Based on the rationale that combination therapy can simultaneously target multiple disease pathways, this study investigated the synergistic potential of MEL and MPH against aluminum-induced neurotoxicity. The MEL was used for its anti-inflammatory and antioxidant properties, while MPH was employed to enhance neuronal capacity. This dual strategy aimed to inhibit pyroptosis as programmed cell death and promote neuroprotection jointly. In the present study, we show that chronic administration of AlCl3 in the drinking water of animals for 15 days caused significant impairments in learning and memory, increased oxidative stress, and induced pyroptosis-induced cell death in the hippocampus.
In our study, AlCl
3 increased oxidative stress in hippocampal neurons, as evidenced by elevated ROS production and MPO activity, leading to neurotoxicity and impaired cognitive function. These findings are consistent with those of Malik et al. and Amber et al., both of which indicate that aluminum induces cognitive deficits through oxidative stress and inflammation, and that appropriate therapeutic interventions can attenuate these effects (
31,
35). Our biochemical findings demonstrated that AlCl
3 increased ROS production and MPO activity, indicating enhanced oxidative stress and microglial activation. These results are consistent with previous reports by Skalny et al., and Cheng et al., which highlight the role of aluminum accumulation in stimulating ROS production, inducing inflammatory pathways, and causing mitochondrial dysfunction — particularly impairments in the electron transport chain and reduced mitochondrial membrane potential. Moreover, aluminum exposure was associated with decreased activity of antioxidant enzymes such as SOD, CAT, and GPx, reduced GSH levels, and activation of inflammatory and apoptotic pathways, including NF‑κB and the NLRP3 inflammasome, ultimately leading to neuroinflammation, neuronal damage, and exacerbation of injury related to NDs (
36,
37). Treatment with MEL, MPH, or a combination of MEL and MPH exerted antioxidant effects and reduced AlCl
3-induced oxidative stress.
Furthermore, analysis of the pyroptosis pathway revealed that AlCl3 increased the expression of key proteins, including caspase-1, GASDMD, and NLRP3, leading to hippocampal cell death. This cellular damage was associated with the observed cognitive deficits. However, the combination of MEL and MPH (without either of them) reduced the expression of these inflammatory complex proteins, thereby suppressing pyroptosis.
Despite extensive research efforts, effective strategies for the prevention of AD, a neurodegenerative disorder, remain elusive due to the unclear understanding of its underlying molecular mechanisms (
38). In the present study, our results provide new insights into therapeutic approaches for AD by demonstrating the potential of this combination therapy to reduce oxidative stress and alleviate cognitive impairment. The findings of this study are consistent with previous findings supporting the synergistic effect of MPH with other compounds and drugs in AD. Our results confirm that MEL inhibits the NLRP3-caspase-1-GSDMD pathway and improves cognitive function by reducing pyroptosis-type neuronal death. Supporting this, a study by Saha et al. demonstrated that MEL can inhibit NLRP3 inflammasome activation in a mouse model. By modulating the TLR4/NF-κB and P2X7R signaling pathways, MEL reduced inflammation, attenuated liver tissue damage, and lowered levels of inflammatory cytokines. These findings suggest that MEL may exert a protective effect in conditions associated with oxidative stress and chronic inflammation by suppressing key inflammatory pathways and mitigating hyperactive immune responses. Similarly, Chitimus et al. reported that MEL, due to its potent antioxidant and anti-inflammatory properties, can reprogram cellular and molecular responses linked to oxidative stress and inflammation. By inhibiting ROS production, reducing inflammatory cytokine levels, and regulating signaling pathways such as NF-κB and NLRP3, MEL helps maintain cellular homeostasis and may contribute to the prevention and treatment of diseases associated with inflammation and oxidative damage (
39,
40).
Although the drug MPH improves cognitive function and mental flexibility by modulating the dopamine and noradrenaline systems, it exhibits dual effects under neurotoxic conditions. Chronic use of MPH can increase oxidative stress. However, a study by Sanches et al., showed that the effect of MPH is highly dependent on environmental conditions: In a healthy state it may be harmful, but in conditions of inflammatory stress it can be beneficial and enhance antioxidant defenses, reduce oxidative stress, lower intracellular calcium levels, and improve mitochondrial structure and function (
41). In a study by Comim et al., it was found that MPH treatment in an animal model of ADHD caused increased oxidative stress and changes in cellular energy metabolism. These findings emphasize that although MPH can improve cognitive and behavioral symptoms, long-term use may cause oxidative damage and cellular energy disruption. In rodent studies, MPH doses between 1 and 20 mg/kg/day are generally considered low to moderate, while doses above 20 mg/kg/day are associated with a higher risk of oxidative stress and neurotoxicity. The 10 mg/kg/day dose used in our study falls within this low to moderate range and has been shown to exert cognitive and neurochemical effects without causing severe oxidative damage. However, coadministration of MEL with MPH attenuated these deleterious effects, indicating the ability of MEL to counteract the stress-inducing and inflammatory effects of MPH. This suggests a synergistic protective interaction between MEL and MPH. Khalid et al. also showed that the combination of MPH with rosemary can improve cognition, regulate inflammation, and increase hippocampal neuronal density in a model of AlCl
3-induced neurotoxicity (
22,
42). In line with these results, the findings of the present study also suggest that the combination of MEL and MPH can be proposed as a novel therapeutic approach to balance oxidative and inflammatory processes in the brain.
