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Review Article

Cholinesterase Inhibitors for Alzheimer's Disease: Multitargeting Strategy Based on Anti-Alzheimer's Drugs Repositioning

Author(s): Md. Tanvir Kabir, Md. Sahab Uddin*, Mst. Marium Begum, Shanmugam Thangapandiyan, Md. Sohanur Rahman, Lotfi Aleya, Bijo Mathew, Muniruddin Ahmed, George E. Barreto and Ghulam Md. Ashraf

Volume 25, Issue 33, 2019

Page: [3519 - 3535] Pages: 17

DOI: 10.2174/1381612825666191008103141

Price: $65

Abstract

In the brain, acetylcholine (ACh) is regarded as one of the major neurotransmitters. During the advancement of Alzheimer's disease (AD) cholinergic deficits occur and this can lead to extensive cognitive dysfunction and decline. Acetylcholinesterase (AChE) remains a highly feasible target for the symptomatic improvement of AD. Acetylcholinesterase (AChE) remains a highly viable target for the symptomatic improvement in AD because cholinergic deficit is a consistent and early finding in AD. The treatment approach of inhibiting peripheral AChE for myasthenia gravis had effectively proven that AChE inhibition was a reachable therapeutic target. Subsequently tacrine, donepezil, rivastigmine, and galantamine were developed and approved for the symptomatic treatment of AD. Since then, multiple cholinesterase inhibitors (ChEIs) have been continued to be developed. These include newer ChEIs, naturally derived ChEIs, hybrids, and synthetic analogues. In this paper, we summarize the different types of ChEIs which are under development and their respective mechanisms of actions.

Keywords: Acetylcholine, acetylcholinesterase inhibitors, tacrine, donepezil, galantamine, rivastigmine, Alzheimer’s disease.

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