Bergamaschini Luigi, Rossi Emanuela, Vergani Carlo, De Simoni Maria Grazia
Department of Internal Medicine, Geriatric Unit, Ospedale Maggiore Policlinico IRCCS, University of Milan, Italy.
ScientificWorldJournal. 2009 Sep 1;9:891-908. doi: 10.1100/tsw.2009.100.
Alzheimer's disease (AD) is the leading cause of dementia and cognitive decline in the elderly. Brain tissue changes indicate that the two main proteins involved in AD are amyloid-beta (A-beta), which is associated with the formation of senile amyloid plaques, and tau, which is associated with the formation of neurofibrillary tangles. Although a central role for A-beta in the pathogenesis of AD is indisputable, considerable evidence indicates that A-beta production is not the sole culprit in AD pathology. AD is also accompanied by an inflammatory response that contributes to irreversible changes in neuronal viability and brain function, and accumulating evidence supports the pivotal role of complement and contact systems in its pathogenesis and progression. The complexity of AD pathology provides numerous potential targets for therapeutic interventions. Compounds that interact directly with A-beta protein or interfere with its production and/or aggregation can reduce the inflammatory and neurotoxic effects of A-beta, and heparin, a glycosaminoglycan mixture currently used in the prophylaxis and treatment of thrombosis, might be a candidate, as recent research has been extended to consider its nonanticoagulant properties, including its modulation of various proteases and anti-inflammatory activity.
阿尔茨海默病(AD)是老年人痴呆和认知衰退的主要原因。脑组织变化表明,AD涉及的两种主要蛋白质是β-淀粉样蛋白(A-β),它与老年淀粉样斑块的形成有关,以及tau蛋白,它与神经原纤维缠结的形成有关。虽然A-β在AD发病机制中的核心作用无可争议,但大量证据表明,A-β的产生并非AD病理的唯一罪魁祸首。AD还伴有炎症反应,这会导致神经元活力和脑功能的不可逆变化,越来越多的证据支持补体和接触系统在其发病机制和进展中的关键作用。AD病理的复杂性为治疗干预提供了众多潜在靶点。直接与A-β蛋白相互作用或干扰其产生和/或聚集的化合物可以降低A-β的炎症和神经毒性作用,肝素是一种目前用于预防和治疗血栓形成的糖胺聚糖混合物,可能是一个候选药物,因为最近的研究已扩展到考虑其非抗凝特性,包括其对各种蛋白酶的调节和抗炎活性。