肌萎缩侧索硬化症/额颞叶痴呆中TDP-43、tau蛋白及其他蛋白可能同时存在的情况。

Possible concurrence of TDP-43, tau and other proteins in amyotrophic lateral sclerosis/frontotemporal lobar degeneration.

作者信息

Takeda Takahiro

机构信息

Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan.

出版信息

Neuropathology. 2018 Feb;38(1):72-81. doi: 10.1111/neup.12428. Epub 2017 Sep 27.

Abstract

Transactivation response DNA-binding protein 43 kDa (TDP-43) has been regarded as a major component of ubiquitin-positive/tau-negative inclusions of motor neurons and the frontotemporal cortices in amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration (FTLD). Neurofibrillary tangles (NFT), an example of tau-positive inclusions, are biochemically and morphologically distinguished from TDP-43-positive inclusions, and are one of the pathological core features of Alzheimer disease (AD). Although ALS/FTLD and AD are distinct clinical entities, they can coexist in an individual patient. Whether concurrence of ALS/FTLD-TDP-43 and AD-tau is incidental is still controversial, because aging is a common risk factor for ALS/FTLD and AD development. Indeed, it remains unclear whether the pathogenesis of ALS/FTLD is a direct causal link to tau accumulation. Recent studies suggested that AD pathogenesis could cause the accumulation of TDP-43, while abnormal TDP-43 accumulation could also lead to abnormal tau expression. Overlapping presence of TDP-43 and tau, when observed in a brain during autopsy, should attract attention, and should initiate the search for the pathological substrate for this abnormal protein accumulation. In addition to tau, other proteins including α-synuclein and amyloid β should be also taken into account as candidates for an interaction with TDP-43. Awareness of a possible comorbidity between TDP-43, tau and other proteins in patients with ALS/FTLD will be useful for our understanding of the influence of these proteins on the disease development and its clinical manifestation.

摘要

转录激活反应DNA结合蛋白43千道尔顿(TDP - 43)被认为是肌萎缩侧索硬化症(ALS)和额颞叶变性(FTLD)中运动神经元及额颞叶皮质泛素阳性/ tau阴性包涵体的主要成分。神经原纤维缠结(NFT)是tau阳性包涵体的一个例子,在生化和形态上与TDP - 43阳性包涵体不同,是阿尔茨海默病(AD)的病理核心特征之一。尽管ALS/FTLD和AD是不同的临床实体,但它们可在个体患者中共存。ALS/FTLD - TDP - 43与AD - tau的并发是偶然现象仍存在争议,因为衰老同时是ALS/FTLD和AD发生的常见风险因素。事实上,ALS/FTLD的发病机制与tau积累是否存在直接因果关系仍不清楚。最近的研究表明,AD发病机制可能导致TDP - 43积累,而TDP - 43异常积累也可能导致tau表达异常。尸检时在大脑中观察到TDP - 43和tau的重叠存在应引起关注,并应着手寻找这种异常蛋白质积累的病理基础。除了tau,其他蛋白质,包括α - 突触核蛋白和淀粉样β蛋白,也应被视为与TDP - 43相互作用的候选蛋白。认识到ALS/FTLD患者中TDP - 43、tau和其他蛋白质之间可能存在的合并症,将有助于我们理解这些蛋白质对疾病发展及其临床表现的影响。

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