Affiliations: [a] Department of Geriatrics, Center for Aging Brain, Memory Unit, University of Bari, Bari, Italy | [b] Department of Geriatrics, University of Foggia, Foggia, Italy | [c] Internal Medicine Unit, IRCSS Casa Sollievo dalla Sofferenza. San Giovanni Rotondo, Foggia, Italy
Correspondence:
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Corresponding author: Francesco Panza, MD, PhD, Department of Geriatrics, Center for Aging Brain, Memory Unit, University of Bari, Policlinico, Piazza Giulio Cesare, 11, 70124 Bari, Italy. Tel.: +39 080 5473685; Fax: +39 080 5478860; E-mail: geriat.dot@geriatria.uniba.it.
Abstract: Very recent findings confirmed that S-adenosylmethionine (SAM) can exert a direct effect on glutathione S-transferase (GST) activity. Alzheimer's disease (AD) is accompanied by reduced GST activity, diminished SAM, and increased S-adenosyl homocysteine (SAH), the downstream metabolic product resulting from SAM-mediated transmethylation reactions, when deprived of folate. Therefore, these findings underscored the critical role of SAM in maintenance of neuronal health, suggesting a possible role of SAM as a neuroprotective dietary supplement in AD. Given recent findings from clinical trials in which ω-3 polyunsturated fatty acids (PUFA) supplementation was effective only in very mild AD subgroups or mild cognitive impairment (MCI), we suggest intervention trials using measures of dietary supplementation (dietary ω-3 PUFA and SAM plus B vitamin supplementation) to determine if such supplements will reduce the risk for cognitive decline in very mild AD and MCI. Therefore, key supplements are not necessarily working in isolation, and the most profound impact, or in some cases the only impact, is noted very early in the course of AD, suggesting that nutriceutical supplements may bolster pharmacological approaches well past the window where supplements can work on their own.
