Department of Physiology and Biophysics, University of Miami Miller School of Medicine, Miami, FL, USA.
The Miami Project to Cure Paralysis, Miami, FL, USA; Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA; Center for Cognitive Neuroscience and Aging, University of Miami Miller School of Medicine, Miami, FL, USA.
Transl Res. 2023 Apr;254:1-12. doi: 10.1016/j.trsl.2022.08.014. Epub 2022 Sep 5.
Traumatic brain injury (TBI) and Alzheimer's disease (AD) represent 2 of the largest sources of death and disability in the United States. Recent studies have identified TBI as a potential risk factor for AD development, and numerous reports have shown that TBI is linked with AD associated protein expression during the acute phase of injury, suggesting an interplay between the 2 pathologies. The inflammasome is a multi-protein complex that plays a role in both TBI and AD pathologies, and is characterized by inflammatory cytokine release and pyroptotic cell death. Products of inflammasome signaling pathways activate microglia and astrocytes, which attempt to resolve pathological inflammation caused by inflammatory cytokine release and phagocytosis of cellular debris. Although the initial phase of the inflammatory response in the nervous system is beneficial, recent evidence has emerged that the heightened inflammatory response after trauma is self-perpetuating and results in additional damage in the central nervous system. Inflammasome-induced cytokines and inflammasome signaling proteins released from activated microglia interact with AD associated proteins and exacerbate AD pathological progression and cellular damage. Additionally, multiple genetic mutations associated with AD development alter microglia inflammatory activity, increasing and perpetuating inflammatory cell damage. In this review, we discuss the pathologies of TBI and AD and how they are impacted by and potentially interact through inflammasome activity and signaling proteins. We discuss current clinical trials that target the inflammasome to reduce heightened inflammation associated with these disorders.
创伤性脑损伤(TBI)和阿尔茨海默病(AD)是美国两个最大的死亡和残疾原因。最近的研究表明 TBI 是 AD 发展的一个潜在风险因素,许多报告表明,TBI 与损伤急性期的 AD 相关蛋白表达有关,提示这两种病理之间存在相互作用。炎症小体是一种多蛋白复合物,在 TBI 和 AD 病理中都发挥作用,其特征是炎症细胞因子释放和细胞焦亡。炎症小体信号通路的产物激活小胶质细胞和星形胶质细胞,试图解决由炎症细胞因子释放和细胞碎片吞噬引起的病理性炎症。尽管神经系统中炎症反应的初始阶段是有益的,但最近的证据表明,创伤后炎症反应的加剧是自我维持的,会导致中枢神经系统的进一步损伤。炎症小体诱导的细胞因子和从小胶质细胞中释放的炎症小体信号蛋白与 AD 相关蛋白相互作用,加剧 AD 病理进展和细胞损伤。此外,与 AD 发展相关的多种基因突变改变了小胶质细胞的炎症活性,增加并持续加剧炎症细胞损伤。在这篇综述中,我们讨论了 TBI 和 AD 的病理,以及它们如何受到炎症小体活性和信号蛋白的影响,并可能相互作用。我们讨论了目前针对炎症小体的临床试验,以减轻与这些疾病相关的高度炎症。