Department of Pathophysiology, Medical University of Lublin, 20-090 Lublin, Poland.
Curr Alzheimer Res. 2024;21(3):166-182. doi: 10.2174/0115672050320921240627050736.
Alzheimer's disease (AD) is the frequent form of dementia in the world. Despite over 100 years of research into the causes of AD, including amyloid and tau protein, the research has stalled and has not led to any conclusions. Moreover, numerous projects aimed at finding a cure for AD have also failed to achieve a breakthrough. Thus, the failure of anti-amyloid and anti-tau protein therapy to treat AD significantly influenced the way we began to think about the etiology of the disease. This situation prompted a group of researchers to focus on ischemic brain episodes, which, like AD, mostly present alterations in the hippocampus. In this context, it has been proposed that cerebral ischemic incidents may play a major role in promoting amyloid and tau protein in neurodegeneration in AD. In this review, we summarized the experimental and clinical research conducted over several years on the role of ischemic brain episodes in the development of AD. Studies have shown changes typical of AD in the course of brain neurodegeneration post-ischemia, i.e., progressive brain and hippocampal atrophy, increased amyloid production, and modification of tau protein. In the post-ischemic brain, the diffuse and senile amyloid plaques and the development of neurofibrillary tangles characteristic of AD were revealed. The above data evidently showed that after brain ischemia, there are modifications in protein folding, leading to massive neuronal death and damage to the neuronal network, which triggers dementia with the AD phenotype.
阿尔茨海默病(AD)是世界上最常见的痴呆症形式。尽管对 AD 的病因(包括淀粉样蛋白和tau 蛋白)进行了 100 多年的研究,但研究已经停滞不前,没有得出任何结论。此外,许多旨在寻找 AD 治疗方法的项目也未能取得突破。因此,抗淀粉样蛋白和抗 tau 蛋白疗法治疗 AD 的失败显著影响了我们开始思考疾病病因的方式。这种情况促使一群研究人员专注于缺血性脑发作,这些发作与 AD 一样,主要表现为海马体的改变。在这种情况下,有人提出脑缺血事件可能在 AD 中神经退行性变的淀粉样蛋白和 tau 蛋白的形成中起主要作用。在这篇综述中,我们总结了几年来关于缺血性脑发作在 AD 发展中的作用的实验和临床研究。研究表明,在脑神经退行性变过程中发生了类似于 AD 的变化,即进行性脑和海马萎缩、淀粉样蛋白生成增加以及 tau 蛋白的修饰。在缺血性脑后,出现了弥漫性和老年斑状淀粉样斑块以及 AD 特征性的神经纤维缠结的发展。上述数据清楚地表明,脑缺血后,蛋白质折叠发生改变,导致大量神经元死亡和神经元网络损伤,从而引发具有 AD 表型的痴呆症。