Alzheimer's Center at Temple, Lewis Katz School of Medicine Temple University, Philadelphia, PA, USA.
J Alzheimers Dis. 2018;62(3):1337-1344. doi: 10.3233/JAD-170700.
Alzheimer's disease (AD) affects over 40 million patients around the world and poses a huge economic burden on society since no effective therapy is available yet. While the cause(s) for the most common sporadic form of the disease are still obscure, lifestyle and different environmental factors have emerged as modulators of AD susceptibility. Hyperhomocysteinemia (HHCY), a condition of high circulating levels of homocysteine, is an independent but modifiable risk factor for AD. Studies in AD mouse models have linked HHCY with memory impairment, amyloidosis, tau pathology, synaptic dysfunction, and neuroinflammation. However, the exact mechanism by which HHCY affects AD pathogenesis is unclear. The 5-lipoxygenase (5LO) is a protein upregulated in postmortem AD brains and plays a functional role in AD pathogenesis. Recently, in vitro and in vivo studies showed that HHCY effects on amyloid-β and tau pathology, synapse and memory impairments are dependent on the activation of the 5LO enzymatic pathway, since its genetic absence or pharmacological inhibition prevents them. HHCY induces 5LO gene upregulation by lowering the methylation of its promoter, which results in increased translation and transcription of its mRNA. Based on these findings, we propose that epigenetic modification of 5LO represents the missing biological link between HHCY and AD pathogenesis, and for this reason it represents a viable therapeutic target to prevent AD development in individuals bearing this risk factor.
阿尔茨海默病(AD)影响着全球超过 4000 万名患者,由于目前尚无有效的治疗方法,该病给社会带来了巨大的经济负担。虽然最常见的散发性疾病的病因尚不清楚,但生活方式和不同的环境因素已成为 AD 易感性的调节剂。高同型半胱氨酸血症(HHCY)是一种同型半胱氨酸循环水平升高的疾病,是 AD 的一个独立但可改变的危险因素。AD 小鼠模型的研究将 HHCY 与记忆障碍、淀粉样变性、tau 病理学、突触功能障碍和神经炎症联系起来。然而,HHCY 影响 AD 发病机制的确切机制尚不清楚。5-脂氧合酶(5LO)是 AD 大脑死后上调的一种蛋白质,在 AD 发病机制中发挥功能作用。最近,体外和体内研究表明,HHCY 对淀粉样蛋白-β 和 tau 病理学、突触和记忆损伤的影响依赖于 5LO 酶促途径的激活,因为其遗传缺失或药物抑制可防止这些影响。HHCY 通过降低其启动子的甲基化来诱导 5LO 基因的上调,从而导致其 mRNA 的翻译和转录增加。基于这些发现,我们提出 5LO 的表观遗传修饰代表了 HHCY 与 AD 发病机制之间缺失的生物学联系,因此它是预防具有这种危险因素的个体发生 AD 的可行治疗靶点。