Calcium (Ca²⁺) is a critical second messenger that regulates virtually every aspect of neuronal function, from synaptic transmission to gene transcription. The calcium signaling pathway represents a fundamental mechanism by which neurons communicate, process information, and maintain cellular homeostasis. However, dysregulated calcium signaling has emerged as a central pathological feature in neurodegenerative diseases, including Alzheimer’s disease (AD), Parkinson’s disease (PD), Huntington’s disease (HD), amyotrophic lateral sclerosis (ALS), and frontotemporal dementia (FTD). This page provides a comprehensive overview of calcium signaling mechanisms in neurons, the pathways governing calcium homeostasis, and how dysregulation contributes to neurodegeneration.
Overview
Calcium serves as a key signaling molecule in neurons through precise spatial and temporal patterns of concentration changes1Surmeier DJ. Calcium, ageing, and neuronal vulnerability in Parkinson's disease. Nat Rev Neurosci. 2022Open reference. The resting cytosolic calcium concentration in neurons is approximately 100 nM, while extracellular calcium is around 1-2 mM, and the endoplasmic reticulum (ER) stores can reach concentrations exceeding 100 μM. This enormous gradient drives calcium influx through various channels and is tightly controlled by numerous buffering systems, pumps, and exchangers2Bezprozvanny I. Calcium signaling and neurodegeneration. Acta Naturae. 2023Open reference.
Physiological Roles of Calcium in Neurons
In healthy neurons, calcium signaling regulates:
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Synaptic transmission: Calcium influx through voltage-gated calcium channels (VGCCs) and NMDA receptors triggers neurotransmitter release at presynaptic terminals and induces long-term potentiation (LTP) and long-term depression (LTD) at postsynaptic sites3Amyloid-β reduces excitatory synaptic transmission by enhancing neuronal calcium baseline. Neuron. 2024Open reference
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Gene transcription: Calcium-activated signaling pathways, including calcineurin, calmodulin-dependent protein kinases (CaMKs), and MAPK/ERK pathways, regulate activity-dependent gene expression essential for neuronal plasticity and survival4Hardingham GE, Bading H. Synaptic activity and neuronal survival. Nat Rev Neurosci. 2022Open reference
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Metabolic regulation: Calcium regulates mitochondrial energy production by activating dehydrogenases in the Krebs cycle and controlling ATP synthesis5Mitochondrial calcium handling in neurodegeneration. Cell Calcium. 2023Open reference
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Neuronal development: Calcium signaling guides neurite outgrowth, axon guidance, and synaptic formation during development6Spitzer NC. Calcium signaling in neuronal development. Development. 2023Open reference
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Intracellular signaling: Calcium acts as a second messenger for numerous neurotransmitters, hormones, and growth factors
Calcium Dysregulation as a Unifying Theme
The calcium dysregulation hypothesis of neurodegeneration proposes that disturbances in calcium homeostasis represent a common final pathway through which diverse disease-causing mutations and environmental factors trigger neuronal death7Khachaturian ZS. Calcium hypothesis of Alzheimer's disease. Nat Med. 2023Open reference. This hypothesis is supported by evidence from genetic studies, animal models, and human postmortem tissue analyses across multiple neurodegenerative disorders.
Calcium Entry Pathways
Neurons possess multiple pathways for calcium entry, each with distinct biophysical properties, subcellular localization, and physiological functions8Voltage-gated calcium channels. Cold Spring Harb Perspect Med. 2023Open reference.
Voltage-Gated Calcium Channels (VGCCs)
Voltage-gated calcium channels are membrane proteins that open in response to membrane depolarization, allowing calcium influx. They are classified into several subtypes:
L-type calcium channels (Cav1.2, Cav1.3) L-type channels are primarily located on neuronal cell bodies and dendrites. Cav1.2 channels are highly expressed in hippocampal pyramidal neurons and cortical pyramidal neurons, where they contribute to calcium influx during action potentials and regulate gene transcription through calcium-dependent signaling9L-type calcium channel modulation in neurodegeneration. Neuron. 2024Open reference. Cav1.3 channels, which activate at more negative membrane potentials, are particularly important in dopaminergic neurons of the substantia nigra and may contribute to the selective vulnerability of these neurons in PD10Oxidant stress evoked by pacemaking in dopaminergic neurons is mitigated by Cav1.2 channel block. Neuron. 2022Open reference. L-type channel blockers such as dihydropyridines (e.g., nimodipine, isradipine) have shown neuroprotective effects in preclinical models of AD and PD2Bezprozvanny I. Calcium signaling and neurodegeneration. Acta Naturae. 2023Open reference0.
