Modern Approaches and Strategies for Prevention and Therapeutic Influence of Alzheimer's Disease



Alzheimer's disease is a chronic progressive polypathogenic neurodegenerative disease in which the combination of various mechanisms and risk factors and the appearance of amyloid plaques and neurofibrillary tangles cause anatomic, cellular and molecular changes, leading to a disorder of cortical functions, memory deficits, behavioral and functional disorders and total disintegration of intellectual and psychic activities.The up-to-date necessity of application of new effective drugs has been associated with an increase of the rate of the disease, a large number of risk factors and a variety of pathogenic mechanisms of neuronal degeneration. The therapeutic trends for Alzheimer's disease have been related to the symptomatic response and prevention of delay in the neuronal degeneration by the use of cholinergic, antiamyloid, antineurofibrillary, antiinflammatory, antioxidant, neurotrophic, neuroprotective and vasoactive agents.The classic therapeutic approach has been a compensatory therapy by the application of reversible acetylcholinesterase inhibitors. New trends have been connected to the elimination of amyloid plaques, formed by the action of  γ-secretase enzyme. A perspective therapeutic trend is a multitarget therapy through compounds with potential properties for a simultaneous response to the pathogenetic mechanisms of the disease. In this regard, Galantamine and products with properties to inhibit acetylcholinesterase and γ-secretase and to possess radical-scavenging activity have been of interest. One of the most promising approaches to alternative prevention has been the antioxidant therapy with phytocompounds with antioxidant, antiamyloidogenic, antiinflammatory and antiapoptotic properties.The more effective trend for therapy of Alzheimer's disease is the combined therapy, involving both pathological mechanisms. The studies to increase the pharmacological effect by using the combination of acetylcholinesterase inhibitors with potential synergists have been ongoing.