Neurodegenerative diseases are characterized by progressive protein aggregation, mitochondrial dysfunction, neuroinflammation, and cognitive decline, yet effective mechanism‐based interventions remain limited. Sirtuin 1 (SIRT1), an NAD+‐dependent deacetylase, has emerged as a multifunctional regulator linking stress adaptation, proteostasis, and metabolic homeostasis to disease progression. Increasing evidence indicates that SIRT1 supports cognitive resilience by coordinating synaptic plasticity, autophagy–lysosomal function, mitochondrial homeostasis, and inflammatory control. In Alzheimer's disease (AD), Parkinson's disease (PD), and Huntington's disease (HD), reduced or dysregulated SIRT1 is associated with protein aggregation, mitochondrial dysfunction, and cognitive decline, although its effects may be disease‐ and stage‐dependent, particularly in HD. This review summarizes the structural and catalytic features of SIRT1, examines the mechanisms linking SIRT1 to cognitive impairment across major neurodegenerative diseases, and evaluates the opportunities and limitations of SIRT1‐targeted therapeutic strategies.
Jia-Bin Duan, Jia-Qiang Liu, Qing-Sheng Meng et al.· The FASEB Journal· 0 citations
ABSTRACT Background The central cholinergic system has long been a cornerstone therapeutic target for neurodegenerative diseases, including Alzheimer's disease (AD), Parkinson's disease dementia (PDD), and dementia with Lewy bodies (DLB). For decades, acetylcholinesterase inhibitors (AChEIs) have served as the standard symptomatic treatment, providing cognitive and functional relief by enhancing synaptic acetylcholine levels. However, their limited efficacy and inability to modify disease progression underscore the fundamental constraint of purely neurochemical enhancement, especially in the context of progressive cholinergic neuron loss. Results and Conclusion This review critically examines the evolution of cholinergic therapies beyond AChEIs. We first explore the shift from broad neurotransmitter enhancement toward precision targeting of receptor subtypes and the development of multi‐target pharmacological strategies. Furthermore, we highlight how neuromodulation techniques—including vagus nerve stimulation, deep brain stimulation, and non‐invasive brain stimulation—directly engage and restore dysfunctional neural circuits, moving beyond mere chemical enhancement. Emerging directions such as advanced cholinergic imaging, gene therapy, and cell‐based regeneration are also discussed as promising pathways toward true disease modification. Ultimately, the integration of sophisticated pharmacological agents with circuit‐level neuromodulation represents the next frontier in treating cholinergic dysfunction across the spectrum of neurodegenerative disorders, advancing the therapeutic goal from chemical enhancement to circuit repair and regeneration.
Lei Lei, Xiao-Yun Hu, Rui-Da Lu et al.· CNS Neuroscience & Therapeut...· 0 citations
We use cookies to run the site and, with your consent, for analytics and to show ads.
See our Cookie Policy.
