Inflammation in neurodegenerative disorders: friend or foe?

Inflammation plays a role in the development of Alzheimer's disease (AD). Several cytokines and chemokines have been detected both immunohistochemically and in cerebrospinal fluid from patients. Some of them, including Tumor Necrosis Factor-alpha, Interferon-gamma-inducible Protein-10, Monocyte Chemotactic Protein-1 and Interleukin-8, are increased in AD and in Mild Cognitive Impairment (MCI), considered the prodromal stage of AD, suggesting that these modifications occur very early during the development of the disease, possibly explaining the failure of trials with anti-inflammatory agents in patients with severe AD. Further evidence suggests that cytokines and chemokines could have a role in other neurodegenerative disorders, such as Frontotemporal Lobar Degeneration and Amyothrophic Lateral Sclerosis. In this regard, analogies and differences among these neurodegenerative disorders will be discussed. Neurodegenerative disorders are considered multifactorial diseases, and genetic factors influence pathological events and contribute to change the disease phenotype from patient to patient. Gene polymorphisms in crucial molecules, including cytokines, chemokines and molecules related to oxidative stress, may act as susceptibility factors, increasing the risk of disease development, or may operate as regulatory factors, modulating the severity of pathogenic processes or the response to drug treatment. With these premises, genetic studies recently carried out will be described and discussed in detail.