Internal Medicine Department, Dr. Samir Abbas Hospital, Jeddah, Saudi Arabia.
Critical Care Medicine, Cairo University, Cairo, Egypt.
Postgrad Med. 2024 May;136(4):377-395. doi: 10.1080/00325481.2024.2360887. Epub 2024 Jun 4.
Insulin serves multiple functions as a growth-promoting hormone in peripheral tissues. It manages glucose metabolism by promoting glucose uptake into cells and curbing the production of glucose in the liver. Beyond this, insulin fosters cell growth, drives differentiation, aids protein synthesis, and deters degradative processes like glycolysis, lipolysis, and proteolysis. Receptors for insulin and insulin-like growth factor-1 are widely expressed in the central nervous system. Their widespread presence in the brain underscores the varied and critical functions of insulin signaling there. Insulin aids in bolstering cognition, promoting neuron extension, adjusting the release and absorption of catecholamines, and controlling the expression and positioning of gamma-aminobutyric acid (GABA). Importantly, insulin can effortlessly traverse the blood-brain barrier. Furthermore, insulin resistance (IR)-induced alterations in insulin signaling might hasten brain aging, impacting its plasticity and potentially leading to neurodegeneration. Two primary pathways are responsible for insulin signal transmission: the phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT) pathway, which oversees metabolic responses, and the mitogen-activated protein kinase (MAPK) pathway, which guides cell growth, survival, and gene transcription. This review aimed to explore the potential shared metabolic traits between Alzheimer's disease (AD) and IR disorders. It delves into the relationship between AD and IR disorders, their overlapping genetic markers, and shared metabolic indicators. Additionally, it addresses existing therapeutic interventions targeting these intersecting pathways.
胰岛素在周围组织中作为一种促生长激素发挥多种功能。它通过促进葡萄糖进入细胞和抑制肝脏中葡萄糖的产生来管理葡萄糖代谢。除此之外,胰岛素还促进细胞生长、驱动分化、辅助蛋白质合成,并抑制糖酵解、脂肪分解和蛋白水解等降解过程。胰岛素和胰岛素样生长因子-1 的受体在中枢神经系统中广泛表达。它们在大脑中的广泛存在强调了胰岛素信号在那里的多样化和关键功能。胰岛素有助于增强认知、促进神经元延伸、调节儿茶酚胺的释放和吸收,并控制γ-氨基丁酸(GABA)的表达和定位。重要的是,胰岛素可以轻松穿过血脑屏障。此外,胰岛素抵抗(IR)引起的胰岛素信号改变可能会加速大脑衰老,影响其可塑性,并可能导致神经退行性变。胰岛素信号转导有两条主要途径:负责代谢反应的磷脂酰肌醇 3-激酶(PI3K)/蛋白激酶 B(AKT)途径,以及指导细胞生长、存活和基因转录的丝裂原激活蛋白激酶(MAPK)途径。本综述旨在探讨阿尔茨海默病(AD)和 IR 障碍之间可能存在的共同代谢特征。它深入探讨了 AD 和 IR 障碍之间的关系、它们重叠的遗传标记以及共同的代谢指标。此外,它还讨论了针对这些交叉途径的现有治疗干预措施。