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This review provides a comprehensive account of advances in the field of cholinesterase inhibitors isolated from the Buxaceae family. Naturally occurring anticholinesterases derived from plants are considered to be a potential source of new drug candidates for treating Alzheimer’s disease (AD). AD is now universally accepted as an irreversible, incurable, and progressive neurological disorder. Initiating with memory impairment, propagating with cognitive deficit, and ultimately leading to death is the general pathway of AD. Lower level of acetylcholine in the brain is characterized as one of the prominent reasons for AD. The cholinergic hypothesis states that elevated levels of acetylcholine in the brain can alleviate symptoms of AD. Steroidal and terpenoidal alkaloids isolated from plants of the Buxaceae family have been reviewed here for their anticholinesterase activity. Most of them have shown in vitro inhibition of horse serum butyrylcholinesterase (BuChE, EC 3.1.1.7) and electric eel acetylcholinesterase (AChE, EC 3.1.1.8). Although the general consensus has concluded that cholinesterase inhibitors may alleviate AD symptoms but cannot cure the disease, new drugs are still being sought to improve the quality of life of AD patients. Steroidal and terpenoidal anticholinesterase alkaloids can prove to be a promising group of AChE inhibitors.
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