Non-cholinergic effects of huperzine A: Beyond inhibition of acetylcholinesterase

The use of acetylcholinesterase inhibitors to decrease the breakdown of the neurotransmitter acetylcholine has been the main symptomatic therapy for mild to moderate Alzheimer's patients, though the etiology of Alzheimer's disease remains unclear and seems to involve multiple factors. Further evidence has indicated that some of these acetylcholinesterase inhibitors also have non-cholinergic functions on the pathogenesis of Alzheimer's disease including the formation and deposition of beta-amyloid. Huperzine A, a potent and reversible inhibitor of acetylcholinesterase that was initially isolated from a Chinese herb, has been found to improve cognitive deficits in a broad range of animal models and has been used for Alzheimer's disease treatment in China. The novel neuroprotective effects of huperzine A might yield beneficial effects in Alzheimer's disease therapy and provide a potential template for the design of new selective and powerful anti-Alzheimer's drugs. The present paper gives an overview on the neuroprotective effects of huperzine A beyond its acetylcholinesterase inhibition. These effects include regulating beta-amyloid precursor protein metabolism, protecting against beta-amyloid-mediated oxidative stress and apoptosis. The structure-function relationship of huperzine A is also discussed.