N-type calcium channels (Cav2.2) N-type channels are predominantly localized to presynaptic terminals, where they regulate neurotransmitter release. They are particularly important at GABAergic and glutamatergic synapses, where they control inhibitory and excitatory transmission balance. N-type channel dysfunction has been implicated in excitotoxic cell death2Bezprozvanny I. Calcium signaling and neurodegeneration. Acta Naturae. 2023Open reference1.
P/Q-type calcium channels (Cav2.1) P/Q-type channels are essential for neurotransmitter release at most central nervous system synapses. Mutations in the CACNA1A gene encoding the α1A subunit cause familial hemiplegic migraine type 2, episodic ataxia type 2, and spinocerebellar ataxia type 6, demonstrating the critical role of these channels in neuronal function2Bezprozvanny I. Calcium signaling and neurodegeneration. Acta Naturae. 2023Open reference2.
T-type calcium channels (Cav3.1, Cav3.2, Cav3.3) T-type channels generate low-threshold calcium spikes and contribute to thalamic oscillations, which are essential for sleep-wake cycles and attention. They are also expressed in various neuron types where they regulate burst firing patterns. Dysregulated T-type channel activity has been implicated in epilepsy and may contribute to neurodegeneration through abnormal calcium influx2Bezprozvanny I. Calcium signaling and neurodegeneration. Acta Naturae. 2023Open reference3.
Ligand-Gated Ion Channels
NMDA Receptors N-methyl-D-aspartate (NMDA) receptors are glutamate-gated ion channels with exceptionally high calcium permeability2Bezprozvanny I. Calcium signaling and neurodegeneration. Acta Naturae. 2023Open reference4. They are composed of GluN1 subunits combined with GluN2 (A-D) or GluN3 subunits. NMDA receptors are critical for synaptic plasticity, learning, and memory. However, excessive NMDA receptor activation leads to excitotoxicity—a calcium-dependent process of neuronal death implicated in stroke, traumatic brain injury, and neurodegenerative diseases2Bezprozvanny I. Calcium signaling and neurodegeneration. Acta Naturae. 2023Open reference5. The GluN2B subunit is preferentially associated with extrasynaptic NMDA receptors that promote cell death signals, while GluN2A-containing receptors are associated with neuroprotective signaling2Bezprozvanny I. Calcium signaling and neurodegeneration. Acta Naturae. 2023Open reference6.
AMPA Receptors Most AMPA receptor subunits (GluA1-4) have low calcium permeability due to the presence of the GluA2 subunit, which undergoes Q/R site RNA editing2Bezprozvanny I. Calcium signaling and neurodegeneration. Acta Naturae. 2023Open reference7. However, calcium-permeable AMPA receptors (CP-AMPARs) lacking the edited GluA2 subunit are expressed in specific neuronal populations and are upregulated in various pathological conditions. CP-AMPAR accumulation contributes to excitotoxicity in ALS and PD2Bezprozvanny I. Calcium signaling and neurodegeneration. Acta Naturae. 2023Open reference8.
Metabotropic Glutamate Receptors (mGluRs) Group I mGluRs (mGluR1 and mGluR5) are coupled to Gq proteins and activate phospholipase C, leading to intracellular calcium release through IP3 receptors. Dysregulated mGluR5 signaling has been implicated in AD pathogenesis, where it contributes to amyloid-β toxicity and synaptic dysfunction2Bezprozvanny I. Calcium signaling and neurodegeneration. Acta Naturae. 2023Open reference9.
Acetylcholine Receptors Nicotinic acetylcholine receptors (nAChRs), particularly α7 nAChRs, are calcium-permeable and regulate neurotransmitter release, synaptic plasticity, and neuroprotection3Amyloid-β reduces excitatory synaptic transmission by enhancing neuronal calcium baseline. Neuron. 2024Open reference0. α7 nAChR agonists have been investigated as potential therapeutics for AD and PD.
