Part 3:Huperzine A And Its Neuroprotective Molecular Signaling in Alzheimer’s Disease
Mar 21, 2022
Contact: joanna.jia@wecistanche.com / WhatsApp: 008618081934791

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4. Concluding Remarks
HupA has therapeutic benefits for the treatment of AD, but the understanding of molecular interactions involved in the recovery of neuronal function after HupA treatment is still incomplete. What is known is that AChEI activity is crucial through the regulation of Aβ peptide accumulation by activation of α-secretase cleavage and down-regulation of β/y-secretase, enhancing BDNF/TrkB signaling as well as PI3K/Akt and PI3K/TrkB/mTOR pathways. Concomitant reduction of IL-1β, IL-6, TNF-α, and NF-kB signaling preserves neuronal function. Modulation of Wnt signaling through HupA treatment might be the most promising therapeutic target, as Wnt is involved in neuronal survival and in synaptic plasticity. There are also non-cholinergic neuroprotective effects such as the preservation of mitochondrial structure and function under Aβ insult, as well as the recovery of Fe2+ homeostasis in the brain. Further research and development of HupA as a common treatment might alleviate the burden related to highly prevalent conditions that are costly in terms of public health policies and devastating to those who bear them and their caretakers.

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Author Contributions: Conceptualization, M.J.F., and N.C.I.; writing—original draft preparation, M.J.F.; writing—review and editing, M.J.F. and N.C.I.; M.J.F., N.C.I.; visualization, M.J.F., and N.C.I.; supervision, N.C.I. All authors have read and agreed to the published version of the manuscript.
Funding: This work was supported by grants from the Basal Centre of Excellence in Aging and Regeneration AFB 170005-ANID (Agencia Nacional de Investigaci6n y Desarrollo) to NCI.
Institutional Review Board Statement: Not applicable.
Informed Consent Statement: Not applicable.
Data Availability Statement: The data presented in this study are available within the article (tables and figures).
Acknowledgments: Authors thank Juan M. Zolezzi for his help with the manuscript and Felipe Serrano for the figures of this manuscript.
Conflicts of Interest: The authors declare no conflict of interest.

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Abbreviations


References
1. Howes, M.R.; Fang, R.; Houghton, P.J. Effect of Chinese Herbal Medicine on Alzheimer’s Disease. Int. Rev. Neurobiol. 2017, 135, 29–56. [CrossRef] [PubMed]
2. Murphy, R.A.; Sarpong, R. Heathcock-inspired strategies for the synthesis of fawcettimine-type Lycopodium alkaloids. Chemistry 2014, 20, 42–56. [CrossRef] [PubMed]
3. Wu, T.Y.; Chen, C.P.; Jinn, T.R. Traditional Chinese medicines and Alzheimer’s disease. Taiwan J. Obstet. Gynecol. 2011, 50, 131–135. [CrossRef] [PubMed]
4. Yang, G.; Wang, Y.; Tian, J.; Liu, J.P. Huperzine A for Alzheimer’s disease: A systematic review and meta-analysis of randomized clinical trials. PLoS ONE 2013, 8, e74916. [CrossRef]
5. Nett, R.S.; Dho, Y.; Low, Y.; Stately, E.S. A metabolic regulon reveals early and late acting enzymes in neuroactive Lycopodium alkaloid biosynthesis. Proc. Natl. Acad. Sci. USA 2021, 118, e2102949118. [CrossRef]
