Alzheimer Therapy

Although currently there is no treatment that can cure Alzheimer's, were proposed several therapeutic strategies to try to manage clinical Alzheimer's disease, these strategies aim to modulate pharmacologically some of the pathological mechanisms that are at the base.

First, on the basis that it has nell'Alzheimer decrease in the levels of acetylcholine, the idea was to try to restore the physiological levels. The pure acetylcholine can not be used, as too unstable and with a limited effect. The cholinergic agonists should rather have systemic effects and produce too many side effects, and are therefore not usable. You can use the cholinesterase inhibitors, the enzyme that metabolizes the acetylcholine: by inhibiting the enzyme, increasing the amount of acetylcholine in the synaptic space.

Will be available for the treatment dell'acetilcolinesterasi inhibitor drugs that have a low affinity for the enzyme found in the suburbs, and are lipophilic enough to overcome the blood-brain barrier (BEE) and then act on the preference of central nervous system. Among them, physostigmine, the galantamine and neostigmine were the founders, but the drug is now more focused on reversible inhibitors of acetilcolinesterasi such as Rivastigmina and galantamine. The Tacrine is no longer used because hepatotoxic while Donepezil, non-competitive inhibitor dell'acetilcolinesterasi, it seems more effective because, with a half-life of about 70 hours, allowing a single dose per day (while galantamine has a half-life of 7 hours) . Donepezil, however, the course is subject to express side effects due to an increase in cholinergic tone (such as insomnia, arrhythmias, bradycardia, nausea, diarrhea). By contrast, galantamine and Rivastigmina can cause the same effects, but to a much lesser degree.

An alternative approach to pathology is the use of NSAIDs (anti-inflammatory non-steroidal). As I said, nell'Alzheimer is an inflammation that destroys neurons. The use of anti could improve the condition of patients. It was also noted that women in post-menopausal treatment with estrogen drugs have a lower incidence of the disease, thereby assumed a protective action of estrogen.

The researchers have highlighted the protective action of vitamin E (alpha-tocopherol), which seems to prevent lipid peroxidation of neuronal membrane caused by inflammation.

Neurodegenerative process can also 'eccitotossicità, that an excessive release of glutamic acid and aspartic both excitatory neurotransmitters that induce an increase of intracellular free calcium, which is cytotoxic. It was therefore suggested to use drugs and glutamate antagonists dell'aspartato, but they also have significant side effects. There are currently marketed drugs defined Nootropi ( "stimulating thinking"), like Piracetam and Aniracetam: these drugs increase the release of glutamic acid, although this seems clearly opposed to the above, it should be noted however, that this neurotransmitter is directly involved in the processes of memory and learning. Increasing the quantity, then it improves the quality of life of patients.

Last suggested approach is the use of Pentossifillina and Diidroergotossina (it seems that these drugs improve blood flow to the brain, allowing a better cerebral oxygenation and an improvement in performance neural). Also for the same purpose has been proposed the use of Gingko biloba.

In the United States is also testing a gene therapy that tries to use growth hormone for the treatment of AD.

The forms of non-pharmacological treatment being in behavioral measures, psychosocial support and cognitive training. Such measures are often integrated in a complementary manner with the drug treatment.

The treatment of AD, however, is in its early stages: at the moment there are no drugs yet stall or curing the disease. You can improve the quality of life of patients and try to slow down the course in the early stages.