Therapeutic implications of hypothalamic-pituitary-adrenal-axis modulation in Alzheimer’s disease: a narrative review of pharmacological and lifestyle interventions
File(s)Manuscript_following_reviewer comments _clean.docx (506.32 KB)
Accepted version
Author(s)
Watermeyer, Tamlyn
Robb, Catherine
Gregory, Sarah
Udeh-Momoh, Chinedu
Type
Journal Article
Abstract
With disease-modifying treatments for Alzheimer’s disease (AD) still elusive, the search for alternative intervention strategies has intensified. Growing evidence suggests that dysfunction in hypothalamic-pituitaryadrenal-axis (HPAA) activity may contribute to the development of AD pathology. The HPAA, may therefore offer a novel target for therapeutic action. This review summarises and critically evaluates animal and human studies investigating the effects of pharmacological and non-pharmacological intervention on HPAA modulation alongside cognitive performance. The interventions discussed include glucocorticoid receptor antagonists and 11β-hydroxysteroid dehydrogenase inhibitors as well as lifestyle treatments such as physical activity, diet, sleep and contemplative practices. Pharmacological HPAA modulators improve pathology and cognitive deficit in animal AD models, but human pharmacological trials are yet to provide definitive support for such benefits. Lifestyle interventions may offer promising strategies for HPAA modification and cognitive health, but several methodological caveats across these studies were identified. Directions for future research in AD studies are proposed.
Date Issued
2021-01-01
Date Acceptance
2020-10-05
Citation
Frontiers in Neuroendocrinology, 2021, 60
ISSN
0091-3022
Publisher
Elsevier
Journal / Book Title
Frontiers in Neuroendocrinology
Volume
60
Copyright Statement
Crown Copyright © 2020 Published by Elsevier Inc. All rights reserved. . This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/
Sponsor
Society for Endocrinology
Alzheimer's Research UK (ARUK)
Grant Number
ARUK-NC2019-IMP
Subjects
Alzheimer’s disease
Carbenoxolone
Cognition
Cortisol
Glucocorticoid receptor antagonists
Hypothalamic-pituitaryadrenal-axis
Intervention
Lifestyle
Endocrinology & Metabolism
1103 Clinical Sciences
1109 Neurosciences
Publication Status
Published
Article Number
ARTN 100877
Date Publish Online
2020-10-09