When researchers discover a new mechanism of action for Alzheimer’s disease in a Traditional Chinese Medicine drug.
For centuries, TCM has emphasised the strong link between the gut and the brain.
The resurgence of a Traditional Chinese Medicine (TCM) drug for the treatment of Alzheimer’s disease has sparked renewed interest in the intersection between ancient medical practices and modern biotechnology.
In a previous report published on February 27, titled “The Rise of Chinese Biotechnology”, the rapid development of China’s biotech sector was examined, identifying the principal factors behind its success. This progress is not at odds with the principles of TCM, which continues to offer valuable innovation.
Jean-Claude Muller
The present article highlights a largely unknown case report within the scientific community, illustrating how TCM can contribute to modern drug discovery.
The Case of Oligomannate (GV-971)
In November 2019, just before the outbreak of the COVID-19 pandemic, the Chinese National Medical Products Administration (NMPA) granted conditional approval to Oligomannate (GV-971), developed by Shanghai Green Valley Pharmaceuticals, for the treatment of mild to moderate Alzheimer’s disease and improvement of cognitive function. This conditional approval was based on positive data gathered from 818 patients. The drug was released in China, selling 2.13 million boxes and generating cummulative sales of approximately $88 million. However, a multinational, multicentric phase 3 trial in the US, Europe, and other regions was never completed. Due to factors including insufficient funding and setbacks related to COVID-19, Green Valley did not conduct the required follow-up studies, and, in 2025, the NMPA did not renew the drug’s conditional approval.
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Innovation in Discovery and Development
The innovation behind Oligomannate can be seen in three distinct areas:
- The initial discovery was inspired by the observations of traditional Chinese physicians, who noted that elderly individuals regularly consuming seaweed had a lower incidence of degenerative diseases.
- Dr. Geng Meyu, at the Chinese Academy of Sciences extracted and identified a unique sugar from seaweed (GV-971), a mixture of acidic linear oligosaccharides with a molecular weight up to 1 kilodalton, exhibiting unique biological properties.
- It took more than twenty years, for Chinese researchers to elucidate an unusual mechanism of action. In September 2019, Dr. Geng’s team published their findings in Cell Research, describing how “sodium oligomannate therapeutically remodels gut microbiota and suppresses gut bacterial amino-acid-induced neuroinflammation in Alzheimer’s disease.”
Mechanism of Action: The Gut-Brain Connection
For centuries, TCM has emphasised the strong link between the gut and the brain. The trillions of bacteria and microbes involved in food digestion also regulate immunity and communicate intimately with the brain. Modern science has confirmed that these gut microorganisms influence both brain's ageing and the progression of neurodegenerative diseases. The original mechanism of action of Oligomannate is summarised as follows:
“During AD progression, the alteration of gut microbiota composition leads to the peripheral accumulation of phenylalanine and isoleucine which stimulates the differentiation and proliferation of pro-inflammatory T Helper 1 (Th1) cells. The brain-infiltrated peripheral Th1 immune cells are associated with the M1 microglia activation, contributing to AD-associated neuroinflammation. GV-971, a sodium Oligomannate, suppresses gut dysbiosis and the associated phenylalanine/isoleucine accumulation, harnesses neuroinflammation and reverses the cognition impairment.”
In summary, Oligomannate not only reduces the accumulation of two amino acids and the infiltration of immune cells into the brain but also modulates the composition of gut bacteria to lower the risk of brain inflammation. These findings suggest that targeting the gut microbiome offers a novel therapeutic approach, independent of the amyloid beta/tau pathway, for slowing Alzheimer’s disease progression. When these results, demonstrating the gut-brain connection, were published they triggered a lot of interest because they opened a new avenue for the treatement of various neurodegenrative diseases.
Further development of Oligomannate
Various Alzheimer’s research institutions are now supporting studies that examine the gut-brain relationship in greater detail. Oligomannate will potentially serve as a valuable tool to further explore this hypothesis if it becomes easily available to the international scientific and medical community.
The promising data encouraged Fosun Pharma, a Chinese pharmaceutical company based in Shanghai to proceed with the requested post-marketing studies and invest 1.4 billion yuan (approximately $200 million) to acquire a 53% stake in Green Valley Pharmaceuticals and thus revive the development of Oligomannate. Fosun must now demonstrate the long-term safety of the drug and establish accepted biomarkers in addition to the ADAS-Cog score, which measures cognitive function. The US FDA has recently adopted more flexible guidance regarding Alzheimer’s disease drugs, although many experts remain unconvinced about the overall value of the reported beneficial effects of the two recently approved anti-amyloïd antibodies: Lequembi and Kisunla. Both drugs have also been approved by Chinese regulators.
Fosun has not announced whether it intends to launch the international multicentric clinical trials referenced by Green Valley in 2019 and requested for approval outside of China.
Conclusion
The main takeaway is that TCM continues to hold significant promise for the discovery of new active compounds and the elucidation of innovative mechanisms of action.
Paris, March 14, 2026
This document has been prepared by Jean-Claude Muller and is provided for information purposes only. The information contained herein has been obtained from sources believed to be reliable but is not warranted to be accurate or complete. The views presented are those of the author at the time of writing and are subject to change. Jean-Claude Muller has no obligation to update these opinions or the information presented.
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