The therapeutic potential of GLP-1 receptor agonists in central nervous system diseases: immune cell modulation and neuroinflammation.

IF 4 3区医学 Q2 IMMUNOLOGY

Expert Review of Clinical Immunology Pub Date : 2026-10-13 DOI:10.1080/1744666X.2026.2747225

Ziyu Wang, Song Xue, Xin Zhou, Mengyao Yuan, Xin Sun

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Abstract

Introduction: Central nervous system (CNS) diseases impose a substantial global burden; however, effective treatments remain limited. Neuroinflammation contributes to the development and progression of various CNS diseases. Preclinical evidence suggests that glucagon-like peptide-1 receptor agonists (GLP-1RAs) may alleviate neuroinflammation by modulating immune cell-related processes, showing therapeutic potential in CNS diseases.

Areas covered: We searched PubMed/MEDLINE, Embase, and Web of Science for literature published between 2016 and 2026. We summarize preclinical evidence that various GLP-1RAs alleviate neuroinflammation across different CNS diseases through modulation of peripheral and central immune cells, focusing on neutrophils, monocytes/macrophages, T lymphocytes, microglia, astrocytes, and their crosstalk, and discuss related clinical translation and challenges.

Expert opinion: Repurposing GLP-1RAs, including exenatide, liraglutide, semaglutide, and dulaglutide, may provide a therapeutic option for CNS diseases. However, most mechanistic evidence remains preclinical, and clinical efficacy has not been established. Future studies should integrate neuroimmune biomarkers with clinical outcomes to determine whether immunomodulatory effects translate into clinical benefit. Future research should also distinguish direct CNS effects from peripheral metabolic effects across different GLP-1RAs and identify appropriate patient populations. The effects of age, sex, comorbidities, and concomitant medications on efficacy and safety, as well as potential adverse effects of long-term use, also warrant attention.

查看原文本刊更多论文

GLP-1受体激动剂在中枢神经系统疾病中的治疗潜力：免疫细胞调节和神经炎症。

中枢神经系统（CNS）疾病造成了巨大的全球负担；然而，有效的治疗方法仍然有限。神经炎症有助于各种中枢神经系统疾病的发生和发展。临床前证据表明，胰高血糖素样肽-1受体激动剂（GLP-1RAs）可能通过调节免疫细胞相关过程来缓解神经炎症，在中枢神经系统疾病中显示出治疗潜力。覆盖领域：我们检索了PubMed/MEDLINE、Embase和Web of Science，检索了2016年至2026年间发表的文献。我们总结了各种GLP-1RAs通过调节外周和中枢免疫细胞缓解不同中枢神经系统疾病的神经炎症的临床前证据，重点是中性粒细胞、单核/巨噬细胞、T淋巴细胞、小胶质细胞、星形胶质细胞及其相互作用，并讨论了相关的临床翻译和挑战。专家意见：重新利用GLP-1RAs，包括艾塞那肽、利拉鲁肽、西马鲁肽和杜拉鲁肽，可能为中枢神经系统疾病提供治疗选择。然而，大多数机理证据仍停留在临床前，临床疗效尚未确定。未来的研究应将神经免疫生物标志物与临床结果结合起来，以确定免疫调节作用是否转化为临床益处。未来的研究还应区分不同GLP-1RAs对中枢神经系统的直接影响和外周代谢影响，并确定合适的患者群体。年龄、性别、合并症和合用药物对疗效和安全性的影响，以及长期使用的潜在不良影响，也值得注意。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Clinical Immunology IMMUNOLOGY-

CiteScore

7.60

自引率

2.30%

发文量

221

审稿时长

6-12 weeks

期刊介绍： Expert Review of Clinical Immunology (ISSN 1744-666X) provides expert analysis and commentary regarding the performance of new therapeutic and diagnostic modalities in clinical immunology. Members of the International Editorial Advisory Panel of Expert Review of Clinical Immunology are the forefront of their area of expertise. This panel works with our dedicated editorial team to identify the most important and topical review themes and the corresponding expert(s) most appropriate to provide commentary and analysis. All articles are subject to rigorous peer-review, and the finished reviews provide an essential contribution to decision-making in clinical immunology. Articles focus on the following key areas: • Therapeutic overviews of specific immunologic disorders highlighting optimal therapy and prospects for new medicines • Performance and benefits of newly approved therapeutic agents • New diagnostic approaches • Screening and patient stratification • Pharmacoeconomic studies • New therapeutic indications for existing therapies • Adverse effects, occurrence and reduction • Prospects for medicines in late-stage trials approaching regulatory approval • Novel treatment strategies • Epidemiological studies • Commentary and comparison of treatment guidelines Topics include infection and immunity, inflammation, host defense mechanisms, congenital and acquired immunodeficiencies, anaphylaxis and allergy, systemic immune diseases, organ-specific inflammatory diseases, transplantation immunology, endocrinology and diabetes, cancer immunology, neuroimmunology and hematological diseases.