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20 pages, 3853 KB  
Article
Study on Regulatory Mechanism of Gastrodia elata Specific microRNA Targeting JNK3 in Alzheimer’s Disease
by Hongyao Li, Zhongteng Lu, Ke Gao, Jianjun Guo, Zuoming Nie and Qing Sheng
Molecules 2026, 31(12), 2075; https://doi.org/10.3390/molecules31122075 (registering DOI) - 12 Jun 2026
Abstract
Alzheimer’s disease (AD) is characterized by Tau hyperphosphorylation, β-amyloid (Aβ) accumulation, and progressive neuronal loss. Gastrodia elata (G. elata), a traditional Chinese medicine with well-established neuroprotective properties, was investigated. Two G. elata-derived miRNAs, Gas-miR04-3p and Gas-miR19-5p, were identified as regulators [...] Read more.
Alzheimer’s disease (AD) is characterized by Tau hyperphosphorylation, β-amyloid (Aβ) accumulation, and progressive neuronal loss. Gastrodia elata (G. elata), a traditional Chinese medicine with well-established neuroprotective properties, was investigated. Two G. elata-derived miRNAs, Gas-miR04-3p and Gas-miR19-5p, were identified as regulators of JNK3. By means of Western blot, RT-qPCR, and assessments of antioxidant indices, it was demonstrated that Gas-miR04-3p and Gas-miR19-5p can suppress JNK3 expression, reduce Tau phosphorylation at Ser202 and Ser396, enhance antioxidant capacity, and attenuate apoptosis in AD-related cellular and molecular pathology models. These miRNAs were also detectable in murine brain tissues following oral administration of total RNA extracted from G. elata. Their administration was associated with decreased JNK3 activation, alleviated Tau hyperphosphorylation, and improved expression of apoptosis-related proteins in AD mouse models. These results suggest that G. elata miRNAs may exert neuroprotective effects through regulation of JNK3 signaling, thereby attenuating Tau-related pathological changes and neuronal injury in AD-related models. Full article
(This article belongs to the Section Medicinal Chemistry)
12 pages, 584 KB  
Article
Better Outcomes After Initiation of Disease-Modifying Therapy in Patients with Transthyretin Cardiac Amyloidosis
by Makiko Nakamura, Teruhiko Imamura, Masaki Nakagaito, Ryuichi Ushijima and Koichiro Kinugawa
J. Clin. Med. 2026, 15(12), 4546; https://doi.org/10.3390/jcm15124546 - 11 Jun 2026
Abstract
Background: Advances in diagnostic criteria for transthyretin cardiac amyloidosis (ATTR-CM) and expanded insurance coverage for bone scintigraphy have facilitated earlier detection of ATTR-CM. However, whether these changes have translated into improved clinical outcomes among patients receiving disease-modifying therapy remains uncertain, especially in [...] Read more.
Background: Advances in diagnostic criteria for transthyretin cardiac amyloidosis (ATTR-CM) and expanded insurance coverage for bone scintigraphy have facilitated earlier detection of ATTR-CM. However, whether these changes have translated into improved clinical outcomes among patients receiving disease-modifying therapy remains uncertain, especially in non-high-volume centers. Methods: Consecutive patients with ATTR-CM who started disease-modifying therapy at our institute between May 2019 and March 2025 were retrospectively analyzed. Baseline characteristics and clinical outcomes were compared between the early period (2019–2021) and the late period (2021–2025). Results: A total of 31 patients (median age 77 years, 77% male) were included. Duration of heart failure was significantly shorter and the dose of loop diuretics at baseline was significantly lower in the late period (p < 0.05 for both). The prevalence of National Amyloid Center (NAC) stage I at baseline tended to be higher in the late period (75.0% versus 53.5%, p = 0.273). The cumulative incidence of worsening heart failure hospitalization and all-cause death was significantly lower in the late period (6.3% versus 44.2%, p = 0.024) during a median follow-up of 5 years. NAC stage I at baseline was independently associated with the lower primary outcome with an adjusted hazard ratio of 0.10 (95% confidence interval 0.01–0.90, p = 0.040). Conclusions: Patients with ATTR-CM in the late group experienced more favorable clinical outcomes after disease-modifying therapy, probably due to earlier diagnosis and therapeutic intervention, although further studies are warranted to verify the hypothesis. Full article
(This article belongs to the Section Cardiology)
23 pages, 2358 KB  
Article
Cross-Category Screening of Food Samples for Amyloid-β42 Aggregation-Inhibitory Activity Using a Microliter-Scale High-Throughput Screening System with Quantum-Dot-Labeled Aβ
by Kota Nakamura, Manae Kawamura-Yamagishi, Masahiro Kuragano, Koji Uwai and Kiyotaka Tokuraku
Foods 2026, 15(12), 2108; https://doi.org/10.3390/foods15122108 - 11 Jun 2026
Abstract
Alzheimer’s disease (AD) is associated with the aggregation and deposition of amyloid-β (Aβ), making Aβ aggregation an important target in AD-related research. Food-derived components have attracted attention as potential modulators of Aβ-related processes, but the direct effects of diverse food samples on Aβ42 [...] Read more.
