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Term Paper Report On
A REVIEW ON TREATMENT OF ALZHEIMER DISEASE
Submitted To
Amity Institute of Biotechnology
Amity University Uttar PradeshLucknow Campus
In PartialFulfilment for the Degree of
MASTER OF SCIENCE
In
BIOTECHNOLOGY
By
PRITI PAL
A7100213018
UNDER THE SUPERVISION OF
Prof Dr. Aditi Singh
Amity Institute of Biotechnology
Amity University Uttar PradeshLucknow Campus

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Declaration
I hereby declare that term paper report entitled “A REVIEW ON
TREATMENT OF ALZHEIMER DISEASE” undertaken by me is an
authentic record of my own work carried out at Amity Institute Of
Biotechnology, Lucknow as a requirement of Internship Project for the award of
degree of M.Sc. in Biotechnology, Amity University, Lucknow, under the
guidance of Dr.Aditi Singh, Professor AIB during 01st May, 2014 to 15st July,
2014.
DATE: 15 July, 2014
PLACE: Lucknow Priti Pal

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FACULTY GUIDE APPROVAL CERTIFICATE
I, hereby declare that the term paper entitled “A REVIEW ON TREATMENT
OF ALZHEIMER DISEASE” is a record of an original work done by Ms Priti
Pal from 01-05-14 to 15-07-14 at Amity University, Lucknow. This work has
been carried out under the guidance of me, Dr. Aditi Singh, Sr. lecturer,Amity
University Lucknow.
Dr. Aditi Singh

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AMITY UNIVERSITY
UTTAR PRADESH
LUCKNOW CAMPUS
PLAGIARISM FREE CERTIFICATION
This is to certify that internship project detailed below has been evaluated by
online anti-plagiarism software. The contents and material was found
satisfactory and within the permissible limit of content copied.
Name of the Student- Priti Pal
Enrollment Number- A7100213018
Programand Batch-M.Sc. BiotechIII rd
Sem, 2013-2015
Title of the Project-AREVIEW ON TREATMENT OF ALZHEIMER
DISEASE
Results-
Student Internal Faculty Supervisor
Date:

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Acknowledgement
The successful completion of any project would be incomplete without thanking the people
who made it possible. With all my submissiveness I thank God for his constant presence
throughout my work. It takes great pleasure in expressing a few words of gratitude and
respect to all those who helped me in completing this project work.
I am highly grateful to Dr. Rajesh Kumar Tiwari, HOI, Amity Institute of Biotechnology,
Lucknow for accepting my candidature and permitting me to undertake the dissertation work.
It is my proud privilege and pleasure to bring my deepest gratitude to my supervisor Dr.
Aditi Singh, Professor AIB, Lucknow for the constant supervision, meticulous guidance, his
ever encouragement, moral support, constructive criticism and above all most sympathetic
attitude throughout the period of investigation.
I feel great pleasure in expressing my earnest and deep sense of gratitude to Dr. .Aiti singh
Abhishek kumar, AIB for their invariable guidance, invaluable healthy instructions, constant
supervision and keen interest throug out the course.
With profound happiness, I want to pay my heartfelt regards and feelings of indebtedness
Towards the eternal love and fondness showered on me by my family.
Date: 15 July, 2014 Priti Pal

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TABLE OF CONTENTS
PARTICULARS PAGE No.
Title Page 01
Declaration 02
Faculty Guide Approval Certificate 03
Plagiarism Free Certificate 04
Acknowledgement 05
Table of Contents & List of Figures 06
Abstract & Key words 07
Introduction on Alzheimer disease
Stages of Alzheimer disease
08-10
Medication of Alzheimer disease 11-12
ResearchDeveloping in the field of treatment of Alzheimer 12-15
Future prospects of treatment of Alzheimer disease 15
Conclusion 16
References 17-18
List of figure
Fig.1. Dig showing a comparisonbetweenhealthy neuron and neuron
containing plaque page 8
Fig.2. Dig showing different stages ofAlzheimer disease page 10
Fig.3. Dig showing beta amyloids blood plaque page 13
Fig.4. Dig showing enzyme activity in reducing blood plaque page 14
Fig.5. Dig showing stem cell therapy in Alzheimer treatment page 15