6. Callizot, N.; Campanari, M.L.; Rouvière, L.; Jacquemot, G.; Henriques, A.; Garayev, E.; Poindron, P. Huperzia serrata Extract ‘NSP01’ with Neuroprotective Effects-Potential Synergies of Huperzine A and Polyphenols. Front. Pharmacol. 2021, 12, 681532. [CrossRef]
7. Kong, Y.R.; Tay, K.C.; Su, Y.X.; Wong, C.K.; Tan, W.N.; Khaw, K.Y. Potential of Naturally Derived Alkaloids as Multi-Targeted Therapeutic Agents for Neurodegenerative Diseases. Molecules 2021, 26, 728. [CrossRef]
8. De La Garza, R.; Verrico, C.D.; Newton, T.F.; Mahoney, J.J.; Thompson-Lake, D.G. Safety and Preliminary Efficacy of the Acetylcholinesterase Inhibitor Huperzine A as a Treatment for Cocaine Use Disorder. Int. J. Neuropsychopharmacol. 2015, 19, pyv098. [CrossRef]
9. Ohba, T.; Yoshino, Y.; Ishisaka, M.; Abe, N.; Tsuruma, K.; Shimazawa, M.; Oyama, M.; Tabira, T.; Hara, H. Japanese Huperzia Serrata extract and the constituent, huperzine A, ameliorate the scopolamine-induced cognitive impairment in mice. Biosci. Biotechnol. Biochem. 2015, 79, 1838–1844. [CrossRef]

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10. Damar, U.; Gersner, R.; Johnstone, J.T.; Schachter, S.; Rotenberg, A. Huperzine A as a neuroprotective and antiepileptic drug: A review of preclinical research. Expert Rev. Neurother. 2016, 16, 671–680. [CrossRef]
11. Ferreira, A.; Rodrigues, M.; Fortuna, A.; Falco, A.; Alves, G. Huperzine A from Huperzia Serrata: A review of its sources, chemistry, pharmacology, and toxicology. Phytochem. Rev. 2016, 15, 51–85. [CrossRef]
12. Ashani, Y.; Grunwald, J.; Kronman, C.; Velan, B.; Shafferman, A. Role of tyrosine 337 in the binding of huperzine A to the active site of human acetylcholinesterase. Mol. Pharmacol. 1994, 45, 555–560.
13. Pang, Y.P.; Kozikowski, A.P. Prediction of the binding sites of huperzine A in acetylcholinesterase by docking studies. J. Comput. Aided Mol. Des. 1994, 8, 669–681. [CrossRef]
14. Raves, M.L.; Harel, M.; Pang, Y.P.; Silman, I.; Kozikowski, A.P.; Sussman, J.L. Structure of acetylcholinesterase complexed with the nootropic alkaloid, (-)-huperzine A. Nat. Struct. Biol. 1997, 4, 57–63. [CrossRef]
15. Tun, M.K.; Herzon, S.B. The pharmacology and therapeutic potential of (-)-huperzine A. Int. J. Exp. Pharmacol. 2012, 4, 113–123. [CrossRef]
16. Colovi´c, M.B.; Krstic, D.Z.; Lazarevi´c-Pašti, T.D.; Bondži´c, A.M.; Vasi´c, V.M. Acetylcholinesterase inhibitors: pharmacology and toxicology. Curr. Neuropharmacol. 2013, 11, 315–335. [CrossRef]
17. Geula, C.; Mesulam, M.M.; Saroff, D.M.; Wu, C.K. Relationship between plaques, tangles, and loss of cortical cholinergic fibers in Alzheimer disease. J. Neuropathol. Exp. Neurol. 1998, 57, 63–75. [CrossRef]
18. Reyes, A.E.; Chac6n, M.A.; Dinamarca, M.C.; Cerpa, W.; Morgan, C.; Inestrosa, N.C. Acetylcholinesterase-Abeta complexes are more toxic than Abeta fibrils in rat hippocampus: Effect on rat beta-amyloid aggregation, laminin expression, reactive astrocytosis, and neuronal cell loss. Am. J. Pathol. 2004, 164, 2163–2174. [CrossRef]
19. Fuentes, M.E.; Inestrosa, N.C. Characterization of a tetrameric G4 form of acetylcholinesterase from bovine brain: A comparison with the dimeric G2 form of the electric organ. Mol. Cell. Biochem. 1988, 81, 53–64. [CrossRef]
