Epstein Alberto L
UMR Inserm U1179 - UVSQ - UFR des sciences de la santé Simone Veil, Université de Versailles-Saint-Quentin-en-Yvelines, 2 avenue de la source de la Bièvre, 78180 Montigny-le-Bretonneux, France.
Med Sci (Paris). 2020 May;36(5):479-486. doi: 10.1051/medsci/2020090. Epub 2020 May 26.
Infection of the brain with various types of pathogens, and the resulting inflammatory response, is becoming increasingly important in our understanding of the etiology of Alzheimer's disease (AD). The fact that several genes identified as risk factors are actually involved in the modulation of the immune response, as well as the very diversity of the infectious agents identified as possible actors in the evolution of this disease, argue in favor of the neuro-inflammatory hypothesis, as does the demonstration that the protein Aβ, one of the most important markers of AD, is an antimicrobial peptide. Among others, herpes viruses (mainly, but not only, HSV-1), which can establish latent infections in brain neurons, especially in the elder population, punctuated by episodes of reactivation following stress or immunosuppression, appear as very strong candidates to play an etiological role, if only as cofactors, of AD. Recent results show that, in human and rat neurons, infection with HSV-1 increases the formation of Aβ along the amyloidogenic pathway, as well as the phosphorylation of Tau proteins, another essential marker of AD. The growing evidence that chronic infections and defense mechanisms, including inflammatory processes, are at the heart of AD, warrants reviewing antiviral drugs such as acyclovir, and possibly vaccination, as potential avenues for AD control.
各种病原体感染大脑以及由此引发的炎症反应,在我们对阿尔茨海默病(AD)病因的理解中变得越来越重要。事实上,一些被确定为风险因素的基因实际上参与了免疫反应的调节,而且被确定为可能在这种疾病发展中起作用的感染因子种类繁多,这都支持了神经炎症假说,同样,AD最重要的标志物之一——蛋白质Aβ是一种抗菌肽这一发现也支持了该假说。其中,疱疹病毒(主要是但不限于单纯疱疹病毒1型,HSV-1),可在脑神经元中建立潜伏感染,尤其是在老年人群中,在压力或免疫抑制后会间歇性激活,似乎是在AD病因中发挥作用(哪怕只是作为辅助因子)的非常有力的候选因素。最近的研究结果表明,在人类和大鼠神经元中,HSV-感染会增加淀粉样蛋白生成途径中Aβ的形成,以及Tau蛋白(AD的另一个重要标志物)的磷酸化。越来越多的证据表明,包括炎症过程在内的慢性感染和防御机制是AD的核心,这使得有必要重新审视诸如阿昔洛韦等抗病毒药物以及疫苗接种,将其作为控制AD的潜在途径。