Decourt Boris, Lahiri Debomoy K, Sabbagh Marwan N
Banner Sun Health Research Institute, 10515 W. Santa Fe Dr., Sun City AZ 85351, United States.
Institute of Psychiatry Research, Department of Psychiatry, School of Medicine, Indiana University-Purdue University, Indianapolis, IN, United States.
Curr Alzheimer Res. 2017;14(4):412-425. doi: 10.2174/1567205013666160930110551.
Alzheimer's disease (AD) affects an estimated 44 million individuals worldwide, yet no therapeutic intervention is available to stop the progression of the dementia. Neuropathological hallmarks of AD are extracellular deposits of amyloid beta (Aβ) peptides assembled in plaques, intraneuronal accumulation of hyperphosphorylated tau protein forming tangles, and chronic inflammation. A pivotal molecule in inflammation is the pro-inflammatory cytokine TNF-α. Several lines of evidence using genetic and pharmacological manipulations indicate that TNF-α signaling exacerbates both Aβ and tau pathologies in vivo. Interestingly, preventive and intervention anti-inflammatory strategies demonstrated a reduction in brain pathology and an amelioration of cognitive function in rodent models of AD. Phase I and IIa clinical trials suggest that TNF-α inhibitors might slow down cognitive decline and improve daily activities in AD patients. In the present review, we summarize the evidence pointing towards a beneficial role of anti-TNF-α therapies to prevent or slow the progression of AD. We also present possible physical and pharmacological interventions to modulate TNF-α signaling in AD subjects along with their limitations.
阿尔茨海默病(AD)在全球约影响4400万人,但尚无可用的治疗干预措施来阻止痴呆症的进展。AD的神经病理学特征是淀粉样β(Aβ)肽在细胞外沉积形成斑块、神经元内过度磷酸化的tau蛋白积累形成缠结以及慢性炎症。炎症中的一个关键分子是促炎细胞因子TNF-α。多项使用基因和药物操作的证据表明,TNF-α信号传导在体内会加剧Aβ和tau病理。有趣的是,预防性和干预性抗炎策略在AD啮齿动物模型中显示出脑病理减少和认知功能改善。I期和IIa期临床试验表明,TNF-α抑制剂可能会减缓AD患者的认知衰退并改善日常活动。在本综述中,我们总结了指向抗TNF-α疗法在预防或减缓AD进展方面有益作用的证据。我们还介绍了调节AD受试者中TNF-α信号传导的可能物理和药物干预措施及其局限性。
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