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Published on: May 2, 2025
The emergence of designed multiple ligands for neurodegenerative disorders
Werner J Geldenhuys1, Moussa B H Youdim, Richard T Carroll
1Department of Pharmaceutical Sciences, Northeast Ohio Medical University (NEOMED), 4209 State Route 44, Rootstown, OH 44272, USA.
Abstract:
The incidence of neurodegenerative diseases has seen a constant increase in the global population, and is likely to be the result of extended life expectancy brought about by better health care. Despite this increase in the incidence of neurodegenerative diseases, there has been a dearth in the introduction of new disease-modifying therapies that are approved to prevent or delay the onset of these diseases, or reverse the degenerative processes in brain. Mounting evidence in the peer-reviewed literature shows that the etiopathology of these diseases is extremely complex and heterogeneous, resulting in significant comorbidity and therefore unlikely to be mitigated by any drug acting on a single pathway or target. A recent trend in drug design and discovery is the rational design or serendipitous discovery of novel drug entities with the ability to address multiple drug targets that form part of the complex pathophysiology of a particular disease state. In this review we discuss the rationale for developing such multifunctional drugs (also called designed multiple ligands or DMLs), and why these drug candidates seem to offer better outcomes in many cases compared to single-targeted drugs in pre-clinical studies for neurodegenerative diseases such as Alzheimer's and Parkinson's disease. Examples are drawn from the literature of drug candidates that have already reached the market, some unsuccessful attempts, and others that are still in the drug development pipeline.
Insights
Multifunctional drugs targeting complex neurodegenerative diseases show promise. These designed multiple ligands (DMLs) offer better outcomes than single-target drugs in preclinical studies for conditions like Alzheimer's and Parkinson's disease.
Area of Science:
- Neuroscience
- Pharmacology
- Drug Discovery
Background:
- Neurodegenerative diseases are increasing globally due to longer life expectancy.
- Current treatments are limited, with few disease-modifying therapies available.
- The complex and heterogeneous nature of these diseases makes single-target drugs less effective.
Purpose of the Study:
- To review the rationale for developing multifunctional drugs (designed multiple ligands or DMLs).
- To discuss why DMLs may offer better outcomes than single-target drugs for neurodegenerative diseases.
- To highlight examples of DMLs in preclinical and clinical development.
Main Methods:
- Literature review of peer-reviewed articles on drug design and discovery for neurodegenerative diseases.
- Analysis of preclinical and clinical data for single-targeted versus multifunctional drug candidates.
- Discussion of the complex pathophysiology of neurodegenerative diseases.
Main Results:
- Multifunctional drugs (DMLs) are emerging as a promising strategy for complex diseases.
- Preclinical studies suggest DMLs may outperform single-targeted drugs for Alzheimer's and Parkinson's disease.
- The review covers successful, unsuccessful, and pipeline DML candidates.
Conclusions:
- The complexity of neurodegenerative diseases necessitates a move towards multifunctional drug development.
- Designed multiple ligands (DMLs) represent a rational approach to address multiple targets in disease pathways.
- Further research and development of DMLs are crucial for advancing treatment options for neurodegenerative disorders.
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