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“A REVIEW ON TREATMENTOF ALZHEIMER DISEASE”
Priti pal, Aditi Singh and RajeshK. Tiwari
AMITY INSTITUTE OF BIOTECHNOLOGY AMITY UNIVERSITY
UTTAR PRADESHLUCKNOW CAMPUS
ABSTRACT-
Nowadays Alzheimer’s disease is the most common and hazardous
neurodegenerative disorder. Alzheimer’s disease (AD) can be featured and characterized on a
macro level as the progressive loss of brain tissue. When this disease gradually progressed or
progresses, the neurons die in a particular pattern over time. One of the early signs of
Alzheimer’s disease is memory loss, particularly short term recall. Many compounds which
are approved had different alternate diagnoses, which all are studied in relation to
Alzheimer’s disease. The aim of my study is to summarize and confer of their importance and
benefits of drugs for Alzheimer disease treatment. There are numerous drugs which are
having known toxicity profiles and can adapt for use in the different purpose, like as a
treatment for Alzheimer’s disease. There are many therapeutic drugs or treatment for the
Alzheimer disease, although there are no proven agreements and negotiations to rectify
Alzheimer disease, hypertension treatment, omega-3 fatty acid supplementation, physical
activity and cognitive engagement determine unpretentious potential. Other agents like
antioxidants vitamin E, selegiline and ginko biloba extracts have shown some benefit in
clinical trials, but their effects are is not sufficient to define clinical practice.
According to the latest study the genetically reconstruct stem cells may provide a new
improved techniques which are developed to treat Alzheimer’s disease. Genetically modified
stem cells when embed in mice bred to have sign and brain hallmarks of Alzheimer they
expand increased connections between brain cells and lessen the amyloid-beta protein that
assemble to form plagues that clog up the brain. Woman is more commonly affected by this
disease as compare to man. Many Researchers are given many researches on Alzheimer’s
disease which scrutinize many feasible technique of preventing or slowing Alzheimer’s
which involve cardiovascular treatments, antioxidants, immunization therapy, cognitive
training and physical occupation. This review covers and discusses all the basic evidence and
role of oxidative stress in Alzheimer disease development. This article discusses the public
health influence of Alzheimer including occurrence and prevalence, mortality rates, costs of
care and overall effect on caregivers and community.
KEYWORDS:- Alzheimer disease, Acetyl cholinesterase inhibitors, treatment, brain tissue.

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INTRODUCTION-
Alzheimer’s disease is a degenerative, progressive disorder which is attacks the brains nerve
cells and neurons denouement in memory loss thinking and language skills and behavioural
commutation. Those neurons that produce the brain chemical or neurotransmitter,
acetylcholine, split connections with other nerve cells and eventually depart this life. For
example:-short term memory lapse when Alzheimer’s disease first demolish nerve cells in the
hippocampus and language ability and judgment shrink when neurons expire in the cerebral
cortex. Two types of unusual contusion plug the brains of discrete with Alzheimer’s disease
beta-amyloid plagues sticky clumps of protein fragments and cellular tangles. Insoluble
twisted fibres composed substantially of the protein Tau that expansion inside the nerve cells.
Although these structure are hallmarks of the disease. Scientists are unsure whether they
genesis it or a by product of it. For people 65 and older Alzheimer’s disease is the most usual
form of dementia or loss of cognitive function. Aging is not a normal part of Alzheimer’s
disease.
Fig.1. Dig showing a comparison between healthy neuron and neuron
containing plaque
SOURCE: http://alzheimerindia.blogspot.com/http://www.stemcell.net.in
TERM GIVEN BY-
Dr. ALOIS Alzheimer a German physician in 1906 gave the term Alzheimer disease. In a
medical meeting he presented a case history about a 51 year old woman who suffered from an
unknown brain disorder. A brain necropsy recognized the plaques and tangles which today
are characterized as Alzheimer disease.

