Multidisciplinary approaches for targeting the secretase protein family as a therapeutic route for Alzheimer's disease

Med Res Rev. 2019 Sep;39(5):1730-1778. doi: 10.1002/med.21563. Epub 2019 Jan 9.

Abstract

The continual increase of the aging population worldwide renders Alzheimer's disease (AD) a global prime concern. Several attempts have been focused on understanding the intricate complexity of the disease's development along with the on- andgoing search for novel therapeutic strategies. Incapability of existing AD drugs to effectively modulate the pathogenesis or to delay the progression of the disease leads to a shift in the paradigm of AD drug discovery. Efforts aimed at identifying AD drugs have mostly focused on the development of disease-modifying agents in which effects are believed to be long lasting. Of particular note, the secretase enzymes, a group of proteases responsible for the metabolism of the β-amyloid precursor protein (βAPP) and β-amyloid (Aβ) peptides production, have been underlined for their promising therapeutic potential. This review article attempts to comprehensively cover aspects related to the identification and use of drugs targeting the secretase enzymes. Particularly, the roles of secretases in the pathogenesis of AD and their therapeutic modulation are provided herein. Moreover, an overview of the drug development process and the contribution of computational (in silico) approaches for facilitating successful drug discovery are also highlighted along with examples of relevant computational works. Promising chemical scaffolds, inhibitors, and modulators against each class of secretases are also summarized herein. Additionally, multitarget secretase modulators are also taken into consideration in light of the current growing interest in the polypharmacology of complex diseases. Finally, challenging issues and future outlook relevant to the discovery of drugs targeting secretases are also discussed.

Keywords: ADAM; Alzheimer's disease; BACE1; amyloid peptide; computational modeling; drug design; drug discovery; neurodegenerative disease; polypharmacology; presenilin; secretase; therapy; βAPP.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Alzheimer Disease / drug therapy*
  • Amyloid Precursor Protein Secretases / drug effects*
  • Animals
  • Drug Discovery
  • Humans
  • Neuroprotective Agents / therapeutic use*
  • Neurotransmitter Agents / metabolism

Substances

  • Neuroprotective Agents
  • Neurotransmitter Agents
  • Amyloid Precursor Protein Secretases