Alzheimer’s disease: aspects of contemporary pharmacological treatment
Authors:
Lucie Drtinová; Miroslav Pohanka
Authors place of work:
Univerzita Obrany v Brně, Fakulta vojenského zdravotnictví Hradec Králové
Published in the journal:
Čes. slov. Farm., 2011; 60, 219-228
Category:
Review Articles
Summary
Neurodegenerative disorders are highly spread all over the world. It is estimated that 23.5 million people worldwide are suffering from neurodegeneration, and Alzheimer’s disease (AD) is the most frequently occurring one. Owing to the increasing life expectancy, the number of patients is supposed to be increased in the next decades. The disease is atrophic-degenerative disorders affecting the brain. Although the etiology of AD is unknown, several interrelated causes are being considered: the loss of the cholinergic system, an amyloid plaque and an amyloid precursor, tau protein, excitotoxicity and other risk factors. The symptomatic manifestations of AD are the disruption of the cognitive function including aphasia, apraxia and agnosia. Today, several registered drugs for the treatment of AD (donepezil, rivastigmine, galantamine and memantine) are in use, but the treatment is not able to resolve or slow down degeneration. In this paper, the authors summarize the available pharmacotherapy and outline an opportunity in the treatment of AD in ongoing clinical studies (etanercept, methylthionium chloride and huperzine). Some nontraditional procedures which are expected to help patients to join common life situation are described at the end of the paper.
Key words:
Alzheimer’s disease – acetylcholinesterase – donepezil – rivastigmine – galantamine – memantine
Zdroje
1. Launer, L. J., Fratiglioni, L., Andersen, K., Breteler, M. M. B., Copeland, R. J. M., Dartiques, J. F., Lobo, A., Martinez-Lage, J., Soininen, H., Hofman, A.: Regional differences in the incidence of dementia in Europe: EURODEM collaborative analyses 1999.
2. Colective authors of alzheimer europe organization: Dementia in Europe Yearbook 2008; 20, (1–178).
3. Weiner, M. W., Aisen, P. S., Clifford, R. J. Jr., Jagust, W. J., Trojanowski, J. Q., Shaw, L., Saykin, A. J., Morris, J. C., Cairns, N., Beckett, L. A., Toga, A., Green, R., Walter, S., Soares, H., Snyder, P., Siemers, E., Potter, W., Cole, P. E., Schmidt, M., The Alzheimer’s disease neuroimaging initiative: The Alzheimer’s disease neuroimaging iniviative: Progress report and future plans. Alzheimer’s & Dementia 2010; 6, 202–211.
4. Ikejima, C., Yasuno, F., Mizukami, K., Sasaki, M., Tanimukai, S., Asada, T.: Prevalence and cause sof early-onset dementia in japan: A population-based study. American stroke journal 2009; 40, 2704–2714.
5. Zanetti, O., Solerte, S. B., Cantoni, F.: Life expectancy in Alzheimer’s diseases (AD). Arch. Gerontol. Geriatr. 2009; 49(Suppl 1), 237–243.
6. Wenk, G. L.: Neuropathologic changes in Alzheimer’s disease. J Clin Psychiatry 2003; 64(Suppl 9), 7–10.
7. Furukawa, K., Sopher, B. L., Rydel, R. E., Begley, J. G., Pham, D. G., Martin, G. M., Fox, M., Mattson, M. P.: Increased activity – regulating and neuroprotective efficacy of alpha-secretase-derived secreted amyloid precursor protein conferred by a c-terminal heparin-binding domain. J. Neurochem. 1996; 67(5), 1882–1896.
8. Shankar, G. M., Li, S., Mehta, T. H., Garcia-MuĖoz, A., Shepardson, N. E., Schmidt, J., Brett, F. M., Farrell, M. A., Rowan, M. J., Lemere, C. A., Regan, C. M., Walsh, D. M., Sabatini, B. L., Selkoe, D. J.: Amyloid beta-protein dimers isolated directly from Alzheimer brains impair synaptic plasticity and memory. Nat. Med. 2008; 14, 837–842.
9. Beeri, M. S., Rapp, M., Silverman, J. M., Schmiedler, J., Grossman, M. T., Fallon, J. T., Purohit, D. P., Perl, D. P., Sidpiqui, A., Lesser, G., Rosendorff, G., Haroutunian, V.: Coronary arthery diseases associated wi th AD neurology APO E4 carriers. Neurology 2006; 66, 1399–1404.
10. Alzheimer Association Report.: 2010 Alzheimer’s disease fact and figures. Alzheimer’s & Dementia 2010; 6, 158–194.
11. Jungsu, K., Basak, J. M., Holtzman, D. M.: The role of apolipoproteine in Alzheimer’s disease. Neuron 2009;, 63, 287–303.
12. Wei, Y., Qu, M. H., Wang, X. S., Chen, L., Wang, D. L., Liu, Y., Hua, Q., He, R. S.: Binding to the minor groove of the double-stand, tau protein prevents DNA from damage by peroxidation. PLoS One 2008; 3, e2600.
13. Rothman, S. M.: The neurotoxicity of excitatory aminoacids is produced by passive chloride influx. J. Neurosci. 1985; 5, 1483–1489.
14. Liu, D., Pitta, M., Lee, J. H. et al.: The K-ATP channel activator diazoxide ameliorates amyloid-beta and tau pathologies and improves memory in the 3xTgAD mouse model of Alzheimer’s disease. J. Alzheimers Dis. 2010; 22, 443–457.
