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Neuroprotective Effects of Cholinesterase Inhibitors: Current Scenario in Therapies for Alzheimer’s Disease and Future Perspectives

Authors
  • Moreira, Natália Chermont dos Santos
  • Lima, Jéssica Ellen Barbosa de Freitas
  • Marchiori, Marcelo Fiori
  • Carvalho, Ivone
  • Sakamoto-Hojo, Elza Tiemi
Type
Published Article
Journal
Journal of Alzheimer's Disease Reports
Publisher
IOS Press
Publication Date
Apr 18, 2022
Volume
6
Issue
1
Pages
177–193
Identifiers
DOI: 10.3233/ADR-210061
PMID: 35591949
PMCID: PMC9108627
Source
PubMed Central
Keywords
Disciplines
  • Review
License
Unknown

Abstract

Alzheimer’s disease (AD) is a slowly progressive neurodegenerative disease conceptualized as a continuous process, ranging from mild cognitive impairment (MCI), to the mild, moderate, and severe clinical stages of AD dementia. AD is considered a complex multifactorial disease. Currently, the use of cholinesterase inhibitors (ChEI), such as tacrine, donepezil, rivastigmine, and galantamine, has been the main treatment for AD patients. Interestingly, there is evidence that ChEI also promotes neuroprotective effects, bringing some benefits to AD patients. The mechanisms by which the ChEI act have been investigated in AD. ChEI can modulate the PI3K/AKT pathway, which is an important signaling cascade that is capable of causing a significant functional impact on neurons by activating cell survival pathways to promote neuroprotective effects. However, there is still a huge challenge in the field of neuroprotection, but in the context of unravelling the details of the PI3K/AKT pathway, a new scenario has emerged for the development of more efficient drugs that act on multiple protein targets. Thus, the mechanisms by which ChEI can promote neuroprotective effects and prospects for the development of new drug candidates for the treatment of AD are discussed in this review.

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