Wang Feixue, Wang Jiandong, Shen Ying, Li Hao, Rausch Wolf-Dieter, Huang Xiaobo
Department of Traditional Chinese Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
Beijing Geriatric Institute of Integrated Traditional and Western Medicine, Beijing, China.
Front Aging Neurosci. 2022 Mar 22;14:830569. doi: 10.3389/fnagi.2022.830569. eCollection 2022.
Iron plays a crucial role in many physiological processes of the human body, but iron is continuously deposited in the brain as we age. Early studies found iron overload is directly proportional to cognitive decline in Alzheimer's disease (AD). Amyloid precursor protein (APP) and tau protein, both of which are related to the AD pathogenesis, are associated with brain iron metabolism. A variety of iron metabolism-related proteins have been found to be abnormally expressed in the brains of AD patients and mouse models, resulting in iron deposition and promoting AD progression. Amyloid β (Aβ) and hyperphosphorylated tau, two pathological hallmarks of AD, can also promote iron deposition in the brain, forming a vicious cycle of AD development-iron deposition. Iron deposition and the subsequent ferroptosis has been found to be a potential mechanism underlying neuronal loss in many neurodegenerative diseases. Iron chelators, antioxidants and hepcidin were found useful for treating AD, which represents an important direction for AD treatment research and drug development in the future. The review explored the deep connection between iron dysregulation and AD pathogenesis, discussed the potential of new hypothesis related to iron dyshomeostasis and ferroptosis, and summarized the therapeutics capable of targeting iron, with the expectation to draw more attention of iron dysregulation and corresponding drug development.
铁在人体许多生理过程中起着关键作用,但随着年龄的增长,铁会不断在大脑中沉积。早期研究发现,铁过载与阿尔茨海默病(AD)的认知衰退直接相关。淀粉样前体蛋白(APP)和tau蛋白均与AD发病机制相关,且与脑铁代谢有关。已发现多种与铁代谢相关的蛋白质在AD患者和小鼠模型的大脑中异常表达,导致铁沉积并促进AD进展。AD的两个病理标志——淀粉样β蛋白(Aβ)和过度磷酸化的tau蛋白,也可促进大脑中的铁沉积,形成AD发展-铁沉积的恶性循环。铁沉积及随后的铁死亡已被发现是许多神经退行性疾病中神经元丢失的潜在机制。已发现铁螯合剂、抗氧化剂和铁调素对治疗AD有用,这代表了未来AD治疗研究和药物开发的一个重要方向。这篇综述探讨了铁调节异常与AD发病机制之间的深层联系,讨论了与铁稳态失衡和铁死亡相关的新假说的潜力,并总结了能够靶向铁的治疗方法,期望引起对铁调节异常及相应药物开发的更多关注。