Alzheimer’s disease (AD) is associated with the aggregation and deposition of amyloid-β (Aβ), making Aβ aggregation an important target in AD-related research. Food-derived components have attracted attention as potential modulators of Aβ-related processes, but the direct effects of diverse food samples on Aβ42 aggregation remain unclear. Here, we screened 120 food-sample preparations derived from 115 food items for inhibitory activity against Aβ42 aggregation using an automated microliter-scale high-throughput screening system with quantum-dot-labeled Aβ (QDAβ). Among primary screening samples, 34 showed detectable Aβ42 aggregation-inhibitory activity, and 12 were classified as highly active (1/EC50 ≥ 10 mL/mg). Within the present screening set, highly active samples were frequently observed among tea-related samples. Black tea, Camembert, Red perilla, and Black soybean were selected as representative hits for further validation. Automated MSHTS images and dose–response data showed concentration-dependent suppression of Aβ42 aggregate formation. These inhibitory effects were further supported by thioflavin T (ThT) assays and transmission electron microscopy, which showed suppression of ThT-positive fibrillar aggregation and reduced fibrillar aggregate formation. In differentiated PC12 cells, selected food samples increased cell viability in Aβ42-treated cells at some concentrations. These findings provide a basis for functional food research and active component analysis of food-derived Aβ42 aggregation modulators. Full article
(This article belongs to the Special Issue Advances in Biological Activities of Functional Food (3rd Edition))
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22 pages, 39602 KB  
Article
The Multiple Functions of Amyloid Beta in the Gut Epithelium and the Role of the Microbiota: A Study in the APP/PS1 Animal Model Subjected to Chronic Synbiotic Treatment
by Giorgia Sarti, Giorgio Tognozzi, Giada Magni, Daniele Lana, Francesca Rossi, Chiara Traini and Maria Giuliana Vannucchi
Nutrients 2026, 18(12), 1883; https://doi.org/10.3390/nu18121883 - 11 Jun 2026
Abstract
Background:/ Over the past decade, increasing evidence has shifted attention from the brain to the gut microbiota (MB) as a source and site of systemic dissemination of amyloid-β (Aβ), an APP derivative responsible for plaque formation in the brains of Alzheimer’s disease (AD) [...] Read more.
Background:/ Over the past decade, increasing evidence has shifted attention from the brain to the gut microbiota (MB) as a source and site of systemic dissemination of amyloid-β (Aβ), an APP derivative responsible for plaque formation in the brains of Alzheimer’s disease (AD) patients. Furthermore, AD patients and APP/PS1 mice, a transgenic model of AD, exhibit dysbiosis. Objectives: Using APP/PS1 mice treated from 2 to 8 months of age, we studied ileal and colonic epithelial integrity, intestinal barrier (IB) integrity assessed through tight junction (TJ) protein expression, local immune system, the presence/increase in Aβ expression in enterocytes, and the protective effects of synbiotic treatment. Methods: The tissue was stained with Periodic Acid-Schiff and Alcian Blue to evaluate epithelial morphology and mucus production, and immunohistochemistry was performed to assess TJs, immune markers, and Aβ expression. Results: Our results demonstrate that colonic and ileal epithelium of 8-month-old APP/PS1 mice displays IB impairment in term of alterations of goblet cells staining and TJ protein expression and signs of immune involvement. The ileum was more severely affected, showing a reduced epithelial surface area, decreased lysozyme production, and fewer tuft cells. Long-term synbiotic treatment largely prevented APP/PS1 mouse changes and caused a significant increase in Aβ expression in all treated mice. Conclusions: These findings support the belief in early intestinal involvement in AD and highlight the potential of the microbiota as a target for early intervention aimed at modifying the progression to neurodegeneration. Increased epithelial Aβ labeling after treatment raises the possibility of intestinal management of Aβ, which requires further validation. Full article
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28 pages, 970 KB  
Review
The Immune-Chemokine Axis in Alzheimer’s Disease: Roles of Adaptive Immune System in Neuroinflammation and Disease Progression
by José Joaquín Merino, José Julio Rodríguez-Arellano, Xavier Busquets, Isabel Álvarez-Vicente, María Eugenia Cabaña-Muñoz, Ana Isabel Flores and Adolfo Toledano Gasca
Biomolecules 2026, 16(6), 855; https://doi.org/10.3390/biom16060855 - 11 Jun 2026
Viewed by 11
Abstract
Alzheimer’s disease (AD) is a multifactorial neurodegenerative disorder characterized by amyloid-β (Aβ) and the accumulation of tau in the brain, which triggers robust innate immune responses. Growing evidence indicates that neuroinflammation contributes to AD progression by overactivating microglia through the release of cytokines [...] Read more.
