Exosome-Based Therapeutics for Alzheimer’s Disease: Modulating Immune Dysregulation

Document Type : Analytic Review

Authors
S. Nouri
M. Soleimani
1. Department of Hematology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Abstract
Alzheimer’s Disease stands as the common neurodegenerative and progressive ailment that leads to dementia. Its pathological manifestations include amyloid-beta (Aβ) plaques, tau neurofibrillary tangles, chronic inflammation, and oxidative stress. The paper reviews recent findings about AD pathogenesis by demonstrating how Aβ plaques link with immunological dysfunction and cellular stress events to drive dementia pathology. Aβ accumulation served initially as the primary therapeutic target. Still, scientists recognize it functions within a more complex sequence that includes glial activation, abnormal tau phosphorylation, and reciprocal neuroimmune processes. Research findings show that neuroinflammation exists in two opposing states because protective and pathological effects depend on disease progression and immune system conditions. The current therapeutic focus has shifted towards monoclonal antibodies, enzymatic modulators, and immunization methods for lowering Aβ burden during the early stages of the disease. These treatments demonstrate restricted effectiveness when applied during advanced stages; thus, researchers investigate multiple treatment approaches focused on simultaneously addressing Aβ and tau and inflammatory pathways. Their access across the blood-brain barrier to transfer therapeutic compounds enables them to be hopeful agents for modifying diseases and creating biomarkers. Preclinical models indicate that exosomes generated from stem cells and immune cells demonstrate a reduction of Aβ accumulation, neuroinflammation control, and cognitive ability maintenance. The paper shows an urgent necessity for customized multi-system treatment methods as it introduces exosome dynamics for modern translational AD investigation. These therapies, integrating three key components of targeted delivery with immune modulation and neuroprotection, offer an innovative solution for managing AD.

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