Abstract
In the last decade, advances in understanding the neurobiology of Alzheimers disease (AD) have translated into an increase in clinical trials assessing various potential AD treatments. At present, drugs used for the treatment of AD only slightly delay the inevitable symptomatic progression of the disease and do not affect the main neuropathological hallmarks of the disease, i.e. senile plaques and neurofibrillary tangles. Brain accumulation of oligomeric species of β-amyloid (Aβ) peptides, the principal components of senile plaques, is believed to play a crucial role in the development of AD. Based on this hypothesis, huge efforts are being made to identify drugs able to interfere with proteases regulating Aβ formation from amyloid precursor protein (APP). Compounds that stimulate α-secretase, the enzyme responsible for non-amyloidogenic metabolism of APP, are being developed and one of these, EHT-0202, has recently commenced evaluation in a phase II study. The discovery of inhibitors of β-secretase (memapsin-2, β-amyloid cleaving enzyme-1 BACE-1), the enzyme that regulates the first step of amyloidogenic APP metabolism, has proved to be particularly difficult because of inherent medicinal chemistry issues and only one compound (CTS-21166) has proceeded to clinical testing. Conversely, several compounds that inhibit γ-secretase, the pivotal enzyme that generates Aβ, have been identified, the most advanced being LY-450139 (semagacestat), presently in phase III clinical development. There has been considerable disappointment over the failure of a phase III study of tarenflurbil, a compound believed to modulate the activity of γ-secretase, after encouraging phase II findings. Nevertheless, other promising γ-secretase modulators are being developed and are approaching clinical testing. All these therapeutic approaches increase the hope of slowing the rate of decline in patients with AD and modifying the natural history of this devastating disease within the next 5 years.
| Original language | English |
|---|---|
| Pages (from-to) | 537-555 |
| Number of pages | 19 |
| Journal | Drugs and Aging |
| Volume | 26 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - 2009 |
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ASJC Scopus subject areas
- Pharmacology (medical)
- Geriatrics and Gerontology
Cite this
Disease-modifying approach to the treatment of alzheimers disease : From α-secretase activators to γ-secretase inhibitors and modulators. / Panza, Francesco; Solfrizzi, Vincenzo; Frisardi, Vincenza; Capurso, Cristiano; D'Introno, Alessia; Colacicco, Anna M.; Vendemiale, Gianluigi; Capurso, Antonio; Imbimbo, Bruno P.
In: Drugs and Aging, Vol. 26, No. 7, 2009, p. 537-555.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Disease-modifying approach to the treatment of alzheimers disease
T2 - From α-secretase activators to γ-secretase inhibitors and modulators
AU - Panza, Francesco
AU - Solfrizzi, Vincenzo
AU - Frisardi, Vincenza
AU - Capurso, Cristiano
AU - D'Introno, Alessia
AU - Colacicco, Anna M.
AU - Vendemiale, Gianluigi
AU - Capurso, Antonio
AU - Imbimbo, Bruno P.
PY - 2009
Y1 - 2009
N2 - In the last decade, advances in understanding the neurobiology of Alzheimers disease (AD) have translated into an increase in clinical trials assessing various potential AD treatments. At present, drugs used for the treatment of AD only slightly delay the inevitable symptomatic progression of the disease and do not affect the main neuropathological hallmarks of the disease, i.e. senile plaques and neurofibrillary tangles. Brain accumulation of oligomeric species of β-amyloid (Aβ) peptides, the principal components of senile plaques, is believed to play a crucial role in the development of AD. Based on this hypothesis, huge efforts are being made to identify drugs able to interfere with proteases regulating Aβ formation from amyloid precursor protein (APP). Compounds that stimulate α-secretase, the enzyme responsible for non-amyloidogenic metabolism of APP, are being developed and one of these, EHT-0202, has recently commenced evaluation in a phase II study. The discovery of inhibitors of β-secretase (memapsin-2, β-amyloid cleaving enzyme-1 BACE-1), the enzyme that regulates the first step of amyloidogenic APP metabolism, has proved to be particularly difficult because of inherent medicinal chemistry issues and only one compound (CTS-21166) has proceeded to clinical testing. Conversely, several compounds that inhibit γ-secretase, the pivotal enzyme that generates Aβ, have been identified, the most advanced being LY-450139 (semagacestat), presently in phase III clinical development. There has been considerable disappointment over the failure of a phase III study of tarenflurbil, a compound believed to modulate the activity of γ-secretase, after encouraging phase II findings. Nevertheless, other promising γ-secretase modulators are being developed and are approaching clinical testing. All these therapeutic approaches increase the hope of slowing the rate of decline in patients with AD and modifying the natural history of this devastating disease within the next 5 years.
AB - In the last decade, advances in understanding the neurobiology of Alzheimers disease (AD) have translated into an increase in clinical trials assessing various potential AD treatments. At present, drugs used for the treatment of AD only slightly delay the inevitable symptomatic progression of the disease and do not affect the main neuropathological hallmarks of the disease, i.e. senile plaques and neurofibrillary tangles. Brain accumulation of oligomeric species of β-amyloid (Aβ) peptides, the principal components of senile plaques, is believed to play a crucial role in the development of AD. Based on this hypothesis, huge efforts are being made to identify drugs able to interfere with proteases regulating Aβ formation from amyloid precursor protein (APP). Compounds that stimulate α-secretase, the enzyme responsible for non-amyloidogenic metabolism of APP, are being developed and one of these, EHT-0202, has recently commenced evaluation in a phase II study. The discovery of inhibitors of β-secretase (memapsin-2, β-amyloid cleaving enzyme-1 BACE-1), the enzyme that regulates the first step of amyloidogenic APP metabolism, has proved to be particularly difficult because of inherent medicinal chemistry issues and only one compound (CTS-21166) has proceeded to clinical testing. Conversely, several compounds that inhibit γ-secretase, the pivotal enzyme that generates Aβ, have been identified, the most advanced being LY-450139 (semagacestat), presently in phase III clinical development. There has been considerable disappointment over the failure of a phase III study of tarenflurbil, a compound believed to modulate the activity of γ-secretase, after encouraging phase II findings. Nevertheless, other promising γ-secretase modulators are being developed and are approaching clinical testing. All these therapeutic approaches increase the hope of slowing the rate of decline in patients with AD and modifying the natural history of this devastating disease within the next 5 years.
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U2 - 10.2165/11315770-000000000-00000
DO - 10.2165/11315770-000000000-00000
M3 - Article
VL - 26
SP - 537
EP - 555
JO - Drugs and Aging
JF - Drugs and Aging
SN - 1170-229X
IS - 7
ER -