Alzheimer’s disease (AD) is a multifactorial neurodegenerative disorder characterized by amyloid-β (Aβ) and the accumulation of tau in the brain, which triggers robust innate immune responses. Growing evidence indicates that neuroinflammation contributes to AD progression by overactivating microglia through the release of cytokines and chemokines. In general, chemokines can disrupt neuronal communication and promote blood–brain barrier permeability. Peripheral immune cells are mobilized into the brain by a gradient of chemokines. These processes link peripheral immune responses with substantial T-cell infiltration into the CNS parenchyma, leptomeninges and cerebrospinal fluid of both AD mice and AD patients. This finding underscores the relevance of the adaptive immune system, particularly T and B cells, in AD neuropathology. T-cell infiltration into the brain can influence amyloid clearance through chemokine signalling. However, chemokines play a critical role in AD by either promoting or suppressing disease progression. The infiltration of peripheral T and B cells into the brain parenchyma can exacerbate neuronal loss, yet it may also exert neuroprotective effects. Despite the presence of CD4+ and CD8+ T cells in postmortem brains of AD patients, debate continues about their role in AD brains, in terms of whether they are protective or detrimental. Understanding the complex role of chemokines in controlling innate and adaptive immune responses by modulating neuron–glia interactions (involving astrocytes and microglia) may provide novel therapeutic approaches for AD. Targeting chemokine signalling or treating with drugs that can prevent the recruitment of immune cells may be promising strategies for treating AD neuropathology. Therapies that prevent the overactivation of T cells in the brain could lead to protective strategies against AD. In fact, regulatory T cells (Tregs) could delay the onset of cognitive symptoms, because they suppress inflammation and slow the accumulation of Aβ plaques and p-Tau in the brain. Complementary strategies, such as photobiomodulation, nanoparticle, and T-cell-based approaches, could mitigate AD progression in patients. Full article
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22 pages, 485 KB  
Review
Transthyretin Amyloidosis—From Peculiar Neuropathy to a Treatable Chronic Multisystemic Disease
by Sasha A. Živković and J. David Avila
Genes 2026, 17(6), 680; https://doi.org/10.3390/genes17060680 - 10 Jun 2026
Viewed by 209
Abstract
Transthyretin amyloidosis (ATTR) is a multisystemic disorder associated with extracellular accumulation of misfolded transthyretin (TTR) protein forming insoluble amyloid deposits. Depending on the TTR genotype, ATTR is classified as hereditary ATTR (ATTRv) with pathogenic gene variants and wild-type ATTR (ATTRwt) with a normal [...] Read more.