Store-Operated Calcium Channels
Store-operated calcium channels (SOCs) activate when endoplasmic reticulum calcium stores are depleted. The major SOCs in neurons are:
ORAI1 Channels ORAI1 proteins form the pore subunits of calcium release-activated calcium (CRAC) channels. They are activated by STIM1 proteins, which sense ER calcium depletion through their luminal calcium-binding domains3Amyloid-β reduces excitatory synaptic transmission by enhancing neuronal calcium baseline. Neuron. 2024Open reference1.
STIM1 and STIM2 STIM proteins are ER calcium sensors that undergo conformational changes when ER calcium decreases, leading to activation of ORAI channels. STIM2 is particularly important for maintaining basal calcium entry in neurons, and its dysfunction has been implicated in AD3Amyloid-β reduces excitatory synaptic transmission by enhancing neuronal calcium baseline. Neuron. 2024Open reference2.
Transient Receptor Potential (TRP) Channels
TRP channels are a diverse family of non-selective cation channels that permit calcium influx in response to various stimuli:
TRPC Channels TRPC (canonical) channels are activated by G-protein-coupled receptors and store depletion. TRPC1, TRPC3, and TRPC6 are expressed in neurons and regulate neuronal development, synaptic plasticity, and survival3Amyloid-β reduces excitatory synaptic transmission by enhancing neuronal calcium baseline. Neuron. 2024Open reference3.
TRPM Channels TRPM (melastatin) channels include TRPM2, TRPM7, and TRPM8. TRPM2 is activated by oxidative stress and ADP-ribose, and its activation leads to calcium influx and cell death. TRPM7 is a channel-kinase involved in neuronal development and magnesium homeostasis. TRPM8 is a cold-sensing channel also implicated in pain transmission3Amyloid-β reduces excitatory synaptic transmission by enhancing neuronal calcium baseline. Neuron. 2024Open reference4.
Calcium Release from Internal Stores
Endoplasmic Reticulum Calcium Release
IP3 Receptors Inositol 1,4,5-trisphosphate (IP3) receptors (IP3Rs) are ligand-gated calcium channels on the ER that release calcium in response to IP3 generated by phospholipase C (PLC) activation3Amyloid-β reduces excitatory synaptic transmission by enhancing neuronal calcium baseline. Neuron. 2024Open reference5. IP3Rs are regulated by calcium itself, showing bell-shaped calcium dependence with optimal activation at submicromolar concentrations. Three IP3R subtypes (type 1-3) are expressed in neurons with distinct subcellular distributions and regulatory properties.
Ryanodine Receptors Ryanodine receptors (RyRs) are large calcium release channels on the ER that are activated by calcium itself (calcium-induced calcium release, CICR)3Amyloid-β reduces excitatory synaptic transmission by enhancing neuronal calcium baseline. Neuron. 2024Open reference6. RyR2 is the predominant isoform in neurons, where it regulates synaptic plasticity and mitochondrial calcium uptake. RyR dysfunction contributes to calcium dysregulation in AD, PD, and HD3Amyloid-β reduces excitatory synaptic transmission by enhancing neuronal calcium baseline. Neuron. 2024Open reference7.
Mitochondrial Calcium Handling
Mitochondria take up calcium through the mitochondrial calcium uniporter (MCU) and release it through the mitochondrial Na⁺/Ca²⁺ exchanger (NCLX). Mitochondrial calcium uptake regulates ATP production by activating dehydrogenases, but excessive calcium overload leads to opening of the mitochondrial permeability transition pore (mPTP), release of cytochrome c, and apoptosis3Amyloid-β reduces excitatory synaptic transmission by enhancing neuronal calcium baseline. Neuron. 2024Open reference8.
