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Microbiota–gut–brain axis and related therapeutics in Alzheimer’s disease: prospects for multitherapy and inflammation control

  • Jiahao Li ORCID logo , Feng Zhang ORCID logo , Li Zhao ORCID logo and Chunbo Dong ORCID logo EMAIL logo
Published/Copyright: April 20, 2023
Become an author with De Gruyter Brill

Abstract

Alzheimer’s disease (AD) is the most common type of dementia in the elderly and causes neurodegeneration, leading to memory loss, behavioral disorder, and psychiatric impairment. One potential mechanism contributing to the pathogenesis of AD may be the imbalance in gut microbiota, local and systemic inflammation, and dysregulation of the microbiota–gut–brain axis (MGBA). Most of the AD drugs approved for clinical use today are symptomatic treatments that do not improve AD pathologic changes. As a result, researchers are exploring novel therapeutic modalities. Treatments involving the MGBA include antibiotics, probiotics, transplantation of fecal microbiota, botanical products, and others. However, single-treatment modalities are not as effective as expected, and a combination therapy is gaining momentum. The purpose of this review is to summarize recent advances in MGBA-related pathological mechanisms and treatment modalities in AD and to propose a new concept of combination therapy. “MGBA-based multitherapy” is an emerging view of treatment in which classic symptomatic treatments and MGBA-based therapeutic modalities are used in combination. Donepezil and memantine are two commonly used drugs in AD treatment. On the basis of the single/combined use of these two drugs, two/more additional drugs and treatment modalities that target the MGBA are chosen based on the characteristics of the patient’s condition as an adjuvant treatment, as well as the maintenance of good lifestyle habits. “MGBA-based multitherapy” offers new insights for the treatment of cognitive impairment in AD patients and is expected to show good therapeutic results.


Corresponding author: Chunbo Dong, Department of Neurology, The First Affiliated Hospital, Dalian Medical University, No. 222 Zhongshan Road, Dalian 116011, China, E-mail:

Funding source: Science and Technology Plan Project of Liaoning Province

Award Identifier / Grant number: (grant no. LZ2020014)

  1. Author contributions: JHL and CBD contributed to the main conception and structure of the review. JHL carried out the literature search and interpreted relevant articles. JHL and FZ wrote the first draft of the manuscript. JHL, FZ, LZ, and CBD revised the manuscript and made suggestions for further improvement. All authors read and approved the final manuscript.

  2. Research funding: This work was supported by the Science and Technology Plan Project of Liaoning Province (grant no. LZ2020014).

  3. Conflict of interest statement: The authors declare no conflicts of interest regarding this article.

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Received: 2023-01-15
Accepted: 2023-03-26
Published Online: 2023-04-20
Published in Print: 2023-08-28

© 2023 Walter de Gruyter GmbH, Berlin/Boston

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