Alzheimer’s disease (AD) is the leading cause of dementia worldwide. Most AD patients develop the disease in late life, named late onset AD (LOAD). Currently, the most recognized explanation for AD pathology is the amyloid cascade hypothesis. It is assumed that amyloid beta (Aβ) aggregation and deposition are critical pathogenic processes in AD, leading to the formation of amyloid plaques, as well as neurofibrillary tangles, neuronal cell death, synaptic degeneration, and dementia. In LOAD, the causes of Aβ accumulation and neuronal loss are not completely clear. Importantly, the blood–brain barrier (BBB) disruption seems to present an essential role in the induction of neuroinflammation and consequent AD development. In addition, we propose that the systemic inflammation triggered by conditions like metabolic diseases or infections are causative factors of BBB disruption, coexistent inflammatory cascade and, ultimately, the neurodegeneration observed in AD. In this regard, the use of anti-inflammatory molecules could be an interesting strategy to treat, delay or even halt AD onset and progression. Herein, we review the inflammatory cascade and underlying mechanisms involved in AD pathogenesis and revise the anti-inflammatory effects of compounds as emerging therapeutic drugs against AD.
1 July 2017 in Progress in Neuro-Psychopharmacology and Biological Psychiatry
Alzheimer's disease (AD) is a neurodegenerative disorder where the main risk factor is age, since its incidence increases dramatically after the age of 60. It is the most common form of dementia, and is accompanied by memory loss and cognitive impairment. Although AD was discovered over a century ago, the only drugs approved by the US Food and Drug Administration for use in its treatment are four cholinesterase inhibitors and memantine. However, these drugs are not fully effective in the treatment of AD. Therefore, the incessant search for new methods of treating AD continues, with the hope of improving both the effectiveness of therapies and the quality of life for patients suffering with AD. Current evidence suggests that the antibiotic minocycline could be a potential therapeutic drug for use in the treatment of AD due to its anti-neuroinflammatory effects. Minocycline is a tetracycline derivative that combines an anti-inflammatory property that is capable of crossing the blood brain barrier with neuroprotective properties that work by limiting inflammation and oxidative stress. Several studies have established the presence of inflammatory markers in the brains of patients suffering with AD, including elevated levels of cytokines/chemokines and microgliosis in damaged regions. Cytokines have been associated with increased tau phosphorylation and decreased levels of synaptophysin, establishing their roles in the cytoskeletal and synaptic alterations that take place in AD. Therefore, pharmacological approaches that allow for the discovery and development of new anti-inflammatory agents such as minocycline will be welcomed in the continuing struggle against AD. Considering these facts, this review will discuss the anti-inflammatory mechanisms underlying the neuroprotective effects of minocycline as a novel therapeutic approach for the treatment of AD.