Dept. of Neuroscience Care and Society, Div. of Neurogeriatrics, Karolinska Institutet, 17164, Solna, Sweden.
Department of Pharmaceutical Engineering & Technology, Indian Institute of Technology (BHU), Varanasi, 221005, India.
Eur J Med Chem. 2021 Jan 1;209:112915. doi: 10.1016/j.ejmech.2020.112915. Epub 2020 Oct 15.
Alzheimer's disease (AD) is the most common form of dementia characterized by presence of extracellular amyloid plaques and intracellular neurofibrillary tangles composed of tau protein. Currently there are close to 50 million people living with dementia and this figure is expected to increase to 75 million by 2030 putting a huge burden on the economy due to the health care cost. Considering the effects on quality of life of patients and the increasing burden on the economy, there is an enormous need of new disease modifying therapies to tackle this disease. The current therapies are dominated by only symptomatic treatments including cholinesterase inhibitors and N-methyl-D-aspartate receptor blockers but no disease modifying treatments exist so far. After several failed attempts to develop drugs against amyloidopathy, tau targeting approaches have been in the main focus of drug development against AD. After an overview of the tauopathy in AD, this review summarizes recent findings on the development of small molecules as therapeutics targeting tau modification, aggregation, and degradation, and tau-oriented multi-target directed ligands. Overall, this work aims to provide a comprehensive and critical overview of small molecules which are being explored as a lead candidate for discovering drugs against tauopathy in AD.
阿尔茨海默病(AD)是最常见的痴呆症形式,其特征是存在细胞外淀粉样斑块和由 tau 蛋白组成的细胞内神经原纤维缠结。目前全球有近 5000 万人患有痴呆症,预计到 2030 年这一数字将增加到 7500 万,这给经济带来了巨大的医疗保健负担。鉴于对患者生活质量的影响以及对经济的不断加重的负担,人们迫切需要新的疾病修饰疗法来应对这种疾病。目前的疗法主要是针对症状的治疗,包括胆碱酯酶抑制剂和 N-甲基-D-天冬氨酸受体阻滞剂,但迄今为止还没有针对疾病修饰的治疗方法。在多次试图开发针对淀粉样变性的药物失败后,针对 tau 蛋白的治疗方法已成为开发 AD 治疗药物的主要关注点。在概述 AD 中的 tau 蛋白病后,本文综述了最近关于针对 tau 蛋白修饰、聚集和降解以及 tau 定向多靶点导向配体的小分子治疗剂的研究进展。总的来说,这项工作旨在提供一个全面而批判性的综述,探讨小分子作为治疗 AD 中 tau 蛋白病的潜在药物。