exosomes: Sequestering intracerebral amyloid - β peptide. FEBS Letters . 2015; 589(1):84 - 88. doi:10.1016 /j.febslet.2014.11.027
Letters to the Editor Genetic Testing Should Not Be Advocated as a Diagnostic Tool in Familial Forms of Dementia 2000; 67:1033 – 1035
Finckh U, Alberici; A, Antoniazzi ; M, et al . Variable Expression of Familial Alzheimer Disease Associated with Presenilin 2 Mutation M239I .2000; 54:2006 – 2008.
V an der Cammen TJM, Croes EA, Dermaut B, et al . Ethics, public policy, and medical economics Genetic Testing Has No Place as a Routine Diagnostic Test in Sporadic and Familial Cases of Alzheimer’s Disease . 2004; 52:2110 – 2113.
Williamson J, Larusse S. Genetics and Genetic Counseling: Recommendations for Alzheimer’s Disease, Frontotemporal Dementia, and Creutzfeldt - Jakob Disease. Current Neurology and Neuroscience Reports . 2004; 4:351 - 35 7.
Goldman JS, Hahn SE, Catania JW, et al . Genetic counseling and testing for Alzheimer disease: Joint practice guidelines of the American College of Medical Genetics and the National Society of Genetic Counselors. Genetics in Medicine . 2011; 13(6):597 - 605. doi:10.1097/GIM.0b01 3e31821d69b8
Francis PT, Palmer AM, Snape M, Wilcock GK . The Cholinergic Hypothesis of Alzheimer’s Disease: A Review of Progress . 1999; 66.
Terry A v., Buccafusco JJ. The cholinergic hypothesis of age and Alzheimer’s disease - related cognitive deficits: Recent challenges and their implications for novel drug development. Journal of Pharmacology and Experimental Therapeutics . 2003; 306(3):821 - 827. doi:10.1124/jpet.102.041616
Terry A v., Buccafusco JJ. The cholinergic hypothesis of age and Alzheimer’s disease - related cognitive deficits: Recent challenges and their implications for novel drug development. Journal of Pharmacology and Experimental Therapeutics . 2003;306(3):821 - 827. doi:10.1124/jpet.102.041616
Hirai K, Aliev G, Nunomura A, et al . Mitochondrial Abnormalities in Alzheimer’s Disease . J Neurosci 2001; 21(9):3017 – 3023 .
Moreira PI. Mitochondrial dysfunction and oxidative stress in Alzheimer’s disease . European Neurological Review . 2010; 5(1):17 - 21. doi:10.17925/ENR.2010.05.01.17
Biernat J, Wu YZ, Timm T, et al . Protein kinase MARK/PAR - 1 is required for neurite outgrowth and establishment of neuronal polarity. Molecular Biology of the Cell . 2002; 13(11):4013 - 4028. doi:10.1091/mbc.02 - 03 - 0046
Fath T, Eidenmü J, Brandt R. Tau - Mediated Cytotoxicity in a Pseudohyperphosphorylation Model of Alzheimer’s Disease . J Neurosci. 2002; 22(22):9733 – 9741
Tatebayashi Y, Haque N, Tung YC, Iqbal K, Grundke - Iqbal I. Role of tau phosphorylation by glycogen synthase kinase - 3 β in the regulation of organelle transport. Journal of Cell Science . 2004; 117(9):1653 - 1663. doi:10.1242/jcs.01018
Johnson GVW, Stoothoff WH. Tau phosphorylation in neuronal cell function and dysfunction. Journal of Cell Science . 2004; 117(24):5721 - 5729. doi:10.1242/jcs.01558
