The application of telmisartan in central nervous system disorders

Abstract

Telmisartan, a well-established antihypertensive drug, has shown promising therapeutic potential for a variety of central nervous system (CNS) disorders. This review outlines the fundamental characteristics of telmisartan, focusing on its dual pharmacological effects as an angiotensin II type 1 receptor (AT1R) antagonist and a peroxisome proliferator-activated receptor (PPAR) γ activator. These mechanisms underpin its neuroprotective and anti-inflammatory effects, which are essential to its therapeutic benefits in CNS diseases. Telmisartan modulates key cellular components of the CNS, including microglia, astrocytes, oligodendrocytes, vascular endothelial cells, and neurons, thereby offering protection against neuroinflammation, oxidative stress, and neuronal damage. We summarize telmisartan's efficacy in addressing a range of neurological conditions, such as stroke, traumatic brain injury, dementia, Parkinson's disease, demyelinating diseases, psychiatric disorders, and gliomas. By targeting multiple pathways involved in these disorders, telmisartan demonstrates potential as both an adjunctive and standalone therapy. Its ability to attenuate neuroinflammation and promote cellular repair highlights its versatility in CNS disease management. This review underscores the potential of telmisartan as a valuable therapeutic option for CNS disorders, warranting continued exploration to optimize its clinical application.

Keywords: AT1R; Central nervous system; Neuroinflammation; PPARγ; Telmisartan.

Fig. 1

Effects of telmisartan on cells of the central nervous system. Telmisartan exerts neuroprotective effects through regulating the function of microglia, astrocytes, oligodendrocytes, cerebrovascular endothelial cells and neurons by the dual effect of angiotensin II type 1 receptor (AT1R) antagonism and peroxisome proliferators-activated receptor (PPAR) γ agonism. (AT1R: Angiotensin II type 1 receptor; PPARγ: Peroxisome proliferators-activated receptor; OPCs: Oligodendrocyte precursor cells)

Fig. 2

Roles of telmisartan in the central nervous system disorders. Telmisartan exerts beneficial effects such as anti-inflammatory, antioxidant, glial cell activity regulation, and maintenance of cerebrovascular function, which makes it resistant to stroke, traumatic brain injury (TBI), dementia, Parkinson’s disease, demyelinating diseases, psychiatric disorders, and gliomas. (TBI: Traumatic brain injury; Aβ: Amyloid-β; α-syn: α-synuclein; ER: Endoplasmic reticulum; HPA: Hypothalamic-pituitary-adrenal)