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CAUSES AND RISK FACTORS OF ALZHEIMERS DISEASE-
Till now there is not a single component identified as the cause of Alzheimer disease. These
are a combination of factors responsible that are age, genetic inheritance, environmental
factors, life style and overall general health. In some cases this disease develops silently
before the symptoms appear. In this one of the major factor which is been noticed is the
family background which include that the family in which a person’s brother and sister
having the alzhiemer diseases are more prone to have this disease so it can be said that
genetic or heredity matters a lot. Apart from the other things which are important are many
which include point such as mild congnitive impairment (MIC). It is also a major risk
factor which possibly is symptom is a mild condition in which a person has a measurable
problem in his or her thinking.
People who have rare genetic changes that guarantee they will develop Alzheimer disease
experience symptoms in 30s.Age is the biggest risk factor for growing Alzheimer disease. As
we grow older, we assemble more beta amyloid. The risk of Alzheimer disease doubles after
the age of 65. Further, risk factor for Alzheimer disease is genetics. Alzheimer diseases rare
form is called familial Alzheimer .It usually starts between the age of 40’S and 50’S.It passes
genetically which is autosomal dominant. Head trauma is another important risk factor for
Alzheimer disease. The loss of consciousness grows the risk of developing Alzheimer
disease. We should always wear a seat belt and helmet for our safety. In a study held in
Japan, about 1000 men and women of age 60 or above who suffered from type 2 diabetes had
an increasing risk of Alzheimer disease simultaneously to those people who don’t suffer from
the same.
Out of 10, about 8 people who suffer from Alzheimer disease also suffer from cardiovascular
diseases. Cholesterol increases the production of beta amyloid. When the levels of beta-
amyloid extends, it increases the risk of Alzheimer diseases. This is the reason that doctors
recommend statins for those people who suffer from Alzheimer disease and also to maintain
their cholesterol levels.
STAGES OF ALZHEIMER’S DISEASE-
There are mainly 7 stages of this disease, the top three main stages of Alzheimer disease are-
 Mild’s Alzheimer’s
 Moderate Alzheimer’s
 Severe Alzheimer’

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Fig.2. Dig showing different stages of Alzhemier’s disease
SOURCE:
http://www.medicinenet.com/imagecollection/alzheimers_disease_picture/picture.htm
The basic character of Mild’s Alzheimer’s disease is that the sufferer may face the problem
of short term memory loss. The duration of this disease is 2-4 years. It is difficult for the
person to recall something easily, to take some judgement or in migrating new places. It is
also not being noticed by others as it is so common.
The symptom of Moderate Alzheimer’s is that the memory loss and confusion is much more
increased. It is difficult for the sufferer to learn something new. They may change to
impulsive behaviour. The duration of this disease is 2-10 years. The person may trouble from
the misapprehension and unrestrained behaviour. Due to weakness Motility and coordination
is affected as there is austerity and shiver in it. They need succour for their daily life routine.
The symptom of Severe Alzheimer’s is that the ability of walk and sit become limited
simultaneously the ability for speech or communication also become hard for the sufferer.
The time duration is 1-3 years. They suddenly become confused about their past and present.
They become generally incapable with their verbal skills. They start depending totally upon
others. They usually suffer from Devour, Lewdness and Ailment. They usually suffer from
Phantasm & Dementia.

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MEDICATION FOR ALZHEIMER’S DISEASE-
There is no particular prevention for this disease, but the process of medication is in progress,
with the symptoms of the disease it can be cure by the available drugs. There is a worldwide
effort going on to find the ways to obtain a perfect cure for it. The treatment for the
Alzheimer’s cannot stop the problem in the mean while it can reduce the effects for the same,
it can aggravate the symptoms of dementia. In a class there are four drugs Donepezil (brand
name Aricept) Alantamine (Reminyl), Rivastigmine (Exelon), Tacrine (cognex) called
cholinesterase inhibitor consent for treatments which only treat the symptoms in the U.S.
Memantine (namenda) an NMDA receptor antagonist is a different kind of drug which can
also be helpful to use, individually or with the combination of cholinesterase inhibitor. The
clinical relevance or aspects of these effects is not clear.
Person older than 65 years usually diagnosed Alzheimer disease and its generality expand
sever decade thereafter. Approx half of the Americans of the age near to 85 years old has
Alzheimer disease.
The major two types of medication which work in different ways and is used for the
prevention of Alzheimer’s are Cholinesterase Inhibitors and Memantine, NMDA receptor
antagonist. In a class there are four drugs Donepezil (Aricept) Alantamine (Reminyl),
Rivastigmine (Exelon), Tacrine (cognex) called cholinesterase inhibitor. Memantine
(Ebixa) is the NMDA receptor antagonist.
SERVICE OF THE MEDICATION-
All the instruction for the medication is recently consent for the treatment of Alzheimer’s
disease symptoms relatively with the class of drugs use in early to moderate stage
Cholinesterase inhibitors. They instruct for the issues related with the power of retention, the
way of reasoning, Variant of judgement.
Cholinesterase inhibitors avert the malfunction of Acetylcholine. It is a chemical messenger
which is very necessary for the power of retention and the process of recognizing. While the
acetylcholine level high in nerve cell it helps to communicate among the same. The retained
aggravate symptoms for 6 to 12 months on average around 50% of person take them. Aricept
medicine is the class of Cholinesterase inhibitors which is consent to treat the stages of
Alzheimer’s disease i.e. moderate and severe.

