AccScience Publishing / GPD / Online First / DOI: 10.36922/GPD026050003
ORIGINAL RESEARCH ARTICLE

Key regulators of Alzheimer’s disease: Network biology and in silico analysis with acetylcholinesterase and glutamate inhibitors

Sayantan Das1*
Show Less
1 Department of Life Science, Faculty of Biological Sciences, University of Essex, Colchester, Essex, United Kingdom
Received: 28 January 2026 | Revised: 4 March 2026 | Accepted: 18 March 2026 | Published online: 30 April 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Alzheimer’s disease (AD) is a complex, progressive neurodegenerative disorder driven by both genetic and environmental factors, with hallmark features including amyloid-β plaques and neurofibrillary tangles. Despite substantial research, the majority of currently licensed medications are still symptomatic, highlighting the need for multi-target and network-based treatment approaches. This study employed a systems biology approach to identify important regulatory proteins implicated in AD development and to assess their interaction patterns with approved glutamate and cholinesterase inhibitors. A protein–protein interaction network was developed using the 85 overlapping genes identified when AD-associated genes were selected from six significant biomedical databases. Seven major regulators were identified using centrality and hub analyses, including APP, APOE, BDNF, VEGFA, PSEN1, CASP1, and NOTCH1. Their participation in axon formation, signal transduction, neuroinflammatory processes, and neurodegenerative pathways was revealed by Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis. The binding affinities of donepezil, galantamine, rivastigmine, and memantine toward these targets were evaluated by molecular docking using AutoDock Vina. While APP demonstrated relatively weaker affinities, BDNF demonstrated the strongest overall binding interactions, especially with donepezil. Memantine showed significant binding to PSEN1, indicating that amyloidogenic processes may be indirectly modulated. These results demonstrate the usefulness of integrated computational techniques in identifying new therapeutic interaction networks and support a multi-target pharmacological paradigm. This study offers a systems-level basis for medication repurposing and precision intervention strategies in AD, although additional experimental validation is needed. 

Graphical abstract
Keywords
Alzheimer’s disease
Cholinesterase inhibitors
Glutamate inhibitors
Molecular docking
In silico studies
Network biology
Drug repurposing
Funding
None.
Conflict of interest
The author declares no competing interests.
References
  1. Scheltens P, De Strooper B, Kivipelto M, et al. Alzheimer’s disease. Lancet. 2021;397(10284):1577-1590. doi: 10.1016/S0140-6736(20)32205-4
  2. 2024 Alzheimer’s disease facts and figures. Alzheimers Dement. 2024;20(5):3708-3821. doi: 10.1002/alz.13809
  3. Montine TJ, Monsell SE, Beach TG, et al. Multisite assessment of NIA-AA guidelines for the neuropathologic evaluation of Alzheimer’s disease. Alzheimers Dement. 2016;12(2):164-169. doi: 10.1016/j.jalz.2015.07.492
  4. Di Benedetto G, Burgaletto C, Bellanca CM, Munafò A, Bernardini R, Cantarella G. Role of Microglia and Astrocytes in Alzheimer’s Disease: From Neuroinflammation to Ca2+ Homeostasis Dysregulation. Cells. 2022;11(17):2728. doi: 10.3390/cells11172728
