Disclaimer: The content of this article is written with authoritative medical data combined with personal opinions, and the source of the literature has been marked at the end of the article, please be aware.
As a star product of the era, "Viagra" became the darling of men around the world as soon as it was launched, creating an insurmountable business myth. In the past 20 years, the global sales of sildenafil have reached more than 200 billion yuan, which has not only made pharmaceutical companies make a lot of money, but also achieved the reputation of "drug king".
In 2020, sildenafil was approved for the treatment of pulmonary hypertension, which pushed this classic drug to the altar and became a "life-saving drug" for many people.
However, the contribution of sildenafil to human health has not stopped.
A new foreign study shows that sildenafil has a potential prevention and treatment effect on Alzheimer's disease, and is expected to become a milestone on the road to overcoming this dangerous disease! What's going on here? Can the well-known "aphrodisiac" really prevent Alzheimer's disease? This starts with the tortuous path of research and development of Alzheimer's drugs.
1. Alzheimer's disease: a nightmare for pharmaceutical companies and a bottomless pit of funding
As one of the most frightening diseases, Alzheimer's disease not only causes cognitive impairment, but also triggers a decline in the body's immunity and mobility, and ultimately causes patients to die within 5-15 years from a series of complications or resulting accidents.
According to statistics, the number of Alzheimer's patients in mainland China has approached 10 million, and it may exceed 40 million in 2050. This notorious disease not only deprives countless elderly people of happiness in their old age, but also places a heavy burden on their families.
The huge patient group means a broad market space, and pharmaceutical companies will certainly not let go of this ownerless "fat". Since the 70s of the last century, anti-Alzheimer's drugs have been the top priority of research and development of major companies around the world, including many of the world's top scientists.
However, as time goes on, the prospect of drug development becomes more and more hopeless.
So far, the total investment of global pharmaceutical companies in Alzheimer's drugs has exceeded 600 billion US dollars, but only a few drug candidates with little efficacy can pass clinical trials, and most of them have failed!
The main reason for this is that the pathogenesis of Alzheimer's disease is very complex.
So far, it has not been possible to explain it at the molecular level. There are two more popular hypotheses: one is the amyloid hypothesis. This hypothesis is that there is a β-amyloid in the space of brain cells, and if this protein is not cleared in time, it will accumulate and form plaques, producing the neurotoxic tau protein, causing the death of brain cells and thus triggering Alzheimer's disease.
The second is the infection hypothesis.
Studies have found that human infection with a series of viruses such as HIV, HHV, and HPV will lead to active expression of genes such as BACE1 and PSEN1, which are genes that are highly related to Alzheimer's disease, so many people believe that viral and bacterial infections can cause Alzheimer's disease.
However, current research believes that neither of these two hypotheses is enough to fully explain the origin of Alzheimer's disease, which makes it difficult to select the target of the drug, and the pharmacological effect is also difficult to directly verify through biological models, and the relevant research has not been able to go deeper.
In this case, pharmaceutical giants have begun to withdraw from this track one after another, making the emergence of special drugs more distant. At this time, some scientists thought, if new drugs cannot be developed, then why not try the strategy of "reusing old drugs"?
Under the guidance of this line of thinking, the "Viagra" - sildenafil was unearthed and once again played the role of the "god of hope".
2. New use of old drugs: sildenafil may be able to treat Alzheimer's disease!
In March 2024, Chinese doctor Cheng Feixiong and his team published an article in the world-renowned journal "Journal of Alzheimer's Disease", pointing out that taking sildenafil can significantly reduce the incidence of Alzheimer's disease.
Researchers analyzed millions of medical claims in a patient database and showed a 30%-54% reduction in the incidence of Alzheimer's disease in people who took sildenafil compared to those who did not take sildenafil.
To further determine the mechanism, the researchers conducted model tests using induced pluripotent stem cell (iPSC) redifferentiated neurons and found that sildenafil significantly reduced tau levels, which is a direct consequence of amyloid accumulation.
Dr Cheng said the discovery will further support and advance sildenafil's potential as a drug candidate for the prevention and treatment of Alzheimer's disease. In fact, as early as 2021, the team published the results of a large study involving 7 million people in the journal Nature Aging, which preliminarily pointed out that sildenafil can reduce the incidence of Alzheimer's disease by about 69%, but there is a lack of effective evidence.
The success of this study undoubtedly provides strong data support for the smooth development of clinical trials.
However, it should be pointed out that the research on the prevention and treatment of Alzheimer's disease is still in the early stage, and the efficacy, safety, dosage and adverse reactions need to be further explored.
So, at the current stage, how can middle-aged and elderly people stay away from the risk of Alzheimer's disease and add a layer of protection to their later life?
Third, to prevent Alzheimer's disease, it is far from enough to count on "Viagra".
In fact, Alzheimer's disease is a progressive disease, and the role of drug prevention is very limited. Only by starting from changing daily habits and gradually improving the health of blood vessels and the cognitive level of the brain can we truly "keep Alzheimer's disease out".
The doctor reminds elderly friends over 50 years old that they must remember the following three points and do not wait for Alzheimer's disease to come before regretting it.
1. Maintain a balanced diet
Studies have found that patients with chronic diseases such as hypertension, diabetes, hyperuricemia, and hyperlipidemia are more likely to suffer from Alzheimer's disease, because the imbalanced internal environment is more likely to lead to the accumulation of amyloid, which indirectly leads to cognitive impairment including Alzheimer's disease.
The best way to prevent these diseases is to eat a balanced diet, that is, eat more high-quality protein such as deep-sea fish and lean meat, fresh fruits and vegetables, and eat less high-sugar foods, especially high-fat foods, to avoid the formation of atheroma and endanger vascular health.
2. Replace solitude with socializing
A large body of evidence shows that older adults who live alone are more likely to experience negative emotions such as loneliness and depression, which are important triggers for cognitive decline. Therefore, the elderly should avoid spending time alone for a long time, participate in more beneficial social activities, and avoid bad emotions.
For example, through literary and artistic creation, sports competitions, public welfare activities and other channels, they can expand their social contacts, enhance their participation in social life, and enhance their sense of value.
In addition, you can also participate in some puzzle games, such as Go, attention training, etc., to improve logical thinking ability and delay the deterioration of brain function.
3. Receive regular cardiovascular and cerebrovascular examinations
Regular screening is the best preventive measure for any disease, and Alzheimer's disease is no exception.
Although there is a lack of reliable quantitative indicators and screening evidence, impaired cardiovascular function is an important "warning light" for Alzheimer's disease, which must be paid special attention.
Therefore, middle-aged and elderly people over the age of 60 should have an electrocardiogram and brain magnetic resonance examination once a year, and patients with relevant medical history should also have an angiogram examination.
If symptoms such as memory loss and slow thinking occur, you should seek medical attention in time for cognitive function testing and early intervention.
Bibliography:
[1] Jiansong Fang, Pengyue Zhang, Yadi Zhou, et al. Endophenotype-based in silico network medicine discovery combined with insurance record data mining identifies sildenafil as a candidate drug for Alzheimer’s disease[J]. Nature Aging, 2021, 1, 1175–1188.
[2] G Dhruv, P Zhang, G Mumar, et al. Sildenafil as a Candidate Drug for Alzheimer’s Disease: Real-World Patient Data Observation and Mechanistic Observations from Patient-Induced Pluripotent Stem Cell-Derived Neurons[J]. Journal of Alzheimer's Disease, 2024, 98(2): 643–657.
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