Transthyretin amyloidosis (ATTR) is a multisystemic disorder associated with extracellular accumulation of misfolded transthyretin (TTR) protein forming insoluble amyloid deposits. Depending on the TTR genotype, ATTR is classified as hereditary ATTR (ATTRv) with pathogenic gene variants and wild-type ATTR (ATTRwt) with a normal TTR genotype. Two cardinal clinical manifestations of ATTR are amyloid cardiomyopathy and peripheral neuropathy, but multisystemic deposition of amyloid may also manifest with ocular and leptomeningeal amyloidosis, various orthopedic complications (carpal tunnel syndrome, spinal stenosis), nephropathy, and gastrointestinal and pulmonary amyloidosis. The natural history of untreated ATTR is characterized by progressive worsening and 25% of patients may die within 24 months from the onset. The first treatment for ATTR was liver transplantation which slows the disease progression, but its use was limited by the scarcity of available liver allografts and complex post-transplant morbidities associated with immunosuppression and various metabolic disturbances. Recent introduction of TTR stabilizers and gene silencing has significantly changed the outcomes and reduced ATTR-related morbidities and mortality, and early diagnosis remains important for improved outcomes. In our narrative expert review, we are discussing epidemiological and clinical features of ATTR, its pathophysiology and available treatments as rapidly progressive fatal disease is being transformed into a treatable chronic disease. Full article
(This article belongs to the Section Genetic Diagnosis)
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17 pages, 5002 KB  
Article
Attack-Related Anticipatory Anxiety Symptoms in Familial Mediterranean Fever: An Exploratory Cross-Sectional Study
by Altuğ Güner
Healthcare 2026, 14(12), 1635; https://doi.org/10.3390/healthcare14121635 - 10 Jun 2026
Viewed by 131
Abstract
Background and Objectives: Familial Mediterranean fever (FMF) is a chronic autoinflammatory disease characterized by recurrent inflammatory attacks and a persistent psychosocial burden. Although generalized anxiety symptoms have been investigated in FMF, disease-specific anticipatory concerns related to recurrent attacks remain insufficiently understood. This study [...] Read more.
Background and Objectives: Familial Mediterranean fever (FMF) is a chronic autoinflammatory disease characterized by recurrent inflammatory attacks and a persistent psychosocial burden. Although generalized anxiety symptoms have been investigated in FMF, disease-specific anticipatory concerns related to recurrent attacks remain insufficiently understood. This study aimed to investigate the associations of attack-related anticipatory anxiety symptoms with clinical characteristics, quality of life, and composite inflammatory indices in FMF. Materials and Methods: This exploratory cross-sectional study included 38 adult patients with FMF. Attack-related anticipatory anxiety symptoms were assessed using an exploratory six-item questionnaire. Generalized anxiety and quality of life were evaluated using the Generalized Anxiety Disorder-7 (GAD-7) and Short-Form–12 (SF-12), respectively. Composite inflammatory indices including the C-reactive protein–albumin–lymphocyte (CALLY) index, log-CALLY, hemoglobin–albumin–lymphocyte–platelet (HALP) score, and systemic immune-inflammation index (SII) were calculated from routine laboratory parameters. Results: Attack-related anticipatory anxiety scores demonstrated a significant positive correlation with GAD-7 scores (r = 0.581, p < 0.001) and an inverse correlation with SF-12 mental component scores (r = −0.380, p = 0.019). Direct correlations between attack-related anticipatory anxiety scores and composite inflammatory indices were weak and not statistically significant. In subgroup analysis, a higher annual attack burden was associated with higher GAD-7 scores, higher CRP and serum amyloid A values, and lower CALLY, log-CALLY, and HALP values. Differences in attack-related anticipatory anxiety, SF-12 MCS, and SII between attack burden groups did not reach statistical significance. In multivariable linear regression analysis, GAD-7 score remained independently associated with attack-related anticipatory anxiety symptoms (β = 0.438, p = 0.010). Conclusions: Attack-related anticipatory anxiety symptoms may represent an exploratory psychosocial dimension of FMF associated mainly with generalized anxiety symptoms and impaired mental well-being. Composite inflammatory indices appeared more closely related to annual attack burden than to attack-related anticipatory anxiety. These findings should be interpreted cautiously and considered hypothesis-generating. Full article
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26 pages, 30463 KB  
Article
Molecular Mechanisms of 6PPD and 6PPD-Q Toxicity in Neurodegenerative Diseases: A Network Toxicology and Experimental Validation Study
by Ze Li, Yuyang Luo, Siyi Wang, Dingming Xue and Yixuan Zhang
Toxics 2026, 14(6), 504; https://doi.org/10.3390/toxics14060504 - 10 Jun 2026
Viewed by 220
Abstract
6PPD is a widely used tire antioxidant that readily transforms into its more toxic ozonation product, 6PPD-quinone (6PPD-Q). Both compounds are emerging environmental contaminants with potential neurotoxic risks, yet their molecular mechanisms in Alzheimer’s disease (AD) and Parkinson’s disease (PD) remain unclear. This [...] Read more.
