Denali Therapeutics Inc., South San Francisco, CA 94080, USA.
German Center for Neurodegenerative Diseases (DZNE) Munich, 81377 Munich, Germany.
Neuron. 2020 Dec 9;108(5):801-821. doi: 10.1016/j.neuron.2020.09.029. Epub 2020 Oct 22.
Alzheimer's disease (AD) is currently untreatable, and therapeutic strategies aimed to slow cognitive decline have not yet been successful. Many of these approaches have targeted the amyloid cascade, indicating that novel treatment strategies are required. Recent genome-wide association studies (GWASs) have identified a number of risk factors in genes expressed in microglia, underscoring their therapeutic potential in neurodegeneration. In this review, we discuss how the recently defined functions of these AD risk genes can be targeted therapeutically to modulate microglial cell state and slow the progression of AD. Antibody-mediated stimulation of the triggering receptor of myeloid cells 2 (TREM2) is on the forefront of these candidate therapeutic approaches based on a combination of compelling human genetics and emerging preclinical data. This and other approaches to modify microglial function are a topic of intensive study and provide an opportunity for innovative AD treatments, which may be applied alone or potentially in combination with classical anti-amyloid therapies.
阿尔茨海默病(AD)目前无法治愈,旨在减缓认知能力下降的治疗策略尚未取得成功。其中许多方法都针对淀粉样蛋白级联反应,这表明需要新的治疗策略。最近的全基因组关联研究(GWAS)已经确定了微胶质细胞中表达的基因中的许多风险因素,突出了它们在神经退行性变中的治疗潜力。在这篇综述中,我们讨论了如何针对这些 AD 风险基因的最近定义的功能进行治疗,以调节小胶质细胞状态并减缓 AD 的进展。基于令人信服的人类遗传学和新兴的临床前数据的组合,抗体介导的髓样细胞触发受体 2(TREM2)刺激是这些候选治疗方法的前沿。这种和其他修饰小胶质细胞功能的方法是一个密集研究的主题,并为创新的 AD 治疗提供了机会,这些治疗方法可以单独应用或可能与经典的抗淀粉样蛋白治疗联合应用。