20. Inestrosa, N.C.; Alvarez, A.; Pérez, C.A.; Moreno, R.D.; Vicente, M.; Linker, C.; Casanueva, O.I.; Soto, C.; Garrido, J. Acetylcholinesterase accelerates assembly of amyloid-b-peptides into Alzheimer’s fibrils: Possible role of the peripheral site of the enzyme. Neuron 1996, 16, 881–891. [CrossRef]
21. Alvarez, A.; Alarc6n, R.; Opazo, C.; Campos, E.O.; Muñoz, F.J.; Calder6n, F.H.; Dajas, F.; Gentry, M.K.; Doctor, B.P.; De Mello, F.G.; et al. Stable Complexes Involving Acetylcholinesterase and Amyloid-β Peptide Change the Biochemical Properties of the Enzyme and Increase the Neurotoxicity of Alzheimer’s Fibrils. J. Neurosci. 1998, 18, 3213–3223. [CrossRef]
22. Bartolini, M.; Bertucci, C.; Cabrini, V.; Andrisano, V. β-Amyloid aggregation induced by human acetylcholinesterase: Inhibition studies. Biochem. Pharmacol. 2003, 65, 407–416. [CrossRef]
23. Zhang, H.Y. New insights into huperzine A for the treatment of Alzheimer’s disease. Acta Pharmacol. Sin. 2012, 33, 1170–1175. [CrossRef]
24. Zhou, X.; Cui, G.; Tseng, H.H.; Lee, S.M.; Leung, G.P.; Chan, S.W.; Kwan, Y.W.; Hoi, M.P. Vascular Contributions to Cognitive Impairment and Treatments with Traditional Chinese Medicine. Evid. Based Complementary Altern. Med. 2016, 9627258. [CrossRef] [PubMed]
25. Ha, G.T.; Wong, R.K.; Zhang, Y. Huperzine an as a potential treatment of Alzheimer’s disease: An assessment on chemistry, pharmacology, and clinical studies. Chem. Biodivers. 2011, 8, 1189–1204. [CrossRef]
26. Tapia-Rojas, C.; Inestrosa, N.C. Wnt signaling loss accelerates the appearance of neuropathological hallmarks of Alzheimer’s disease in J20-APP transgenic and wild-type mice. J. Neurochem. 2018, 144, 443–465. [CrossRef]
27. Rahman, M.; Bajgai, J.; Fadriquela, A.; Sharma, S.; Trinh, T.T.; Akter, R.; Lee, K.J. Therapeutic Potential of Natural Products in Treating Neurodegenerative Disorders and Their Future Prospects and Challenges. Molecules 2021, 26, 5327. [CrossRef]
28. Xu, Z.Q.; Liang, X.M.; Juan, W.; Zhang, Y.F.; Zhu, C.X.; Jiang, X.J. Treatment with Huperzine A improves cognition in vascular dementia patients. Cell Biochem. Biophys. 2012, 62, 55–58. [CrossRef]
29. Yang, Y.; Wang, Z.; Wu, J.; Chen, Y. Chemical Constituents of Plants from the Genus Phlegmariurus. Chem. Biodivers. 2016, 13, 269–274. [CrossRef]
30. Orhan, I.E.; Orhan, G.; Gurkas, E. An overview on natural cholinesterase inhibitors—A multi-targeted drug class-and their mass production. Mini Rev. Med. Chem. 2011, 11, 836–842. [CrossRef]
31. Chauhan, P.S.; Yadav, D. Dietary Nutrients and Prevention of Alzheimer’s disease. CNS Neurol. Disord. Drug Targets 2021. (E-pub Ahead of Print). [CrossRef] [PubMed]
32. Wang, C.Y.; Zheng, W.; Wang, T.; Xie, J.W.; Wang, S.L.; Zhao, B.L.; Teng, W.P.; Wang, Z.Y. Huperzine A activates Wnt/β-catenin signaling and enhances the nonamyloidogenic pathway in an Alzheimer transgenic mouse model. Neuropsychopharmacology 2011, 36, 1073–1089. [CrossRef] [PubMed]
33. Yuan, Q.; Lin, Z.X.; Wu, W.; Albert, W.N.; Zee, B.C.Y. Huperzine A in treatment of amyloid-β-associated neuropathology in a mouse model of Alzheimer disease: Abridged secondary publication. Hong Kong Med. J. 2020, 26 (Suppl.8), 34–37.
