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Published on: February 11, 2019
Cholinergic deficiency involved in vascular dementia: possible mechanism and strategy of treatment
Juan Wang1, Hai-Yan Zhang, Xi-Can Tang
1State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China.
Insights
Vascular dementia (VaD) treatment shows promise through cholinergic therapies. These therapies may work by reducing inflammation via the vagus nerve, offering a new strategy for cognitive improvement.
Area of Science:
- Neuroscience
- Pharmacology
Background:
- Vascular dementia (VaD) is a prevalent neurodegenerative disease.
- VaD is associated with cholinergic deficits impacting cognitive function.
- Cholinergic therapies demonstrate potential for cognitive enhancement in VaD.
Purpose of the Study:
- To review cholinergic treatment strategies for Vascular dementia.
- To elucidate the anti-inflammatory mechanisms of cholinergic agents in VaD.
Main Methods:
- Literature review of studies on VaD and cholinergic therapies.
- Analysis of proposed mechanisms of action for cholinergic agents.
Main Results:
- Cholinergic deficits are linked to VaD pathophysiology and cognitive impairment.
- Cholinergic therapies show efficacy in improving cognition in VaD patients.
- Evidence suggests a role for the cholinergic anti-inflammatory pathway.
Conclusions:
- Cholinergic therapies represent a promising treatment avenue for VaD.
- The cholinergic anti-inflammatory pathway is a key mechanism, alongside others like oxidative stress regulation and apoptosis alleviation.
Abstract:
Vascular dementia (VaD) is a progressive neurodegenerative disease with a high prevalence. Several studies have recently reported that VaD patients present cholinergic deficits in the brain and cerebrospinal fluid (CSF) that may be closely related to the pathophysiology of cognitive impairment. Moreover, cholinergic therapies have shown promising effects on cognitive improvement in VaD patients. The precise mechanisms of these cholinergic agents are currently not fully understood; however, accumulating evidence indicates that these drugs may act through the cholinergic anti-inflammatory pathway, in which the efferent vagus nerve signals suppress pro-inflammatory cytokine release and inhibit inflammation, although regulation of oxidative stress and energy metabolism, alleviation of apoptosis may also be involved. In this paper, we provide a brief overview of the cholinergic treatment strategy for VaD and its relevant mechanisms of anti-inflammation.Acta Pharmacologica Sinica (2009) 30: 879-888; doi: 10.1038/aps.2009.82.
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