Lall Rahul, Mohammed Raihan, Ojha Utkarsh
Department of Medicine, University of Cambridge, Cambridge, UK.
Faculty of Medicine, Imperial College London, London, UK.
Neuropsychiatr Dis Treat. 2019 May 21;15:1343-1354. doi: 10.2147/NDT.S203103. eCollection 2019.
Alzheimer's disease (AD) is the most common neurodegenerative disease. Histological characterization of amyloid plaques and neurofibrillary tangles in the brains of AD patients, alongside genetic studies in individuals suffering the familial form of the disease, has fueled the accumulation of the amyloid-β protein as the initial pathological trigger of disease. Association studies have recently showed that cerebral hypoxia, via both genetic and epigenetic mechanisms, increase amyloid-β deposition by altering expression levels of enzymes involved in the production/degradation of the protein. Furthermore, hypoxia has also been linked to neuronal and glial-cell calcium dysregulation through formation of calcium-permeable pores, dysregulated glutamate signaling, and intracellular calcium-store dysfunction. Hypoxia has also been strongly linked to neuroinflammation; however, this relationship to AD has not been thoroughly discussed in the literature. Here, we highlight and organize critical research evidence showing that in both hypoxic and AD brains, there are similarities in terms of 1) the substances mediating/modulating the neuroinflammatory environment and 2) the immune cells that drive the formation of these substances.
阿尔茨海默病(AD)是最常见的神经退行性疾病。AD患者大脑中淀粉样斑块和神经原纤维缠结的组织学特征,以及对患家族性AD个体的基因研究,都表明β淀粉样蛋白的积累是该疾病最初的病理触发因素。关联研究最近表明,脑缺氧通过遗传和表观遗传机制,改变参与该蛋白产生/降解的酶的表达水平,从而增加β淀粉样蛋白的沉积。此外,缺氧还通过形成钙通透性孔、谷氨酸信号失调和细胞内钙库功能障碍,与神经元和神经胶质细胞的钙调节异常有关。缺氧也与神经炎症密切相关;然而,这种与AD的关系在文献中尚未得到充分讨论。在这里,我们重点介绍并整理了关键研究证据,表明在缺氧和AD大脑中,在以下两方面存在相似之处:1)介导/调节神经炎症环境的物质;2)驱动这些物质形成的免疫细胞。