SGLT2 inhibitors and their possible use in prevention and treatment of neurological diseases

Abstract

Neurological diseases, neurological complications of diabetes and cardiovascular disease complications affecting the central nervous system (CNS) are one of the greatest challenges of modern medicine. Many of these diseases require the introduction of new therapies to improve the prognosis and quality of life of patients. Drugs with the increasing use in recent years are the SGLT2 inhibitors (SGLT2i): canagliflozin, dapagliflozin, empagliflozin. They demonstrate multiple pleiotropic actions with potential applications in CNS diseases. In addition to renal tubules, SGLT receptors are also found within the central nervous system. In numerous studies in animal models, SGLT2i have had promising results in the treatment of neurological conditions such as Alzheimer's disease, autism spectrum disorders, lesions caused by vascular diseases or complications of ischaemic stroke. SGLT2 inhibitors reduce oxidative stress and activation of inflammatory processes within the CNS, which may in the future be used to treat neurological diseases. So far, published studies on the effects of SGLT2 inhibitors on the nervous system are promising, but extensive, multicentre randomised trials on large groups of patients are needed to understand the exact mechanisms of action, therapeutic effects and potential side effects of SGLT2i.