Alzheimer’s disease (AD), one of the most common neurodegenerative diseases worldwide, has a devastating personal, familial, and societal impact. In spite of profound investment and effort, numerous clinical trials targeting amyloid-β, which is thought to have a causative role in the disease, have not yielded any clinically meaningful success to date. Iron is an essential cofactor in many physiological processes in the brain. An extensive body of work links iron dyshomeostasis with multiple aspects of the pathophysiology of AD. In particular, regional iron load appears to be a risk factor for more rapid cognitive decline. Existing iron-chelating agents have been in use for decades for other indications, and there are preliminary data that some of these could be effective in AD. Many novel iron-chelating compounds are under development, some with in vivo data showing potential Alzheimer’s disease-modifying properties. This heretofore underexplored therapeutic class has considerable promise and could yield much-needed agents that slow neurodegeneration in AD.

阿尔茨海默病 (AD) 是全球最常见的神经退行性疾病之一，对个人、家庭和社会都具有毁灭性的影响。尽管进行了大量投资和努力，但迄今为止，许多针对被认为在该疾病中具有致病作用的淀粉样蛋白 β 的临床试验尚未取得任何具有临床意义的成功。铁是大脑中许多生理过程中必不可少的辅助因子。大量工作将铁稳态失调与 AD 病理生理学的多个方面联系起来。特别是，区域铁负荷似乎是认知能力更迅速下降的危险因素。现有的铁螯合剂已用于其他适应症数十年，并且有初步数据表明其中一些可能对 AD 有效。许多新型铁螯合化合物正在开发中，其中一些具有体内数据显示潜在的阿尔茨海默氏病改善特性。这种迄今为止未被充分探索的治疗类别具有相当大的前景，并且可以产生急需的减缓 AD 神经变性的药物。