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阿尔茨海默病及转基因啮齿动物模型中的脑血管功能障碍

Cerebrovascular Dysfunction in Alzheimer's Disease and Transgenic Rodent Models.

作者信息

Fang Xing, Fan Fan, Border Jane J, Roman Richard J

机构信息

Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, MS 39216, USA.

Department of Physiology, Augusta University, Augusta, GA 30912, USA.

出版信息

J Exp Neurol. 2024;5(2):42-64. doi: 10.33696/neurol.5.087.

Abstract

Alzheimer's Disease (AD) and Alzheimer's Disease-Related Dementia (ADRD) are the primary causes of dementia that has a devastating effect on the quality of life and is a tremendous economic burden on the healthcare system. The accumulation of extracellular beta-amyloid (Aβ) plaques and intracellular hyperphosphorylated tau-containing neurofibrillary tangles (NFTs) in the brain are the hallmarks of AD. They are also thought to be the underlying cause of inflammation, neurodegeneration, brain atrophy, and cognitive impairments that accompany AD. The discovery of and mutations that increase Aβ production in families with early onset familial AD led to the development of numerous transgenic rodent models of AD. These models have provided new insight into the role of Aβ in AD; however, they do not fully replicate AD pathology in patients. Familial AD patients with mutations that elevate the production of Aβ represent only a small fraction of dementia patients. In contrast, those with late-onset sporadic AD constitute the majority of cases. This observation, along with the failure of previous clinical trials targeting Aβ or Tau and the modest success of recent trials using Aβ monoclonal antibodies, has led to a reappraisal of the view that Aβ accumulation is the sole factor in the pathogenesis of AD. More recent studies have established that cerebral vascular dysfunction is one of the earliest changes seen in AD, and 67% of the candidate genes linked to AD are expressed in the cerebral vasculature. Thus, there is an increasing appreciation of the vascular contribution to AD, and the National Institute on Aging (NIA) and the Alzheimer's Disease Foundation recently prioritized it as a focused research area. This review summarizes the strengths and limitations of the most commonly used transgenic AD animal models and current views about the contribution of Aβ accumulation versus cerebrovascular dysfunction in the pathogenesis of AD.

摘要

阿尔茨海默病(AD)和阿尔茨海默病相关痴呆(ADRD)是痴呆的主要病因,对生活质量具有毁灭性影响,并且给医疗保健系统带来巨大经济负担。大脑中细胞外β淀粉样蛋白(Aβ)斑块的积累和细胞内含有过度磷酸化tau的神经原纤维缠结(NFTs)是AD的标志。它们也被认为是伴随AD的炎症、神经退行性变、脑萎缩和认知障碍的根本原因。早发性家族性AD家族中增加Aβ产生的 和 突变的发现,导致了众多AD转基因啮齿动物模型的开发。这些模型为Aβ在AD中的作用提供了新的见解;然而,它们并未完全复制患者的AD病理。携带增加Aβ产生突变的家族性AD患者仅占痴呆患者的一小部分。相比之下,晚发性散发性AD患者占大多数。这一观察结果,连同以往针对Aβ或Tau的临床试验的失败以及近期使用Aβ单克隆抗体试验的适度成功,导致人们重新评估Aβ积累是AD发病机制中唯一因素的观点。最近的研究表明,脑血管功能障碍是AD中最早出现的变化之一,与AD相关的67%的候选基因在脑血管中表达。因此,人们越来越认识到血管因素对AD的影响,美国国立衰老研究所(NIA)和阿尔茨海默病基金会最近将其作为一个重点研究领域。本综述总结了最常用的转基因AD动物模型的优缺点,以及目前关于Aβ积累与脑血管功能障碍在AD发病机制中的作用的观点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba33/10906803/80b39870a0ae/nihms-1963005-f0001.jpg

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