Mohammed Ousman, Kelemu Tsehayneh
Department of Medical Biochemistry, School of Medicine, College of Health Sciences Addis Ababa University Addis Ababa Ethiopia.
Department of Medical Laboratory Sciences, College of Medicine and Health Sciences Wollo University Dessie Ethiopia.
Health Sci Rep. 2025 Jul 15;8(7):e71065. doi: 10.1002/hsr2.71065. eCollection 2025 Jul.
BACKGROUND: Alzheimer's disease (AD) and Parkinson's disease (PD) are progressive neurodegenerative disorders with significant cognitive and motor impairments, affecting millions globally. Current treatments offer limited efficacy, prompting the exploration of new therapeutic approaches. AIM: To discuss the intricate relationship between incretin and insulin signaling pathways and their relevance to the pathogenesis and treatment of Alzheimer's and Parkinson's diseases. METHODS: A comprehensive literature review was conducted using a variety of search engines, including Google Scholar, PubMed Central, Scopus, Web of Science, and others. RESULTS: Emerging evidence highlights disrupted insulin signaling in AD and, to a lesser extent, in PD, suggesting that insulin plays a key neuroprotective role. Incretins, such as GLP-1 and GIP, which enhance insulin signaling, have shown potential in preclinical and clinical studies. Incretin-based therapies, particularly GLP-1/GIP receptor agonists, have demonstrated promising effects by addressing several pathological processes, including oxidative stress, inflammation, misfolded protein aggregation, and insulin resistance. Dual agonists like DA-CH3, DA5-CH, and DA4-JC have proven superior in crossing the blood-brain barrier and offering improved neuroprotection in comparison with conventional GLP-1 agonists. Triple agonists provide even greater neuroprotective benefits, highlighting their potential as disease-modifying therapies for AD and PD. CONCLUSION: While GLP-1 and GIP analogs hold promise in modulating early neurodegenerative processes, their efficacy likely depends on timely intervention before permanent neuronal damage occurs.
背景:阿尔茨海默病(AD)和帕金森病(PD)是具有显著认知和运动障碍的进行性神经退行性疾病,全球数百万人受其影响。目前的治疗效果有限,促使人们探索新的治疗方法。 目的:探讨肠促胰岛素和胰岛素信号通路之间的复杂关系及其与阿尔茨海默病和帕金森病发病机制及治疗的相关性。 方法:使用多种搜索引擎进行全面的文献综述,包括谷歌学术、PubMed Central、Scopus、科学网等。 结果:新出现的证据表明,AD中胰岛素信号通路受损,PD中受损程度较轻,这表明胰岛素起着关键的神经保护作用。增强胰岛素信号的肠促胰岛素,如胰高糖素样肽-1(GLP-1)和葡萄糖依赖性促胰岛素多肽(GIP),在临床前和临床研究中已显示出潜力。基于肠促胰岛素的疗法,特别是GLP-1/GIP受体激动剂,通过解决包括氧化应激、炎症、错误折叠蛋白聚集和胰岛素抵抗在内的多种病理过程,已显示出有前景的效果。与传统的GLP-1激动剂相比,DA-CH3、DA5-CH和DA4-JC等双激动剂已被证明在穿越血脑屏障和提供更好的神经保护方面更具优势。三联激动剂具有更大的神经保护益处,凸显了它们作为AD和PD疾病修饰疗法的潜力。 结论:虽然GLP-1和GIP类似物在调节早期神经退行性过程方面具有前景,但其疗效可能取决于在永久性神经元损伤发生之前的及时干预。
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