Reed Sarah, Taka Equar, Darling-Reed Selina, Soliman Karam F A
Division of Pharmaceutical Sciences, College of Pharmacy and Pharmaceutical Sciences, Institute of Public Health, Florida A&M University, Tallahassee, FL 32307, USA.
Cells. 2025 Jul 11;14(14):1064. doi: 10.3390/cells14141064.
Epidemiological studies have shown that individuals with type 2 diabetes have an increased risk of developing neurodegenerative diseases. These diseases and type 2 diabetes share several risk factors. Meanwhile, the antidiabetic drug metformin offers promising neuroprotective effects by reducing oxidative stress and neuroinflammation, two significant factors in neurodegenerative diseases. This review examines the mechanisms by which metformin mitigates neuronal damage. Metformin reduces neuroinflammation by inhibiting microglial activation and suppressing proinflammatory cytokines. It also triggers the nuclear factor erythroid-2-related factor-2 (Nrf2) pathway to combat oxidative stress, an essential regulator of antioxidant defenses. These outcomes support the possible neuroprotective roles of metformin in type 2 diabetes-related cognitive decline and conditions like Alzheimer's disease. Metformin's therapeutic potential is further supported by its capacity to strengthen the blood-brain barrier's (BBB's) integrity and increase autophagic flux. Metformin also offers several neuroprotective effects by targeting multiple pathological pathways. Moreover, metformin is being studied for its potential benefits beyond glycemic control, particularly in the areas of cognition, Alzheimer's disease, aging, and stroke management. Evidence from both clinical and preclinical studies indicates a complex and multifaceted impact, with benefits varying among populations and depending on underlying disease conditions, making it an appealing candidate for managing several neurodegenerative diseases.
流行病学研究表明,2型糖尿病患者患神经退行性疾病的风险增加。这些疾病与2型糖尿病有若干共同的风险因素。同时,抗糖尿病药物二甲双胍通过减轻氧化应激和神经炎症(神经退行性疾病的两个重要因素),展现出有前景的神经保护作用。本综述探讨了二甲双胍减轻神经元损伤的机制。二甲双胍通过抑制小胶质细胞活化和抑制促炎细胞因子来减轻神经炎症。它还触发核因子红细胞2相关因子2(Nrf2)途径以对抗氧化应激,氧化应激是抗氧化防御的重要调节因子。这些结果支持了二甲双胍在2型糖尿病相关认知衰退以及阿尔茨海默病等病症中可能具有的神经保护作用。二甲双胍增强血脑屏障(BBB)完整性和增加自噬通量的能力进一步支持了其治疗潜力。二甲双胍还通过靶向多种病理途径发挥多种神经保护作用。此外,正在研究二甲双胍在血糖控制之外的潜在益处,特别是在认知、阿尔茨海默病、衰老和中风管理等领域。临床和临床前研究的证据均表明其影响复杂且多方面,益处因人群而异,并取决于潜在疾病状况,这使其成为治疗多种神经退行性疾病的有吸引力的候选药物。