Frost B, Jacks RL, Diamond MI. Propagation of Tau misfolding from the outside to the inside of a cell. Journal of Biological Chemistry . 2009; 284(19):12845 - 12852. doi:10.1074/jbc.M808759200
Bagyinszky E, Giau V van, Shim K, Suk K, An SSA, Kim SY. Role of inflammatory molecules in the Alzheimer’s disease progression and diagnosis. Journal of the Neurological Sciences . 2017; 376:242 - 254. doi:10.1016/j.jns.2017.03.031
Santos LE, Beckman D, Ferreira ST. Microglial dysfunction connects depression and Alzheimer’s disease. Brain, Behavior, and Immunity . 2016; 55:151 - 165. doi:10.1016/j.bbi.2015.11.011
Dal Prà I, Chiarini A, Gui L, et al . Do astrocytes collaborate with neurons in spreading the “infectious” A β and Tau drivers of Alzheimer’s disease? Neuroscientist . 2015; 21(1):9 - 29. doi:10.1177/1073858414529828
Oh ES, Savonenko A v., King JF, et al . Amyloid precursor protein increases cortical neuron size in transgenic mice. Neurobiology of Aging . 2009; 30(8):1238 - 1244. doi:10.1016/j.neurobiolaging.2007.12.024
Kumar A, Singh A, Ekavali. A review on Alzheimer’s disease pathophysiology and its management: An update. Pharmacological Reports . 2015; 67(2):195 - 203. doi:10.1016/j.pharep.2014.09.004
Bothwell M. Recent advances in understanding neurotrophin signaling [version 1; referees: 2 approved]. F1000Research . 2016; 5. doi:10.12688/F1000RESEARCH.8434.1
Peng S, Wuu J, Mufson EJ, Fahnestock M. Precursor form of brain - derived neurotrophic factor and mature brain - derived neurotrophic factor are decreased in the pre - clinical stages of Alzheimer’s disease. Journal of Neurochemistry . 2005; 93(6):1412 - 1421. doi:10.1111/j.1471 - 4159.2005.03135.x
Patterson SL. Immune dysregulation and cognitive vulnerability in the aging brain: Interactions of microglia, IL - 1 β , BDNF and synaptic plasticity. Neuropharmacology . 2015; 96(PA):11 - 18. doi:10.1016/j.neuropharm.2014.12.020
Mendez MF. The accurate diagnosis of early - onset dementia . Int J Psychiatry Med 2006; 36.
Tanpitukpongse TP, Mazurowski MA, Ikhena J, Petrella JR. Predictive utility of marketed volumetric software tools in subjects at risk for Alzheimer disease: Do regions outside the hippocampus matter? American Journal of Neuroradiology . 2017; 38(3):546 - 552. doi:10.3174/ajnr.A5061 .
Lombardi G, Crescioli G, Cavedo E, et al . Structural magnetic resonance imaging for the early diagnosis of dementia due to Alzheimer’s disease in people with mild cognitive impairment. Cochrane Database of Systematic Reviews . 2020; 2020(3). doi:10.1002/14651858.CD009628.pub2
Chance SA, Clover L, Cousijn H, Currah L, Pettingill R, Esiri MM. Microanatomical correlates of cognitive ability and decline: Normal ageing, MCI, and Alzheimer’s disease. Cerebral Cortex . 2011; 21(8):1870 - 1878. doi:10.1093/cercor/bhq264 .