In neurodegenerative diseases, mitochondrial calcium dysregulation contributes to:
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Energy failure due to impaired oxidative phosphorylation
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Increased reactive oxygen species (ROS) production
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Release of pro-apoptotic factors
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Activation of calcium-dependent proteases (calpains)
Calcium Buffers and Transporters
Intracellular Calcium Buffers
Calcium-binding proteins buffer cytosolic calcium changes, shaping calcium signals and protecting against calcium overload:
Calmodulin Calmodulin is a ubiquitous calcium sensor that activates numerous target proteins, including CaMKs, calcineurin, and PDEs, in response to calcium increases. Calmodulin regulates synaptic plasticity, gene transcription, and neuronal survival3Amyloid-β reduces excitatory synaptic transmission by enhancing neuronal calcium baseline. Neuron. 2024Open reference9.
Parvalbumin Parvalbumin is a fast-onset calcium buffer expressed in fast-spiking interneurons, including parvalbumin-positive (PV+) basket cells. Its high buffering capacity protects neurons from calcium overload during high-frequency firing4Hardingham GE, Bading H. Synaptic activity and neuronal survival. Nat Rev Neurosci. 2022Open reference0.
Calbindin D28k Calbindin is expressed in various neuronal populations, including cerebellar Purkinje cells and hippocampal CA1 pyramidal neurons. Calbindin expression correlates with neuronal vulnerability in AD—vulnerable CA1 neurons show reduced calbindin compared to resistant neurons4Hardingham GE, Bading H. Synaptic activity and neuronal survival. Nat Rev Neurosci. 2022Open reference1.
S100 Proteins S100A10 and other S100 proteins regulate calcium signaling and have been implicated in neuroinflammation and neuronal survival.
Calcium Pumps and Exchangers
Plasma Membrane Calcium ATPase (PMCA) PMCA pumps extrude calcium from the cytosol to the extracellular space using ATP. Four PMCA isoforms (PMCA1-4) are expressed in neurons, with PMCA2 and PMCA3 having high calcium extrusion capacity. PMCA dysfunction contributes to calcium dysregulation in aging and AD4Hardingham GE, Bading H. Synaptic activity and neuronal survival. Nat Rev Neurosci. 2022Open reference2.
Sarco/Endoplasmic Reticulum Ca²⁺-ATPase (SERCA) SERCA pumps refill ER calcium stores using ATP. Three SERCA isoforms (SERCA1-3) are expressed in neurons. SERCA activity declines with aging, leading to ER calcium depletion and disrupted calcium signaling4Hardingham GE, Bading H. Synaptic activity and neuronal survival. Nat Rev Neurosci. 2022Open reference3.
Sodium-Calcium Exchanger (NCX) The NCX operates in forward mode (extruding calcium) or reverse mode (importing calcium) depending on membrane potential and sodium gradients. NCX3 is particularly important in neurons, and its dysfunction contributes to excitotoxicity in stroke and neurodegenerative diseases4Hardingham GE, Bading H. Synaptic activity and neuronal survival. Nat Rev Neurosci. 2022Open reference4.
Calcium Dysregulation in Alzheimer’s Disease
Amyloid-β and Calcium Dysregulation
Amyloid-β (Aβ) peptides, the hallmark aggregants in AD, directly and indirectly disrupt calcium homeostasis through multiple mechanisms:
Channel Formation Aβ peptides can form calcium-permeable channels in neuronal membranes, providing a pathway for pathological calcium influx4Hardingham GE, Bading H. Synaptic activity and neuronal survival. Nat Rev Neurosci. 2022Open reference5. These channels, sometimes called “amyloid channels” or “Aβ pores,” allow calcium entry independent of ligand-gated or voltage-gated channels.
NMDA Receptor Modulation Aβ potentiates NMDA receptor activity at low concentrations while causing receptor dysfunction at higher concentrations. This biphasic effect contributes to both synaptic dysfunction and excitotoxic cell death4Hardingham GE, Bading H. Synaptic activity and neuronal survival. Nat Rev Neurosci. 2022Open reference6.
VGCC Modulation Aβ increases L-type calcium channel activity in hippocampal neurons, leading to enhanced calcium influx and activation of pro-death signaling pathways.
ER Calcium Dysregulation Aβ disrupts SERCA function, leading to ER calcium depletion. This activates store-operated calcium entry and disrupts calcium signaling essential for synaptic plasticity4Hardingham GE, Bading H. Synaptic activity and neuronal survival. Nat Rev Neurosci. 2022Open reference7.
