FROM NEUROSCIENCE LABORATORY TO NEUROLOGY CLINIC

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ALZHEIMER’S DISEASE:NEW TREATMENT APPROACHES THROUGH SUBGROUPS

Cennet Sena Parlatan

İstanbul Medipol University, Faculty of Medicine, Department of Physiology, İstanbul, Türkiye

Parlatan CS. Alzheimer’s Disease: New Treatment Approaches Through Subgroups. In: Hanoğlu L, editor. From Neuroscience Laboratory to Neurology Clinic. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.161172.

ABSTRACT

Alzheimer’s disease (AD) is a progressive and irreversible neurodegenerative disorder with increasing prevalence due to the aging global population. It is characterized by memory loss, cognitive decline, and difficulty performing daily activities. The pathophysiology of the disease involves complex and multifactorial processes, including amyloidbeta plaques, tau protein accumulation, and synaptic dysfunction. The heterogeneity of these processes leads to significant variations in the clinical course and treatment response. AD treatment presents substantial challenges due to its complex pathophysiology and progressive nature. Treatment strategies can be grouped into symptomatic treatment, diseasemodifying treatment, and regenerative treatment. Symptomatic treatments aim to alleviate cognitive symptoms and improve quality of life through medications such as acetylcholinesterase inhibitors and NMDA receptor antagonists. Diseasemodifying treatments target amyloidbeta and tau proteins to slow or halt disease progression. Regenerative treatments aim to repair damaged brain tissue using approaches such as stem cell therapy and gene therapy. The development of new drugs for AD faces low success rates due to the slow progression of the disease, its heterogeneous nature, and challenges encountered in clinical trials. Although several drugs targeting amyloidbeta have been developed in recent years, debates regarding their efficacy and safety are ongoing.

The heterogeneous nature of AD indicates that different subtypes of the disease may require distinct treatment approaches. Recent research has thus focused on identifying AD subtypes and developing specific treatment strategies for these subtypes. Subtyping studies utilize various factors, including neuropathological differences, disease onset, metabolic pathways, clinical variables, imaging data, biomarkers, and molecular profiles. These studies are critical for understanding the complex nature of AD and recognizing that different subgroups exhibit unique biological mechanisms and clinical features. This understanding enables better prediction of disease progression and treatment response, facilitating the development of more effective personalized treatment strategies.

In conclusion, the future of AD treatment lies in a personalized medicine approach, which is poised to be a turning point in combating the disease. Emphasizing subtyping studies and focusing on the development of new therapeutic targets and drugs will increase the likelihood of success in the fight against AD.

Keywords: Alzheimer disease; Precision medicine

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