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Original Article

Natl J Community Med. 2013; 4(1): 109-116


Future Pharmacological Armamentaria in Management of Alzheimer Disease

Megha H Shah; Hetal D Shah; Vipul P Chaudhari.

Abstract
"Introduction: Alzheimer’s disease (AD) is a chronic progressive neurodegenerative disorder and common cause of dementia in elderly. With advancing age, number of people suffering from AD is also increased. Exact aetiology of AD was not known and therapy was focused mainly on increasing central cholinergic transmission with drugs like donepazil, reivastigmine and galantamine. With the generation of amyloid hypothesis, extracellular amyloid plaques, consisting of amorphous extra cellular deposits of ?-amyloid protein (known as A?) and intraneuronal neurofibrillary tangles(Tau) mainly in the hippocampus and frontal cortex ,altered processing of amyloid protein from its precursor (amyloid precursor protein, APP) recognised as the key to the pathogenesis of AD. But, now various studies have shown that etiology may be multifactorial. Inspite of having identified many potential targets, currently no drug modifying disease pathology is available .Advancement of the early diagnostic methods like positron emission tomography (PET) scan and measurement of various biomarkers like NO tagged proteins, ADAM-10 in c.s.f. could potentiate research to develop disease modifying drugs. Drugs modifying Y secretase, tyrosine kinase inhibitors, sigma receptor agonists, anti-A? monoclonal Abs are in the various stages of drug development and could become the cornerstone in the management of AD in future.
Methods: Reviews from index journals and books were taken in this study. In this process, we identified 276 possible sources of information which, upon further scrutiny, were eventually reduced to 30 appropriate studies for inclusion in the review.
Conclusion: Understanding the role and extent of factors causing AD, robust designing of RCTs with use of various biomarkers and multitargeted therapeutic approach are required to develop disease modifying drug which can ameliorate suffering of alzheimer disease patients."

Key words: Alzheimer Disease;Management;New Targets;Dementia



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