  5. Varadharajan A, Davis AD, Ghosh A, et al. Guidelines for pharmacotherapy in Alzheimer’s disease - A primer on FDA-approved drugs. J Neurosci Rural Pract. 2023;14(4):566-573. doi: 10.25259/JNRP_356_2023
  6. Beach TG, Monsell SE, Phillips LE, Kukull W. Accuracy of the clinical diagnosis of Alzheimer disease at National Institute on Aging Alzheimer Disease Centers, 2005-2010. J Neuropathol Exp Neurol. 2012;71(4):266-273. doi: 10.1097/NEN.0b013e31824b211b
  7. Schneider JA, Arvanitakis Z, Leurgans SE, Bennett DA. The neuropathology of probable Alzheimer disease and mild cognitive impairment. Ann Neurol. 2009;66(2):200-208. doi: 10.1002/ana.21706
  8. Serrano-Pozo A, Qian J, Monsell SE, et al. Mild to moderate Alzheimer dementia with insufficient neuropathological changes. Ann Neurol. 2014;75(4):597-601. doi: 10.1002/ana.24125
  9. Andrade-Guerrero J, Santiago-Balmaseda A, Jeronimo- Aguilar P, et al. Alzheimer’s Disease: An Updated Overview of Its Genetics. Int J Mol Sci. 2023;24(4):3754. doi: 10.3390/ijms24043754
  10. Bekris LM, Yu CE, Bird TD, Tsuang DW. Genetics of Alzheimer disease. J Geriatr Psychiatry Neurol. 2010;23(4):213-227. doi: 10.1177/0891988710383571
  11. Strang KH, Golde TE, Giasson BI. MAPT mutations, tauopathy, and mechanisms of neurodegeneration. Lab Invest. 2019;99(7):912-928. doi: 10.1038/s41374-019-0197-x
  12. Hampel H, Vassar R, De Strooper B, et al. The β-Secretase BACE1 in Alzheimer’s Disease. Biol Psychiatry. 2021;89(8):745-756. doi: 10.1016/j.biopsych.2020.02.001
  13. Selkoe DJ. Biochemistry and molecular biology of amyloid beta-protein and the mechanism of Alzheimer’s disease. Handb Clin Neurol. 2008;89:245-260. doi: 10.1016/S0072-9752(07)01223-7
  14. Hardy J. Amyloid, the presenilins and Alzheimer’s disease. Trends Neurosci. 1997;20(4):154-159. doi: 10.1016/s0166-2236(96)01030-2
  15. Surguchov A, Emamzadeh FN, Titova M, Surguchev AA. Controversial Properties of Amyloidogenic Proteins and Peptides: New Data in the COVID Era. Biomedicines. 2023;11(4):1215. doi: 10.3390/biomedicines11041215
  16. Cole SL, Vassar R. The role of amyloid precursor protein processing by BACE1, the beta-secretase, in Alzheimer disease pathophysiology. J Biol Chem. 2008;283(44):29621- 29625. doi: 10.1074/jbc.R800015200
  17. Wang Y, Mandelkow E. Tau in physiology and pathology. Nat Rev Neurosci. 2016;17(1):5-21. doi: 10.1038/nrn.2015.1
  18. Husain MA, Laurent B, Plourde M. APOE and Alzheimer’s Disease: From Lipid Transport to Physiopathology and Therapeutics. Front Neurosci. 2021;15:630502. doi: 10.3389/fnins.2021.630502
  19. Farrer LA, Cupples LA, Haines JL, et al. Effects of age, sex, and ethnicity on the association between apolipoprotein E genotype and Alzheimer disease. A meta-analysis. APOE and Alzheimer Disease Meta Analysis Consortium. JAMA. 1997;278(16):1349-1356. doi: 10.1001/jama.278.16.1349
  20. Kim BH, Kim S, Nam Y, Park YH, Shin SM, Moon M. Second-generation anti-amyloid monoclonal antibodies for Alzheimer’s disease: current landscape and future perspectives. Transl Neurodegener. 2025;14(1):6. doi: 10.1186/s40035-025-00465-w
  21. Sam C, Bordoni B. Physiology, Acetylcholine. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2023. Available from https://www.ncbi.nlm.nih.gov/books/NBK557825/ [Last accessed on].