V an Veluw SJ, Sawyer EK, Clover L, et al . Prefrontal cortex cytoarchitecture in normal aging and Alzheimer’s disease: A relationship with IQ. Brain Structure and Function . 2012; 217(4):797 - 808. doi:10.1007/s00429 - 012 - 0381 - x
Dubois B, Feldman HH, Jacova C, et al . Advancing research diagnostic criteria for Alzheimer’s disease: The IWG - 2 criteria. The Lancet Neurology . 2014; 13(6):614 - 629. doi:10.1016/S1474 - 4422(14)70090 - 0
Hanseeuw BJ, Betensky RA, Jacobs HIL, et al . Association of Amyloid and Tau with Cognition in Preclinical Alzheimer Disease: A Longitudinal Study. JAMA Neurology . 2019; 76(8):915 - 924. doi:10.1001/jamaneurol.2019.1424
Jansen WJ, Ossenkoppele R, Knol DL, et al . Prevalence of cerebral amyloid pathology in persons without dementia: A meta - analysis. JAMA - Journal of the American Medical Association . 2015 ; 313(19):1924 - 1938. doi:10.1001/jama.2015.4668
Palmqvist S, Janelidze S, Quiroz YT, et al . Discriminative Accuracy of Plasma Phospho - tau217 for Alzheimer Disease vs Other Neurodegenerative Disorders. JAMA - Journal of the American Medical Association . 20 20; 324(8):772 - 781. doi:10.1001/jama.2020.12134
Fandos N, Pérez - Grijalba V, Pesini P, et al . Plasma amyloid β 42/40 ratios as biomarkers for amyloid β cerebral deposition in cognitively normal individuals. Alzheimer’s and Dementia: Diagnosis, Assessment and Disease Monitoring . 2017; 8:179 - 187. doi:10.1016/j.dadm.2017.07.004
Janelidze S, Mattsson N, Palmqvist S, et al . Plasma P - tau181 in Alzheimer’s disease: relationship to other biomarkers, differential diagnosis, neuropathology and longitudinal progression to Alzheimer’s dementia. Nature Medicine . 2020; 26(3):379 - 386. doi:10.1038/s41591 - 020 - 0755 - 1
Hansen RA, Gartlehner G, Webb AP, Morgan LC, Moore CG, Jonas DE. Effi Cacy and Safety of Donepezil, Galantamine, and Rivastigmine for the Treatment of Alzheimer’s Disease: A Systematic Review and Meta - Analysis . 2008; 3.
Kroger E, van Marum R, Souverein P, Carmichael PH, Egberts T. Treatment with rivastigmine or galantamine and risk of urinary incontinence: Results from a Dutch database study. Pharmacoepidemiology and Drug Safety . 2015; 24(3):276 - 285. doi:10.1002/pds.3741
Olovi MB, Krsti DZ, Lazarevi - Pati TD, Bondi AM, Vasi VM. Send Orders of Reprints at Reprints@ benthamscience.Net Acetylcholinesterase Inhibitors: Pharmacology and Toxicology . 2013; 11, 315 - 335
Lockhart IA, Mitchell SA, Kelly S. Safety and tolerability of donepezil, rivastigmine and galantamine for patients with alzheimer’s disease: Systematic review of the “real - world” evidence. Dementia and Geriatric Cognitive Disorders . 2009; 28(5):389 - 403. doi:10.1159/000255578
Parsons CG, Danysz W, Dekundy A, Pulte I. Memantine and cholinesterase inhibitors: Complementary mechanisms in the treatment of Alzheimer’s disease. Neurotoxicity Research . 2013; 24(3):358 - 369. doi:10.1007/s12640 - 013 - 9398 - z
Stroebel D, Carvalho S, Grand T, Zhu S, Paoletti P. Controlling NMDA receptor subunit composition using ectopic retention signals. Journal of Neuroscience . 2014; 34(50):16630 - 16636. doi:10.1523/JNEUROSCI.2736 - 14.2014
Mota SI, Ferreira IL, Rego AC. Dysfunctional synapse in Alzheimer’s disease - A focus on NMDA receptors. Neuropharmacology . 2014; 76(PART A):16 - 26. doi:10.1016/j.neuropharm.2013.08.013
Rothman SM, Olney JW. NEUROLOGICAL PROGRESS Glutamate and the Pathophysiology of Hypoxic - Ischemic Brain Damage . 1986 ; 19:105 - 111
Wilkinson D. A review of the effects of memantine on clinical progression in Alzheimer’s disease . International Journal of Geriatric Psychiatry . 2012; 27(8 ):769 - 776. doi:10.1002/gps.2788