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Memantine is authorized for the betterment of the power of retention, consciousness, dialect
and cause to accomplish an easy task. Memantine modulate the work of glutamate, which is
a different chemical messenger used in the process of memorizing and retaining.
ADVERSE EFFECT OF THIS DRUGS-
Usually, cholinesterase inhibitor and Memantine can worked without too many adverse
effects. It’s not necessary to have the same problem or do not have it for the same time
interval if they even experience it at all. The common side-effects of donepezil, rivastigmine
and galantamine are loss of appetite, nausea, vomiting and diarrhoea .Some another side
effects of the same are stomach cramps, headaches, dizziness, fatigue and insomnia. These
kind of problems like side effects are usually dislike by those who recently start following
that treatment with the lower prescribed dose at least for a last month. The side-effect of
memantine are not common and less severe than for cholinesterase inhibitor .They include
dizziness, headaches, tiredness, increased blood pressure and constipation.
Available pharmacological treatments for Alzheimer disease have limited effectiveness
are expensive and some time induce side effects.
RESEARCHDEVELOPING IN THE FEILD OF TREATMENT OF
ALZHEIMER
Up-till now it was known that Alzheimer was cureless. Only few medication were been
developed in favour of treatment. But during the increasing course of time new techniques
are been developed and trials are been made in order to develop a standard treatment of this
diseases. In order to have a brief study of the treatment Alzheimer have to be studied in very
contrast. Over the past decades when all the discoveries were been going on and a better
treatment was been searching then also the drugs discoveries were found to be disappointing.
If the major feature of Alzheimer is to be noted then it is the presence of brain plaque which
is marked to be a hallmark pathological feature in Alzheimer. This brain plaque contain
primarily β-amyloid peptide, these are present in aggregates which are the main primarily
reason behind the formation of blood plaque in the brain. This β-amyloid peptide, aggregates
is one of the important reasons which cause the later stages of the disease.

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Fig.3. Dig showing beta amyloids blood plaque
Source: http://thebrain.mcgill.ca/flash/d/d_08/d_08_cl/d_08_cl_alz/d_08_cl_alz.html
In many researches which are been done in recent years have been found that the production
of insulin in body is one of the reason why Alzheimer is growing at such an alarming rate. It
was found that the decrease in the level of cerebrospinal fluid level of the insulin which
ultimately decrease the level of insulin sensitivity (insulin resistance) inside the brain. It was
also found that if the nasal insulin level is increased then it would be helpful in treating the
Alzheimer diseases.
Hence like this many other techniques are been developed since the past two decades which
include the management of the insulin inside the body and maintaining the level of it. Thus
this diseases although is incurable but still holds up a promising cure which are still been
developing.
Now some new extremity to drug is required for evolution. Translational Neuroscience pivot
on the connection between general neuroscience and the growth of advanced diagnostic and
therapeutic production that will be helpful for the sufferer to make better their lives or avert
the recurrence of brain disorder. Translational neuroscience involve comprehend preclinical
models that may become more suitable express human effeminacy and security, better
clinical tentative designs and results that will help to advance the drug growth, for more
knowledge concerning the effects of drugs on the latent disease biology the use of biomarkers
is depleted. In the beginning, translational research is achieve and after later stage
translational make approach for use the proof to collision clinical practice and to approach
the repercussion of advance therapeutics on the public health.