  22. Puranik N, Song M. Glutamate: Molecular Mechanisms and Signaling Pathway in Alzheimer’s Disease, a Potential Therapeutic Target. Molecules. 2024;29(23):5744. doi: 10.3390/molecules29235744
  23. Barabási AL, Oltvai ZN. Network biology: understanding the cell’s functional organization. Nat Rev Genet. 2004;5(2):101- 113. doi: 10.1038/nrg1272
  24. Shannon P, Markiel A, Ozier O, et al. Cytoscape: a software environment for integrated models of biomolecular interaction networks. Genome Res. 2003;13(11):2498-2504. doi: 10.1101/gr.1239303
  25. Kulkarni VS, Alagarsamy V, Solomon VR, Jose PA, Murugesan S. Drug Repurposing: An Effective Tool in Modern Drug Discovery. Russ J Bioorg Chem. 2023;49(2):157-166. doi: 10.1134/S1068162023020139
  26. Talevi A. Multi-target pharmacology: possibilities and limitations of the “skeleton key approach” from a medicinal chemist perspective. Front Pharmacol. 2015;6:205. doi: 10.3389/fphar.2015.00205
  27. Kitchen DB, Decornez H, Furr JR, Bajorath J. Docking and scoring in virtual screening for drug discovery: methods and applications. Nat Rev Drug Discov. 2004;3(11):935-949. doi: 10.1038/nrd1549
  28. Genheden S, Ryde U. The MM/PBSA and MM/GBSA methods to estimate ligand-binding affinities. Expert Opin Drug Discov. 2015;10(5):449-461. doi: 10.1517/17460441.2015.1032936
  29. De Strooper B, Karran E. The Cellular Phase of Alzheimer’s Disease. Cell. 2016;164(4):603-615. doi: 10.1016/j.cell.2015.12.056
  30. Swerdlow RH. Mitochondria and Mitochondrial Cascades in Alzheimer’s Disease. J Alzheimers Dis. 2018;62(3):1403- 1416. doi: 10.3233/JAD-170585
  31. Heneka MT, Carson MJ, El Khoury J, et al. Neuroinflammation in Alzheimer’s disease. Lancet Neurol. 2015;14(4):388-405. doi: 10.1016/S1474-4422(15)70016-5
  32. Xu LZ, Li FY, Xu J, Li BQ, Li Y, Jia JP. Vascular endothelial growth factor is an effective biomarker for vascular dementia, not for Alzheimer’s disease: A meta-analysis. Alzheimers Dement. 2024;16(2):e12612.doi: 10.1002/dad2.12612
  33. Heberle H, Meirelles GV, da Silva FR, Telles GP, Minghim R. InteractiVenn: a web-based tool for the analysis of sets through Venn diagrams. BMC Bioinform. 2015;16(1):169. doi: 10.1186/s12859-015-0611-3
  34. Braschi B, Denny P, Gray K, et al. Genenames.org: the HGNC and VGNC resources in 2019. Nucleic Acids Res. 2019;47(D1):D786-D792. doi: 10.1093/nar/gky930
  35. Barrett T, Wilhite SE, Ledoux P, et al. NCBI GEO: archive for functional genomics data sets--update. Nucleic Acids Res. 2013;41(Database issue):D991-D995. doi: 10.1093/nar/gks1193
  36. Budni J, Bellettini-Santos T, Mina F, Garcez ML, Zugno AI. The involvement of BDNF, NGF and GDNF in aging and Alzheimer’s disease. Aging Dis. 2015;6(5):331-341. doi: 10.14336/AD.2015.0825
  37. Bendix I, Serdar M, Herz J, et al. Inhibition of acetylcholinesterase modulates NMDA receptor antagonist mediated alterations in the developing brain. Int J Mol Sci. 2014;15(3):3784-3798. doi: 10.3390/ijms15033784
  38. Mishchenko TA, Mitroshina EV, Usenko AV, et al. Features of Neural Network Formation and Their Functions in Primary Hippocampal Cultures in the Context of Chronic TrkB Receptor System Influence. Front Physiol. 2019;9:1925. doi: 10.3389/fphys.2018.01925
