Departamento de Farmacologia, ICB, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Nutr Neurosci. 2022 Nov;25(11):2442-2457. doi: 10.1080/1028415X.2021.1972514. Epub 2021 Sep 11.
The mechanism behind the progression of Mild Cognitive Impairment (MCI) to Alzheimer's disease (AD) remains poorly understood. However some evidence pointed out that the co-occurrence of metabolic conditions affecting glucose homeostasis, as type 2 diabetes mellitus (T2DM), may be an important catalyst in this context. Notably, candidate drugs which modulate common pathways in the development of MCI-to-AD mediated by T2DM may offer likely therapy for AD. Nonetheless, limited pharmacological alternatives that modulate common pathways in T2DM, MCI, and AD are available. In the recent decades, studies have shown that resveratrol may act as a neuroprotective compound, but little is known about its potential in improving cognitive and metabolic aspects associated with AD progression mediated by the co-association between TDM2-MCI. In this review, we discuss possible protective mechanisms of resveratrol on shared pathways associated with AD progression mediated by T2DM-MCI co-occurrence. Some studies indicated that insulin resistance and hyperglycemia may be also a T2DM risk factor for the progression of MCI-to-AD, promoting alterations in metabolic pathways associated with neuronal plasticity, and increasing pro-inflammatory environment. Interestingly, basic research and clinical trials indicate that resveratrol may modulate those pathways, showing a potential neuroprotective effect of this polyphenol. Therefore, there is not enough clinical data supporting the translational therapeutic use of resveratrol in this scenario.
轻度认知障碍 (MCI) 向阿尔茨海默病 (AD) 进展的背后机制仍知之甚少。然而,有一些证据表明,影响葡萄糖稳态的代谢性疾病(如 2 型糖尿病)的共同发生可能是这种情况下的一个重要催化剂。值得注意的是,调节 2 型糖尿病介导的 MCI 向 AD 发展的共同途径的候选药物可能为 AD 提供潜在的治疗方法。尽管如此,能够调节 2 型糖尿病、MCI 和 AD 共同途径的有限药理学选择仍然存在。在最近几十年,研究表明白藜芦醇可能作为一种神经保护化合物,但关于其在改善与 TDM2-MCI 共同关联介导的 AD 进展相关的认知和代谢方面的潜在作用知之甚少。在这篇综述中,我们讨论了白藜芦醇对与 2 型糖尿病 -MCI 共同发生相关的 AD 进展介导的共同途径的可能保护机制。一些研究表明,胰岛素抵抗和高血糖也可能是 MCI 向 AD 进展的 2 型糖尿病危险因素,导致与神经元可塑性相关的代谢途径发生改变,并增加促炎环境。有趣的是,基础研究和临床试验表明,白藜芦醇可能调节这些途径,显示出这种多酚的潜在神经保护作用。因此,在这种情况下,没有足够的临床数据支持白藜芦醇的转化治疗用途。