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Fig.4. Dig showing enzyme activity in reducing blood plaque
SOURCE: http://www.nature.com/nature/journal/v461/n7266/fig_tab/461895a_F1.html
If the research work is been talked about there has been a new criteria which was developed.
By 1984 a new guidelines were been update which was successful done by Alzheimer
Association and the National Institute of Neurological Disorder and Stroke. The updates
which were done in 1984 were mainly done by over viewing approx 40 medicinal research
institute that were working over the Alzheimer disease. Earlier also it was seen that
Alzheimer has no cure. After several researches The U.S Drug and food administration has
approved five drugs for the treating the diseases and finding out improvements. Despite of
lack disease inappropriate medication still there are several things which can be done in
respect to treatment of Alzheimer. One of the effective ways of treating these diseases is the
ACTIVE MANAGEMENT of the diseases. Proper care should be taken for such type of
patients.
According to the latest study the genetically reconstruct stem cells may provide a new
improved techniques which are developed to treat Alzheimer’s disease. Genetically modified
stem cells when embed in mice bred to have sign and brain hallmarks of Alzheimer they

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expand increased connections between brain cells and lessen the amyloid-beta protein that
assemble to form plagues that clog up the brain.
Fig.5. Dig showing stem cell therapy in Alzheimer treatment
Source:http://stemcells.nih.gov/info/basics/pages/basics6.aspx
FUTURE PROSPECTSOF TREATMENTOFALZHIMER DISEASE
Up till now the major discoveries which are been done in the field of drugs and medicine are
been discussed. Now as it is known to all that Alzheimer is one of the fast growing world-
wide epidemic diseases. As it is been spreading up worldwide an ultimate cure is also
necessary for the treatment of this diseases. Now for this future prospectus a treatment is been
searching up which can be helpful in two of the major factors that are Early detection as well
as a perfect therapeutic medication of Alzheimer is. In despite of this some of the major
discoveries in medicine are also involved. The new drugs are been found up which will be
effective in curing the diseases and would be beneficial for the future point of view. It was
seen that the beta amyloid aggregates which were mainly responsible for causing the plague
in the brain which was leading to the diseases was one of the major factor. Researchers were
finding the ways in order to find out the drugs which are amyloid based which helps in
avoiding the plaque formation in the brain. As Alzheimer is an uncontrolled condition which
is to be tackling seriously and effective thing should be kept in mind. For instance:
a) Care and responsibility toward the patient is of at most importance

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b) Proper medication of drugs is also needed
c) Another factor which is of equally importance is proper scenario of the condition and
regular check-ups.
Hence these are all things which are to be seen and are necessary for the treatment in the
Alzheimer diseases.
CONCLUSION
In this review article up till now the major points which are regarding the topic i.e. A review
treatment of Alzheimer Diseases are been discussed. At last it is just said that Alzheimer is
a disease that has no cure. Until now the researchers are been trying to find out a way to
discover and find out an accurate way so as to cure the diseases. The blood plaque which is
responsible for the inability of thinking of dementia is a major problem which is too treated
first. It was also found that in order to treat and cure these amyloids plague major two steps
are: a) inhibitory drugs and b) vaccination. In this the inhibitory drugs which are been
discovered are helpful in removal of these plaques. Out of this one of the important and
effective drugs is PT32. It was seen that this drug is an enzymatic which act as a catalyst and
are required for amyloids fragments to move away from their origin of space thus reducing its
accumulation in the brain. Hence this drug proves to be quite effective. Apart from the drugs
vaccination also played one of the important steps in removal of this plaque. Out of this the
injection regarding to this is quite interesting in which the injection of beta amyloid itself is
capable of producing antibodies against the protein itself thus it helps in reducing the
accumulation of plaque.
Not only had another related treatments of this is stem cell treatment, biomarker as well as
increase or decrease in the concentration of insulin with respect to cerebrospinal fluid is also
one of the treatment of this disease. And not only this research which is going on and the
drugs which are been inventing up by the researchers is also under process and are on their
Way. Thus this term paper comprises of a brief summary about all the important points
related to the topic which is treatment on Alzheimer and all the effective way with which its
treatment can be possible not in present but in future also....

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