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Failure, Success, and Future Direction of Alzheimer Drugs Targeting Amyloid‐β Cascade: Pros and Cons of Chemical and Biological Modalities

Von Wiley-VCH zur Verfügung gestellt

This review paper examines immunotherapeutic and chemical drug candidates for Alzheimer's disease (AD) and suggests a drug discovery strategy to overcome the obstacles in chemical-driven drug discovery. We evaluate the prospects of an alternative approach in chemical-based drug development that will help bypass the difficulties of chemical-driven drug development, capable of amyloid clearance just as immunotherapy candidates.


Alzheimer's disease (AD) is the most prevalent cause of dementia and has become a health concern worldwide urging for an effective therapeutic. The amyloid hypothesis, currently the most pursued basis of AD drug discovery, points the cause of AD to abnormal production and ineffective removal of pathogenic aggregated amyloid-β (Aβ). AD therapeutic research has been focused on targeting different species of Aβ in the amyloidogenic process to control Aβ content and recover cognitive decline. Among the different processes targeted, the clearance mechanism has been found to be the most effective, supported by the recent clinical approval of an Aβ-targeting immunotherapeutic drug which significantly slowed cognitive decline. Although the current AD drug discovery field is extensively researching immunotherapeutic drugs, there are numerous properties of immunotherapy in need of improvements that could be overcome by an equally performing chemical drug. Here, we review chemical and immunotherapy drug candidates, based on their mechanism of modulating the amyloid cascade, selected from the AlzForum database. Through this review, we aim to summarize and evaluate the prospect of Aβ-targeting chemical drugs.

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