Neurology V - Neuropathology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.
Department of Molecular Biochemistry and Pharmacology, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
Mol Psychiatry. 2022 Dec;27(12):5227-5234. doi: 10.1038/s41380-022-01745-x. Epub 2022 Aug 26.
Alzheimer's disease (AD) is an irreversible neurodegenerative disorder that affects millions of people worldwide. AD pathogenesis is intricate. It primarily involves two main molecular players-amyloid-β (Aβ) and tau-which actually have an intrinsic trend to generate molecular assemblies that are toxic to neurons. Incomplete knowledge of the molecular mechanisms inducing the onset and sustaining the progression of the disease, as well as the lack of valid models to fully recapitulate the pathogenesis of human disease, have until now hampered the development of a successful therapy for AD. The overall experience with clinical trials with a number of potential drugs-including the recent outcomes of studies with monoclonal antibodies against Aβ-seems to indicate that Aβ-targeting is not effective if it is not accompanied by an efficient challenge of Aβ neurotoxic properties. We took advantage from the discovery of a naturally-occurring variant of Aβ (Aβ) that has anti-amyloidogenic properties, and designed a novel bio-inspired strategy for AD based on the intranasal delivery of a six-mer peptide (Aβ1-6) retaining the anti-amyloidogenic abilities of the full-length Aβ variant. This approach turned out to be effective in preventing the aggregation of wild type Aβ and averting the synaptic damage associated with amyloidogenesis in a mouse model of AD. The results of our preclinical studies inspired by a protective model already existing in nature, that is the human heterozygous Aβ carriers which seem to be protected from AD, open the way to an unprecedented and promising approach for the prevention of the disease in humans.
阿尔茨海默病(AD)是一种不可逆转的神经退行性疾病,影响着全球数百万人。AD 的发病机制很复杂。它主要涉及两种主要的分子参与者——β淀粉样蛋白(Aβ)和 tau——它们实际上有一种内在的趋势,会产生对神经元有毒的分子聚集体。由于对诱导疾病发作和持续进展的分子机制缺乏完整的认识,以及缺乏能够充分再现人类疾病发病机制的有效模型,迄今为止,AD 的治疗方法一直未能取得成功。大量潜在药物的临床试验的总体经验——包括最近针对 Aβ 的单克隆抗体的研究结果——似乎表明,如果不有效地对抗 Aβ 的神经毒性,针对 Aβ 的靶向治疗是无效的。我们利用 Aβ(Aβ)的一种天然存在的变体的发现,设计了一种基于鼻内递送六肽(Aβ1-6)的新型仿生 AD 治疗策略,该六肽保留了全长 Aβ 变体的抗淀粉样特性。该方法在预防野生型 Aβ聚集和避免与淀粉样形成相关的突触损伤方面非常有效,在 AD 小鼠模型中。我们的临床前研究结果受到了自然界中已经存在的一种保护模型的启发,即人类杂合子 Aβ 携带者似乎可以免受 AD 的影响,为预防人类疾病开辟了一条前所未有的、有前途的途径。