Kulbe Jacqueline R, Hall Edward D
Spinal Cord & Brain Injury Research Center, University of Kentucky College of Medicine, United States; Department of Neuroscience, University of Kentucky College of Medicine, United States.
Spinal Cord & Brain Injury Research Center, University of Kentucky College of Medicine, United States; Department of Neuroscience, University of Kentucky College of Medicine, United States.
Prog Neurobiol. 2017 Nov;158:15-44. doi: 10.1016/j.pneurobio.2017.08.003. Epub 2017 Aug 26.
In recent years, a new neurodegenerative tauopathy labeled Chronic Traumatic Encephalopathy (CTE), has been identified that is believed to be primarily a sequela of repeated mild traumatic brain injury (TBI), often referred to as concussion, that occurs in athletes participating in contact sports (e.g. boxing, American football, Australian football, rugby, soccer, ice hockey) or in military combatants, especially after blast-induced injuries. Since the identification of CTE, and its neuropathological finding of deposits of hyperphosphorylated tau protein, mechanistic attention has been on lumping the disorder together with various other non-traumatic neurodegenerative tauopathies. Indeed, brains from suspected CTE cases that have come to autopsy have been confirmed to have deposits of hyperphosphorylated tau in locations that make its anatomical distribution distinct for other tauopathies. The fact that these individuals experienced repetitive TBI episodes during their athletic or military careers suggests that the secondary injury mechanisms that have been extensively characterized in acute TBI preclinical models, and in TBI patients, including glutamate excitotoxicity, intracellular calcium overload, mitochondrial dysfunction, free radical-induced oxidative damage and neuroinflammation, may contribute to the brain damage associated with CTE. Thus, the current review begins with an in depth analysis of what is known about the tau protein and its functions and dysfunctions followed by a discussion of the major TBI secondary injury mechanisms, and how the latter have been shown to contribute to tau pathology. The value of this review is that it might lead to improved neuroprotective strategies for either prophylactically attenuating the development of CTE or slowing its progression.
近年来,一种名为慢性创伤性脑病(CTE)的新型神经退行性tau蛋白病已被确认,据信它主要是反复轻度创伤性脑损伤(TBI)的后遗症,这种损伤常被称为脑震荡,发生在参与接触性运动的运动员(如拳击、美式橄榄球、澳式橄榄球、英式橄榄球、足球、冰球)或军事战斗人员中,尤其是在爆炸导致的损伤之后。自从CTE被发现以及其神经病理学发现了过度磷酸化tau蛋白沉积以来,人们的研究重点一直是将这种疾病与其他各种非创伤性神经退行性tau蛋白病归为一类。事实上,经尸检确诊的疑似CTE病例的大脑,在其解剖分布与其他tau蛋白病不同的部位已被证实存在过度磷酸化tau蛋白沉积。这些个体在其运动或军事生涯中经历了重复性TBI事件,这一事实表明,在急性TBI临床前模型和TBI患者中已被广泛描述的继发性损伤机制,包括谷氨酸兴奋性毒性、细胞内钙超载、线粒体功能障碍、自由基诱导的氧化损伤和神经炎症,可能导致与CTE相关的脑损伤。因此,本综述首先深入分析了关于tau蛋白及其功能和功能障碍的已知情况,随后讨论了主要的TBI继发性损伤机制,以及后者如何导致tau蛋白病变。本综述的价值在于,它可能会带来更好的神经保护策略,用于预防性减轻CTE的发展或减缓其进展。