34. Huang, X.T.; Qian, Z.M.; He, X.; Gong, Q.; Wu, K.C.; Jiang, L.R.; Lu, L.N.; Zhu, Z.J.; Zhang, H.Y.; Yung, W.H.; et al. Reducing iron in the brain: A novel pharmacologic mechanism of huperzine A in the treatment of Alzheimer’s disease. Neurobiol. Aging 2014, 35, 1045–1054. [CrossRef]
35. Yang, L.; Ye, C.Y.; Huang, X.T.; Tang, X.C.; Zhang, H.Y. Decreased accumulation of subcellular amyloid-β with improved mitochondrial function mediates the neuroprotective effect of huperzine A. J. Alzheimer’s Dis. 2012, 31, 131–142. [CrossRef]
36. Lei, Y.; Yang, L.; Ye, C.Y.; Qin, M.Y.; Yang, H.Y.; Jiang, H.L.; Tang, X.C.; Zhang, H.Y. Involvement of Intracellular and Mitochondrial Aβ in the Ameliorative Effects of Huperzine A against Oligomeric Aβ42-Induced Injury in Primary Rat Neurons. PLoS ONE 2015, 10, e0128366. [CrossRef]
37. Tao, Y.; Fang, L.; Yang, Y.; Jiang, H.; Yang, H.; Zhang, H.; Zhou, H. Quantitative proteomic analysis reveals the neuroprotective effects of huperzine A for amyloid-beta treated neuroblastoma N2a cells. Proteomics 2013, 13, 1314–1324. [CrossRef]
38. Zhu, N.; Lin, J.; Wang, K.; Wei, M.; Chen, Q.; Wang, Y. Huperzine A protects neural stem cells against Aβ-induced apoptosis in neural stem cells and microglia co-culture system. Int. J. Clin. Exp. Pathol. 2015, 8, 6425–6433.
39. Xie, L.; Jiang, C.; Wang, Z.; Yi, X.; Gong, Y.; Chen, Y.; Fu, Y. Effect of Huperzine A on Aβ-induced p65 of astrocyte in vitro. Biosci. Biotechnol. Biochem. 2016, 80, 2334–2337. [CrossRef]
40. Rafii, M.S.; Walsh, S.; Little, J.T.; Behan, K.; Reynolds, B.; Ward, C.; Jin, S.; Thomas, R.; Aisen, P.S. A phase II trial of huperzine A in mild to moderate Alzheimer disease. Neurology 2011, 76, 1389–1394. [CrossRef]
41. Xing, S.H.; Zhu, C.X.; Zhang, R.; An, L. Huperzine an in the treatment of Alzheimer’s disease and vascular dementia: A meta-analysis. Evid. Based Complementary Altern. Med. 2014, 363985. [CrossRef]
42. Gul, A.; Bakht, J.; Mehmood, F. Huperzine-A response to cognitive impairment and task switching deficits in patients with Alzheimer’s disease. J. Chin. Med Assoc. 2019, 82, 40–43. [CrossRef]
43. Xu, S.S.; Gao, Z.X.; Weng, Z.; Du, Z.M.; Xu, W.A.; Yang, J.S.; Zhang, M.L.; Tong, Z.H.; Fang, Y.S.; Chai, X.S.; et al. Efficacy of tablet Huperzine-A on memory, cognition, and behavior in Alzheimer’s disease. Zhongguo Yao Li Xue Bao 1995, 16, 391–395.