Pariente A, Joseph - Reinette Sanctussy D, Miremont - Salamé G, Moore N, Haramburuoise, Fourrier - Réglat A. Factors Associated with Serious Adverse Reactions to Cholinesterase Inhibitors A Study of Spontaneous Reporting . 2010; 24 (1): 55 - 63
Namzaric (memantine hydrochloride extended - release/donepezil hydrochloride) Capsules. Accessed November 3, 2021. https://www.accessdata.fda.gov/drugs atfda_docs/nda/2014/206439Orig1s000TOC.cfm
Zhao QF, Tan L, Wang HF, et al . Erratum: Corrigendum to: “The prevalence of neuropsychiatric symptoms in Alzheimer’s disease: Systematic review and meta - analysis” (J. Affect. Disord. (2016) 190 (264 – 271)). Journal of Affective Disorders . 2016 ; 206:8. doi:10.1016/j.jad.2016.04.054
Abraha I, Rimland JM, Trotta FM, et al . Systematic review of systematic reviews of non - pharmacological interventions to treat behavioural disturbances in older patients with dementia. The SENATOR - OnTop series. BMJ Open . 2017; 7:12759. doi:10.1136/bmjopen - 2016
Magierski R, Sobow T, Schwertner E, Religa D. Pharmacotherapy of Behavioral and Psychological Symptoms of Dementia: State of the Art and Future Progress. Frontiers in Pharmacology . 2020; 11. doi:10.3389/fphar.2020.01168
Selkoe DJ, Hardy J. The amyloid hypothesis of Alzheimer’s disease at 25 years. EMBO Molecular Medicine . 2016; 8(6):595 - 608. doi:10.15252/emmm.201606210
Egan MF, Kost J, Voss T, et al . Randomized Trial of Verubecestat for Prodromal Alzheimer’s Disease. New England Journal of Medicine . 2019; 380(15):1408 - 1420. doi:10.1056/nejmoa1812840
Salloway S, Sperling R, Fox NC, et al . Two Phase 3 Trials of Bapineuzumab in Mild - to - Moderate Alzheimer’s Disease. New England Journal of Medicine . 2 014; 370(4):322 - 333. doi:10.1056/nejmoa1304839
Doody RS, Thomas RG, Farlow M, et al . Phase 3 Trials of Solanezumab f or Mild - to - Moderate Alzheimer’s Disease. New England Journal of Medicine . 2014; 370(4):311 - 321. doi:10.1056/nejmoa1312889
Huang LK, Chao SP, Hu CJ. Clinical trials of new drugs for Alzheimer disease. Journal of Biomedical Science . 2020; 27(1). doi:10.1186/s12929 - 019 - 0609 - 7
Azeliragon | ALZFORUM. Accessed November 3, 2021. https://www.alzforum.org/therapeutics/azeliragon
Gauthier S, Albert M, Fox N, et al . Why has therapy development for dementia failed in the last two decades? Alzheimer’s and Dementia . 2016; 12(1):60 - 64. doi:10.1016/j.jalz.2015.12.003
Marti HH, Wenger RH, Rivas LA, et al . Erythropoietin Gene Expression in Human, Monkey and Murine Brain . 1996; Vol 8.
Lombardero M, Kovacs K, Scheithauer BW. Erythropoietin: A hormone with multiple functions. Pathobiology . 2011; 78(1):41 - 56. doi:10.1159/000322975
Ng T, Marx G, Littlewood T. Recombinant Erythropoietin in Clinical Practice . 2003; 79.
Rey F, Balsari A, Giallongo T, et al . Erythropoietin as a Neuroprotective Molecule: An Overview of Its Therapeutic Potential in Neurodegenerative Diseases. ASN Neuro . 2019;
doi:10.1177/1759091419871420
Samy DM, Ismail CA, Nassra RA, Zeitoun TM, Nomair AM. Downstream modulation of extrinsic apoptotic pathway in streptozotocin - induced Alzheimer’s dementia in rats: Erythropoietin versus curcumin. European Journal of Pharmacology . 2016; 770:52 - 60. doi:10.1016/j.ejphar.2015.11.046
Cruz YR, Strehaiano M, Rodríguez Obaya T, Rodríguez JCG, Maurice T. An intranasal formulation of erythropoietin (Neuro - EPO) prevents memory deficits and amyloid toxicity in the APPSwe transgenic mouse model of Alzheimer’s disease. Journal of Alzheimer’s Disease 2016; 55(1):231 -
Bali P, Lahiri DK, Banik A, et al . Potential for Stem Cells Therapy in Alzheimer’s Disease: Do Neurotrophic Factors Play Critical Role? HHS Public Access Author Manuscript . 2 017; 14.
