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Tafamidis-amide (also known as compound 1a) is a brain-permeable piperazine amide prodrug of the transthyretin (TTR) kinetic stabilizer tafamidis. It was designed to enhance central nervous system bioavailability and overcome the blood-brain barrier (BBB) limitations of the parent compound. Upon crossing the BBB, tafamidis-amide undergoes physiological proteolysis to release active tafamidis, which stabilizes the TTR tetramer. TTR acts as a natural amyloid-beta (Aβ) sequestration protein, preventing its oligomerization and promoting clearance. Tafamidis-amide is being investigated for its neuroprotective potential in sporadic Alzheimer's disease (sAD) and other TTR amyloidosis-related central nervous system pathologies. Preclinical studies in mouse models have demonstrated its ability to reduce neuroinflammation, restore insulin signaling, and lower oxidative stress markers, particularly in the hippocampus.
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