Bufill E, Blesa R
Unidad de Neurología, Servicio de Medicina Interna, Hospital General de Vic, Vic, Barcelona, Spain.
Rev Neurol. 2006;42(1):25-33.
Alzheimer's disease (AD) appears to be exclusive to our species. This suggests a relationship between the disease and genetic, functional and structural changes that have taken place throughout the evolution of the human brain.
The expression of genes linked to neurotransmission, neuroplasticity, axonal transport, aerobic metabolism and neuroprotection seems to have increased within the human cerebral cortex and such phenomena represent adaptations that induce greater neuronal activity throughout a long lifespan. High levels of neuroplasticity increase neuronal vulnerability to factors capable of triggering the lesions that are typically found in AD. Several genes related to increased neuronal activity are extremely vulnerable to factors related to old age, such as oxidative stress. Some kind of dysfunction in such genes can disrupt proper regulation of a number of pathways (neuroplasticity, axonal transport) and promote the abnormal accumulation of peptides that is characteristic of AD. Possessing certain polymorphisms of neuroprotective genes or of the electron transport chain could afford protection against AD. Increased intake of animal fats could alter the balance of polyunsaturated fatty acids in the neuronal membrane and favour a higher susceptibility to oxidative stress.
AD could constitute an example of antagonistic pleiotropy: the increased expression of advantageous genes at an early age could turn out to be harmful at an advanced age.
阿尔茨海默病(AD)似乎是人类特有的疾病。这表明该疾病与人类大脑进化过程中发生的遗传、功能和结构变化之间存在某种关联。
与神经传递、神经可塑性、轴突运输、有氧代谢和神经保护相关的基因在人类大脑皮层中的表达似乎有所增加,这种现象代表了一种适应性变化,可在漫长的生命周期中诱导更强的神经元活动。高水平的神经可塑性增加了神经元对能够引发AD中常见病变的因素的易感性。一些与神经元活动增加相关的基因极易受到与衰老相关因素的影响,如氧化应激。这些基因的某种功能障碍可能会破坏许多通路(神经可塑性、轴突运输)的正常调节,并促进AD特有的肽异常积累。拥有神经保护基因或电子传递链的某些多态性可能为预防AD提供保护。动物脂肪摄入量的增加可能会改变神经元膜中多不饱和脂肪酸的平衡,从而增加对氧化应激的易感性。
AD可能是拮抗性多效性的一个例子:早期有利基因表达的增加在老年时可能会变得有害。