Inuzuka Hiroyuki, Liu Jing, Wei Wenyi, Rezaeian Abdol-Hossein
Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.
Acta Mater Med. 2022;1(1):24-41. doi: 10.15212/amm-2021-0001. Epub 2022 Jan 21.
Neurodegenerative diseases (NDs) are characteristic with progression of neuron degeneration, resulting in dysfunction of cognition and mobility. Many neurodegenerative diseases are because of proteinopathies that results from unusual protein accumulations and aggregations. The aggregation of misfolded proteins like β-amyloid, α-synuclein, tau, and polyglutamates are hallmarked in Alzheimer's disease (AD), which are undruggable targets, and usually do not respond to conventional small-molecule agents. Therefore, developing novel technology and strategy for reducing the levels of protein aggregates would be critical for treatment of AD. Recently, the emerging proteolysis targeting chimeras (PRPTACs) technology has been significantly considered for artificial and selective degradation of aberrant target proteins. These engineered bifunctional molecules engage target proteins to be degraded by either the cellular degradation machinery in the ubiquitin-proteasome system (UPS) or via the autophagy-lysosome degradation pathway. Although the application of PROTACs technology is preferable than oligonucleotide and antibodies for treatment of NDs, many limitations such as their pharmacokinetic properties, tissue distribution and cell permeabilities, still need to be corrected. Herein, we review the recent advances in PROTACs technology with their limitation for pharmaceutical targeting of aberrant proteins involved in Alzheimer's diseases. We also review therapeutic potential of dysregulated signaling such as PI3K/AKT/mTOR axis for the management of AD.
神经退行性疾病(NDs)的特征是神经元退化的进展,导致认知和运动功能障碍。许多神经退行性疾病是由蛋白质病变引起的,这些病变是由异常的蛋白质积累和聚集导致的。在阿尔茨海默病(AD)中,错误折叠的蛋白质如β-淀粉样蛋白、α-突触核蛋白、tau蛋白和多聚谷氨酸的聚集很明显,这些是不可成药的靶点,通常对传统小分子药物无反应。因此,开发降低蛋白质聚集体水平的新技术和策略对于AD的治疗至关重要。最近,新兴的蛋白酶靶向嵌合体(PRPTACs)技术已被显著考虑用于异常靶蛋白的人工和选择性降解。这些工程化的双功能分子使靶蛋白通过泛素-蛋白酶体系统(UPS)中的细胞降解机制或通过自噬-溶酶体降解途径被降解。尽管PROTACs技术在治疗NDs方面比寡核苷酸和抗体更具优势,但仍有许多局限性,如它们的药代动力学性质、组织分布和细胞通透性,需要加以纠正。在此,我们综述了PROTACs技术的最新进展及其在针对AD中异常蛋白质的药物靶向方面的局限性。我们还综述了失调信号通路如PI3K/AKT/mTOR轴在AD治疗中的潜在作用。