Pharmacological Effects of Cholinesterase Inhibitors and Alzheimer Disease Therapy:
Four main pharmacological effects of cholinesterase inhibitors (ChEI) constitute the theoretical basis for therapy of Alzheimer disease (AD): 1) functional improvement of central cholinergic synapses mediated through muscarinic and nicotinic mechanisms (Summers et al., 1994; Cuadra et al., 1994); 2) protection against neuronal degeneration mediated through nicotinic receptor activation (Janson and Moller, 1993; Sjak-shie et al., 1990); 3) modification of amyloid precursor protein (APP) processing mediated through muscarinic M, receptor activation (Nitsch et al., 1993; Buxbaum et al., 1992); and 4) regional enhanced synthesis of neurotrophic molecules [nerve growth factor (NGF) and brain derived nerve factor (BDNF)] via muscarinic receptor stimulation (Lindfors et al., 1992; Berzaghi et al., 1993).