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维生素 D 与阿尔茨海默病的关系:从遗传学基础到生物标志物。

Vitamin D basis of Alzheimer's disease: from genetics to biomarkers.

机构信息

Brain and Neurodegenerative Disorders Research Laboratory, Department of Medical Biology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, 34098, Istanbul, Turkey.

出版信息

Hormones (Athens). 2019 Mar;18(1):7-15. doi: 10.1007/s42000-018-0086-5. Epub 2018 Nov 27.

Abstract

Alzheimer's disease (AD) is a progressive neurodegenerative disorder seen mostly in the elderly population. While to date AD research has focused on either neurochemical disruptions, genetic studies, or the pathological hallmarks, little has been done to establish a novel approach that would encompass all three aspects, one that would overcome the current barriers in AD research and determine the cause of AD and, eventually, discover a treatment. Meanwhile, there have been strong indications in recent years that vitamin D, a secosteroid hormone, and its receptors are fundamentally involved in neurodegenerative mechanisms. Observational studies have pointed to vitamin D deficiency as a genetic risk factor for AD, Parkinson's disease (PD), vascular dementia, and multiple sclerosis (MS), as well as other neurological disorders, brought about by alterations in genes involved in metabolism, transportation, and actions of vitamin D. Molecular studies have demonstrated that vitamin D treatments prevent amyloid production while also increasing its clearance from the brain in AD. Finally, recent vitamin D intervention studies have reported significant improvement in cognitive performance in subjects with senile dementia, mild cognitive impairment, and AD. This review aims to describe how a vitamin D research strategy, fully integrating all aspects of present-day AD research, would elucidate the genetic, molecular, and biochemical background of the disease.

摘要

阿尔茨海默病(AD)是一种常见于老年人群体的进行性神经退行性疾病。虽然迄今为止 AD 的研究主要集中在神经化学紊乱、遗传研究或病理特征上,但几乎没有采取任何措施来建立一种新的方法,将这三个方面结合起来,克服 AD 研究中的当前障碍,并确定 AD 的病因,最终发现治疗方法。与此同时,近年来有强烈迹象表明,维生素 D 是一种类固醇激素及其受体,它从根本上参与了神经退行性机制。观察性研究表明,维生素 D 缺乏是 AD、帕金森病(PD)、血管性痴呆和多发性硬化症(MS)以及其他神经紊乱的遗传风险因素,这是由于涉及维生素 D 代谢、运输和作用的基因发生改变所致。分子研究表明,维生素 D 治疗可预防淀粉样蛋白的产生,同时还可增加 AD 大脑中淀粉样蛋白的清除。最后,最近的维生素 D 干预研究报告称,维生素 D 干预可显著改善老年痴呆症、轻度认知障碍和 AD 患者的认知表现。本综述旨在描述一种维生素 D 研究策略,该策略将全面整合当今 AD 研究的各个方面,阐明疾病的遗传、分子和生化背景。

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