Can We Treat Neuroinflammation in Alzheimer's Disease?

Int J Mol Sci. 2020 Nov 19;21(22):8751. doi: 10.3390/ijms21228751.

Abstract

Alzheimer's disease (AD), considered the most common type of dementia, is characterized by a progressive loss of memory, visuospatial, language and complex cognitive abilities. In addition, patients often show comorbid depression and aggressiveness. Aging is the major factor contributing to AD; however, the initial cause that triggers the disease is yet unknown. Scientific evidence demonstrates that AD, especially the late onset of AD, is not the result of a single event, but rather it appears because of a combination of risk elements with the lack of protective ones. A major risk factor underlying the disease is neuroinflammation, which can be activated by different situations, including chronic pathogenic infections, prolonged stress and metabolic syndrome. Consequently, many therapeutic strategies against AD have been designed to reduce neuro-inflammation, with very promising results improving cognitive function in preclinical models of the disease. The literature is massive; thus, in this review we will revise the translational evidence of these early strategies focusing in anti-diabetic and anti-inflammatory molecules and discuss their therapeutic application in humans. Furthermore, we review the preclinical and clinical data of nutraceutical application against AD symptoms. Finally, we introduce new players underlying neuroinflammation in AD: the activity of the endocannabinoid system and the intestinal microbiota as neuroprotectors. This review highlights the importance of a broad multimodal approach to treat successfully the neuroinflammation underlying AD.

Keywords: Alzheimer’s disease; endocannabinoid system; gut microbiota; insulin resistance; neuroinflammation; nutraceuticals.

Publication types

  • Review

MeSH terms

  • Aging / genetics*
  • Aging / pathology
  • Alzheimer Disease / drug therapy*
  • Alzheimer Disease / genetics
  • Alzheimer Disease / immunology
  • Alzheimer Disease / physiopathology
  • Anti-Inflammatory Agents / therapeutic use*
  • Cannabinoids / therapeutic use*
  • Clinical Trials as Topic
  • Cognitive Dysfunction / genetics
  • Cognitive Dysfunction / immunology
  • Cognitive Dysfunction / physiopathology
  • Cognitive Dysfunction / prevention & control
  • Depression / genetics
  • Depression / immunology
  • Depression / physiopathology
  • Depression / prevention & control
  • Dietary Supplements
  • Gastrointestinal Microbiome / immunology
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Inflammation
  • Insulin Resistance
  • Metabolic Syndrome / genetics
  • Metabolic Syndrome / immunology
  • Metabolic Syndrome / physiopathology
  • Metabolic Syndrome / prevention & control
  • Neuroimmunomodulation / drug effects
  • Neuroprotective Agents / therapeutic use*
  • Stress, Psychological / genetics
  • Stress, Psychological / immunology
  • Stress, Psychological / physiopathology
  • Stress, Psychological / prevention & control

Substances

  • Anti-Inflammatory Agents
  • Cannabinoids
  • Hypoglycemic Agents
  • Neuroprotective Agents