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先天性免疫和炎性小体是否参与肌萎缩侧索硬化症(ALS)的发病机制?

Is Innate Immunity and Inflammasomes Involved in Pathogenesis of Amyotrophic Lateral Sclerosis (ALS)?

作者信息

Volpe Caroline M O, Nogueira-Machado Jose A

机构信息

Nucleo de Pos-Graduacao e Pesquisa (NPGP), Santa Casade Belo Horizonte, Hospital - Belo Horizonte, Minas Gerais- Brazil.

出版信息

Recent Pat Endocr Metab Immune Drug Discov. 2015;9(1):40-5. doi: 10.2174/1872214809666150407111420.

Abstract

Amyotrophic Lateral Sclerosis (ALS) or Lou Gehrig's disease is an axonopathy with adultonset, progressive and irreversible degeneration of upper and lower motor neurons. Around 90% of ALS is considered as sporadic ALS (sALS) without apparent genetic cause while in the familial type of ALS (fALS) at least one affected blood relative needs to be identified. Both sALS and fALS show similar progression and pathological profile. Biochemical and immunological roles have been reported for both types of ALS. It has been suggested that mutation in SOD1 gene would be responsible for the oxidative stress and neurotoxicity. Besides, oxidative stress, protein aggregation, altered cholinergic synapse, neuro-inflammation and production of pro-inflammatory cytokines have also been reported. Thus, the focus of the present review was on biochemical and immunological biomarkers and pathogenic mechanism. Regulatory T cells, pro-inflammatory cytokines and activation of pro-inflammatory signaling pathway are discussed. The activation of NRL inflammasomes in ALS and the involvement of IL-18, IL-1β and caspases-1 are also suggested. The presence and importance of HMGB-1 (DAMP) and activation of Tolllike receptors and/or RAGE also are envisaged. The patents US20140212508, WO2014145776, WO2014145118, US20140255371, US20140194427, US20140243400, WO2014128254, WO2014076702, WO2014071449, WO2014043696, WO2014001742, and WO2013082299 are summarized. This review intends to evaluate the biochemical and immunological responses and the involvement of inflammasomes in the pathogenesis of ALS. In the present review, we suggest hypothetical model for ALS pathogenesis and we discuss some patents that suggest new treatment and/or therapeutic targets. Due to a large number of patents covering therapy and control of neurodegenerative diseases, our focus was restricted only to discuss the latest registered patents in 2014.

摘要

肌萎缩侧索硬化症(ALS),即卢伽雷氏病,是一种轴索性疾病,其特征为成年起病,上下运动神经元进行性、不可逆性退变。约90%的ALS被认为是散发性ALS(sALS),无明显遗传病因,而在家族性ALS(fALS)中,至少需要确定一名患病的血亲。sALS和fALS具有相似的病程和病理特征。两种类型的ALS都有生化和免疫方面的作用报道。有人提出,超氧化物歧化酶1(SOD1)基因突变会导致氧化应激和神经毒性。此外,氧化应激、蛋白质聚集、胆碱能突触改变、神经炎症以及促炎细胞因子的产生也有报道。因此,本综述的重点是生化和免疫生物标志物以及致病机制。文中讨论了调节性T细胞、促炎细胞因子和促炎信号通路的激活。还提出了ALS中NLR家族炎性小体的激活以及白细胞介素-18(IL-18)、白细胞介素-1β(IL-1β)和半胱天冬酶-1(caspases-1)的参与。还设想了高迁移率族蛋白B1(HMGB-1,一种损伤相关分子模式)的存在及重要性以及Toll样受体和/或晚期糖基化终末产物受体(RAGE)的激活。对美国专利US20140212508、WO2014145776、WO2014145118、US20140255371、US20140194427、US20140243400、WO2014128254、WO2014076702、WO2014071449、WO2014043696、WO2014001742和WO2013082299进行了总结。本综述旨在评估生化和免疫反应以及炎性小体在ALS发病机制中的作用。在本综述中,我们提出了ALS发病机制的假设模型,并讨论了一些提出新治疗方法和/或治疗靶点的专利。由于涉及神经退行性疾病治疗和控制的专利众多,我们的重点仅限于讨论2014年最新注册的专利。

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