Challenges and Opportunities of Metal Chelation Therapy in Trace Metals Overload-Induced Alzheimer's Disease

Neurotox Res. 2023 Jun;41(3):270-287. doi: 10.1007/s12640-023-00634-7. Epub 2023 Jan 27.

Abstract

Essential trace metals like zinc (Zn), iron (Fe), and copper (Cu) play an important physiological role in the metabolomics and healthy functioning of body organs, including the brain. However, abnormal accumulation of trace metals in the brain and dyshomeostasis in the different regions of the brain have emerged as contributing factors in neuronal degeneration, Aβ aggregation, and Tau formation. The link between these essential trace metal ions and the risk of AD has been widely studied, although the conclusions have been ambiguous. Despite the absence of evidence for any clinical benefit, therapeutic chelation is still hypothesized to be a therapeutic option for AD. Furthermore, the parameters like bioavailability, ability to cross the BBB, and chelation specificity must be taken into consideration while selecting a suitable chelation therapy. The data in this review summarizes that the primary intervention in AD is brain metal homeostasis along with brain metal scavenging. This review evaluates the impact of different trace metals (Cu, Zn, Fe) on normal brain functioning and their association with neurodegeneration in AD. Also, it investigates the therapeutic potential of metal chelators in the management of AD. An extensive literature search was carried out on the "Web of Science, PubMed, Science Direct, and Google Scholar" to investigate the effect of trace elements in neurological impairment and the role of metal chelators in AD. In addition, the current review highlights the advantages and limitations of chelation therapies and the difficulties involved in developing selective metal chelation therapy in AD patients.

Keywords: Alzheimer’s disease; Amyloid-β aggregates; Dyshomeostasis of Cu, Fe, Zn in AD; Metal chelators therapy in AD; Tau formation.

Publication types

  • Review

MeSH terms

  • Alzheimer Disease* / drug therapy
  • Amyloid beta-Peptides
  • Chelating Agents / pharmacology
  • Chelating Agents / therapeutic use
  • Chelation Therapy
  • Copper
  • Humans
  • Trace Elements* / therapeutic use
  • Zinc / therapeutic use

Substances

  • Amyloid beta-Peptides
  • Chelating Agents
  • Copper
  • Trace Elements
  • Zinc