Free radicals in Alzheimer's dementia: currently available therapeutic strategies

Substantial evidence now exists that oxidative stress may play an important role in the etiopathogenesis of DAT. The different sources of oxidative st ress in DAT are suggesting several pharmacological opportunities for influe ncing the disease. It is possible to distinguish 2 major types of possible therapeutic agents according to their pharmacological. point of attack. 1. Radical scavengers, agents directly interacting with free radicals. Cand idates of this type are gingko biloba, vitamins A, C, E and estrogen. 2. Antioxidants, which are able to prevent or decrease the production of fr ee radicals by use of specific neuropharmacological properties. Candidates are selegiline, a MAO-B inhibitor well established in the therapy of Parkin son's disease, and tenilsetam, which is believed to be an AGE-inhibitor. Recent in vitro studies have demonstrated the efficacy of both types of the rapeutic agents by preventing or delaying oxidative neural damage. Some clinical data exist regarding the antidementive properties particularl y in terms of gingko biloba, selegiline and vitamin E. The efficacy studies about these compounds seem to indicate a promising future strategy in the therapy of DAT. But it is too early to draw definite conclusions since it i s well kown that all of our candidate substances do not act specifically as radical scavengers or antioxidants.