15. Salter, M. W., Kalia, L. V.: Src kinase: A hub for NMDA receptor regulation. Nature reviews neuroscience 2004; 5, 317–328.
16. Gurland, B. J., Wilder, D. E., Lantigua, R., Stern, Y., Chen, J., Killerffer, E. H. P. et al.: Rates of dementia in three ethnoracial groups. Int J Geriatr Psychiatry 1999; 14, 481–493.
17. Kim, H., Bang, O. Y., Jung, M. W., Ha, S. D., Hong, H. S., Huh, K., Kim, S. U., Mook-Jung, I.: Neuroprotective effects of estrogen against beta-amyloid toxicity are mediated by estrogen receptors in cultured neuronal cells. Neuroscience Letters 2001; 302, 58–62.
18. Plassman, B. L., Langa, K. M., Fischer, G. G., Heeringa, S. G., Weir, D. R., Ofstedal, M. B. et al.: Prevence of dementia the united states: The aging, demographic and memory study. Neuroepidemiology 2007; 29, 125–132.
19. McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., Stadlan, E. M.: Clinical diagnosis of Alzheimer’s disease: report of NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984; 34, 939–944.
20. Guerrero-Berroa, E., Luo, X., Schmiedler, J. et al.: The MMSE orientation for the time domain is a strong predictor of subsequent cognitive decline in the elderly. Int. J. Geriatr. Psychiatry 2009; 24, 1429–1437.
21. Hodkinson, H. M.: Evaluation of a mental test score for assessment of mental impairment in the elderly. Oxford Journal 2010; 1, 233–238.
22. Bullock, R., Bergman, H., Touchon, J., Gambina, G., He, Y., Nagel, J., Lane, R.: Effect of age on respons on rivastigmine or donepezil in patient with Alzheimer’s disease. Curr Med Res Opin. 2006; 22, 483–494.
23. Birks, J., Harvey, R. J.: Donepezil for dementia due to Alzheimer’s disease. Cochrane Database Syst. Rev. 2003; 3, CD001190.
24. Muller, T.: Rivastigmine in the treatment of pacients with Alzheimer’s disease. Neuropsychiatr. Dis. Treat. 2007; 3, 211–218.
25. Huang, F., Fu, Y.: A review of clinical pharmacokinetics and pharmacodynamics of galantamine, a reversible acetylcholinesterase inhibitor for the treatment of Alzheimer’s disease, in healthy subjects and pacients. Curr Clin Pharmacol. 2010; 5, 115–124.
26. Gomolin, I. H., Smith, C., Jeitner, T. M.: Once-daily memantine: pharmacokinetics and clinical considerations. J. AM Geriatr Soc. 2010; 58, 1812–1813.
27. Drawn form: www.emea.europa.eu/docs/cs_CZ/docu ment_library/EPAR_-_Product_Information/ human/000463/WC500058763.pdf
28. Goertelmeyer, R., Erbler, H.: Memantin in treatment of milf to moderate dementia syndrome. A double-blind placebo-controlled study. Arzneimittelforschung 1992; 42, 904–913.
29. No Authors Listed. EGb 761: Ginkgo biloba extract, Ginkor. Drug RD 2003; 4(3), 188–193.
30. Loew, D.: Value of Ginkgo biloba in treatment of Alzheimer dementia. Wien Med Wochenschr. 2002; 152, 418–422.
31. Keil, U., Scherping, I., Hauptman, S., Schuessel, K., Eckert, A., Muller, W. E.: Piracetam improves mitochondrial dysfunction following oxidative stress. Br. J. Pharmacol. 2006; 147, 199–208.
32. Martin, K. J., Vyas, S.: Increase in acetylcholine concentrations in the brain of „old“ rats following treatment with pyritinol (Encephabol). Br. J. Pharmacol. 1987; 90, 561–565.
33. Mazzon, E., Esposito, E., Di Paola, R., Muia, C., Crisafulli, C., Genovese, T., Caminiti, R., měli, R., Bramanti, P., Cozzocrea, S.: Effect of tumorous necrosis factor-alpha receptor 1 genetic deletion on carrageenan-induced acute imflammation: A comparison with etanercept. Clin. Exp. Immunol. 2008; 153, 136–149.
34. Combe, B.: Update on the use of etanercept across a spectrum of rheumatoid disorders. Biologics 2008; 2, 165–173.
35. Wischik, C., Staff, R.: Challenges in the conduct of disease – modyfying trials in AD: Practical experience from phase 2 trial of Tau-aggregation inhibition therapy. Journal of Nutrition Health & Aging 2009; 13, 367–369.
36. Wischik, C., Edwards, P. C., Lai, R. Y., Roth, M., Harrington, C. R.: Selective inhibition of alzheimer’s disease – like tau aggregation by phenothiazines. Proc. Natl. Acad. Sci. USA 1996; 93, 11213–11218.
37. Ho, Y., So, K., Chuen-Chung Chang, R.: Drug discovery from Chinese medicine against neurodegeneration in Alzheimer’s and vascular dementia. Chin. Med. 2011; 6, 15.
Štítky
Pharmacy Clinical pharmacologyČlánok vyšiel v časopise
Czech and Slovak Pharmacy
2011 Číslo 5
Najčítanejšie v tomto čísle
- Alzheimer’s disease: aspects of contemporary pharmacological treatment
-
Medicinal preparations in this country at the end of the 18th century
Part I – Introduction and liquid dosage forms - Clinical significance of cytochrome P450 genetic polymorphism – part III. cytochrome P450 2C19
- Viscosity and consistence measurements following Ph.B. 2009