  39. Haass C, Selkoe DJ. Soluble protein oligomers in neurodegeneration: lessons from the Alzheimer’s amyloid beta-peptide. Nat Rev Mol Cell Biol. 2007;8(2):101-112. doi: 10.1038/nrm2101
  40. Xiao X, Liu H, Liu X, Zhang W, Zhang S, Jiao B. APP, PSEN1, and PSEN2 Variants in Alzheimer’s Disease: Systematic Re-evaluation According to ACMG Guidelines. Front Aging Neurosci. 2021;13:695808. doi: 10.3389/fnagi.2021.695808
  41. Targa Dias Anastacio H, Matosin N, Ooi L. Familial Alzheimer’s Disease Neurons Bearing Mutations in PSEN1 Display Increased Calcium Responses to AMPA as an Early Calcium Dysregulation Phenotype. Life. 2024;14(5):625. doi: 10.3390/life14050625
  42. Cheung KH, Shineman D, Müller M, et al. Mechanism of Ca2+ disruption in Alzheimer’s disease by presenilin regulation of InsP3 receptor channel gating. Neuron. 2008;58(6):871-883. doi: 10.1016/j.neuron.2008.04.015
  43. Bezprozvanny I, Mattson MP. Neuronal calcium mishandling and the pathogenesis of Alzheimer’s disease. Trends Neurosci. 2008;31(9):454-463. doi: 10.1016/j.tins.2008.06.005
  44. Tang BC, Wang YT, Ren J. Basic information about memantine and its treatment of Alzheimer’s disease and other clinical applications. Ibrain. 2023;9(3):340-348. doi: 10.1002/ibra.12098
  45. Parsons CG, Stöffler A, Danysz W. Memantine: a NMDA receptor antagonist that improves memory by restoration of homeostasis in the glutamatergic system--too little activation is bad, too much is even worse. Neuropharmacology. 2007;53(6):699-723. doi: 10.1016/j.neuropharm.2007.07.013
  46. Shankar GM, Li S, Mehta TH, et al. Amyloid-beta protein dimers isolated directly from Alzheimer’s brains impair synaptic plasticity and memory. Nat Med. 2008;14(8):837- 842. doi: 10.1038/nm1782
  47. Sarasija S, Norman KR. A γ-Secretase Independent Role for Presenilin in Calcium Homeostasis Impacts Mitochondrial Function and Morphology in Caenorhabditis elegans. Genetics. 2015;201(4):1453-1466. doi: 10.1534/genetics.115.182808
  48. Zhang C, Wu B, Beglopoulos V, et al. Presenilins are essential for regulating neurotransmitter release. Nature. 2009;460(7255):632-636. doi: 10.1038/nature08177
  49. Venkatraman L, Claesson-Welsh L. The role of VEGF in controlling vascular permeability. In: Tumor Angiogenesis: A Key Target for Cancer Therapy. Cham, Switzerland: Springer; 2019; 33-50. doi: 10.1007/978-3-319-31215-6_37-1
  50. Quaggin SE. A half-century of VEGFA: from theory to practice. J Clin Invest. 2024;134(15):e184205. doi: 10.1172/JCI184205
  51. Lee C, Kim MJ, Kumar A, Lee HW, Yang Y, Kim Y. Vascular endothelial growth factor signaling in health and disease: from molecular mechanisms to therapeutic perspectives. Signal Transduct Target Ther. 2025;10(1):170. doi: 10.1038/s41392-025-02249-0
  52. Shibuya M. Vascular Endothelial Growth Factor (VEGF) and Its Receptor (VEGFR) Signaling in Angiogenesis: A Crucial Target for Anti- and Pro-Angiogenic Therapies. Genes Cancer. 2011;2(12):1097–1105. doi: 10.1177/1947601911423031
  53. Yang HS, Yau WW, Carlyle BC, et al. Plasma VEGFA and PGF impact longitudinal tau and cognition in preclinical Alzheimer’s disease. Brain. 2024;147(6):2158-2168. doi: 10.1093/brain/awae034
  54. Zhang M, Zhang Z, Li H, et al. Blockage of VEGF function by bevacizumab alleviates early-stage cerebrovascular dysfunction and improves cognitive function in a mouse model of Alzheimer’s disease. Transl Neurodegener. 2024;13(1):1. doi: 10.1186/s40035-023-00388-4
