Although DPP-4 inhibitors do not cross the BBB under normal conditions (the pharmacokinetic feature may prevent their repurposing use in neurodegenerative diseases), the permeability of BBB is increased in neurodegenerative diseases, so molecules otherwise unable to cross BBB could enter into CNS in these conditions (103)
Su et al., 2022), however, metanalysis of cIinical data with ADPKD patients receiving rapamycin, sirolimus, or everolimus did not support a significant influence on renal progression ( AMP-activated protein kinase (AMPK) AMPK is activated under conditions of metabolic and other cellular stresses (Steinberg and Hardie, 2022)
While current clinical evidence is preliminary, emerging case reports and observational studies provide early support for these mechanisms
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