Potential Therapeutic Approaches for Cerebral Amyloid Angiopathy and Alzheimer's Disease

Int J Mol Sci. 2020 Mar 14;21(6):1992. doi: 10.3390/ijms21061992.

Abstract

Cerebral amyloid angiopathy (CAA) is a cerebrovascular disease directly implicated in Alzheimer's disease (AD) pathogenesis through amyloid-β (Aβ) deposition, which may cause the development and progression of dementia. Despite extensive studies to explore drugs targeting Aβ, clinical benefits have not been reported in large clinical trials in AD patients or presymptomatic individuals at a risk for AD. However, recent studies on CAA and AD have provided novel insights regarding CAA- and AD-related pathogenesis. This work has revealed potential therapeutic targets, including Aβ drainage pathways, Aβ aggregation, oxidative stress, and neuroinflammation. The functional significance and therapeutic potential of bioactive molecules such as cilostazol and taxifolin have also become increasingly evident. Furthermore, recent epidemiological studies have demonstrated that serum levels of a soluble form of triggering receptor expressed on myeloid cells 2 (TREM2) may have clinical significance as a potential novel predictive biomarker for dementia incidence. This review summarizes recent advances in CAA and AD research with a focus on discussing future research directions regarding novel therapeutic approaches and predictive biomarkers for CAA and AD.

Keywords: Alzheimer’s disease; amyloid-β; antioxidants; cerebral amyloid angiopathy; cilostazol; glycation; inflammation; intramural peri-arterial drainage; taxifolin; triggering receptor expressed on myeloid cells 2.

Publication types

  • Review

MeSH terms

  • Alzheimer Disease / drug therapy*
  • Alzheimer Disease / pathology*
  • Amyloid Precursor Protein Secretases / antagonists & inhibitors
  • Amyloid beta-Peptides / metabolism
  • Animals
  • Aspartic Acid Endopeptidases / antagonists & inhibitors
  • Biomarkers / blood
  • Brain
  • Cerebral Amyloid Angiopathy / drug therapy*
  • Cerebral Amyloid Angiopathy / pathology*
  • Cilostazol / therapeutic use
  • Disease Models, Animal
  • Humans
  • Membrane Glycoproteins / blood
  • Mice
  • Neuroprotective Agents / therapeutic use*
  • Oxidative Stress / physiology
  • Protein Aggregation, Pathological / drug therapy*
  • Protein Aggregation, Pathological / pathology
  • Quercetin / analogs & derivatives
  • Quercetin / therapeutic use
  • Receptors, Immunologic / blood

Substances

  • Amyloid beta-Peptides
  • Biomarkers
  • Membrane Glycoproteins
  • Neuroprotective Agents
  • Receptors, Immunologic
  • TREM2 protein, human
  • Quercetin
  • taxifolin
  • Amyloid Precursor Protein Secretases
  • Aspartic Acid Endopeptidases
  • BACE1 protein, human
  • Cilostazol