6PPD is a widely used tire antioxidant that readily transforms into its more toxic ozonation product, 6PPD-quinone (6PPD-Q). Both compounds are emerging environmental contaminants with potential neurotoxic risks, yet their molecular mechanisms in Alzheimer’s disease (AD) and Parkinson’s disease (PD) remain unclear. This study integrated network toxicology, molecular docking, transcriptomic validation, and experimental models to investigate their neurotoxic effects. In silico analyses predicted significant neurotoxicity and blood–brain barrier permeability for both compounds. Target prediction and PPI network analysis identified 145/121 overlapping targets with AD/PD for 6PPD and 120/100 for 6PPD-Q. Functional enrichment analysis suggested that 6PPD-associated targets were mainly enriched in axon regeneration-, p75NTR-, and AGE-RAGE-related pathways, whereas 6PPD-Q-associated targets were enriched in MAPK cascade-, endosomal TLR signaling-, and amyloid-β formation-related pathways. Molecular docking suggested favorable binding affinities between these compounds and several core targets, including MAP2K1, EGFR, GSK3B, and CYCS. Transcriptomic validation in GEO datasets prioritized multiple hub genes. In vivo experiments showed activation of apoptosis-related signaling in the brain, while in vitro assays demonstrated ROS accumulation and neuroinflammatory activation (elevated TNF-α, IL-1β, IL-6, IFN-γ). CYCS and MAP2K1 emerged as key convergent nodes. Our findings reveal distinct yet synergistic neurotoxic mechanisms of 6PPD and 6PPD-Q in AD and PD, highlighting tire-derived pollutants as potential environmental risk factors for neurodegenerative diseases. Full article
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21 pages, 6931 KB  
Article
Islet Amyloid Polypeptide Analogues with Reduced Aggregation: Implications for Type 2 Diabetes
by Shahab Hassan, Sasha L. Evans, James H. Torpey, Tam Bui, Rivka L. Isaacson, Kenneth White and Cassandra Terry
Endocrines 2026, 7(2), 28; https://doi.org/10.3390/endocrines7020028 - 9 Jun 2026
Viewed by 200
Abstract
Background: Type 2 diabetes is projected to affect millions of people annually as the number of cases rises year on year. This includes children. Treating diabetes and its related comorbidities has a huge economic impact and puts pressure on healthcare providers. Understanding the [...] Read more.
Background: Type 2 diabetes is projected to affect millions of people annually as the number of cases rises year on year. This includes children. Treating diabetes and its related comorbidities has a huge economic impact and puts pressure on healthcare providers. Understanding the disease at a molecular level is key for developing better therapeutics. The protein Islet Amyloid Polypeptide (IAPP) or amylin is important for glucose regulation; however, it is also instrumental in type 2 diabetes pathology. Human IAPP can misfold into oligomers and amyloid fibrillar aggregates within pancreatic islets, promoting β-cell dysfunction and death, contributing to progressive insulin deficiency and worsening hyperglycaemia. Methods: Based on previous studies on mutations at residues 18, 28 and 31,we have designed three novel IAPP analogues (two double and one triple mutant) to assess whether the combined amino acid substitutions impact fibril formation, solubility and toxicity. Results: All three of our analogues show a reduced propensity to aggregate and are more soluble than wild type IAPP. Compared with pramlintide, a clinically prescribed synthetic analogue of human amylin, all of our analogues appeared to have similarly reduced toxicity and improved solubility relative to human IAPP. Additionally, two of our analogues exhibited a markedly slower rate of fibril formation. Conclusions: Our results highlight the importance of targeting multiple residues as a promising strategy for developing improved diabetes therapeutics in the future. Full article
(This article belongs to the Section Obesity, Diabetes Mellitus and Metabolic Syndrome)
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28 pages, 4738 KB  
Article
Biophysical and Computational Insights into Alpha-1 Antitrypsin Aggregation and Its Inhibition by Natural Polyphenols
by Tarique Sarwar, Ahmed Abdur Rehman, Hussain Arif, Wanian M. Alwanian, Hajed Obaid A. Alharbi and Arshad Husain Rahmani
Biomedicines 2026, 14(6), 1310; https://doi.org/10.3390/biomedicines14061310 - 9 Jun 2026
Viewed by 142
Abstract
Background/Objectives: Protein misfolding and amyloid fibril formation underlie several degenerative diseases, including Alzheimer’s disease and Parkinson’s disease. Alpha-1 antitrypsin (A1AT), a serpin protein, is particularly prone to misfolding, with polymerization and aggregation implicated in alpha-1 antitrypsin deficiency and associated hepatic and pulmonary [...] Read more.
