Ababei et al have published an interesting review of renin-angiotensin modulators in Alzheimer’s Type Dementia.
The referenced paper is a highly technical article geared towards healthcare professionals and scientists.
In summary, they review a broad range of renin-angiotensin modulators from the perspective of influencing cognitive decline both in human and animal studies. The evidence is not just restricted to Alzheimer’s Type Dementia but includes Vascular Dementia in some studies for example.
I would say that they provide some intriguing evidence that ticks lots of boxes. The pharmaceutical agents are mostly already approved for clinical practice for other indications. This means that they would already have demonstrated an acceptable safety profile (for those other indications).
From a theoretical perspective, the authors cite an abundance of mechanisms by which they may exert their effect. The most straightforward from my perspective is that hypertension has been demonstrated to have a strong link with risk of Dementia in numerous studies. Nevertheless they identify a number of other pathways that may be of relevance and cite evidence to support this.
To move from there to a point where these agents may be used in clinical practice requires the usual steps of trials and regulatory approval. So this is a highly promising line of inquiry at present.
References
Ababei DC, Bild V, Macadan I, Vasincu A, Rusu RN, Blaj M, Stanciu GD, Lefter RM, Bild W. Therapeutic Implications of Renin-Angiotensin System Modulators in Alzheimer’s Dementia. Pharmaceutics. 2023 Sep 6;15(9):2290. doi: 10.3390/pharmaceutics15092290. PMID: 37765259;
