Novel therapeutic opportunities for Alzheimer's disease: focus on nonsteroidal anti-inflammatory drugs

FASEB J. 2005 Oct;19(12):1592-601. doi: 10.1096/fj.04-3620rev.

Abstract

Alzheimer's disease (AD) is the most common form of neurodegenerative disorder with dementia in the elderly. The AD brain pathology is characterized by deposits of amyloid-beta (Abeta) peptides and neurofibrillary tangles but also (among other aspects) by signs of a chronic inflammatory process. Epidemiological studies have shown that long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) reduces the risk of developing AD and delays its onset. Classical targets of NSAIDs include cycloxygenase, nuclear factor kappaB, and peroxisome proliferator-activated receptors. Modulation of these pathways, all of which have been implicated in AD pathogenesis, could explain the NSAID effect on AD progression. However, recent studies indicate that a subset of NSAIDs such as ibuprofen, indomethacin, and flurbiprofen may have direct Abeta-lowering properties in cell cultures as well as transgenic models of AD-like amyloidosis. A renewed interest in the old and a discovery of new pharmacological properties of these drugs are providing vital insight for future clinical trials. In this review we will summarize how the combination of traditional (anti-inflammatory) and new (anti-amyloidogenic) properties of some NSAIDs is providing unprecedented opportunities for drug discovery and could potentially result in novel therapeutic approaches for the treatment of AD.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / drug therapy*
  • Alzheimer Disease / pathology*
  • Animals
  • Animals, Genetically Modified
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Cell Culture Techniques
  • Cyclooxygenase Inhibitors / therapeutic use
  • Disease Models, Animal
  • Enzyme-Linked Immunosorbent Assay
  • Flurbiprofen / therapeutic use
  • Humans
  • Ibuprofen / therapeutic use
  • Indomethacin / therapeutic use
  • Inflammation
  • Models, Biological
  • Models, Chemical
  • Models, Genetic
  • NF-kappa B / metabolism
  • PPAR gamma / metabolism
  • Peptides / chemistry
  • Peroxisome Proliferator-Activated Receptors / metabolism
  • Prostaglandin-Endoperoxide Synthases / metabolism

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Cyclooxygenase Inhibitors
  • NF-kappa B
  • PPAR gamma
  • Peptides
  • Peroxisome Proliferator-Activated Receptors
  • Flurbiprofen
  • Prostaglandin-Endoperoxide Synthases
  • Ibuprofen
  • Indomethacin