Ageing is a key factor in the development of cognitive decline and neurodegeneration, including Alzheimer’s disease (AD), the most common form of dementia diagnosed. In 2023 the US Federal Drug Administration (FDA) approved a new drug (Lecanemab, Leqembi) to treat AD that very moderately slows down cognitive decline in early-stage AD (van Dyck et al., 2023). Donanemab (Kisunla, Eli Lilley), acting similarly to lecanemab, was approved by the FDA in 2024 in the US, but not yet by the European Medicines Agency (EMA) in the EU. The mechanism of action of both of these monoclonal antibodies is similar to that of aducanumab (Aduhelm), conditionally approved for AD in 2021 (but subsequently discontinued by the producer), by acting on and reducing β-amyloid deposits (Sevigny et al., 2016; van Dyck et al., 2023). However, trials of all these monoclonal antibodies revealed significant adverse events (brain swelling or brain bleeding); hence treatment for AD and neurodegeneration in general remains an important unmet medical need, affecting millions of people worldwide. Here I discuss the role of the noradrenergic system innervating the brain and the spinal cord, consisting of the nucleus locus coeruleus (LC), which appears to be the most vulnerable structure in the central nervous system (CNS) to ageing-related factors, leading to early LC demise and cognitive impairments. Therefore, I propose that understanding the action of noradrenaline on the brain cells, in particular on astrocytes, homeostasis-providing cells, which exhibit a high density of adrenergic receptors, is a future strategy to develop new drugs to mitigate neurodegeneration and cognitive decline. Keywords: ageing; noradrenaline; adrenoceptors; locus coeruleus; neurodegeneration, neuroglia, astrocytes
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