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阿尔茨海默病发病机制与缺血性脑退行性变。

Alzheimer's mechanisms in ischemic brain degeneration.

机构信息

Laboratory of Ischemic and Neurodegenerative Brain Research, Department of Neurodegenerative Disorders, Mossakowski Medical Research Centre, Polish Academy of Sciences, Pawinskiego 5 Str., Warsaw, Poland.

出版信息

Anat Rec (Hoboken). 2009 Dec;292(12):1863-81. doi: 10.1002/ar.21018.

Abstract

There is increasing evidence for influence of Alzheimer's proteins and neuropathology on ischemic brain injury. This review investigates the relationships between beta-amyloid peptide, apolipoproteins, presenilins, tau protein, alpha-synuclein, inflammation factors, and neuronal survival/death decisions in brain following ischemic episode. The interactions of these molecules and influence on beta-amyloid peptide synthesis and contribution to ischemic brain degeneration and finally to dementia are reviewed. Generation and deposition of beta-amyloid peptide and tau protein pathology are important key players involved in mechanisms in ischemic neurodegeneration as well as in Alzheimer's disease. Current evidence suggests that inflammatory process represents next component, which significantly contribute to degeneration progression. Although inflammation was initially thought to arise secondary to ischemic neurodegeneration, recent studies present that inflammatory mediators may stimulate amyloid precursor protein metabolism by upregulation of beta-secretase and therefore are able to establish a vicious cycle. Functional brain recovery after ischemic lesion was delayed and incomplete by an injury-related increase in the amount of the neurotoxic C-terminal of amyloid precursor protein and beta-amyloid peptide. Moreover, ischemic neurodegeneration is strongly accelerated with aging, too. New therapeutic alternatives targeting these proteins and repairing related neuronal changes are under development for the treatment of ischemic brain consequences including memory loss prevention.

摘要

越来越多的证据表明阿尔茨海默病蛋白和神经病理学对缺血性脑损伤有影响。本综述探讨了β-淀粉样肽、载脂蛋白、早老素、tau 蛋白、α-突触核蛋白、炎症因子与缺血后大脑神经元存活/死亡决定之间的关系。综述了这些分子的相互作用及其对β-淀粉样肽合成的影响,以及对缺血性脑退化和最终导致痴呆的贡献。β-淀粉样肽和 tau 蛋白病理的产生和沉积是缺血性神经退行性变以及阿尔茨海默病中涉及机制的重要关键因素。目前的证据表明,炎症过程是下一个重要组成部分,它显著促进了退化的进展。尽管炎症最初被认为是继发于缺血性神经退行性变,但最近的研究表明,炎症介质可以通过上调β-分泌酶来刺激淀粉样前体蛋白代谢,从而能够建立一个恶性循环。与缺血性神经损伤相关的神经毒性淀粉样前体蛋白 C 端和β-淀粉样肽的增加,延迟和不完全了缺血性损伤后的功能性脑恢复。此外,缺血性神经退行性变随着年龄的增长而加速。针对这些蛋白质的新治疗选择以及相关神经元变化的修复正在开发中,以治疗包括预防记忆丧失在内的缺血性脑后果。

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