Garbuz D G, Zatsepina O G, Evgen'ev M B
Engelhardt Institute of Molecular Biology Russian Academy of Sciences, Moscow, 119991 Russia.
Mol Biol (Mosk). 2021 Sep-Oct;55(5):734-747. doi: 10.31857/S0026898421050049.
Alzheimer's disease (AD) is a neurodegenerative disease that inevitably results in dementia and death. Currently, there are no pathogenetically grounded methods for the prevention and treatment of AD, and all current treatment regimens are symptomatic and unable to significantly delay the development of dementia. The accumulation of β-amyloid peptide (Aβ), which is a spontaneous, aggregation-prone, and neurotoxic product of the processing of signaling protein APP (Amyloid Precursor Protein), in brain tissues, primarily in the hippocampus and the frontal cortex, was for a long time considered the main cause of neurodegenerative changes in AD. However, attempts to treat AD based on decreasing Aβ production and aggregation did not bring significant clinical results. More and more arguments are arising in favor of the fact that the overproduction of Aβ in most cases of AD is not the initial cause, but a concomitant event of pathological processes in the course of the development of sporadic AD. The concept of neuroinflammation has come to the fore, suggesting that inflammatory responses play the leading role in the initiation and development of AD, both in brain tissue and in the periphery. The hypothesis about the key role of neuroinflammation in the pathogenesis of AD opens up new opportunities in the search for ways to treat and prevent this socially significant disease.
阿尔茨海默病(AD)是一种神经退行性疾病,最终不可避免地导致痴呆和死亡。目前,尚无基于发病机制的AD预防和治疗方法,当前所有治疗方案均为对症治疗,无法显著延缓痴呆的发展。β-淀粉样肽(Aβ)是信号蛋白APP(淀粉样前体蛋白)加工过程中产生的一种自发、易于聚集且具有神经毒性的产物,其在脑组织中,主要是海马体和额叶皮质中的积累,长期以来被认为是AD神经退行性变化的主要原因。然而,基于减少Aβ产生和聚集来治疗AD的尝试并未带来显著的临床效果。越来越多的观点支持这样一个事实,即在大多数散发性AD病例中,Aβ的过度产生并非初始原因,而是散发性AD发展过程中病理过程的伴随事件。神经炎症的概念已成为焦点,这表明炎症反应在AD的发生和发展中,在脑组织和外周均起主导作用。关于神经炎症在AD发病机制中关键作用的假说为寻找治疗和预防这种具有社会意义疾病的方法开辟了新机会。