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阿尔茨海默病发病机制及中医药干预的研究进展

A Review of the Pathogenesis and Chinese Medicine Intervention of Alzheimer's Disease.

机构信息

Laboratory of Medical Molecular and Cellular Biology, College of Basic Medical Sciences, Hubei University of Chinese Medicine, 430065 Wuhan, Hubei, China.

Department of Pharmacology, College of Pharmacy, Hubei University of Chinese Medicine, 430065 Wuhan, Hubei, China.

出版信息

J Integr Neurosci. 2022 Nov 25;22(1):2. doi: 10.31083/j.jin2201002.

Abstract

Alzheimer's disease (AD) is an age-related neurodegenerative disease that is primary characterized as a cognitive disorder. Its pathology is characterized by the formation of senile plaques in the brain from amyloid-beta (Aβ) aggregation, neuronal fibrillary tangles from hyperphosphorylated tau protein aggregation, prolonged inflammatory responses, and neuronal death. The pathogenesis and clinical manifestations of AD are complex, but aging is generally accepted as one of the most important contributing factors. In addition, there are several hypotheses, including the Aβ hypothesis based on amyloid plaques, the tau hypothesis based on neuronal fiber entanglement, the inflammation hypothesis based on long-term inflammatory responses causing brain damage, and the neuroprotection hypothesis based on synaptic dysfunction and neuronal death. Although the pathogenesis of AD has been broadly classified into four major hypotheses, there are multiple forms of interactions, which is one of the reasons for its complex pathogenesis. Numerous epidemiological studies have shown the important role of genes in AD, followed by brain damage, hyperlipidemia, diabetes, hypertension, and obesity as risk factors for the disease. Despite years of research, several mysteries in AD remain unsolved. Drugs based on various pathogenetic hypotheses are being investigated in large numbers, but the effects are unsatisfactory. In recent years, traditional Chinese medicine (TCM) has made excellent progress and is expected to provide a new possibility for AD treatment. In this review, we focus on the latest developments in studies on the risk factors-Aβ aggregates and related factors such as apolipoprotein E, synaptic loss, and fatty acids, and then present the progress in the research of TCM based on the above pathogenesis, intended to provide a research reference and treatment for AD.

摘要

阿尔茨海默病(AD)是一种与年龄相关的神经退行性疾病,主要表现为认知障碍。其病理学特征是大脑中淀粉样蛋白-β(Aβ)聚集形成老年斑、过度磷酸化tau 蛋白聚集形成神经元纤维缠结、长期炎症反应和神经元死亡。AD 的发病机制和临床表现复杂,但衰老被普遍认为是最重要的致病因素之一。此外,还有几种假说,包括基于淀粉样斑块的 Aβ假说、基于神经元纤维缠结的 tau 假说、基于长期炎症反应导致脑损伤的炎症假说以及基于突触功能障碍和神经元死亡的神经保护假说。尽管 AD 的发病机制已广泛分为四大假说,但它们之间存在多种形式的相互作用,这也是其发病机制复杂的原因之一。大量的流行病学研究表明,基因在 AD 中的重要作用,其次是脑损伤、高血脂、糖尿病、高血压和肥胖症等疾病的危险因素。尽管经过多年的研究,AD 仍有一些未解之谜。基于各种发病机制假说的药物正在大量研究中,但效果并不理想。近年来,中医药取得了优异的进展,有望为 AD 治疗提供新的可能。在本文中,我们重点介绍了 AD 风险因素-Aβ 聚集物及载脂蛋白 E、突触丢失和脂肪酸等相关因素的最新研究进展,然后根据上述发病机制介绍了中医药的研究进展,旨在为 AD 的研究和治疗提供参考。

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