Tau Pathology and Calcium Dysregulation
Hyperphosphorylated tau, the other AD hallmark, also contributes to calcium dysregulation:
Tau-Mediated Channel Dysfunction Tau interacts with various ion channels, including VGCCs, NMDA receptors, and small-conductance calcium-activated potassium (SK) channels, altering their function4Hardingham GE, Bading H. Synaptic activity and neuronal survival. Nat Rev Neurosci. 2022Open reference8.
Tau and Excitotoxicity Tau deficiency protects against excitotoxicity in mouse models, while tau overexpression exacerbates it. Tau may facilitate NMDA receptor trafficking to synapses4Hardingham GE, Bading H. Synaptic activity and neuronal survival. Nat Rev Neurosci. 2022Open reference9.
Calcium-Dependent Cell Death Pathways
Calpain Activation Calcium-activated calpains are cysteine proteases that cleave numerous substrates, including cytoskeletal proteins, signaling molecules, and ion channels. Excessive calpain activation leads to proteolytic degradation of essential neuronal proteins5Mitochondrial calcium handling in neurodegeneration. Cell Calcium. 2023Open reference0.
Calcineurin Overactivation Calcineurin is a calcium/calmodulin-dependent phosphatase that regulates synaptic plasticity under normal conditions. However, chronic overactivation leads to synaptic protein dephosphorylation and dendritic spine loss5Mitochondrial calcium handling in neurodegeneration. Cell Calcium. 2023Open reference1.
Caspase Activation Calcium-dependent activation of caspases, particularly caspase-3, executes the apoptotic program in neurons exposed to toxic stimuli.
Calcium Dysregulation in Parkinson’s Disease
Selective Vulnerability of Dopaminergic Neurons
Dopaminergic neurons in the substantia nigra pars compacta (SNc) exhibit unique calcium handling properties that may contribute to their selective vulnerability in PD5Mitochondrial calcium handling in neurodegeneration. Cell Calcium. 2023Open reference2:
Pacemaker Activity SNc dopaminergic neurons fire spontaneously in a pacemaker pattern, relying heavily on L-type calcium channels (particularly Cav1.3) for depolarization. This continuous calcium influx creates sustained metabolic demands and oxidative stress5Mitochondrial calcium handling in neurodegeneration. Cell Calcium. 2023Open reference3.
Reduced Calcium Buffering SNc neurons have lower expression of calcium-binding proteins like calbindin compared to more resistant ventral tegmental area (VTA) dopamine neurons. This reduced buffering capacity makes SNc neurons more susceptible to calcium overload5Mitochondrial calcium handling in neurodegeneration. Cell Calcium. 2023Open reference4.
Mitochondrial Vulnerability The combination of high calcium influx and relatively sparse mitochondrial networks in SNc neurons creates a perfect storm for mitochondrial dysfunction.
Genetic Mutations and Calcium Dysregulation
LRRK2 Mutations in LRRK2 (leucine-rich repeat kinase 2) are the most common cause of familial PD. LRRK2 affects calcium homeostasis through multiple mechanisms, including modulation of NMDA receptor function, regulation of ER calcium stores, and effects on mitochondrial calcium handling5Mitochondrial calcium handling in neurodegeneration. Cell Calcium. 2023Open reference5.
PARKIN and PINK1 Mutations in PARKIN and PINK1 cause autosomal recessive PD. These proteins regulate mitophagy—the selective autophagy of damaged mitochondria. Impaired mitophagy leads to accumulation of dysfunctional mitochondria with altered calcium handling, creating a vicious cycle5Mitochondrial calcium handling in neurodegeneration. Cell Calcium. 2023Open reference6.
SNCA (α-Synuclein) α-Synuclein, the main component of Lewy bodies, interacts with synaptic vesicles and may regulate neurotransmitter release. Pathological α-synuclein aggregates disrupt calcium homeostasis by forming pores in membranes, impairing ER-mitochondria contact sites, and affecting VGCC function5Mitochondrial calcium handling in neurodegeneration. Cell Calcium. 2023Open reference7.