44. Tsai, S. Huperzine-A, a versatile herb, for the treatment of Alzheimer’s disease. Crit. Care Med. 2019, 82, 750–751. [CrossRef]
45. Ghassab-Abdollahi, N.; Mobasseri, K.; Dehghani Ahmadabad, A.; Nadrian, H.; Mirghafourvand, M. The effects of Huperzine A on dementia and mild cognitive impairment: An overview of systematic reviews. Phytother. Res. 2021, 35, 4971–4987. [CrossRef]
46. Damar, U.; Gerstner, R.; Johnstone, J.T.; Schachter, S.; Rotenberg, A. Huperzine A: A promising anticonvulsant, disease-modifying, and memory-enhancing treatment option in Alzheimer’s disease. Med. Hypotheses 2017, 99, 57–62. [CrossRef]
47. Südhof, T.C. Neurotransmitter release: The last millisecond in the life of a synaptic vesicle. Neuron 2013, 80, 675–690. [CrossRef]
48. Wang, Y.; Tang, X.C.; Zhang, H.Y. Huperzine A alleviates synaptic deficits and modulates amyloidogenic and nonamyloidogenic pathways in APPswe/PS1dE9 transgenic mice. J. Neurosci. Res. 2012, 90, 508–517. [CrossRef]
49. Ma, T.; Gong, K.; Yan, Y.; Zhang, L.; Tang, P.; Zhang, X.; Gong, Y. Huperzine A promotes hippocampal neurogenesis in vitro and in vivo. Brain Res. 2013, 1506, 35–43. [CrossRef]
50. Mao, X.Y.; Zhou, H.H.; Li, X.; Liu, Z.Q. Huperzine A Alleviates Oxidative Glutamate Toxicity in Hippocampal HT22 Cells via Activating BDNF/TrkB-Dependent PI3K/Akt/mTOR Signaling Pathway. Cell. Mol. Neurobiol. 2016, 36, 915–925. [CrossRef]
51. Kerr, F.; Bjedov, I.; Sofola-Adesakin, O. Molecular Mechanisms of Lithium Action: Switching the Light on Multiple Targets for Dementia Using Animal Models. Front. Mol. Neurosci. 2018, 11, 297. [CrossRef]
52. Qian, Z.M.; Ke, Y. Huperzine A: Is it an Effective Disease-Modifying Drug for Alzheimer’s Disease? Front. Aging Neurosci. 2014, 6, 216. [CrossRef]
53. Rahman, M.H.; Bajgai, J.; Fadriquela, A.; Sharma, S.; Trinh Thi, T.; Akter, R.; Goh, S.H.; Kim, C.-S.; Lee, K.-J. Redox Effects of Molecular Hydrogen and Its Therapeutic Efficacy in the Treatment of Neurodegenerative Diseases. Processes 2021, 9, 308. [CrossRef]
54. Du, Y.; Liang, H.; Zhang, L.; Fu, F. Administration of Huperzine A exerts antidepressant-like activity in a rat model of post-stroke depression. Pharmacol. Biochem. Behav. 2017, 158, 32–38. [CrossRef]
55. Mak, S.; Li, W.; Fu, H.; Luo, J.; Cui, W.; Hu, S.; Pang, Y.; Carlier, P.R.; Tsim, K.W.; Pi, R.; et al. Promising tacrine/huperzine A-based dimeric acetylcholinesterase inhibitors for neurodegenerative disorders: From relieving symptoms to modifying diseases through multitarget. J. Neurochem. 2021, 158, 1381–1393. [CrossRef]
56. Carvajal, F.J.; Inestrosa, N.C. Interactions of AChE with Aβ Aggregates in Alzheimer’s Brain: Therapeutic Relevance of IDN 5706. Front. Mol. Neurosci. 2011, 4, 19. [CrossRef]
57. Rees, T.; Hammond, P.I.; Soreq, H.; Younkin, S.; Brimijoin, S. Acetylcholinesterase promotes beta-amyloid plaques in the cerebral cortex. Neurobiol. Aging 2003, 24, 777–787. [CrossRef]
