Title:Perspectives on the Tertiary Prevention Strategy for Alzheimer’s Disease
Volume: 13
Issue: 3
Author(s): Xian-Le Bu, Shu-Sheng Jiao, Yan Lian and Yan-Jiang Wang
Affiliation:
Keywords:
Alzheimer's disease, beta-amyloid, tau hyperphosphorylation, stroke, therapeutic strategy.
Abstract: Amyloid-beta (Aβ) plays a pivotal role in Alzheimer’s disease (AD) pathogenesis, and is
the most promising disease-modifying target for AD. A succession of failures in Aβ-targeting clinical
trials, however, has prompted questions on whether Aβ is the true cause of AD and a valid therapeutic
target. Therefore, current therapeutic targets and intervention strategies must be reconsidered. In addition
to Aβ, multiple pathological events such as tau hyperphosphorylation, oxidative stress and neuroinflammation
are involved in the disease pathogenesis and cause cross-talk between these pathological pathways, which
synergistically drive disease progression. Increasing evidence also reveals that the pathogenesis varies at different stages
of the disease. Therefore, targeting Aβ alone at all stages of the disease would not be sufficient to halt or reverse disease
progression. In the light of the pathophysiologic similarities between the development of ischemic stroke and AD, we can
formulate management strategies for AD from the successful practice of ischemic stroke management, namely the tertiary
prevention strategy. These new perspectives of tertiary prevention target both Aβ and different pathological pathways of
AD pathogenesis at different stages of the disease, and may represent a promising avenue for the effective prevention and
treatment of AD.
