Department of Mechanical Engineering and Engineering Science, Center for Biomedical Engineering and Science, University of North Carolina, Charlotte, NC 28223, USA.
Department of Biological Sciences, Center for Biomedical Engineering and Science, University of North Carolina, Charlotte, NC 28223, USA.
Int J Mol Sci. 2020 Dec 16;21(24):9591. doi: 10.3390/ijms21249591.
Alzheimer's disease (AD) is the most common cause of dementia, typically showing progressive neurodegeneration in aging brains. The key signatures of the AD progression are the deposition of amyloid-beta (Aβ) peptides, the formation of tau tangles, and the induction of detrimental neuroinflammation leading to neuronal loss. However, conventional pharmacotherapeutic options are merely relying on the alleviation of symptoms that are limited to mild to moderate AD patients. Moreover, some of these medicines discontinued to use due to either the insignificant effectiveness in improving the cognitive impairment or the adverse side effects worsening essential bodily functions. One of the reasons for the failure is the lack of knowledge on the underlying mechanisms that can accurately explain the major causes of the AD progression correlating to the severity of AD. Therefore, there is an urgent need for the better understanding of AD pathogenesis and the development of the disease-modifying treatments, particularly for severe and late-onset AD, which have not been covered thoroughly. Here, we review the underlying mechanisms of AD progression, which have been employed for the currently established therapeutic strategies. We believe this will further spur the discovery of a novel disease-modifying treatment for mild to severe, as well as early- to late-onset, AD.
阿尔茨海默病(AD)是痴呆症最常见的病因,通常在衰老大脑中表现出进行性神经退行性变。AD 进展的关键特征是淀粉样β(Aβ)肽的沉积、tau 缠结的形成以及导致神经元丧失的有害神经炎症的诱导。然而,传统的药物治疗选择仅仅依赖于对轻度至中度 AD 患者的症状缓解。此外,由于在改善认知障碍方面效果不明显或因恶化重要身体功能的不良反应而停止使用其中一些药物。失败的原因之一是缺乏对潜在机制的了解,这些机制可以准确解释与 AD 严重程度相关的 AD 进展的主要原因。因此,迫切需要更好地了解 AD 的发病机制和开发疾病修饰治疗方法,特别是对于严重和迟发性 AD,这些方法尚未得到充分覆盖。在这里,我们回顾了 AD 进展的潜在机制,这些机制已被用于目前确立的治疗策略。我们相信,这将进一步推动对轻度至重度、早期至晚期 AD 的新型疾病修饰治疗的发现。