Background/Objectives: Protein misfolding and amyloid fibril formation underlie several degenerative diseases, including Alzheimer’s disease and Parkinson’s disease. Alpha-1 antitrypsin (A1AT), a serpin protein, is particularly prone to misfolding, with polymerization and aggregation implicated in alpha-1 antitrypsin deficiency and associated hepatic and pulmonary disorders. In this study, we examined the structural changes in A1AT induced by the fluorinated alcohol, trifluoroethanol (TFE), and assessed the inhibitory effects of two natural polyphenols, amentoflavone (AMF) and theaflavin (TF), on aggregation and fibril formation. Methods: A library of selected phytocompounds was virtually screened against the crystal structure of A1AT (PDB 3NE4) using AutoDock Vina to elucidate their binding affinity towards it. Based on binding affinities, two compounds, AMF and TF, were selected for further studies. Protein aggregation was induced with TFE, and the protective effects of AMF and TF were evaluated using protease inhibitory activity, intrinsic fluorescence, turbidity, Rayleigh scattering, ANS fluorescence, and ThT fluorescence assays. Furthermore, 100 ns molecular dynamics simulation and MM-PBSA calculations were performed to assess the stability and binding interactions of the A1AT–ligand complexes. Results: Pre-treatment of A1AT with AMF or TF significantly inhibited TFE-induced aggregation in a dose-dependent manner, with AMF being consistently more effective. ThT fluorescence analysis revealed a ~60–65% decrease in aggregate formation upon treatment with polyphenols, with IC50 values estimated at ~40 µM for AMF and ~50 µM for TF, both of which are statistically significant. Molecular docking and 100 ns molecular dynamics simulation also revealed stable A1AT–polyphenol interactions, with AMF exhibiting greater binding affinity and greater attenuation of solvent-induced conformational perturbation. Conclusions: Collectively, our findings show that TFE causes A1AT misfolding via a molten globule-like intermediate, resulting in fibril formation at 30–40% TFE, and natural polyphenols AMF and TF inhibited aggregation in a concentration-dependent manner. These observations suggest the potential of AMF and TF as lead scaffolds for anti-aggregation strategies, as modulators of amyloidogenic processes. Full article
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29 pages, 3047 KB  
Review
Multitarget Actions of Pentacyclic Triterpenic Acids in Alzheimer’s Disease: Mechanistic Insights
by Niti Sharma and Seong Soo A. An
Molecules 2026, 31(12), 2018; https://doi.org/10.3390/molecules31122018 - 9 Jun 2026
Viewed by 238
Abstract
Alzheimer’s disease (AD) is a complex neurodegenerative disorder with features of amyloid-beta (Aβ) accumulations, tau hyperphosphorylation, oxidative stress, neuroinflammation, and synaptic losses. Despite extensive therapeutic investigations for many decades, the clinical treatment options remained largely symptomatic, while anti-amyloid antibody therapies were expensive and [...] Read more.
Alzheimer’s disease (AD) is a complex neurodegenerative disorder with features of amyloid-beta (Aβ) accumulations, tau hyperphosphorylation, oxidative stress, neuroinflammation, and synaptic losses. Despite extensive therapeutic investigations for many decades, the clinical treatment options remained largely symptomatic, while anti-amyloid antibody therapies were expensive and had limited accessibility. A subclass of triterpenoids generated from plants, pentacyclic triterpenic acids (PTAs), exhibited a variety of pharmacological properties. The neuroprotective effects of some important PTAs in AD models were reviewed in this study. These phytochemicals displayed a multimodal neuroprotection by lowering amyloid and tau, improving mitochondrial function, inhibiting inflammation, and improving synaptic plasticity and cognition. However, the neuroprotective mechanisms of several PTAs remained poorly characterized. In addition, most evidence were preclinical, while poor bioavailability and the limited clinical validation hindered the therapeutic translation. Studies were needed to evaluate these phytochemicals in AD, improve their pharmacokinetics, and enhance brain delivery. Their diverse bioactivities and encouraging preclinical findings suggest these compounds may serve as promising lead candidates for future drug development in neurodegenerative diseases. Full article
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28 pages, 9650 KB  
Review
The Role of Sphingosine-1-Phosphate Signaling in Cerebral Ischemia/Reperfusion Injury and Alzheimer’s Disease Pathology
by Kinga Czubowicz, Joanna Agata Motyl, Agnieszka Wencel and Robert Piotr Strosznajder
Int. J. Mol. Sci. 2026, 27(12), 5200; https://doi.org/10.3390/ijms27125200 - 9 Jun 2026
Viewed by 107
Abstract
Sphingosine-1-phosphate (S1P) is a pleiotropic bioactive sphingolipid that regulates key cellular processes, like proliferation, apoptosis, inflammation, and vascular homeostasis. S1P acts as a signaling molecule both inside and outside cells by interacting with five G-protein-coupled S1P receptors (S1PR1–S1PR5). Accumulating evidence indicates that dysregulation [...] Read more.
