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神经炎症。

Neuroinflammation.

机构信息

Department of Anatomy and Neurobiology, Virginia Commonwealth University, Richmond, VA, United States.

Department of Neurology, Virginia Commonwealth University, Richmond, VA, United States.

出版信息

Handb Clin Neurol. 2020;175:235-259. doi: 10.1016/B978-0-444-64123-6.00017-5.

Abstract

Neuroinflammation is implicated in contributing to a variety of neurologic and somatic illnesses including Alzheimer's disease (AD), Parkinson's disease (PD), and depression. In this chapter, we focus on the role of neuroinflammation in mediating these three illnesses and portray interactions between the immune response and the central nervous system in the context of sex differences in disease progression. The majority of this chapter is supported by clinical findings; however, we occasionally utilize preclinical models where human studies are currently lacking. We begin by detailing the pathology of neuroinflammation, distinguishing between acute and chronic inflammation, and examining contributions from the innate and adaptive immune systems. Next, we summarize potential mechanisms of immune cell mediators including interleukin-1 beta (IL-1β), tumor necrosis factor α, and IL-6 in AD, PD, and depression development. Given the strong sex bias seen in these illnesses, we additionally examine the role of sex hormones, e.g., estrogen and testosterone in mediating neuroinflammation at the cellular level. Systematically, we detail how sex hormones may contribute to distinct behavioral and clinical symptoms and prognosis between males and females with AD, PD, or depression. Finally, we highlight the possible role of exercise in alleviating neuroinflammation, as well as evidence that antiinflammatory drug therapies improve cognitive symptoms observed in brain-related diseases.

摘要

神经炎症与多种神经和躯体疾病有关,包括阿尔茨海默病(AD)、帕金森病(PD)和抑郁症。在本章中,我们重点关注神经炎症在介导这三种疾病中的作用,并描述了免疫反应与中枢神经系统在疾病进展过程中的性别差异方面的相互作用。本章的大部分内容都得到了临床发现的支持;然而,我们偶尔会使用目前缺乏人类研究的临床前模型。我们首先详细介绍神经炎症的病理学,区分急性和慢性炎症,并研究先天和适应性免疫系统的贡献。接下来,我们总结了免疫细胞介质(包括白细胞介素-1β(IL-1β)、肿瘤坏死因子-α和 IL-6)在 AD、PD 和抑郁症发展中的潜在机制。鉴于这些疾病中存在强烈的性别偏见,我们还检查了性激素(例如雌激素和睾酮)在介导细胞水平的神经炎症中的作用。系统地,我们详细说明了性激素如何导致 AD、PD 或抑郁症男性和女性之间出现不同的行为和临床症状以及预后。最后,我们强调了运动在缓解神经炎症中的可能作用,以及抗炎药物治疗改善与大脑相关疾病中观察到的认知症状的证据。

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