Shin JY, Park HJ, Kim HN, et al . Mesenchymal stem cells enhance autophagy and increase β - amyloid clearance in Alzheimer disease models. Autophagy . 2014; 10(1):32 - 44. doi:10.4161/auto.26508
Yiannopoulou KG, Papageorgiou SG. Current and Future Treatments in Alzheimer Disease: An Update. Journal of Central Nervous System Disease . 2020; 12: 117957352090739. doi:10.1177/1179573520907397
Sluijter JPG, Verhage V, Deddens J, van den Akker F, Doevendans PAF. Microvesicles and Exosomes for Intracardiac Communication Downloaded From . 2014; Vol
http://cardiovascres.oxfordjournals.org/
Chen CC, Liu L, Ma F, et al . Elucidation of Exosome Migration Across the Blood – Brain Barrier Model In Vitro. Cellular and Molecular Bioengineering . 20 16; 9(4):509 - 529. doi:10.1007/s12195 - 016 - 0458 - 3
Schneider A, Simons M. Exosomes: Vesicular carriers for intercellular communication in neurodegenerative disorders. Cell and Tissue Research . 2013; 352(1):33 - 47. doi:10.1007/s00441 - 012 - 1428 - 2
Reza - Zaldivar EE, Hernández - Sapiéns MA, Gutiérrez - Mercado YK, et al . Mesenchymal stem cell - derived exosomes promote neurogenesis and cognitive function recovery in a mouse model of Alzheimer’s disease. Neural Regeneration Research . 2019; 14(9):1626 - 1634. doi:10.4103/1673 - 5374.255978
Wischik CM, Harrington CR, Storey JMD. Tau - aggregation inhibitor therapy for Alzheimer’s disease. Biochemical Pharmacology . 2014; 88( 4):529 - 539. doi:10.1016/j.bcp.2013.12.008
Panza F, Solfrizzi V, Seripa D, et al . Tau - Centric Targets and Drugs in Clinical Development for the Treatment of Alzheimer’s Disease. BioMed Research International . 2016; 2016. Article ID 3245935, doi:10.1155/2016/3245935
Schenk D, Basi GS, Pangalos MN. Treatment strategies targeting amyloid β - protein. Cold Spring Harbor Perspectives in Medicine . 2012; 2(9). doi:10.1101/cshperspect.a006387
Sevigny J, Chiao P, Bussière T, et al . The antibody aducanumab reduces A β plaques in Alzheimer’s disease. Nature . 2016; 537(7618):50 - 56. doi:10.1038/nature19323
Novakovic D, Feligioni M, Scaccianoce S, et al . Profile of gantenerumab and its potential in the treatment of Alzheimer’s disease. Drug Design, Development and Therapy . 2013; 7:1359 - 1364. doi:10.2147/DDDT.S53401
Mackey H, Cho W, Ward M, et al . P2 ‐ 006: Exploratory Analyses of Cognitive Effects of Crenezumab in a Mild Alzheimer’s Disease Subpopulation of a Randomized, Double ‐ Blind, Placebo ‐ Controlled, Parallel ‐ Group Phase 2 Study (ABBY). Alzheimer’s & Dementia . 2016; 12(7S_Part_12). doi:10.1016/j.jalz.2016.06.1210 .
After the FDA’s approval, what to know about the new Alzheimer’s drug Available from https://www.brown.edu/news/2021 - 06 - 11/aducanumab .
Published
How to Cite
Issue
Section
Copyright (c) 2022 Yasmin Maher Helmy, Ahmed M. A. Akabawy, Laila A. Rashed, Sahar A. Ali

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.


Journal of Innovations in Pharmaceutical and Biological Sciences is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Based on a work at