58. Leone, P.; Comoletti, D.; Taylor, P.; Bourne, Y.; Margot, P. Structure-function relationships of the alpha/beta-hydrolase fold domain of neuroligin: A comparison with acetylcholinesterase. Chem. Biol. Interact. 2010, 187, 49–55. [CrossRef] [PubMed]
59. Scholl, F.G.; Scheiffele, P. Making connections: Cholinesterase-domain proteins in the CNS. Trends Neurosci. 2003, 26, 618–624. [CrossRef] [PubMed]
60. Dinamarca, M.C.; Sagal, J.P.; Quintanilla, R.A.; Godoy, J.A.; Arrazola, M.S.; Inestrosa, N.C. Amyloid-beta-Acetylcholinesterase complexes potentiate neurodegenerative changes induced by the Abeta peptide. Implications for the pathogenesis of Alzheimer’s disease. Mol. Neurodegener. 2010, 5, 4. [CrossRef] [PubMed]
61. Dinamarca, M.C.; Di Luca, M.; Godoy, J.A.; Inestrosa, N.C. The soluble extracellular fragment of neuroligin-1 targets Aβ oligomers to the postsynaptic region of excitatory synapses. Biochem. Biophys. Res. Commun. 2015, 466, 66–71. [CrossRef]
62. Nhan, H.S.; Chiang, K.; Koo, E.H. The multifaceted nature of amyloid precursor protein and its proteolytic fragments: friends and foes. Acta Neuropathol. 2015, 129, 1–19. [CrossRef]
63. Inestrosa, N.C.; Arenas, E. Emerging roles of Wnts in the adult nervous system. Nat. Rev. Neurosci. 2010, 11, 77–86. [CrossRef]
64. Oliva, C.A.; Montecinos-Oliva, C.; Inestrosa, N.C. Wnt Signaling in the Central Nervous System: New Insights in Health and Disease. Prog. Mol. Biol. Transl. Sci. 2018, 153, 81–130. [CrossRef]
65. Varela-Nallar, L.; Inestrosa, N.C. Wnt signaling in the regulation of adult hippocampal neurogenesis. Front. Cell. Neurosci. 2013, 7, 100. [CrossRef]
66. Menet, R.; Lecordier, S.; ElAli, A. Wnt Pathway: An Emerging Player in Vascular and Traumatic Mediated Brain Injuries. Front. Physiol. 2020, 11, 565667. [CrossRef]
67. Tapia-Rojas, C.; Burgos, P.V.; Inestrosa, N.C. Inhibition of Wnt signaling induces amyloidogenic processing of amyloid precursor protein and the production and aggregation of Amyloid-β (Aβ)(42) peptides. J. Neurochem. 2016, 139, 1175–1191. [CrossRef]
68. Inestrosa, N.C.; Varela-Nallar, L. Wnt signaling in the nervous system and in Alzheimer’s disease. J. Mol. Cell Biol. 2014, 6, 64–74. [CrossRef]
69. Lu, H.; Jiang, M.; Lu, L.; Zheng, G.; Dong, Q. Ultrastructural mitochondria changes in the perihematomal brain and neuroprotective effects of Huperzine A after acute intracerebral hemorrhage. Neuropsychiatr. Dis. Treat. 2015, 11, 2649–2657. [CrossRef]
70. Yang, X.; Wei, H.M.; Hu, G.Y.; Zhao, J.; Long, L.-N.; Li, C.-J.; Zhao, Z.-J.; Zeng, H.-K.; Nie, H. Combining antioxidant astaxanthin and cholinesterase inhibitor huperzine A boosts neuroprotection. Mol. Med. Rep. 2020, 21, 1043–1050. [CrossRef]
71. Baez-Pagan, C.A.; Delgado-Vélez, M.; Lasalde-Dominicci, J.A. Activation of the Macrophage α7 Nicotinic Acetylcholine Receptor and Control of Inflammation. J. Neuroimmune Pharmacol. 2015, 10, 468–476. [CrossRef]
72. Donat, C.K.; Scott, G.; Gentleman, S.M.; Sastre, M. Microglial Activation in Traumatic Brain Injury. Front. Aging Neurosci. 2017, 9, 208. [CrossRef]





