Multiple target combinatorial approach of Acetyl-cholinesterase inhibitors, NMDA receptor antagonist and a phytoconstituent for the possible treatment of Alzheimer’s disease

Abstract

Alzheimer's disease (AD) is a severe condition in ageing societies. Alzheimer's disease (AD) is a type of dementia in which cognitive functions decline. More than 50 million people are affected by this disease across the world. Many kinds of research on Alzheimer's Disease are advancing rapidly, but very limited numbers of drugs are effective and have found a clinical application for AD patients.

The currently widely used medicines such as Donepezil and Galantamine transiently improve the symptoms of patients with mild to moderate AD. In the long history of the development of traditional Chinese medicine, many herbs and their phytoconstituents have been discovered and employed to treat dementia diseases. In recent decades, several agents were isolated from these herbs and their efficacies against AD were tested. Some flavonoids, alkaloids, phenylpropanoids, triterpenoid saponins, and polysaccharides were demonstrated to have potential efficacies against AD via targeting multiple pathological changes of AD. Because regeneration of neurons is a complicated process due to the involvement of multiple pathways, a combination of drugs that can work through multiple pathways could prove to be effective in treating AD. Based on prior studies and different mechanisms involved in the treatment, a new hypothesis has been proposed that a combination of galantamine, memantine and liquiritin is anticipated to produce better activity as compared to the current therapies available in the market for the treatment of Alzheimer's disease. In this article, we reviewed Acetylcholinesterase inhibitors, NMDA receptorantagonists and a phytoconstituents combination for the possible treatment of Alzheimer’s disease.

Keywords: Alzheimer's disease, Neuroinflammation, Acetylcholinesterase inhibitors, NMDA receptor antagonist, phytoconstituents, memantine, galantamine, Liquiritin, the combinatorial approach, and Antioxidant.