Beyond symptomatic therapy: a re-examination of acetylcholinesterase inhibitors in Alzheimer's disease.
Acetylcholinesterase inhibitors (AChEIs) are generally regarded as palliative treatments for Alzheimer's disease that slow the progression of dementia symptoms without altering Alzheimer's disease's underlying pathogenic mechanisms. This concept is based on inference rather than evidence, and has limited the scope and persistence of AChEI use in clinical practice. Recent preclinical studies demonstrate that AChEIs exhibit a number of biological effects in addition to cholinesterase inhibition. A broader understanding of the possible mechanisms of action of AChEIs in Alzheimer's disease could result in more effective use and assist in the development of new and improved therapies. The available evidence brings into question the prevailing view that AChEIs are exclusively symptomatic treatments and supports the use of these agents persistently throughout the course of Alzheimer's disease.
Relkin
Norman R
NR
Joan and Sanford I. Weill Medical College of Cornell University, 428 East 72nd Street, Suite 500, NY 10017, USA. nrelkin@med.cornell.edu
D000110:Acetylcholinesterase / Q000378:metabolism*; D000544:Alzheimer Disease / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism*; D000818:Animals; D001921:Brain / Q000187:drug effects / Q000503:physiopathology*; D002800:Cholinesterase Inhibitors / Q000008:administration & dosage*; D002986:Clinical Trials as Topic / Q000639:trends; D003072:Cognition Disorders / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism*; D006801:Humans
D002800:Cholinesterase Inhibitors; D000110:Acetylcholinesterase