Alzheimer’s disease  (AD) is a chronic neurodegenerative disease that affects millions of  people worldwide. The causes of AD are complex and not fully  understood, but is widely acknowledged as a multifactorial process.  Therefore, a useful strategy for developing anti-AD agents is to design  multiple-target directed ligands (MTDLs) that can act on different aspects  of the disease. One of these aspects is the cholinergic system, which  regulates cognitive function through acetylcholine (ACh). In AD patients,  ACh levels decline significantly, leading to dementia. Thus, inhibiting  acetylcholinesterase (AChE), an enzyme that breaks down ACh, is a key  target for anti-AD drugs. Moreover, AChE can also modulate oxidative  stress and inflammation, which are also involved in AD pathology. Hence, we proposed a multi-target therapy that combines AChE  inhibitors with antioxidants to achieve a better therapeutic effect. One of  the antioxidants we chose is nuclear factor erythroid 2-related factor 2  (Nrf2), which can activate the expression of antioxidant response elements (AREs) and protect against inflammation and oxidative stress.  Herein, we designed, synthesized, and evaluated one series of hybrids as multifunctional anti-AD agents by fusing the 1,2,4-oxadiazole core from  the Nrf2 activator that we previously reported and the benzylpiperidine  motif from AChE inhibitor donepezil

Design, synthesis, and evaluation of fused hybrids with acetylcholinesterase inhibiting and Nrf2 activating functions for Alzheimer's disease

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