Sodium Thiosulfate: An Innovative Multi-Target Repurposed Treatment Strategy for Late-Onset Alzheimer's Disease.

Area of Science:

• Neuroscience
• Pharmacology
• Gerontology

Background:

• Late-onset Alzheimer's disease (LOAD) is a progressive neurodegenerative disorder affecting individuals over 65.
• Aging exacerbates LOAD, characterized by multifactorial pathologies.
• Current treatments for LOAD are limited, necessitating novel therapeutic strategies.

Purpose of the Study:

• To explore the potential of sodium thiosulfate (STS) as a multi-targeting treatment for LOAD.
• To review the known properties of STS and their relevance to LOAD pathogenesis.
• To evaluate the feasibility of STS for neuroprotection and cognitive enhancement in LOAD.

Main Methods:

• This narrative review synthesizes existing literature on sodium thiosulfate (STS).
• The review examines STS's chemical properties, biological activities, and established clinical uses.
• Investigated are STS's antioxidant, anti-inflammatory, and metal-chelating effects, alongside its role in nitric oxide and hydrogen sulfide production.

Main Results:

• STS exhibits antioxidant, anti-inflammatory, and metal-chelating properties beneficial for neuroprotection.
• It can modulate nitric oxide and hydrogen sulfide pathways, crucial for brain health.
• STS has a proven safety profile in treating conditions like cisplatin toxicity and calciphylaxis, with minimal side effects.

Conclusions:

• Sodium thiosulfate (STS) presents a promising therapeutic candidate for LOAD due to its multifaceted neuroprotective mechanisms.
• While STS has limited penetration of the intact blood-brain barrier (BBB), it can access dysfunctional BBBs and the cerebrospinal fluid.
• Future strategies, including nanotechnology, may enhance STS brain delivery for effective LOAD treatment.