Hydrogen sulfide in the brain as a silent neuroprotector in Alzheimer's disease

Hydrogen sulfide (H₂S) is an endogenously produced gasotransmitter that has garnered growing attention for its critical roles in cellular signalling and brain function. It regulates NMDA receptors during long-term potentiation, a fundamental mechanism underlying memory consolidation and influences neurotransmission and essential neurophysiological functions. H₂S is synthesized by three enzymes: cystathionine γ-lyase (CSE) and cystathionine β-synthase (CBS) and 3-mercaptopyruvate sulfurtransferase (MST) within the cell. CBS is suggested to be the primary source of H₂S in the brain parenchyma, while CSE and MST predominantly contribute to its production in cerebral microvessels and astrocytes, respectively. This gasotransmitter plays a pivotal role in modulating hippocampal memory formation, reducing inflammation, promoting vasorelaxation, and supporting angiogenesis. It has been suggested to act as a second messenger or neurotransmitter in the brain, typically activated by neuronal excitation. H₂S has been widely investigated for its therapeutic potential in Alzheimer's disease. Notably, Alzheimer's disease patients display significantly diminished levels of H₂S compared to age matched subjects. This review offers a consolidated and updated role of H₂S in Alzheimer's disease, emphasizing recent mechanistic advances not covered in earlier literature. The work presents a novel perspective by integrating emerging findings on H₂S based neurotherapeutic strategies.