Immunotherapy for Alzheimer's Disease: Current Scenario and Future Perspectives

Abstract

Alzheimer's disease (AD) is a global health concern owing to its complexity, which often poses a great challenge to the development of therapeutic approaches. No single theory has yet accounted for the various risk factors leading to the pathological and clinical manifestations of dementia-type AD. Therefore, treatment options targeting various molecules involved in the pathogenesis of the disease have been unsuccessful. However, the exploration of various immunotherapeutic avenues revitalizes hope after decades of disappointment. The hallmark of a good immunotherapeutic candidate is not only to remove amyloid plaques but also to slow cognitive decline. In line with this, both active and passive immunotherapy have shown success and limitations. Recent approval of aducanumab for the treatment of AD demonstrates how close passive immunotherapy is to being successful. However, several major bottlenecks still need to be resolved. This review outlines recent successes and challenges in the pursuit of an AD vaccine.

Keywords: Alzheimer’s disease; active immunotherapy; amyloid plaque; monoclonal antibody; passive immunotherapy.

Figure 1

Neurobiology of Alzheimer's disease

Figure 2

Classification of Alzheimer's disease immunotherapy and hypothetical mechanisms of anti-Aβ antibody action

Figure 3

Alzheimer's disease immunotherapy or anti-Aβ vaccines associated adverse effects