  55. Fukumura D, Gohongi T, Kadambi A, et al. Predominant role of endothelial nitric oxide synthase in vascular endothelial growth factor-induced angiogenesis and vascular permeability. Proc Natl Acad Sci USA. 2001;98(5):2604- 2609. doi: 10.1073/pnas.041359198
  56. Figueroa XF, González DR, Martínez AD, Durán WN, Boric MP. ACh-induced endothelial NO synthase translocation, NO release and vasodilatation in the hamster microcirculation in vivo. J Physiol. 2002;544(3):883-896. doi: 10.1113/jphysiol.2002.021972
  57. Jackson RJ, Meltzer JC, Nguyen H, et al. APOE4 derived from astrocytes leads to blood-brain barrier impairment. Brain. 2022;145(10):3582-3593. doi: 10.1093/brain/awab478
  58. Wang C, Xiong M, Gratuze M, et al. Selective removal of astrocytic APOE4 strongly protects against tau-mediated neurodegeneration and decreases synaptic phagocytosis by microglia. Neuron. 2021;109(10):1657-1674.e7. doi: 10.1016/j.neuron.2021.03.024
  59. Williams T, Borchelt DR, Chakrabarty P. Therapeutic approaches targeting Apolipoprotein E function in Alzheimer’s disease. Mol Neurodegener. 2020;15(1):8. doi: 10.1186/s13024-020-0358-9
  60. Waring JF, Tang Q, Robieson WZ, et al. APOE-ɛ4 Carrier Status and Donepezil Response in Patients with Alzheimer’s Disease. J Alzheimers Dis. 2015;47(1):137-148. doi: 10.3233/JAD-142589
  61. De Beaumont L, Pelleieux S, Lamarre-Théroux L, Dea D, Poirier J. Butyrylcholinesterase K and Apolipoprotein E-ɛ4 Reduce the Age of Onset of Alzheimer’s Disease, Accelerate Cognitive Decline, and Modulate Donepezil Response in Mild Cognitively Impaired Subjects. J Alzheimers Dis. 2016;54(3):913-922. doi: 10.3233/JAD-160373
  62. Cheng YC, Huang YC, Liu HC. Effect of Apolipoprotein E ɛ4 Carrier Status on Cognitive Response to Acetylcholinesterase Inhibitors in Patients with Alzheimer’s Disease: A Systematic Review and Meta-Analysis. Dement Geriatr Cogn Disord. 2018;45(5-6):335-352. doi: 10.1159/000490175
  63. Han YH, Liu XD, Jin MH, Sun HN, Kwon T. Role of NLRP3 inflammasome-mediated neuronal pyroptosis and neuroinflammation in neurodegenerative diseases. Inflamm Res. 2023;72(9):1839-1859. doi: 10.1007/s00011-023-01790-4
  64. Lu B, Kwan K, Levine YA, et al. α7 nicotinic acetylcholine receptor signaling inhibits inflammasome activation by preventing mitochondrial DNA release. Mol Med. 2014;20(1):350-358. doi: 10.2119/molmed.2013.00117
  65. Ke P, Shao BZ, Xu ZQ, Chen XW, Wei W, Liu C. Activating α7 nicotinic acetylcholine receptor inhibits NLRP3 inflammasome through regulation of β-arrestin-1. CNS Neurosci Ther. 2017;23(11):875-884. doi: 10.1111/cns.12758
  66. Ye X, Song G, Huang S, et al. Caspase-1: A Promising Target for Preserving Blood-Brain Barrier Integrity in Acute Stroke. Front Mol Neurosci. 2022;15:856372. doi: 10.3389/fnmol.2022.856372
  67. Sachan N, Sharma V, Mutsuddi M, Mukherjee A. Notch signalling: multifaceted role in development and disease. FEBS J. 2024;291(14):3030-3059. doi: 10.1111/febs.16815
  68. Brai E, Marathe S, Astori S, et al. Notch1 Regulates Hippocampal Plasticity Through Interaction with the Reelin Pathway, Glutamatergic Transmission and CREB Signaling. Front Cell Neurosci. 2015;9:447. doi: 10.3389/fncel.2015.00447
