Abstract

Alzheimer's disease (AD) is the most common cause of dementia among older people, and the prevalence of this disease is estimated to rise quickly in the upcoming years. Unfortunately, almost all of the drug candidates tested for AD until now have failed to exhibit any efficacy. Henceforth, there is an increased necessity to avert and/or slow down the advancement of AD. It is known that one of the major pathological characteristics of AD is the presence of senile plaques (SPs) in the brain. These SPs are composed of aggregated amyloid beta (Aβ), derived from the amyloid precursor protein (APP). Pharmaceutical companies have conducted a number of studies in order to identify safe and effective anti-Aβ drugs to combat AD. It is known that α-, β-, and γ-secretases are the three proteases that are involved in APP processing. Furthermore, there is a growing interest in these proteases, as they have a contribution to the modulation and production of Aβ. It has been observed that small compounds can be used to target these important proteases. Indeed, these compounds must satisfy the common strict requirements of a drug candidate targeted for brain penetration and selectivity toward different proteases. In this article, we have focused on the auspicious molecules which are under development for targeting APP-processing enzymes. We have also presented several anti-AD molecules targeting Aβ accumulation and phosphorylation signaling in APP processing. This review highlights the structure-activity relationship and other physicochemical features of several pharmacological candidates in order to successfully develop new anti-AD drugs.

Highlights

  • Alzheimer’s disease (AD) is one of the utmost prevalent agerelated neurodegenerative disorders affecting older people [1, 2]

  • It has been found that the aforesaid forms of AD (i.e., early-onset AD (EOAD) and familial AD (FAD)) might take place because of the mutations in any of the presenilin-1 (PSEN1), presenilin-2 (PSEN2), and amyloid precursor protein (APP) genes [10,11,12]

  • It has been reported by Désiré et al [76] on the identification in AD patients of blood-based transcriptomic signatures related to treatment response of EHT0202 in a placebo-controlled, three-month, phase IIA study for estimating the exploratory efficacy, tolerability, and clinical safety of EHT-0202 (i.e., 80 and 40 mg twice a day) as adjunctive therapy to one cholinesterase inhibitor in mildto-moderate AD individuals

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Summary

Introduction

Alzheimer’s disease (AD) is one of the utmost prevalent agerelated neurodegenerative disorders affecting older people [1, 2]. In 2015, it was estimated that around 44 million people were affected by this neurodegenerative disorder This number is projected to become double by the year 2050 [6, 7]. The downstream effects of these pathological mechanisms involve neurodegeneration with neuronal and synaptic loss, which can lead to macroscopic atrophy [19] It has been suggested in various studies that AD-related alterations in the brain might start even 20 or more years before the symptoms even appear [20,21,22,23]. Neuronal damage becomes so substantial that people exhibit clear cognitive impairment, including symptoms for instance loss of memory or confusion regarding the place or time [25, 26]. Auspicious molecules targeting Aβ accumulation and phosphorylation signaling in APP processing are presented

Approved Anti-Alzheimer’s Drugs
Amyloid Precursor Protein Processing
Anti-Alzheimer’s Molecules Targeting αSecretase
Natural α-Secretase Modulators
Anti-Alzheimer’s Molecules Targeting βSecretase
Anti-Alzheimer’s Molecules Targeting γ-Secretase
Anti-Alzheimer’s Molecules Targeting Aβ Accumulation
Conclusions
Findings
Conflicts of Interest
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