Therapeutic targets and delivery challenges for Alzheimer's disease

Dementia,including Alzheimer’s disease,the 21st Centuryepidemic,is one of the most significant social and health crises which has currently afflicted nearly 44 million patients worldwide and about new 7.7 million cases are reported every year.This portrays the unmet need towards better understanding of Alzheimer’s disease pathomechanisms and related research towards more effective treatment strategies.The review thus comprehensively addresses Alzheimer’s disease pathophysiology with an insight of underlying multicascade pathway and elaborates possible therapeutic targets-particularly anti-amyloid approaches,anti-tau approaches,acetylcholinesterase inhibitors,glutamatergic system modifiers,immunotherapy,antiinflammatory targets,antioxidants,3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors and insulin.In spite of extensive research leading to identification of newer targets and potent drugs,complete cure of Alzheimer’s disease appears to be an unreached holy grail.This can be attributed to their ineffective delivery across blood brain barrier and ultimately to the brain.With this understanding,researchers are now focusing on development of drug delivery systems to be delivered via suitable route that can circumvent blood brain barrier effectively with enhanced patient compliance.In this context,we have summarized current drug delivery strategies by oral,transdermal,intravenous,intranasal and other miscellaneous routes and have accentuated the future standpoint towards promising therapy ultimately leading to Alzheimer’s disease cure.