Lee V M, Goedert M, Trojanowski J Q
Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
Annu Rev Neurosci. 2001;24:1121-59. doi: 10.1146/annurev.neuro.24.1.1121.
The defining neuropathological characteristics of Alzheimer's disease are abundant filamentous tau lesions and deposits of fibrillar amyloid beta peptides. Prominent filamentous tau inclusions and brain degeneration in the absence of beta-amyloid deposits are also hallmarks of neurodegenerative tauopathies exemplified by sporadic corticobasal degeneration, progressive supranuclear palsy, and Pick's disease, as well as by hereditary frontotemporal dementia and parkinsonism linked to chromosome 17 (FTDP-17). Because multiple tau gene mutations are pathogenic for FTDP-17 and tau polymorphisms appear to be genetic risk factors for sporadic progressive supranuclear palsy and corticobasal degeneration, tau abnormalities are linked directly to the etiology and pathogenesis of neurodegenerative disease. Indeed, emerging data support the hypothesis that different tau gene mutations are pathogenic because they impair tau functions, promote tau fibrillization, or perturb tau gene splicing, thereby leading to formation of biochemically and structurally distinct aggregates of tau. Nonetheless, different members of the same kindred often exhibit diverse FTDP-17 syndromes, which suggests that additional genetic or epigenetic factors influence the phenotypic manifestations of neurodegenerative tauopathies. Although these and other hypothetical mechanisms of neurodegenerative tauopathies remain to be tested and validated, transgenic models are increasingly available for this purpose, and they will accelerate discovery of more effective therapies for neurodegenerative tauopathies and related disorders, including Alzheimer's disease.
阿尔茨海默病典型的神经病理学特征是大量丝状tau蛋白病变和淀粉样β肽纤维沉积物。在没有β淀粉样蛋白沉积的情况下出现显著的丝状tau蛋白包涵体和脑变性,也是神经退行性tau蛋白病的标志,如散发性皮质基底节变性、进行性核上性麻痹、匹克病,以及与17号染色体相关的遗传性额颞叶痴呆和帕金森综合征(FTDP - 17)。由于多个tau基因突变对FTDP - 17具有致病性,并且tau基因多态性似乎是散发性进行性核上性麻痹和皮质基底节变性的遗传风险因素,因此tau蛋白异常与神经退行性疾病的病因和发病机制直接相关。事实上,新出现的数据支持这样一种假说,即不同的tau基因突变具有致病性,是因为它们损害了tau蛋白的功能、促进了tau蛋白的纤维化或扰乱了tau基因的剪接,从而导致形成生化和结构上不同的tau蛋白聚集体。尽管如此,同一家族的不同成员往往表现出不同的FTDP - 17综合征,这表明其他遗传或表观遗传因素会影响神经退行性tau蛋白病的表型表现。虽然神经退行性tau蛋白病的这些及其他假说机制仍有待检验和验证,但为此目的越来越多的转基因模型可供使用,它们将加速发现针对神经退行性tau蛋白病及相关疾病(包括阿尔茨海默病)更有效的治疗方法。