Sphingosine-1-phosphate (S1P) is a pleiotropic bioactive sphingolipid that regulates key cellular processes, like proliferation, apoptosis, inflammation, and vascular homeostasis. S1P acts as a signaling molecule both inside and outside cells by interacting with five G-protein-coupled S1P receptors (S1PR1–S1PR5). Accumulating evidence indicates that dysregulation of S1P signaling is implicated in the pathophysiology of cerebral ischemia/reperfusion (I/R) injury and Alzheimer’s disease (AD). In I/R injury, S1P signaling regulates vascular permeability, immune cell infiltration, and neuronal survival and death. In AD, alterations in S1P metabolism are associated with β-amyloid deposition, tau hyperphosphorylation, synaptic dysfunction, and sustained neuroinflammation. S1P receptor (S1PR) modulators represent promising therapeutic agents in both preclinical and clinical studies. Fingolimod was the first oral disease-modifying therapy approved for the treatment of multiple sclerosis and, at the same time, the first S1PR modulator introduced into clinical practice. New selective S1PR-targeting agents, including siponimod and ozanimod (S1PR1 and S1PR5), as well as the S1PR1-selective agent ponesimod, have also been approved for clinical use. In addition to their immunomodulatory properties, S1PR modulators have direct effects in the central nervous system, facilitating the maintenance of blood–brain barrier integrity, reducing microglial activation, and enhancing neuronal survival pathways. Building on this knowledge, we discuss the role of S1P signaling, highlighting recent advances in S1PR modulators as promising therapeutic agents for cerebral I/R injury and AD. Full article
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21 pages, 519 KB  
Review
From Genes to Imaging Phenotypes: Radiomics and Machine Learning as Tools to Decode Molecular Pathways in Alzheimer’s Disease
by Marta Rusek and Monika Pitucha
Genes 2026, 17(6), 672; https://doi.org/10.3390/genes17060672 - 8 Jun 2026
Viewed by 115
Abstract
Alzheimer’s disease (AD) is a heterogeneous neurodegenerative disorder driven by complex interactions between genetic susceptibility, molecular pathways, and progressive brain alterations. Key genetic factors, including APOE, TREM2, and MAPT, contribute to pathological processes such as amyloid-β accumulation, tau aggregation, neuroinflammation, [...] Read more.
Alzheimer’s disease (AD) is a heterogeneous neurodegenerative disorder driven by complex interactions between genetic susceptibility, molecular pathways, and progressive brain alterations. Key genetic factors, including APOE, TREM2, and MAPT, contribute to pathological processes such as amyloid-β accumulation, tau aggregation, neuroinflammation, and synaptic dysfunction. Despite substantial advances in understanding these mechanisms, translating molecular insights into clinically accessible biomarkers remains a major challenge. Radiomics and machine learning (ML) have emerged as promising approaches for extracting high-dimensional quantitative features from medical imaging data and identifying complex patterns associated with disease processes. Radiomic features capture spatial heterogeneity and subtle characteristics of neurodegeneration that are not discernible using conventional imaging analysis. When integrated with ML, these features may serve as noninvasive surrogates of molecular activity, enabling the identification of imaging signatures associated with specific genetic backgrounds and biological pathways. This review aims to explore how radiomics and ML can bridge the gap between genetic and molecular mechanisms and in vivo imaging phenotypes in AD. We summarize current knowledge on genetic determinants and molecular pathways and discuss advances in molecular imaging, particularly tracers targeting amyloid and tau pathology. Furthermore, we analyze the emerging role of radiomics and ML in linking imaging phenotypes with underlying biological processes. This integrative framework may support improved disease stratification, early diagnosis, and prediction of therapeutic response, contributing to the development of precision medicine strategies and future theranostic approaches in Alzheimer’s disease. Full article
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12 pages, 2521 KB  
Article
Diagnostic Performance and Clinical Utility of Automated Plasma Amyloid-β 1-42/1-40 Assay
by Seseung Kim, Seok Ryun Kwon, Joon Hee Lee, Kyunghoon Lee, Sang Hoon Song and Junghan Song
Diagnostics 2026, 16(12), 1767; https://doi.org/10.3390/diagnostics16121767 - 8 Jun 2026
Viewed by 155
Abstract
Background: Blood-based biomarkers offer an accessible alternative to cerebrospinal fluid or positron emission tomography (PET) imaging for Alzheimer’s disease (AD) screening and diagnosis. This study evaluated the diagnostic performance of the fully automated HISCL plasma Aβ42/40 assay in a real-world clinical setting. [...] Read more.
