Therapeutic strategies in Alzheimer's disease: M1 muscarinic agonists

Jpn J Pharmacol. 2000 Oct;84(2):101-12. doi: 10.1254/jjp.84.101.

Abstract

The cholinergic hypofunction in Alzheimer's disease (AD) appears to be linked with two other major hallmarks of this disease, beta-amyloid and hyperphosphorylated tau protein. Formation of beta-amyloids might impair the coupling of M1 muscarinic acetylcholine receptors (mAChR) with G-proteins. This can lead to decreased signal transduction, a decrease of trophic and non-amyloidogenic amyloid precursor protein (APPs) and generation of more beta-amyloids, aggravating further the cholinergic deficiency. This review is an attempt to explore the M1 mAChR regulation of beta-amyloid metabolism, tau hyperphosphorylation and cognitive functions. The therapeutic potential of M1-selective muscarinic agonists including AF102B, AF150(S), AF267B (the AF series) is evaluated and compared, when possible, with several FDA-approved acetylcholinesterase inhibitors. These M1 agonists can elevate APPs, decrease tau protein phosphorylation/hyperphosphorylation in vitro and in vivo and restore cognitive impairments in several animal models for AD. Except for the M1 agonists, no other compounds were reported yet with combined effects; e.g., amelioration of cognition dysfunction and beneficial modulation of APPs/beta-amyloid together with tau hyperphosphorylation/phosphorylation. This property of M1 agonists to alter different aspects associated with AD pathogenesis could represent the most remarkable clinical value of such drugs.

Publication types

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

MeSH terms

  • Alzheimer Disease / drug therapy*
  • Alzheimer Disease / metabolism
  • Alzheimer Disease / pathology
  • Amyloid beta-Peptides / physiology
  • Animals
  • Apoptosis
  • Carbamates / therapeutic use
  • Cheirogaleidae
  • Disease Models, Animal
  • Humans
  • Muscarinic Agonists / therapeutic use*
  • Neuroprotective Agents / therapeutic use
  • Phenylcarbamates*
  • Piperidines / therapeutic use
  • Receptor, Muscarinic M1
  • Receptors, Muscarinic / drug effects
  • Receptors, Muscarinic / metabolism*
  • Rivastigmine
  • Signal Transduction
  • Thiazoles / therapeutic use
  • tau Proteins / metabolism

Substances

  • 1-methylpiperidine-4-spiro-(2'-methylthiazoline)
  • Amyloid beta-Peptides
  • Carbamates
  • Muscarinic Agonists
  • Neuroprotective Agents
  • Phenylcarbamates
  • Piperidines
  • Receptor, Muscarinic M1
  • Receptors, Muscarinic
  • Thiazoles
  • tau Proteins
  • Rivastigmine