Inflammasome complex activation led to caspase-1 cleavage and the induction of GSDMD protein, resulting in neuronal pyroptosis (inflammatory cell death). In addition, the elevated MPO levels in the aluminum-treated group indicated microglial activation and enhanced oxidative and inflammatory responses in brain tissue. These findings are consistent with the studies by Hao et al., which collectively demonstrated that aluminum exposure induces severe central nervous system damage primarily through activation of the NLRP3-dependent pyroptosis pathway. Both studies reported that aluminum triggers inflammatory neuronal death by increasing oxidative stress, activating the NLRP3 inflammasome, elevating caspase-1 expression, promoting GSDMD cleavage, and stimulating the release of inflammatory cytokines IL-1β and IL-18. Overall, these investigations highlight NLRP3-dependent signaling — particularly the DDX3X–NLRP3 axis — as a key mechanism underlying aluminum-induced neurotoxicity and a potential therapeutic target in NDs. This is also consistent with evidence identifying aluminum accumulation as a cause of mitochondrial dysfunction and the activation of inflammatory pathways (
43,
44).
The MEL treatment significantly reduced indices of oxidative stress and inflammation. With its potent antioxidant and anti-inflammatory properties, MEL exerts protective effects by inhibiting NLRP3 inflammasome activation, reducing ROS generation, and suppressing the caspase-1/GSDMD pathway. The decreased MPO activity observed in MEL-treated groups further indicates a reduction in oxidative damage associated with inflammatory responses.
The findings of the present study are consistent with those reported by Hardeland, who demonstrated that MEL exerts broad anti-inflammatory actions primarily through inhibition of NF-κB signaling, reduction of ROS production, and modulation of cytokine levels. Similarly, the study by Zhang et al. highlighted the neuroprotective capacity of MEL in spinal cord injury. They showed that MEL mitigates oxidative stress and inflammatory reactions, prevents neuronal cell death, and promotes neural tissue repair. Moreover, by improving mitochondrial function and reducing mitochondrial membrane permeability, MEL enhances neuronal survival and contributes to improved motor outcomes.
Taken together, these findings — along with the results of previous studies — indicate that MEL is a promising therapeutic agent for neuroprotection under injury conditions. By targeting the NF-κB/NLRP3 axis and enhancing mitochondrial function, MEL effectively suppresses the ROS-NLRP3-caspase-1-GSDMD cascade, thereby preventing neuronal death and exerting its neuroprotective role (
45,
46). Therefore, MEL prevents neuronal death by inhibiting the ROS-NLRP3-caspase-1-GSDMD cascade and plays its neuroprotective role.
In the present study, the effects of MEL and MPH on an AlCl
3-induced Alzheimer's model in mice were investigated. The study focused on the NLRP3, caspase-1, GSDMD, ROS, and MPO pathways. The results showed that chronic exposure to AlCl
3 increased oxidative stress, neuroinflammation, and neuronal damage; a finding that is consistent with previous reports of the neurotoxic role of aluminum and its ability to induce cognitive and inflammatory abnormalities in animal models (
43,
44). Collectively, our results indicate that AlCl
3-induced neurotoxicity is mediated through ROS-dependent activation of the NLRP3 inflammasome and caspase-1/GSDMD signaling, leading to pyroptotic neuronal death. The MEL effectively attenuates these effects by reducing ROS, MPO activity, and inflammasome activation. When combined with MPH, MEL mitigates MPH-induced oxidative stress, resulting in improved neuronal survival and cognitive performance.
Despite extensive research efforts, effective strategies for preventing AD — a progressive neurodegenerative disorder — remain elusive due to the incomplete understanding of its underlying molecular mechanisms. The novelty of the present study lies in demonstrating, for the first time, the synergistic effects of MEL and MPH in an AlCl3-induced Alzheimer’s model. While previous studies have not primarily focused on investigating MEL and MPH in combination, our study uniquely evaluates their combined impact on oxidative stress, neuroinflammation, and cognitive outcomes.
5.1. Conclusions
This study demonstrates that the combination of MEL and MPH effectively mitigates cognitive deficits, reduces oxidative stress, and alleviates neuroinflammation and pyroptosis in an AlCl3-induced model of AD. These findings suggest that this combination therapy holds significant potential as a novel therapeutic approach for AD. By addressing multiple pathological mechanisms, MEL and MPH offer a promising strategy to combat the multifactorial nature of NDs. Further research is warranted to translate these findings into clinical applications.