Background: Blood-based biomarkers offer an accessible alternative to cerebrospinal fluid or positron emission tomography (PET) imaging for Alzheimer’s disease (AD) screening and diagnosis. This study evaluated the diagnostic performance of the fully automated HISCL plasma Aβ42/40 assay in a real-world clinical setting. Methods: We retrospectively enrolled 127 participants, stratified into cognitively normal (CN), mild cognitive impairment (MCI), AD, and Non-AD subgroups. Plasma Aβ42/40 levels were quantified using the HISCL and Simoa platforms. Additionally, plasma oligomerized Aβ (OAβ), glial fibrillary acidic protein (GFAP), and neurofilament light chain (NfL) were measured. Results: The HISCL plasma Aβ42/40 ratio was significantly lower in the AD continuum (MCI + AD) compared to the CN subgroup (p < 0.001). The HISCL assay demonstrated robust diagnostic performance (AUC = 0.747), yielding a comparably higher AUC value compared to the Simoa Aβ42/40 ratio (AUC = 0.687). Although method comparison showed a proportional difference between HISCL and Simoa, the HISCL assay maintained high discriminative capability. Notably, integrating plasma GFAP and NfL with the HISCL Aβ42/40 ratio significantly enhanced the diagnostic accuracy (AUC = 0.823, p = 0.046). Method comparison between heparinized and EDTA plasma in the HISCL assay confirmed assay stability, showing a significant correlation and a regression slope near unity. Conclusions: The HISCL plasma Aβ42/40 assay demonstrates reliable diagnostic performance for identifying AD pathology in clinical practice, showing stability across sample types. Furthermore, its combination with neurodegeneration markers significantly improves predictive accuracy, supporting its utility as a robust screening tool and foundational component of future multimarker diagnostic panels. Full article
(This article belongs to the Section Clinical Laboratory Medicine)
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30 pages, 1514 KB  
Review
The Neuroprotective Role of Exercise in Alzheimer’s Disease: An Integrative Review of Animal and Human Studies
by Danqing Xiao, Akshita Duvvuri, Lenna V. Makrigiannis and Catherine Fuller
Neurol. Int. 2026, 18(6), 113; https://doi.org/10.3390/neurolint18060113 - 8 Jun 2026
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Abstract
Alzheimer’s disease (AD), the leading cause of dementia, is characterized by progressive cognitive decline along with hallmark brain pathologies including amyloid-beta accumulation, hyperphosphorylated tau, neuroinflammation and neuronal mitochondrial dysfunction. As current pharmaceutical treatments only provide modest symptomatic improvement, there is an urgent need [...] Read more.
Alzheimer’s disease (AD), the leading cause of dementia, is characterized by progressive cognitive decline along with hallmark brain pathologies including amyloid-beta accumulation, hyperphosphorylated tau, neuroinflammation and neuronal mitochondrial dysfunction. As current pharmaceutical treatments only provide modest symptomatic improvement, there is an urgent need for effective non-pharmaceutical treatment options for the prevention or slowing down of this disease. This review synthesizes results from randomized controlled trials, observational studies, and animal model research on the ability of exercise to influence cognitive functions, brain structural changes, inflammatory processes, and neuroplasticity-related pathways. Exercise has demonstrated the capacity to enhance neurotrophic signaling, improve the regulation of mitochondria, improve cerebrovascular function and reduce pro-inflammatory cytokine levels in preclinical and mild cognitive impairment (MCI) subjects. Additionally, aerobic and resistance training has been shown to enhance physical performance and functional capacity. Furthermore, mind–body, dual-task and multimodal types of interventions may also provide additional cognitive and psychological benefits. Although the overall cognitive effect of exercise in individuals with established AD is generally small, it has been demonstrated that exercise can contribute to maintaining brain health through multiple interconnected metabolic, vascular and molecular pathways, thereby preserving cognitive reserve and slowing disease progression, particularly when initiated during early to midlife prior to the onset of AD symptoms. Therefore, future research will require establishing stage-specific exercise recommendations based on modality type, intensity and duration to achieve optimal clinical outcomes. Full article
(This article belongs to the Section Movement Disorders and Neurodegenerative Diseases)
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