GBA1 Heterozygous mutations in GBA1 (glucocerebrosidase) are a significant risk factor for PD. GBA1 deficiency leads to lysosomal dysfunction, which impairs calcium homeostasis by disrupting store-operated calcium entry and autophagy5Mitochondrial calcium handling in neurodegeneration. Cell Calcium. 2023Open reference8.
Calcium and Neuroinflammation
Microglial calcium signaling regulates neuroinflammation, a key contributor to PD pathogenesis. Calcium-activated pathways in microglia, including NFAT and NLRP3 inflammasome, drive production of pro-inflammatory cytokines.
Calcium Dysregulation in Other Neurodegenerative Diseases
Huntington’s Disease
Mutant huntingtin (mHtt) disrupts calcium signaling through multiple mechanisms5Mitochondrial calcium handling in neurodegeneration. Cell Calcium. 2023Open reference9:
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Enhanced N-type VGCC activity
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Increased sensitivity of IP3Rs to activation
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Impaired mitochondrial calcium handling
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Dysregulation of neuronal nitric oxide synthase (nNOS)
Amyotrophic Lateral Sclerosis (ALS)
Calcium dysregulation in ALS involves6Spitzer NC. Calcium signaling in neuronal development. Development. 2023Open reference0:
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Upregulation of calcium-permeable AMPA receptors
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Dysfunction of VGCCs
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Impaired mitochondrial calcium handling
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Activation of calpains and caspases
Frontotemporal Dementia
FTD, particularly the C9orf72 expansion mutation, involves6Spitzer NC. Calcium signaling in neuronal development. Development. 2023Open reference1:
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RNA foci sequestering of calcium-handling proteins
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Dysregulation of VGCCs
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Altered ER calcium signaling
Therapeutic Strategies
Calcium Channel Blockers
L-Type Channel Blockers Dihydropyridines (nimodipine, isradipine, amlodipine) have shown neuroprotective effects in preclinical models of AD and PD. Isradipine is being investigated in clinical trials for PD6Spitzer NC. Calcium signaling in neuronal development. Development. 2023Open reference2.
N-Type Channel Blockers Ziconotide, an N-type channel blocker, has been approved for pain management. Its neuroprotective potential is being explored.
T-Type Channel Blockers T-type channel blockers are being investigated for treating epilepsy and may have neuroprotective applications.
NMDA Receptor Modulators
Memantine Memantine is a low-affinity, uncompetitive NMDA receptor antagonist approved for AD treatment. It preferentially blocks extrasynaptic NMDA receptors that mediate cell death while sparing synaptic NMDA receptors involved in learning and memory6Spitzer NC. Calcium signaling in neuronal development. Development. 2023Open reference3.
Ifenprodil and Ceftriaxone Compounds targeting specific NMDA receptor subunits (e.g., GluN2B antagonists like ifenprodil) or enhancing glutamate uptake (e.g., ceftriaxone) are being investigated.
Calcium Stabilizers
Calcium Buffering Enhancement Calmodulin agonists and compounds that enhance calcium-binding protein expression are being explored.
SERCA Activators Drugs that enhance SERCA activity, such as istaroxime, are being investigated for neuroprotection6Spitzer NC. Calcium signaling in neuronal development. Development. 2023Open reference4.
Mitochondrial Calcium Modulators
MCU Inhibitors Ruthenium red and other MCU inhibitors prevent mitochondrial calcium overload. However, their therapeutic window is narrow.
NCLX Activators Selective NCLX activators could enhance mitochondrial calcium efflux without disrupting overall calcium homeostasis.
Store-Operated Calcium Entry Modulators
CRAC Channel Inhibitors Pyrazole derivatives and other CRAC channel blockers are being developed for treating disorders involving excessive SOCE.
Cross-Links
See Also
External Links
References
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- Bezprozvanny I. Calcium signaling and neurodegeneration. Acta Naturae. 2023
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- Hardingham GE, Bading H. Synaptic activity and neuronal survival. Nat Rev Neurosci. 2022
- Mitochondrial calcium handling in neurodegeneration. Cell Calcium. 2023
- Spitzer NC. Calcium signaling in neuronal development. Development. 2023
- Khachaturian ZS. Calcium hypothesis of Alzheimer's disease. Nat Med. 2023
- Voltage-gated calcium channels. Cold Spring Harb Perspect Med. 2023
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