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淀粉样β肽的代谢与阿尔茨海默病的发病机制。迈向症状前诊断、预防及治疗。

Metabolism of amyloid beta peptide and pathogenesis of Alzheimer's disease. Towards presymptomatic diagnosis, prevention and therapy.

作者信息

Saido Takaomi C, Iwata Nobuhisa

机构信息

Laboratory for Proteolytic Neuroscience, RIKEN Brain Science Institute, Wako-shi, Saitama, Japan.

出版信息

Neurosci Res. 2006 Apr;54(4):235-53. doi: 10.1016/j.neures.2005.12.015. Epub 2006 Feb 2.

Abstract

The conversion of what has been interpreted as "normal brain aging" to Alzheimer's disease (AD) via a transition state, i.e. mild cognitive impairment, appears to be a continuous process caused primarily by aging-dependent accumulation of amyloid beta peptide (Abeta) in the brain. This notion give us a hope that, by manipulating the Abeta levels in the brain, we may be able not only to prevent and cure the disease but also to partially control some very significant aspects of brain aging. Abeta is constantly produced from its precursor and immediately catabolized under normal conditions, whereas dysmetabolism of Abeta seems to lead to pathological deposition upon aging. We have focused our attention on elucidation of the unresolved mechanism of Abeta catabolism in the brain. In this review, we describe a new approach to prevent AD development by reducing Abeta burdens in aging brains through up-regulation the catabolic mechanism involving neprilysin that can degrade both monomeric and oligomeric forms of Abeta. The strategy of combining presymptomatic diagnosis with preventive medicine seems to be the most pragmatic in both medical and socio-economical terms. We also introduce a novel non-invasive amyloid imaging approach using a high-power magnetic resonance imaging (MRI) for the presymptomatic diagnosis of AD.

摘要

通过一个过渡状态,即轻度认知障碍,将被解释为“正常脑老化”的情况转变为阿尔茨海默病(AD),这似乎是一个主要由大脑中淀粉样β肽(Aβ)随年龄增长而积累所导致的连续过程。这一观点给我们带来了一个希望,即通过控制大脑中的Aβ水平,我们不仅或许能够预防和治愈这种疾病,还能够部分控制脑老化的一些非常重要的方面。Aβ由其前体不断产生,并在正常条件下立即被分解代谢,而Aβ的代谢异常似乎会导致其在衰老时发生病理性沉积。我们将注意力集中在阐明大脑中Aβ分解代谢尚未解决的机制上。在这篇综述中,我们描述了一种新的方法,即通过上调涉及能降解单体和寡聚体形式Aβ的中性内肽酶的分解代谢机制,来减轻衰老大脑中的Aβ负担,从而预防AD的发展。从医学和社会经济角度来看,将症状前诊断与预防医学相结合的策略似乎是最务实的。我们还介绍了一种使用高功率磁共振成像(MRI)进行AD症状前诊断的新型非侵入性淀粉样蛋白成像方法。

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