Viral Hypothesis and Antiviral Treatment in Alzheimer's Disease

Current Neurology and Neuroscience Reports
D P Devanand

Abstract

Viruses, particularly herpes simplex virus (HSV), may be a cause of Alzheimer's disease (AD). The evidence supporting the viral hypothesis suggests that antiviral treatment trials, which have not been conducted, are warranted. HSV1 (oral herpes) and HSV2 (genital herpes) can trigger amyloid aggregation, and their DNA is common in amyloid plaques. HSV1 reactivation is associated with tau hyperphosphorylation and possibly tau propagation. Anti-HSV drugs reduce Aβ and p-tau accumulation in infected mouse brains. Clinically, after the initial oral infection, herpes simplex virus-1 (HSV1) becomes latent in the trigeminal ganglion and recurrent reactivation may produce neuronal damage and AD pathology. Clinical studies show cognitive impairment in HSV seropositive patients, and antiviral drugs show strong efficacy against HSV. An antiviral treatment trial in AD is clearly warranted. A phase II treatment trial with valacyclovir, an anti-HSV drug, recently began with evaluation of clinical and biomarker outcomes.

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Citations

Dec 19, 2019·Frontiers in Microbiology·Yingying Lin, Chunfu Zheng
Dec 8, 2020·Frontiers in Cellular Neuroscience·Matylda B MielcarskaFelix N Toka
Jan 30, 2021·Microbial Cell Factories·Dana VigasovaJiri Damborsky
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May 5, 2021·Translational Neurodegeneration·Xiaohuan XiaJialin Zheng
Jul 18, 2020·CNS & Neurological Disorders Drug Targets·Roma GhaiGarima Kapoor

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