Young John K
Professor Emeritus, Department of Anatomy, Howard University College of Medicine, Washington, DC, USA.
J Alzheimers Dis Rep. 2020 Sep 3;4(1):365-371. doi: 10.3233/ADR-200218.
One unexplained feature of Alzheimer's disease (AD) is that the lateral entorhinal cortex undergoes neurodegeneration before other brain areas. However, this brain region does not have elevated levels of amyloid peptides in comparison with undamaged regions. What is the cause of this special vulnerability of the entorhinal cortex? One special feature of the lateral entorhinal cortex is that it projects to newborn neurons that have undergone adult neurogenesis in the dentate gyrus of the hippocampus. Neurogenesis is abnormal in human AD brains, and modulation of neurogenesis in experimental animals influences the course of AD. This complex process of neurogenesis may expose axon terminals originating from neurons of the entorhinal cortex to a unique combination of molecules that can enhance toxic effects of amyloid. Retrograde degeneration of neurons with axons terminating in the dentate gyrus provides a likely explanation for the spatial patterns of neuronal cell death seen in AD. Specialized astrocytes in the dentate gyrus participate in adult neurogenesis and produce fatty acid binding protein7 (FABP7). These FABP7+ cells undergo an aging-related mitochondrial pathology that likely impairs their functions. This age-related abnormality may contribute to the impairment in neurogenesis seen in aging and Alzheimer's disease. Also, a compromised function of these astrocytes likely results in local elevations of palmitic acid, iron, copper, and glucose, which all enhance the toxicity of amyloid peptides. Treatments that modulate neurogenesis or diminish the production of these toxic substances may prove more successful than treatments that are solely aimed at reducing the amyloid burden alone.
阿尔茨海默病(AD)一个无法解释的特征是,外侧内嗅皮质比其他脑区更早发生神经退行性变。然而,与未受损区域相比,该脑区的淀粉样肽水平并未升高。内嗅皮质这种特殊易损性的原因是什么?外侧内嗅皮质的一个特殊特征是,它投射到海马齿状回中经历成年神经发生的新生神经元。人类AD大脑中的神经发生是异常的,实验动物中神经发生的调节会影响AD的病程。这种复杂的神经发生过程可能会使源自内嗅皮质神经元的轴突终末暴露于一组独特的分子组合中,这些分子会增强淀粉样蛋白的毒性作用。轴突终末位于齿状回的神经元逆行性变性,为AD中观察到的神经元细胞死亡空间模式提供了一种可能的解释。齿状回中的特化星形胶质细胞参与成年神经发生并产生脂肪酸结合蛋白7(FABP7)。这些FABP7+细胞会发生与衰老相关的线粒体病变,这可能会损害它们的功能。这种与年龄相关的异常可能导致衰老和阿尔茨海默病中神经发生受损。此外,这些星形胶质细胞功能受损可能会导致棕榈酸、铁、铜和葡萄糖局部升高,所有这些都会增强淀粉样肽的毒性。调节神经发生或减少这些有毒物质产生的治疗方法可能比单纯旨在减轻淀粉样蛋白负担的治疗方法更成功。