  69. Giniger E. Notch signaling and neural connectivity. Curr Opin Genet Dev. 2012;22(4):339-346. doi: 10.1016/j.gde.2012.04.003
  70. Lleó A, Berezovska O, Ramdya P, et al. Notch1 competes with the amyloid precursor protein for gamma-secretase and down-regulates presenilin-1 gene expression. J Biol Chem. 2003;278(48):47370-47375. doi: 10.1074/jbc.M308480200
  71. Kim WY, Snider WD. Functions of GSK-3 Signaling in Development of the Nervous System. Front Mol Neurosci. 2011;4:44. doi: 10.3389/fnmol.2011.00044
  72. Liu YW, Luo JL, Ren H, et al. Inhibition of NMDA-gated ion channels by bis(7)-tacrine: whole-cell and single-channel studies. Neuropharmacology. 2008;54(7):1086-1094. doi: 10.1016/j.neuropharm.2008.02.015
  73. Bajda, M., Guzior, N., Ignasik, M., & Malawska, B. Multi-target-directed ligands in Alzheimer’s disease treatment. Curr Med Chem. 2011; 18(32), 4949–4975. doi: 10.2174/092986711797535245
  74. Kabir MT, Uddin MS, Mamun AA, et al. Combination Drug Therapy for the Management of Alzheimer’s Disease. Int J Mol Sci. 2020;21(9):3272. doi: 10.3390/ijms21093272
  75. Cummings JL, Osse AML, Kinney JW, Cammann D, Chen J. Alzheimer’s Disease: Combination Therapies and Clinical Trials for Combination Therapy Development. CNS Drugs. 2024;38(8):613-624. doi: 10.1007/s40263-024-01103-1
  76. Ferreira LG, Dos Santos RN, Oliva G, Andricopulo AD. Molecular docking and structure-based drug design strategies. Molecules. 2015;20(7):13384-13421. doi: 10.3390/molecules200713384
  77. Tycko R. Amyloid polymorphism: structural basis and neurobiological relevance. Neuron. 2015;86(3):632-645. doi: 10.1016/j.neuron.2015.03.017
  78. Mahley RW. Apolipoprotein E: from cardiovascular disease to neurodegenerative disorders. J Mol Med. 2016;94(7):739- 746. doi: 10.1007/s00109-016-1427-y
  79. Ferrara N, Kerbel RS. Angiogenesis as a therapeutic target. Nature. 2005;438(7070):967-974. doi: 10.1038/nature04483
  80. Chao MV. Neurotrophins and their receptors: a convergence point for many signalling pathways. Nat Rev Neurosci. 2003;4(4):299-309. doi: 10.1038/nrn1078
  81. Pagadala NS, Syed K, Tuszynski J. Software for molecular docking: a review. Biophys Rev. 2017;9(2):91-102. doi: 10.1007/s12551-016-0247-1
  82. Kim SH, Kandiah N, Hsu JL, Suthisisang C, Udommongkol C, Dash A. Beyond symptomatic effects: potential of donepezil as a neuroprotective agent and disease modifier in Alzheimer’s disease. Br J Pharmacol. 2017;174(23):4224- 4232. doi: 10.1111/bph.14030
  83. Jelinek M, Jurajda M, Duris K. Oxidative Stress in the Brain: Basic Concepts and Treatment Strategies in Stroke. Antioxidants. 2021;10(12):1886. doi: 10.3390/antiox10121886
  84. Urrutia J, Arrizabalaga-Iriondo A, Sanchez-Del-Rey A, et al. Therapeutic role of voltage-gated potassium channels in age-related neurodegenerative diseases. Front Cell Neurosci. 2024;18:1406709. doi: 10.3389/fncel.2024.1406709

85. Baumgartner TJ, Haghighijoo Z, Goode NA, Dvorak NM, Arman P, Laezza F. Voltage-Gated Na+ Channels in Alzheimer’s Disease: Physiological Roles and Therapeutic Potential. Life. 2023;13(8):1655. doi: 10.3390/life13081655

Share
Back to top
Gene & Protein in Disease, Electronic ISSN: 2811-003X Published by AccScience Publishing