Yassine Hussein N, Self Wade, Kerman Bilal E, Santoni Giulia, Navalpur Shanmugam NandaKumar, Abdullah Laila, Golden Lesley R, Fonteh Alfred N, Harrington Michael G, Gräff Johannes, Gibson Gary E, Kalaria Raj, Luchsinger Jose A, Feldman Howard H, Swerdlow Russell H, Johnson Lance A, Albensi Benedict C, Zlokovic Berislav V, Tanzi Rudolph, Cunnane Stephen, Samieri Cécilia, Scarmeas Nikolaos, Bowman Gene L
Department of Medicine, Keck School of Medicine, University of Southern, California, Los Angeles, California, USA.
Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Alzheimers Dement. 2023 Mar;19(3):1041-1066. doi: 10.1002/alz.12845. Epub 2022 Dec 8.
Disturbances in the brain's capacity to meet its energy demand increase the risk of synaptic loss, neurodegeneration, and cognitive decline. Nutritional and metabolic interventions that target metabolic pathways combined with diagnostics to identify deficits in cerebral bioenergetics may therefore offer novel therapeutic potential for Alzheimer's disease (AD) prevention and management. Many diet-derived natural bioactive components can govern cellular energy metabolism but their effects on brain aging are not clear. This review examines how nutritional metabolism can regulate brain bioenergetics and mitigate AD risk. We focus on leading mechanisms of cerebral bioenergetic breakdown in the aging brain at the cellular level, as well as the putative causes and consequences of disturbed bioenergetics, particularly at the blood-brain barrier with implications for nutrient brain delivery and nutritional interventions. Novel therapeutic nutrition approaches including diet patterns are provided, integrating studies of the gut microbiome, neuroimaging, and other biomarkers to guide future personalized nutritional interventions.
大脑满足其能量需求的能力出现紊乱会增加突触丧失、神经退行性变和认知衰退的风险。因此，针对代谢途径的营养和代谢干预措施，结合用于识别大脑生物能量学缺陷的诊断方法，可能为阿尔茨海默病（AD）的预防和管理提供新的治疗潜力。许多源自饮食的天然生物活性成分可以调控细胞能量代谢，但其对大脑衰老的影响尚不清楚。本综述探讨营养代谢如何调节大脑生物能量学并降低AD风险。我们关注衰老大脑在细胞水平上大脑生物能量分解的主要机制，以及生物能量学紊乱的假定原因和后果，特别是在血脑屏障方面，其对营养物质向大脑输送及营养干预具有影响。文中提供了包括饮食模式在内的新型治疗性营养方法，整合了肠道微生物组、神经影像学和其他生物标志物的研究，以指导未来的个性化营养干预。
