Department of Pharmaceutical Science, Taneja College of Pharmacy, University of South Florida, Tampa, FL, USA.
J Alzheimers Dis. 2024;98(3):755-772. doi: 10.3233/JAD-231163.
Alzheimer's disease (AD) is an extremely complex and heterogeneous pathology influenced by many factors contributing to its onset and progression, including aging, amyloid-beta (Aβ) plaques, tau fibril accumulation, inflammation, etc. Despite promising advances in drug development, there is no cure for AD. Although there have been substantial advancements in understanding the pathogenesis of AD, there have been over 200 unsuccessful clinical trials in the past decade. In recent years, immunotherapies have been at the forefront of these efforts. Immunotherapy alludes to the immunological field that strives to identify disease treatments via the enhancement, suppression, or induction of immune responses. Interestingly, immunotherapy in AD is a relatively new approach for non-infectious disease. At present, antibody therapy (passive immunotherapy) that targets anti-Aβ aimed to prevent the fibrillization of Aβ peptides and disrupt pre-existing fibrils is a predominant AD immunotherapy due to the continuous failure of active immunotherapy for AD. The most rational and safe strategies will be those targeting the toxic molecule without triggering an abnormal immune response, offering therapeutic advantages, thus making clinical trial design more efficient. This review offers a concise overview of immunotherapeutic strategies, including active and passive immunotherapy for AD. Our review encompasses approved methods and those presently under investigation in clinical trials, while elucidating the recent challenges, complications, successes, and potential treatments. Thus, immunotherapies targeting Aβ throughout the disease progression using a mutant oligomer-Aβ stimulated dendritic cell vaccine may offer a promising therapy in AD.
阿尔茨海默病(AD)是一种极其复杂和异质的病理学,受许多因素影响,这些因素导致其发病和进展,包括衰老、淀粉样蛋白-β(Aβ)斑块、tau 纤维缠结积累、炎症等。尽管在药物开发方面取得了有希望的进展,但 AD 仍然无法治愈。尽管在理解 AD 的发病机制方面取得了实质性进展,但在过去十年中,有 200 多项临床试验都以失败告终。近年来,免疫疗法一直处于这些努力的前沿。免疫疗法是指努力通过增强、抑制或诱导免疫反应来识别疾病治疗方法的免疫学领域。有趣的是,AD 中的免疫疗法是一种针对非传染性疾病的相对较新的方法。目前,针对抗 Aβ的抗体疗法(被动免疫疗法)旨在阻止 Aβ肽的纤维化并破坏预先存在的纤维,由于 AD 的主动免疫疗法不断失败,这是一种主要的 AD 免疫疗法。最合理和安全的策略将是那些针对毒性分子而不引发异常免疫反应的策略,从而提供治疗优势,从而使临床试验设计更加高效。这篇综述简要概述了 AD 的免疫治疗策略,包括主动和被动免疫疗法。我们的综述包括已批准的方法和目前正在临床试验中研究的方法,同时阐明了最近的挑战、并发症、成功和潜在的治疗方法。因此,使用突变寡聚体-Aβ刺激树突状细胞疫苗针对疾病进展中的 Aβ 进行免疫疗法可能是 AD 的一种有前途的治疗方法。