Can brain impermeable BACE1 inhibitors serve as anti-CAA medicine?

Abstract:

BACKGROUND:Cerebral amyloid angiopathy (CAA) is characterized by the deposition of ß-amyloid peptides (Aß) in and surrounding the wall of microvasculature in the central nervous system, together with parenchymal amyloid plaques collectively referred to as cerebral amyloidosis, which occurs in the brain commonly among the elderly and more frequently in patients with Alzheimer's disease (AD). CAA is associated with vascular injury and may cause devastating neurological outcomes. No therapeutic approach is available for this lesion to date. MAIN BODY:ß-Secretase 1 (BACE1) is the enzyme initiating Aß production. Brain permeable BACE1 inhibitors targeting primarily at the parenchymal plaque pathology are currently evaluated in clinical trials. This article presents findings in support of a role of BACE1 elevation in the development of CAA, in addition to plaque pathogenesis. The rationale, feasibility, benefit and strategic issues for developing BACE1 inhibitors against CAA are discussed. Brain impermeable compounds are considered preferable as they might exhibit sufficient anti-CAA efficacy without causing significant neuronal/synaptic side effects. CONCLUSION:Early pharmacological intervention to the pathogenesis of CAA is expected to provide significant protection for cerebral vascular health and hence brain health. Brain impermeable BACE1 inhibitors should be optimized and tested as potential anti-CAA therapeutics.

journal_name

BMC Neurol

journal_title

BMC neurology

authors

Li JM,Huang LL,Liu F,Tang BS,Yan XX

doi

10.1186/s12883-017-0942-y

subject

Has Abstract

pub_date

2017-08-25 00:00:00

pages

163

issue

1

issn

1471-2377

pii

10.1186/s12883-017-0942-y

journal_volume

17

pub_type

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