Moawad Mostafa Hossam El Din, Serag Ibrahim, Alkhawaldeh Ibraheem M, Abbas Abdallah, Sharaf Abdulrahman, Alsalah Sumaya, Sadeq Mohammed Ahmed, Shalaby Mahmoud Mohamed Mohamed, Hefnawy Mahmoud Tarek, Abouzid Mohamed, Meshref Mostafa
Faculty of Pharmacy, Clinical Department, Alexandria Main University Hospital, Alexandria, Egypt.
Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Mol Neurobiol. 2025 Jun;62(6):6785-6810. doi: 10.1007/s12035-024-04468-y. Epub 2024 Sep 10.
Alzheimer's disease (AD) presents a significant challenge to global health. It is characterized by progressive cognitive deterioration and increased rates of morbidity and mortality among older adults. Among the various pathophysiologies of AD, mitochondrial dysfunction, encompassing conditions such as increased reactive oxygen production, dysregulated calcium homeostasis, and impaired mitochondrial dynamics, plays a pivotal role. This review comprehensively investigates the mechanisms of mitochondrial dysfunction in AD, focusing on aspects such as glucose metabolism impairment, mitochondrial bioenergetics, calcium signaling, protein tau and amyloid-beta-associated synapse dysfunction, mitophagy, aging, inflammation, mitochondrial DNA, mitochondria-localized microRNAs, genetics, hormones, and the electron transport chain and Krebs cycle. While lecanemab is the only FDA-approved medication to treat AD, we explore various therapeutic modalities for mitigating mitochondrial dysfunction in AD, including antioxidant drugs, antidiabetic agents, acetylcholinesterase inhibitors (FDA-approved to manage symptoms), nutritional supplements, natural products, phenylpropanoids, vaccines, exercise, and other potential treatments.
阿尔茨海默病(AD)对全球健康构成了重大挑战。其特征是老年人认知功能逐渐衰退,发病率和死亡率上升。在AD的各种病理生理学中,线粒体功能障碍起着关键作用,包括活性氧产生增加、钙稳态失调和线粒体动力学受损等情况。本综述全面研究了AD中线粒体功能障碍的机制,重点关注葡萄糖代谢受损、线粒体生物能量学、钙信号传导、与蛋白质tau和淀粉样β相关的突触功能障碍、线粒体自噬、衰老、炎症、线粒体DNA、线粒体定位的微小RNA、遗传学、激素以及电子传递链和三羧酸循环等方面。虽然lecanemab是唯一获得美国食品药品监督管理局(FDA)批准用于治疗AD的药物,但我们探索了减轻AD中线粒体功能障碍的各种治疗方法,包括抗氧化药物、抗糖尿病药物、乙酰胆碱酯酶抑制剂(FDA批准用于控制症状)、营养补充剂、天然产物、苯丙烷类化合物、疫苗、运动以及其他潜在治疗方法。