Uncorrected Author Proof Journal of Alzheimer’s Disease xx (20xx) x–xx DOI 10.3233/JAD-170188 IOS Press 1 Review 1 The Mechanisms of Action of Curcumin in Alzheimer’s Disease 2 3 Mengxi Tang and Changiz Taghibiglou * 4 Department of Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada 5 Handling Associate Editor: Jia Liu 6 Accepted 10 April 2017 Abstract. Alzheimer’s disease (AD) is a neurodegenerative disorder of the elderly. As the prevalence of AD rises in the 21st century, there is an urgent need for the development of effective pharmacotherapies. Currently, drug treatments target the symptoms of the disease and do not modify or halt the disease progress. Thus, natural compounds have been investigated for their ability to treat AD. This review examines the efficacy of curcumin, a polyphenol derived from turmeric herb, to treat AD. We summarize the in vivo and in vitro research describing the mechanisms of action in which curcumin modifies AD pathology: curcumin inhibits the formation and promotes the disaggregation of amyloid-plaques, attenuates the hyperphosphorylation of tau and enhances its clearance, binds copper, lowers cholesterol, modifies microglial activity, inhibits acetylcholinesterase, mediates the insulin signaling pathway, and is an antioxidant. In conclusion, curcumin has the potential to be more efficacious than current treatments. However, its usefulness as a therapeutic agent may be hindered by its low bioavailability. If the challenge of low bioavailability is overcome, curcumin-based medications for AD may be in the horizon. 7 8 9 10 11 12 13 14 15 16 17 Keywords: Alzheimer’s disease, amyloid, curcumin, turmeric, tau protein 18 INTRODUCTION 19 Alzheimer’s disease (AD), accounting for 60 to 20 80% of dementia cases, is an irreversible, pro- 21 gressive brain disorder characterized by behavioral 22 changes and loss of cognitive functions [1]. Common 23 symptoms include short-term memory loss, cogni- 24 tive deficits, and an inability to perform tasks of 25 daily living [2]. As the disease progresses, afflicted 26 individuals often withdraw from society, lose bod- 27 ily functions, and die. The life expectancy following 28 * Correspondence to: Changiz Taghibiglou, PharmD/PhD, Associate Professor, Department of Pharmacology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada. Tel.: +1 306 966 8816; E-mail: changiz.taghibiglou@usask.ca. diagnosis ranges from an average of three to nine 29 years [3]. Globally, approximately 46 million people 30 are afflicted with dementia and the population ages, 31 the number is projected to increase to 131.5 million 32 by 2050 [4]. The worldwide cost of dementia is US 33 $818 billion and is expected to be a trillion dollar 34 disease in 2018 [4]. Given the economic cost and the 35 increasing prevalence of the disease, it is essential to 36 explore drug therapies. 37 Presently, there are a limited number of synthetic 38 drugs that are available for the management of the 39 disease. However, several natural compounds have 40 been investigated for their efficacy in treating AD 41 [5]. Curcumin is a natural compound derived from 42 the herb turmeric [6]. Recent research has focused on 43 its mechanisms of action by which it can modulate 44 AD progression. ISSN 1387-2877/17/$35.00 © 2017 – IOS Press and the authors. All rights reserved