摘要
痴呆是某些发达地区主要疾病之一。根据世界卫生组织(WHO),它将成为本世纪中期世界上第二大死亡疾病,超越癌症。这将对医疗行业产生巨大的影响,并具有重要的社会和经济意义,除非发现更有效的预防或治疗措施。阿尔茨海默病(AD)是痴呆的最常见病之一,痴呆患者中约占50–75%,其次是血管性痴呆,混合性痴呆及路易体痴呆。目前,乙酰胆碱酯酶(AChE)抑制剂,如多奈哌齐,卡巴拉汀和加兰他敏用于治疗轻中度AD,美金刚用于治疗重度AD,为谷氨酸受体-天门冬氨酸(NMDA)亚型拮抗剂。然而,这些药物仅能改善症状,并不会治愈疾病,但某些病人可除外。近年来,在治疗AD方面已开发了不同的有效方法。这些方法包括针对某个单一的靶点,发现新靶点和新药物,但给定的某些复杂疾病,可能需要不同靶点同时参与。新方案已探索双靶点抑制剂的作用,如单一药物作用于乙酰胆碱酯酶的不同位点产生至少两种不同的活性,而多靶点药物作用于多个靶点。本文探索从双抑制剂到多靶点药物对AD未来的治疗作用
关键词: 乙酰胆碱酯酶,阿尔茨海默病,BACE-1,双靶点药物,胆碱酯酶,大麻,GSK3β,多靶点
Current Medicinal Chemistry
Title:From Bitopic Inhibitors to Multitarget Drugs for the Future Treatment of Alzheimer’s Disease
Volume: 22 Issue: 33
Author(s): Daniel I. Perez, Ana Martinez, Carmen Gil and Nuria E. Campillo
Affiliation:
关键词: 乙酰胆碱酯酶,阿尔茨海默病,BACE-1,双靶点药物,胆碱酯酶,大麻,GSK3β,多靶点
摘要: Dementia is one of the main causes of the disease burden in developed regions. According to the World Health Organization (WHO), it will become the world’s second leading cause of death by the middle of the century, overtaking cancer. This will have a dramatic impact on medical care, and have important social and economic implications, unless more effective preventive procedures or treatments become available. Alzheimer’s disease (AD) is the most common cause of dementia, accounting for approximately 50–75% of all dementias worldwide, followed by vascular dementia, mixed dementia, and Lewy body dementia.
Currently, acetylcholinesterase (AChE) inhibitors, such as donepezil, rivastigmine and galantamine are used to treat mild to moderate AD. An alternative therapy for severe AD is memantine, an antagonist of the NMDA-subtype of glutamate receptors. However, these drugs provide only temporary symptom improvement, and do not alter disease progression, except temporarily in some patients.
In recent years different approaches have been developed to provide a more effective treatment for AD. These approached include the discovery of emerging targets and new drugs aiming at a single target, but given the complexity of the disease, different targets may need to be engaged simultaneously. New strategies have explored bitopic inhibitors, for example a single drug that acts on different sites of the acetylcholinesterase enzyme to produce at least two different activities, and multitarget drugs that act on multiple therapeutic targets.
In this review, we explore the journey from a bitopic inhibitor strategy to multitarget drugs for the future treatment of AD.
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Cite this article as:
Daniel I. Perez, Ana Martinez, Carmen Gil and Nuria E. Campillo , From Bitopic Inhibitors to Multitarget Drugs for the Future Treatment of Alzheimer’s Disease, Current Medicinal Chemistry 2015; 22 (33) . https://dx.doi.org/10.2174/0929867322666150812145825
DOI https://dx.doi.org/10.2174/0929867322666150812145825 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
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