Toledano-Díaz Adolfo, Álvarez M Isabel, Toledano Adolfo
Departamento de Reproducción, INIA, Madrid, Spain.
Instituto Cajal, CSIC, Madrid, Spain.
J Cent Nerv Syst Dis. 2022 Nov 14;14:11795735221123896. doi: 10.1177/11795735221123896. eCollection 2022.
Since the original description of Alzheimer´s disease (AD), research into this condition has mainly focused on assessing the alterations to neurons associated with dementia, and those to the circuits in which they are involved. In most of the studies on human brains and in many models of AD, the glial cells accompanying these neurons undergo concomitant alterations that aggravate the course of neurodegeneration. As a result, these changes to neuroglial cells are now included in all the "pathogenic cascades" described in AD. Accordingly, astrogliosis and microgliosis, the main components of neuroinflammation, have been integrated into all the pathogenic theories of this disease, as discussed in this part of the two-part monograph that follows an accompanying article on gliopathogenesis and glioprotection. This initial reflection verified the implication of alterations to the neuroglia in AD, suggesting that these cells may also represent therapeutic targets to prevent neurodegeneration. In this second part of the monograph, we will analyze the possibilities of acting on glial cells to prevent or treat the neurodegeneration that is the hallmark of AD and other pathologies. Evidence of the potential of different pharmacological, non-pharmacological, cell and gene therapies (widely treated) to prevent or treat this disease is now forthcoming, in most cases as adjuncts to other therapies. A comprehensive AD multimodal therapy is proposed in which neuronal and neuroglial pharmacological treatments are jointly considered, as well as the use of new cell and gene therapies and non-pharmacological therapies that tend to slow down the progress of dementia.
自从最初对阿尔茨海默病(AD)进行描述以来,针对这种病症的研究主要集中在评估与痴呆相关的神经元变化,以及它们所涉及的神经回路的变化。在大多数关于人类大脑的研究以及许多AD模型中,伴随这些神经元的胶质细胞会发生相应的变化,从而加剧神经退行性变的进程。因此,神经胶质细胞的这些变化现在已被纳入AD所描述的所有“致病级联反应”中。相应地,神经炎症的主要成分星形胶质细胞增生和小胶质细胞增生,已被纳入该疾病的所有致病理论中,这将在接下来的两部分专题论文的这一部分中进行讨论,该论文紧随一篇关于胶质细胞病变发生和胶质细胞保护的相关文章。这一初步思考证实了神经胶质细胞变化在AD中的作用,表明这些细胞也可能是预防神经退行性变的治疗靶点。在本专题论文的第二部分,我们将分析作用于胶质细胞以预防或治疗作为AD及其他病症标志的神经退行性变的可能性。现在,不同的药理学、非药理学、细胞和基因疗法(已广泛讨论)预防或治疗该疾病的潜力证据正在不断涌现,在大多数情况下,这些疗法作为其他疗法的辅助手段。本文提出了一种全面的AD多模式疗法,其中联合考虑了神经元和神经胶质细胞的药物治疗,以及使用新的细胞和基因疗法和非药物疗法,这些疗法往往会减缓痴呆的进展。